My name is Ben McGiffin, and I’m a D1 here at Midwestern University. I’d like to share a little bit about my experiences in dental hygiene and being an active member of the American Dental Hygienists Association prior to becoming a dental student and ASDA member. During my 9 years as a registered dental hygienist, I have been an active member of my local, state, and national dental hygiene associations. I attended several WA state House of Delegates meetings and 3 national dental hygiene annual sessions in: Washington DC, Boston, and Las Vegas.
The dental hygiene association in Washington state has long been a powerful advocate for dental hygienists in the state. They’ve helped expand the hygiene scope of practice in order to improve access to care and increase the efficiency of the dental team. Dental hygienists in WA state were the first to be able to deliver local anesthetic to patients, getting it through the state legislature in 1971.
“Expanded duties legislation passed the Washington Legislature in 1971, adding anesthesia and some restorative dentistry procedures for dental hygienists. Dentists supported these expanded functions as a way of handling increasing numbers of clients by using dental hygienists to take over selected duties, saving time for dentists.” (wsdha.com) (emphasis added)
In addition to local anesthesia, WA state was among the first states to allow hygienists to safely deliver nitrous oxide, finish restorations, and provide direct access to hygiene care for patients in elementary schools, nursing homes, and public health facilities.
Meanwhile, a handful of states still do not allow hygienists to deliver local anesthetic under any circumstance, or even clean a child’s teeth while not under the direct supervision of a dentist.
I worked for 5 years in low-income elementary schools, providing basic dental hygiene screenings, cleanings, sealants, fluoride varnish, and oral hygiene instructions to thousands of children, many of whom had never been to a dentist. I distinctly remember one child who presented with 5 draining fistulas. While I couldn’t officially diagnose caries or abscesses, I alerted the school nurse and the parents that he had holes in his teeth and several painful, draining lumps on his gums. He had been living with pain in his mouth for months, if not years, and we were able to get him to a dentist that afternoon. This highlights the value that hygienists can have working independently from dentists.
It’s no secret that the dental and dental hygiene associations often butt heads when it comes to dental hygiene scope of practice. For me, it comes down to two things. The first is this: properly trained dental hygienists are better equipped to provide dental hygiene care than dentists, period. They are the leading experts in the fields of prevention and routine periodontal therapy, spending a minimum of two years in an intense curriculum focused solely on these two areas. I see no reason why a properly trained hygienist should not be able to practice dental hygiene in any and all capacities and settings. Especially in areas where dentists are sparse, hygienists could provide affordable and effective preventive dentistry services.
That being said, my second point is this: dental hygiene and dental hygiene education does not include restorative or operative dentistry. While the push for midlevel providers is admirable from the standpoint of increasing access to basic dental services, I believe that the gap between hygiene and restorative/operative dentistry is significant. Even in the first quarter of my D1 year, I can appreciate the magnitude of the preparation, knowledge and training necessary to safely and competently provide these services. As an active ASDA and future ADA member, I plan to advocate for dentistry. For me, that includes both dentists and dental hygienists, as well as dental students, assistants, and patients.
– Ben McGiffin, Midwestern Dental Class of 2023