Reconnecting Practicing Hygienists with the Nation's Leading Educators and Researchers.

Guest Editorial: The Journey to Opportunity

Dental hygienists who embrace change, reflect on their professional status and goals, and unite with colleagues are poised for professional growth.

The profession of dental hygiene is undergoing immense change with new workforce models, expanded scope of practice, and interprofessional collaboration. Change is often challenging, but embracing it can open the door to new opportunities. Much can transpire from merely taking a different direction.

When I was asked to design a baccalaureate-level course on evidence-based dental hygiene practice, I was nervous. At the time, the thought of creating such a class seemed overwhelming. But I decided to take this opportunity—regardless of my fear—and it led me to a better destination. Today, I am passionate about evidence-based decision making, and I share this passion with my students and colleagues.

If you are interested in research and evidence-based decision making, many resources are available. Reading peer-reviewed journals, such as Dimensions of Dental Hygiene and the Journal of Dental Hygiene, is a good start. Several journals dedicated to evidence-based practice are also available, including the Journal of Evidence-Based Dental Practice, which publishes an annual report on dental hygiene, and Evidence-Based Dentistry. Attending research-oriented educational events is also helpful. The National Center for Dental Hygiene Research and Practice and the Canadian Dental Hygienists’ Association are hosting a global dental hygiene conference “Translating Knowledge to Action” October 19 to 21, 2017, in Ottawa, Canada ( The Association of Clinical Research Professionals hosts regional chapter meetings that provide an excellent venue for clinicians to network and see what research positions are available in their locations ( Clinicians can also join the National Dental Practice-Based Research Network, which provides research opportunities in private clinical settings. More than 6,500 dentists and dental hygienists are currently members of this network ( By taking advantage of the opportunities presented by change, dental hygienists can grow both professionally and personally.


The key to effective change is reflection. Create a personal leadership plan and mission statement to provide a sense of self-direction.1 Self-assessment can improve critical thinking and decision-making skills. By reflecting on your professional progress as a clinician and patient-care provider, you will be able to confirm your path or redirect your focus and energy.

If a new direction seems in order, the profession of dental hygiene offers a variety of opportunities that are becoming available in a growing number of states. For instance, 39 states currently allow dental hygienists direct access to patients, meaning that clinicians can provide services to patients without the direct supervision of a dentist.2 This access enables public health dental hygienists to administer preventive therapies, such as sealants and fluoride varnish, in nontraditional settings, including schools, federally qualified health centers, and long-term care facilities.3 The growth of the midlevel practitioner is another opportunity for dental hygienists. Minnesota was the first state to legislate midlevel practitioners, and Maine and Vermont have followed suit. Native tribes in Alaska, Washington, and Oregon have been using a type of midlevel oral health practitioner since 2009. Several other states are considering legislation to expand scope of practice for dental hygienists or license midlevel practitioners to address the access-to-care problem that plagues the United States.4 

The journey to licensing midlevel practitioners in Minnesota required the collaboration of dental hygiene, dentistry, public health, and lawmakers. This process continues today with efforts to improve access to oral health care in Minnesota for vulnerable populations and expand practice gateways and competencies for Minnesota dental hygienists. Funded by a grant from the US Health Resources and Services Administration, the project’s specific goals include: 

  • Strengthening the state’s collaborative practice infrastructure
  • Ensuring that access to preventive and primary health care services is readily available to those in need
  • Educating a workforce that is better prepared to provide high-quality oral health care to diverse and unpreserved populations
  • Providing professional leadership to encourage other states to create innovative workforce models.

In some states, including California, Colorado, Maine, and New Mexico, dental hygienists with additional education can own their own businesses and practice independently. Some of these dental hygienists accomplish this via mobile oral health care practices, purchasing portable dental equipment—including patient chairs, imaging systems, and even air compressors—to serve disadvantaged populations in their homes, schools, or health-care facilities. Others, like Colorado dental hygienists, can hang their own “shingle” with a private dental hygiene practice where they can provide preventive oral health care services.5


Dental hygienists can accomplish much more when we work collectively vs individually. Your local component of the American Dental Hygienists’ Association (ADHA) is a great place to start making a difference in the profession. Last year, my belief in the power of collaboration was confirmed when I became a member of the second ADHA cohort dedicated to transforming dental hygiene education. Nothing is more rewarding for an educator than to see dental hygiene advancing its academic standards to strongly encourage baccalaureate-level education. As Associate of Science and Bachelor of Science program partnerships are established and nurtured, dental hygiene curricula are moving well beyond the fundamentals. Today, dental hygiene students graduate with versatile skills in leadership, collaboration, project and practice management, advocacy, and conflict management. 

As the US health care system becomes more integrated, interprofessional education is key. Dental hygienists need to be just as skilled in the application of critical thinking through the practice of translational research and more equipped to ensure health equity with a deeper understanding of cultural competency and health literacy as their medical colleagues.

Dental hygiene students are the future of our profession, and the leaders of today must mentor the younger generation and empower them to help navigate the profession’s growth and development. 


In his book The Energy Bus: 10 Rules to Fuel Your Life, Work, and Team with Positive Energy, John Gordon explains the importance of keeping the right people on your bus in the right seats, so that the right direction can be taken to reach your ideal destination.6 We, as dental hygienists, need to remember to fill our bus with positive energy so that we can make a difference in improving oral health for all. 

Today, the dental hygiene profession has no boundaries. As oral health becomes more integrated in overall health care delivery, additional opportunities will be revealed for oral health professionals. By embracing change, reflecting on our professional status and where we hope to go, and remaining united, dental hygienists will be unstoppable.


  1. Hansen RS. The five-step plan for creating personal mission statements. Available at: Accessed March 23, 2017.
  2. American Dental Hygienists’ Association. Direct Access 2016 39 States. Available at: Accessed March 23, 2017.
  3. Battrell A, Lynch A. Representing dental hygienists. Perspectives on the Midlevel Practitioner.2016;14(10):28–31.
  4. Legislative update. Perspectives on the Midlevel Practitioner. 2016;14(10):19–23.
  5. Legislating the midlevel practitioner. Perspectives on the Midlevel Practitioner. 2014;13(10):14–20.
  6. Gordon J. The Energy Bus: 10 Rules to Fuel Your Life, Work, and Team with Positive Energy. Hoboken, New Jersey: John Wiley & Sons Inc; 2007.

From Dimensions of Dental HygieneApril 2017;15(4):16-17. 

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