RDHAPs expand access and enhance quality of dental care
In an era where health-care disparities are increasingly evident, the role of registered dental hygienists in alternative practice (RDHAPs) has never been more essential. RDHAPs are licensed dental professionals trained to provide preventive dental care independently in underserved and vulnerable communities. Their practice model addresses two pressing concerns in modern dentistry: improving access to care, and ensuring the delivery of high-quality, patient-centered services.
Access to care: Bridging the gap
Millions of Americans live in dental health professional shortage areas, with limited or no access to regular dental services. According to the Health Resources and Services Administration (HRSA), more than 67 million people reside in areas where the dentist-to-population ratio is too low to meet community needs.1
RDHAPs are uniquely positioned to bridge this gap by delivering preventive dental services in nontraditional settings such as schools, nursing homes, community clinics, and patients’ homes. This model of care reaches populations who often face significant barriers, including mobility issues, financial limitations, language differences, or lack of transportation.
RDHAPs are particularly impactful in addressing the needs of the elderly, people with disabilities, and low-income families, groups that are statistically less likely to seek or receive timely dental care. A study published in the Journal of Public Health Dentistry noted that RDHAPs in California have significantly increased access to care for populations that historically had no regular dental provider.2 By working autonomously within the scope of their license, RDHAPs help alleviate pressure on the traditional dental system while fostering equity in oral health.
Quality of care: Preventive and patient-focused
In addition to increasing access, RDHAPs provide high-quality preventive care that’s essential for long-term oral and systemic health. Dental hygienists are trained to recognize early signs of oral disease, perform thorough cleanings, and educate patients about maintaining oral hygiene. These services are not only critical to preventing cavities and gum disease but also reduce the risk of systemic conditions linked to poor oral health, such as cardiovascular disease, diabetes, and respiratory infections.3
Moreover, RDHAPs emphasize patient education and individualized care, which enhances patient outcomes and satisfaction. Their ability to spend more time with patients, build rapport, and understand social determinants of health allows for a more holistic approach. As preventive providers, RDHAPs reduce the need for costly emergency dental visits, saving significant expense for both patients and health-care systems.
A timely solution for a growing need
The COVID-19 pandemic highlighted the urgent need for flexible, community-based health-care models. As dental clinics shut down and patients delayed care, RDHAPs became even more vital in sustaining basic oral health services. Their mobility and independence allowed safer and socially distanced care delivery. With a rapidly aging population and rising health-care costs, their role is set to become even more critical in the coming years.
RDHAPs offer a practical and powerful solution to two of dentistry’s most persistent challenges: access and quality. As more states explore expanding the scope of practice for dental hygienists, the RDHAP model serves as a proven blueprint for integrating preventive, accessible, and equitable dental care into the broader health-care landscape.
Editor's note: This article appeared in the July 2025 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
1. Health workforce shortage areas. Data HRSA. May 26, 2025. https://data.hrsa.gov/topics/health-workforce/shortage-areas.
2. Mertz EA, Glassman P. Alternative practice dental hygiene in California: past, present, and future. J Pub Health Dent. 2011;39(1):37–46.
3. Oral health in America: advances and challenges. National Institutes of Health. https://www.nidcr.nih.gov/research/oralhealthinamerica
