I remember one of my professors and now mentor, Teal Mercer, MPH, RDH, speaking to the class my senior year of hygiene school. We were intently listening, as overwhelmed students do, when the professor said, “Let me give you a practical tip.”
She told us to thoroughly consider selecting multiple states for our regional board. I can still hear her saying, “It’s easier to select any state now than having to apply in the future. It’s not always easy to apply to a state years after you take the board, and depending on the state, it could require you to retake the board.”
I proudly selected the states nearest where I lived during school: Connecticut, Maine, and Massachusetts. To this day I’m licensed in those states, and I’ve dreamt of the day when it will be easier for us to transfer our licenses from one state to another.
This was back in 2010, so of course, things have changed a bit with legislation. Tthe biggest change we’ve seen is the potentially career-transforming Dentist and Dental Hygienist Compact!
What is the DDH Compact?
The DDH Compact is a fantastic option for dental professionals who want to relocate. Many states have a shortage of providers, and the Compact offers many opportunities and spans multiple aspects of our profession, from educational institutions to public health practice, to private practice, and of course, opportunities in clinical care.
The DDH Compact is a legal agreement between states for dental hygienists and dentists that allows them to practice without a separate license in each state.1 This means that a hygienist can hold one license that will allow them to practice in states that have agreed to be a part of the Compact.1
The Compact is not immediate entry to working in a new state; it takes an estimated 18 to 24 months for full implementation.1 The requirements and eligibility in each state may require additional clinical assessments, background checks, certain jurisprudence requirements, and proof of board certification.1
Benefits of the DDH Compact
The Compact does many things, such as increases workforce mobility, access to care, and professional opportunities, and most of all, demonstrates how critical dental hygienists are! A colleague of mine works in an area where, if she drove just 10 more minutes over the state line, her hourly rate would increase by $10! Just think how life-changing an additional income of $20,800 could be.
The Compact allows dentists and hygienists to be employed in multiple states, which increases access to care by expanding opportunities for public health work and mobile dentistry. Many of my clients’ next openings are five to six months out, which makes it extremely challenging to maintain proper standards of care in our soft tissue management and other preventive services.
And think of this from a patient perspective. We tell patients they’re in active disease, and then tell them we can’t fit them in. This Compact can serve as a solution to those problems and the hygiene shortages.
Status of the Compact
The states where the DDH legislation has been enacted are Maine, Kansas, Virginia, Tennessee, Washington, Iowa, Wisconsin, Colorado, Minnesota, and Ohio. The pending legislation is in Michigan, Pennsylvania, New Hampshire, Massachusetts, New Jersey, and Delaware.2
This is truly an exciting time for dental hygienists as we’re being given a new opportunity. Contacting your legislators is a good way to keep up the momentum and work to expand our opportunities to increase access to our life-saving preventive oral health services. Our profession is truly amazing in our ability to identify disease at its earliest stages. Advancements in preventive hygiene, such as SDF, fluoride varnishes, air polishing, and so much more, can be implemented in a wide variety of clinical settings. I am so thankful for those involved in advancing our profession through the amazing DDH Compact!
Editor's note: This article appeared in the January/February 2026 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
- Dentist and Dental Hygienist Compact. National Center for Interstate Compacts. https://compacts.csg.org/compact-updates/dentistry-and-dental-hygiene/
- Schroeder K. License portability is here. Is your state on board with Dentist and Dental Hygiene Compact privileges? CareQuest. October 27, 2024. https://www.carequest.org/about/blog-post/license-portability-here-your-state-board-dentist-and-dental-hygiene-compact
