The Time for Self-Regulation Is Now
The history of the dental profession dates back thousands of years. With a focus on various types of treatment for oral diseases, early procedures were primitive and often quite brutal. Throughout the ages, dentistry was performed by individuals who were not formally trained, and, until the mid-18th century, barbers also functioned as dentists. As methods evolved and advances in therapies were developed, dentistry progressed to establishing itself as a recognized profession requiring formal training and licensure.
Dental hygiene began with a focus on prevention. Since the first dental hygiene school was established in 1913, dental hygienists have been trained in programs with specific curricula and have always been licensed to practice. It’s interesting to consider the distinct foundations of each profession. These origins and rationale for existence are now coming to light in a big way, especially with shocking legislative attempts in states like Nevada.
What’s important to understand is this key concept: one profession has always focused on treatment, and the other has always focused on prevention. The two professions are diametrically opposed in their reasons for being, yet one controls the other. This is not only a professional conflict of interest but an ethical one. Recently, it’s become very clear that the divide between the professions is deepening. Organized dentistry through the actions of the American Dental Association is attempting to dilute the educational standards required to practice dental hygiene and thus is exercising unwarranted control.
Many questions arise: Why are we controlled by another profession and not self-regulated? Is the dental profession truly concerned about high-quality, safe patient care? When did this situation become so outrageous that the long-standing partnership we’ve had is now shattered? Can there be a resolution to this divide or is it forever unbreachable? The most important question is: Where do we go from here to save the dental hygiene profession and maintain our educational standards? After all, if the quality of dental hygiene education is lowered, the true losers are the patients who rely on us to be knowledgeable and appropriately trained. They also expect an oral healthcare team that works together and supports each other.
Without doubt, many dentists value their relationships with dental hygienists. They respect our education and they realize collaboration is what’s best for patients. Dental hygiene’s connection with these colleagues won’t change. In fact, it may grow stronger as dentists speak out opposing radical legislation. That said, the overall landscape must change with dental hygienists empowered to practice to their full scope.
Perhaps it’s time for dental hygienists to be the oral healthcare gatekeepers, seeing patients in their own practices to provide preventive services and then referring to affiliated dentists when necessary. Perhaps it’s time for dental hygienists to work more frequently alongside physicians and in hospital settings. Perhaps it’s time for us to have autonomy and self-regulation with peer-to-peer accountability. We can no longer rely on organized dentistry to do the right thing. It’s up to us to do what’s right and to shape our future.
From Dimensions of Dental Hygiene. July/August 2025; 23(4):6.
