Educating the providers of the future

A century after the beginning of dental hygiene, significant issues still remain in dental care in the United States.

by Christine Nathe, RDH, MS

A century after the beginning of dental hygiene, significant issues still remain in dental care in the United States. Although dental hygiene science and practice have evolved and preventive dental care has increased among Americans, gaps still exist between those who remain in good oral health and those who are unable to obtain dental care regularly. Many Americans receive urgent dental care in hospital emergency rooms, and some end up in the operating room to receive treatment for infections that could have been prevented. The heart of the problem can be seen in data that reveal that many Americans do not receive annual preventive dental care. There is also the reality that oral health does affect general health and well-being.

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Dr. Alfred Fones, the founder of dental hygiene, originally promoted dental hygienists based on the premise that oral health significantly affects overall health. Interestingly, present-day studies continue to confirm the relationship between oral and overall health. This becomes very significant because more Americans are living longer lives with medical conditions and diseases, and these people have more teeth than ever before. Simply put, dental hygienists see more patients who are older, with more teeth, and therefore, they must be ready to treat individuals with complex medical and health-care issues.

The need for educated dental hygiene providers has never been greater. While we need to promote the use of dental hygienists, we also need to develop ways to increase access to preventive care for all Americans. Even though dental hygiene was developed with a focus on public health, as witnessed in the early practice settings in the Bridgeport public schools, the profession developed for the most part in the private sector, delivering care in private dental practices.

This focus on developing dental hygienists for private dental offices has continued through the traditional education of dental hygienists. Clinicians will focus their employment opportunities on private dental practices. Patients will include those with dental insurance who are healthy enough to visit dental offices. Dental hygienists have been prepared with strong technical abilities.

This has helped improve the oral health of a significant portion of our population, but there continue to be many individuals with unmet needs. So, we need to find solutions for those with unmet needs. We must meet the challenge of society's evolving health-care needs. Dental hygienists should be taught how to position dental hygiene in settings other than the private dental office, and they should be taught how to work as part of an interdisciplinary team. There is no easy solution to the dilemma, but there are a few solutions that I believe are worth exploring.

First, dental hygiene students need to be exposed to the practice settings of dental hygienists who deliver dental care outside of the traditional private dental practice. Dental hygiene schools should increase the service learning method of teaching. Dental hygiene students should rotate through school-based health centers, pediatric clinics, WIC programs, preschools, nursing homes, and hospitals. They should become familiar with the historical beginnings of dental hygienists outside of the private dental practice, and understand the necessity that dental hygiene must evolve in order to advance as a science and practice.

Dental hygienists working in public health agencies should routinely speak to dental hygiene students so that the next generation of dental hygiene providers knows the opportunities available to them. They should be assigned readings about dental hygiene practices outside the traditional dental practice.

As qualified health-care professionals, dental hygienists have been thrust into a big role as members of interdisciplinary health-care teams. This is accomplished by involving dental hygiene students on interdisciplinary teams as part of their learning process. If this is not readily available at schools, as dental hygienists we need to develop this. We need to teach students how to integrate oral health care into existing health-care and social-care settings.

Although many worry about the quantity of dental hygienists entering the workforce, we need to focus on the quality of dental hygiene education. If we develop students in quality-focused programs, with the ability to redefine the profession, we will advance the profession while increasing access to dental hygiene for those in need. The profession of dental hygiene as a whole is responsible for shaping the future of our profession. Guiding dental hygiene students to develop the profession in the next century is where we should focus our energies, while also developing sound solutions for dental care delivery issues. RDH

CHRISTINE NATHE, RDH, MS, is a professor and graduate program director at the University of New Mexico, Division of Dental Hygiene, in Albuquerque, N.M. She is also the author of "Dental Public Health Research" (www.pearsonhighered. com/educator), which is in its third edition with Pearson. She can be reached at cnathe@salud.unm.edu or (505) 272-8147

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