A passel of trouble

April 1, 2007
I don’t know. The winter was harsher than normal.

by Mark Hartley

I don’t know. The winter was harsher than normal. At one point, this native Texan was chopping ice 18 inches thick with a hatchet. I can recall how unhappy I was. Spring is here. I’m just relaxing in the sun. I think all is well with dental hygiene. I don’t need to stray very far from the lawn chair in the backyard. Wrong. A buddy of mine in Illinois forwarded an e-mail. The world is still full of danger. What’s dangerous about it appears to be dental hygienists.

I haven’t seen any dental hygienists out in the backyard. But that doesn’t mean that they won’t come swarming over the fence like a passel of rabid squirrels (a conspiracy theory often voiced through the barks of my dog Seattle).

The forwarded e-mail is about a certain piece of legislation floating around the Illinois assembly. According to the “action alert” from the Illinois State Dental Society, dentists are worried that SB1144 will put some Americans in harm’s way. Again, think of a passel of dental hygienists swarming over the fence. You might be able to stop a couple with the fireplace poker, but they just keep coming.

The key word here is “without.” The dentists are saying the bill would allow dental hygienists to provide “fluoride treatments, teeth cleaning, and sealant services” without supervision. I didn’t know dental hygienists needed any supervision with these procedures, although I can think of a few who wouldn’t mind a little help with the “teeth cleaning” part.

“My hand’s tired, boss. Would you scrape for awhile?”

If the bill passes, the “next step” will be the passel of dental hygienists practicing independently without supervision and without the dentist’s involvement.

Illinois dentists prepared a short message that they can e-mail to the neighborhood’s legislator about this danger. SB1144 “would undermine the way dentistry is practiced” since dental hygienists would be caring for “children … without any supervision … Patient protection would be seriously eroded …” Protection? All I can think is that I’m glad I wasn’t watching the news on television.

“Bob, what can you tell us about the robbery?”

“Well, the robbers entered the bank about 1:45 this afternoon and took an undisclosed amount of cash. They were wearing masks and fled the scene promptly after the robbery.”

“Bob, did witnesses see anything else?”

“No. But some dentists in town came up to me afterwards and said it was likely a passel of hygienists who did it.”

“Thank you, Bob. We now turn to an update on the home burglary last night. Fred Vigil is in our studio with the report. Fred?”

“The burglars entered after 5 p.m. and, as reported last night, they took many valuables from the residence at 412 North Main. What’s new to report today is that a group of dentists came forward and said a passel of hygienists probably committed the crime. They base their suspicion on the fact that dental offices around town were closed for the day and that this passel of dental hygienists were roaming the streets without supervision.”

If I had seen those news reports, I would have been lamenting the day I decided against training Seattle to be a guard dog. However, it definitely would have been a change of pace from watching the news about the dental professional typically featured on the news: insurance fraud, sexual molestation, selling prescriptions illegally, driving over spouses, etc.

I’m kind of comfortable out here in the backyard. I’ll let you argue about independent practice to your heart’s content. To me, the best argument for independent practice is that hygienists will treat folks dentists don’t really care about. In the case of Illinois, the intent was to improve health coverage of Medicaid recipients. The best argument against independent practice is that it doesn’t really simplify dental care for the consumer. In SB1144, which is still awaiting committee action as I write this, the “independent” dental hygienists are required by law to “refer to treatment any child with needs outside of the dental hygienist’s scope of practice.” How does that make life simpler for anyone? Another appointment, have to drive somewhere else, explain to another receptionist about insurance.

But one thing I do have an opinion about on this fine April day is that dentists really need to stop making a passel of unsupervised dental hygienists sound like a really bad thing. They need to stop making it sound like, if they weren’t holding hygienists’ hands all day long, we’d be in a passel of trouble.

Don’t do that.