Why dental hygiene autonomy varies by state—and what’s really behind it

Episode Description

Scope of practice in dental hygiene is often framed as a political issue—but the reality is more complex. In this episode, Derik J. Sven, RDH, shares insights from his research and experience to unpack what truly drives differences in autonomy across states.

From ethical tensions in clinical care to the role of education, lobbying, and legal literacy, the conversation explores how systemic forces shape everyday practice. It also challenges clinicians to think beyond the operatory and consider how advocacy and policy engagement influence the future of the profession.

This discussion offers a grounded look at legislation—not as an abstract concept, but as something that directly impacts diagnosis, treatment decisions, and patient outcomes.

More on advocacy in dental hygiene

• How one hygienist turned patient frustration into legislative change
• From burnout to purpose: How one hygienist rebuilt her career

Derik J. Sven

Dentists are not concerned about dental hygiene autonomy as a safety issue because there is no safety issue. They are concerned about it because of the business model they’ve relied on for a century, of keeping another licensed group of professionals under the thumb of another group of licensed professionals.

One of the big calls to action I am now asking hygienists across the country to consider is, if you are considering graduate-level education, don’t do a master’s in public health. Don’t do a master’s in healthcare law or business or any other subject. Apply to law school.

It is easier for a hygienist to become an attorney than it is for them to become a dentist or a medical doctor. If we had a generation of hygienists, even if it was 1% of the 200,000 hygienists in the U.S., consider that pathway, and we had more hygienist attorneys on our side, the dynamics in the policy and political arenas would completely change.

David Torres

And welcome back, listeners, to another episode of A Tale of Two Hygienists. I am here with my co-host Jessica Atkinson, and I am David Torres. And in this episode, we’re going to be talking about what I consider to be something very important for our career, which is legislation and the 101 of it.

Introducing the episode

Jessica Atkinson

Legislation 101. I was thinking, who would be the best, the best guest for talking about legislation? And that would be Derik. And we have Derik with us today, and he’s going to give a little bit of background on why he’s the best at legislation.

Derik J. Sven

I don’t know if I’m the best at legislation, but I have things to share today.

Jessica Atkinson

You do, you do. I’d say the best.

Derik’s background

Derik J. Sven

Thank you guys for having me. I really do appreciate it. If you want me to give a little background on myself, I am a dental hygienist. I have 10 years of clinical experience. Prior to becoming a dental hygienist, I was a dental laboratory ceramist. My dad actually owned two different laboratories, one in Southern California and one in Washington State. So I grew up around teeth.

My initial real goal in life was to become a medical doctor, but that wasn’t in the cards for me for a number of different reasons. So I did the next best thing and I became a hygienist.

Jessica Atkinson

Prevention, the heart of prevention.

Derik J. Sven

Yes, prevention is definitely my passion now that I’ve been working in the field for 10 years. But originally I wanted to be a medical doctor. And during hygiene school, I actually got involved in the political aspects of dentistry pretty quickly. I was pretty passionate about going into our legislative events as a hygiene student.

I was the chapter president for our school at the time. And when I was in dental hygiene school, that was when Washington State was first looking at dental therapy. They since passed it, but I got a good bird’s-eye view of how that was being processed through the legislature. And I saw some flaws in the way it was being done. So that kind of piqued my interest.

I thought, you know, I want to learn more about this process. I want to get a better education and really get into the weeds on this.

Derik J. Sven

So I pursued my bachelor’s in healthcare administration, finished that. And shortly afterwards, I started working in an all-on-four full mouth rehabilitation clinic, which was a really cool experience, but also there is a lot of ethical dilemmas and just ethical landmines, if you will, in that whole arena in dentistry.

There was a CBS News exposé in 2024 highlighting the financial exploitation that these type of practices are putting patients through. And there’s actually a really good journal article in the Journal of the American Dental Association on this very subject.

So after I saw that, I really started to become disenfranchised with the way I was seeing dentistry being run—private equity and business concerns kind of taking over clinical autonomy and the rightful place that ethics has in dentistry.

So I decided to do my master’s in public health, finished that, and about halfway through, I started realizing that there were a lot of public health initiatives that I was studying that were failing or had failed historically because the people who were pushing them didn’t really understand business.

And without understanding how business dynamics affect public health, some of those really good ideas were falling apart. So I decided to do an MBA as well. Why not?

I mean, why not? I’ve already done one. What’s the second one going to hurt?

And then as I was finishing the MBA, I started to see another big area that had a void, and that was legal literacy. So I started a third master’s degree in healthcare law. That was actually super interesting. And I really, really loved the legal studies that I’ve been doing over the past several years.

And honestly, if I could do everything all over again, I would have just gone straight to law school and become an attorney. There’s going to be so much schooling you can do and so many student loans you can take out before you have to just—

Jessica Atkinson

Before you got to start balancing, balancing those.

Derik J. Sven

I’m going to do. But I did decide to complete my doctorate in health sciences alongside the third master’s degree. So I’m giving my dissertation in exactly two weeks from today.

Jessica Atkinson

Congratulations.

Researching hygiene autonomy

Derik J. Sven

Thank you. It’s actually—the dissertation is actually looking at the political landscape of all 50 states and the scope of practice for hygienists in all 50 states and measuring whether political dynamics are actually the responsible baseline for why hygiene autonomy is so different—why you can have a state like Colorado where you have full independence or a state like Missouri where you can barely do anything.

And I also, just to kind of give a variance on the data I was collecting, I also wanted to look at it from the angle of regional culture within the United States to see if that was maybe a better explanation as to why hygiene autonomy and independence is so different from area to area.

And I’ll just give you guys a preview of what the dissertation is going to look like, because the results were actually fascinating to me. Politics actually didn’t really explain that dynamic.

And I was really, really surprised. When you look at a map of hygiene autonomy, it actually looks very similar to an Electoral College map. But the data I was collecting actually was going back 40 years to the first recorded instance that the American Dental Hygienists’ Association had on direct access dates.

Washington State was the first one recorded in 1984. So I took 1984 all the way to 2026 and looked at that data.

Politics doesn’t actually explain it because you have states like Utah and Alaska that are homogeneously conservative against states like Washington and Oregon and California that are pretty much homogeneously liberal. And that didn’t really explain the differences in these dynamics.

But regional culture did. That went off the map as a high degree of correlation. If you take the U.S. and you divide it into the CDC regional areas—the West, the South, the Northeast, and the Midwest—those give a really good explanation as to why these practice acts are so different.

Western states uniformly have much higher degrees of autonomy for hygienists as opposed to the South. The Midwest also has a pretty high vantage point. The Northeast, for whatever reason, and the explanation I’ve only been able to get from the literature on this is that the Northeast tends to rely on hierarchy. They don’t like change. They’re very kind of rigid in their outlooks.

So yeah, that’s kind of what the data showed us on those. And that kind of outlines my academic achievements too.

Jessica Atkinson

That bio really described why we have you today to talk about legislation 101 for hygienists.

David Torres

Yeah, and most importantly, why that matters, right? Like, again, I had no idea that obviously, like, politics and all that is important, but I had no idea how much it actually affects our career and our day-to-day, right?

Like if you’re a hygienist in one state and you want to move to a different one, how that could potentially impact a bunch of things in the future of your career, right?

Practice differences across states

Derik J. Sven

Yeah, I was pretty naive when I moved out to the East Coast for grad school from Washington State. I just, you know, being naive in that area, I just thought, well, it can’t be that different. I mean, Virginia has a moderate scope of practice for hygienists.

It’s not as good as Washington State or other parts of the West Coast. And when I got out there, I was in complete culture shock. I could not believe what I was seeing in dental practices. And the conversations I had with dentists out there were just super, super depressing to see how far off the scope of practice and ethics really were in these arenas.

Just to give you kind of a quick example, in Washington State, most of the dental insurances out there will cover SRP and perio maintenance almost all the time. With Google, Amazon, and Microsoft having most of the policies for most of the major people out in Washington State, they have really good coverage.

SRPs are covered at 90% to 100% a lot of the time. You can get three to four perio maintenances a year at 100%, and they don’t have weird requests that go along with that other than just accurate perio charting and radiographs to back it up.

In the South, I was looking over the different policies in these practices I was working at, and I kid you not, some of them completely eliminated the 4000 codes. Really? None of it. You get two prophylaxes a year, and if you need anything else, practices will just either falsify the documentation and have perio maintenances be listed as prophylaxis, or they just don’t diagnose.

A patient case that changed everything

Derik J. Sven

Go from one practice to the next to the next. And it was the same thing. You had prophy mill after prophy mill after prophy mill. And one time I was temping at an office and I had this—the last patient of the day had no teeth on the top. He was edentulous on the maxillary.

The lower had eight remaining teeth. It was clearly stage 3 periodontitis. There was barely even one-quarter of the root left in the alveolar bone. There were huge chunks of calculus on this patient. And all the teeth were treatment planned for extraction on the lower. But it was on my schedule for a prophy.

And I just looked at this and I said, I’m not going to be doing this as a prophy. I’m not going to.

So I talked to the office manager, who by this time had become a friend of mine. And she said, well, just, you know, bring the patient back when he gets here, talk to him, see what’s going on, and, you know, check with the dentist and see what else you can do. He can maybe reappoint for two quads of SRP.

So the patient comes in. And he has this heavy southern drawl and a little bit of blood dripping on his face as he walks into the office. Three of his remaining teeth in his hand.

And he said something along the lines of, oh, three of my teeth fell out on the way here and here they are. I’m like, sir, come on, let’s get you back to the operatory.

Sat him down. And I asked him, I said, sir, what do you believe you’re here for? Because your treatment plan says all of your teeth are planned for extraction.

And he said, I just need them buffed up and cleaned up before the dentist makes a partial for me on the lower.

And now I’m looking at this going, no, we are not doing a prophy, especially if the intention here is to use some of these teeth as the remaining anchor for a partial.

Jessica Atkinson

And with less than one-third remaining.

Derik J. Sven

Yeah, it gets worse, it gets worse. So I go to the dentist in the back, I pull him out of his operatory, and I said, what is going on here? Like his treatment plan shows all extractions. He thinks there’s partials here.

And the dentist told me, he said, yeah, I’m planning on saving the premolar teeth here for anchoring on a partial. I said, well, that’s not a prophy. This is stage 3 periodontitis. Like he needs two quads of SRP. I am not going to be doing this as a prophylaxis.

He said, if that’s what you want, you’re going to have to either find somebody else to do it or you’re going to have to change the treatment plan. I said, that’s not a line I’m going to cross.

And his words to me were, prophylaxis, SRP, it’s all semantics.

Jessica Atkinson

And here we are needing legislation where we have a legislative body and we can pull up the actual documentation. The ADA—well, when you are not thinking that there is a difference between a prophy and a periodontal therapy, no wonder they think a dental assistant is a good option for bridging this need for access to care.

Derik J. Sven

And if dentists truly believe that, which I’ve seen multiple ones—that that’s their mentality—you think that they’re going to be only having quote-unquote healthy patients being seen for these procedures. I don’t believe that’s going to be the case.

That law is going to be abused and people are going to have—there’s going to end up being lawsuits over this. That’s just the way this is going to be.

Jessica Atkinson

People are going to think they’re coming to the dentist to be cared for and walk out with substandard care.

Derik J. Sven

Yeah, it’s really sad. There was another office I went to, and again, I was temping for the day. Patient came in and she had huge chunks of radiographic calculus on her X-rays when I took them.

And she’d been coming in every six months for prophylaxis.

And I went through the X-rays and there were 10 years’ worth of it. And the radiographic chunks were on there every single year, getting bigger and bigger. And you could see the progressive bone loss around the chunks of calculus going back 10 years.

And I read through the notes and every single time the dentist had signed off saying patient demonstrates health, no issues. And looking at this, it is clear as day on the X-rays.

Patient had to be referred out to a periodontist. And that’s because that office had abused her. They did not diagnose active disease. They could have caught it early. And now she had stage 2, approaching stage 3 periodontitis that needed attention of the periodontist.

What can hygienists do?

David Torres

So Derik, I want to backtrack a little bit because I am sure right now our listeners are listening to you talk. And man, we can hear the passion, right?

I think everybody’s blood pressure and heart rate went up a little bit higher as soon as you told that story, right? Because it has happened to me. I think we all have had—I’ve had a moment, right?

How can we take that energy to go beyond our chairs, our clinical chairs? What can we do beyond like, no, I’m not going to do that, to actually make a difference?

Or who can we contact or what do we do? Because I’m sure people are out there walking around and it’s happening every day, where the dentists don’t know what they don’t know and the hygienists feel like they’re being suppressed, where we’re definitely a lot more than just tartar polishers.

The limits of business arguments

Derik J. Sven

Yeah. So I’m a big-picture sort of guy. I look at this and I don’t pivot to the typical explanations that you’ll hear some of the influencers and thought leaders start talking about.

There’s a few of them out there who are insistent that the reason behind all these issues is that hygienists just don’t have enough business sense, and they need to be taught more business angles, make their offices more profitable, and you can hold up the money angle for increased care as the driving force behind getting dentists on board with ethical practices.

I would argue that there is some truth to that, but hygienists do need better business sense. But trying to use money as the objective for getting people to practice ethically, to me is not a great way to go.

Jessica Atkinson

Distasteful.

Derik J. Sven

Thank you. That’s the word I want. Distasteful, yes.

So I’m looking at this from sort of a bigger, broader picture. How do we start to change the landscape on this? And I actually have two research articles I intend to publish this year.

One of which I actually did touch on two years ago when Andrew had me on the podcast when I was first developing the concept. But now I’m actually part of a group that Delta Dental is funding to really look broadly at solutions across the country for access to care issues. And I’ll be making a big point of this with that group.

But I’ll give you a little background on it.

Rethinking dental education

Derik J. Sven

I think dental education needs to be reinvented, straight up. I just think it does.

And this is the solution that I came up with. If you look at dental school, if you want to become a dentist, you’re looking at a four-year undergrad in biochemistry typically, and then four years of dental school after that.

If you are a passionate clinician, I’ll use that word, you should pursue a residency afterwards, right? You’re going to be working on the public to the full extent of your abilities.

I think that if you took dental education and you re-envisioned it as a 2 + 2 + 2 + 2 year program , in which somebody starts off with a mandatory two-year associate’s in dental hygiene, and then you looked at using dental therapy as a bridge between dental hygiene and dentistry, you could develop a bachelor’s degree in dental therapy with just basic elements of restorative care that could be incorporated into scope of practice.

Have a master’s degree in advanced dental therapy in which your scope is increased, you have a different designation, you’d be an advanced dental therapist at that point, and then a two-year completion for the remaining curricula of dental school.

Because dental school—the curricula on that—is somewhat covered in dental therapy.

You would re-envision the entire curriculum of dental hygiene, dental therapy, and dentistry as a 2 + 2 + 2 + 2 year program . It takes eight years, but people could be credentialed at each step, depending on where they wanted to stop.

What that would do is it would provide every practitioner in dentistry with a baseline in prevention, which they all desperately need.

But then as people became dentists, they wouldn’t have the misunderstandings or the animosity that some dentists have towards hygienists.

Jessica Atkinson

Some of those experiences that you have had.

Derik J. Sven

Yes, but I don’t think my experiences are unique. I’ve talked to many other hygienists who have had similar experiences.

Why hygienists leave the field

Derik J. Sven

And the reason why, if you look at the data on why hygienists are leaving the field, it’s because of workplace sabotage by employers, toxic work environments.

And I don’t think there’s been enough study as to really getting into the weeds on what those toxic environments look like.

So the American Dental Hygienists’ Association is now conducting a major research study looking at really the ethical dilemmas that are causing hygienists to burn out in the field.

Jessica Atkinson

Because if I were guessing, girl, I would say from my own personal experience, where I have felt the most frustration is where my clinical expertise has been challenged and has required me to be in situations that you’ve described that ethically make me very uncomfortable.

I work in a school, and one of the reasons why I am in education is I can be very ethical in education.

I don’t have those typical conundrums that happen in private practice where I have just explained to the patient the results of my assessment, explained bone loss, presence of calculus, the etiology of disease, to then be overridden and told to do a prophy.

And I think that is one of the loss of care.

Access to care and autonomy

Jessica Atkinson

When we talk about access to care, I find this so fascinating.

Out of one corner of the mouth, I hear one thing, and then on the other corner, I hear another thing.

Just recently in the state of Utah, one of the senators was requested to run a bill that was for the OPAs.

And he said, that’s really fascinating that you’re asking me to run a bill when at the same time, this is the dental association, at the same time the dental association is making sure that dental hygienists don’t have the autonomy to do what they are educated and proven to do.

And I think that’s where a lot of this concern is.

And if I had a magic wand, I would wave it and every dentist would recognize the rigor of dental hygiene school and understand the expertise that we bring to the table, and if allowed to, how that would change the care of our communities.

Derik J. Sven

Yeah, I have a whole webinar on demystifying dental hygiene autonomy, which I go through the whole history behind it, but also I break down a lot of the arguments the dentists will throw at you saying why dental hygiene autonomy can’t or won’t work.

It does work. There’s a 40-year track record in Colorado. They have a 20-year track record in California. They have an extensive track record again in Maine.

Dentists are not concerned about dental hygiene autonomy as a safety issue because there is no safety issue.

They are concerned about it because of the business model they’ve relied on for a century, of keeping another licensed group of professionals under the thumb of another group of licensed professionals, which I was talking with one of the major leaders at ADHA recently about this, and she brought up a really good point that I had never considered.

Dentistry is the only organization in which a group is supervising another licensed group. That’s not the language they use in the medical field when they’re talking about dynamics between nurse practitioners or physician associates and medical doctors.

Supervision of a licensed group is not what supervision is for. Supervision is for unlicensed individuals.

So the whole dynamic organized dentistry is built around this concept of supervising licensed individuals and being able to completely dismiss their diagnosis or assessments if they so choose is a major issue.

And when you start to look at the conflicts of interest that exist between preventive medicine and restorative medicine in dentistry, there become legal issues on this.

You have Federal Trade Commission guidelines, antitrust laws that are clearly being violated by organized dentistry.

Why Derik urges hygienists toward law school

Derik J. Sven

And again, when I was talking earlier about being a big-picture sort of guy, one of the big calls to action I am now asking hygienists across the country to consider is if you are considering graduate-level education, forget the master’s degrees.

Don’t do a master’s in public health. Don’t do a master’s in healthcare law or business or any other subject, apply to law school.

It is easier for a hygienist to become an attorney than it is for them to become a dentist or a medical doctor.

All you need is a bachelor’s degree, and it can be in any subject, including dental hygiene, and take the LSATs.

So there are multiple two-year programs, there are online programs, there are fully ABA accredited.

If we had a generation of hygienists, even if it was 1% of the 200,000 hygienists in the U.S., consider that pathway, and we had more hygienist attorneys on our side, the dynamics in the policy and political arenas would completely change.

Because if there’s one group that organized industry fears and respects, it’s attorneys.

The “Derikverse” idea

David Torres

So Derik, I want to see if I can get this right.

In a parallel universe, let’s call it Derikverse.

In my understanding that ideally you would love to see a world where if a dentist wants to be a dentist, they have to be a hygienist first or have some sort of education first.

Did I hear that correctly?

I would say it would.

Derik J. Sven

Have to be, but that a pathway should start to be formed now that allows that pathway to exist.

Ideally, yes, I would love to just wave a magic wand across all of dental education and say, this is a great idea. This is how this should be arranged.

And when you dig into the weeds on this, that type of 2 + 2 + 2 + 2 year program has huge financial benefits to people because you don’t have to go eight years before you can start generating income.

You can stop along the way and practice to your ability. And when you have saved up enough money or you pay down some of your debt, you can go on to the next tier.

David Torres

I like this. I like this Derikverse because, I mean, I’ll give you an example of my story.

I was an assistant. Became a hygienist. But before I became a hygienist, I wanted to be a dentist.

Realized very quickly, it’s very expensive. And I don’t come from a world where I’m a second-generation dentist, right?

Like I’m the first one to go to college in my generation. And so I became a hygienist thinking that I can just easily transition to become a dentist.

Now my brother is a dentist. He chose the traditional way.

And with that said, living in this Derikverse, I agree very much that it’s going to check a lot of boxes when it comes to that synergy that we have now.

I’m very fortunate that I do have a brother who’s a dentist and understands what hygienists do, mostly because my wife and myself are hygienists.

So he has no room to disagree, right? We got two against one.

But at the end of the day, I think we all feel this way. And I think it’s very impactful that you’re saying if you want to create some sort of change, go towards the law school route because yes, I do agree.

Like oftentimes most providers are afraid to be in a legal issue, if that makes sense. You know what I mean?

How credentials change perception

Derik J. Sven

So it also generates a great deal of respect when you’re working at policy arenas. Having a JD after your name, people are paying very close attention to what you’re saying.

If you come in and you have an RDH after your name, I was discussing this issue with a dentist I work with, and he admitted after working with me for three years, I had changed his perception of hygienists.

But he did honestly tell me, he said, Derik, if I see a CE event and there’s an RDH after that person’s name, I automatically tune it out. I’m not even going to look at it.

And I have a dentist I’ve worked with from the financial angle where if I did not have an RDH after my name and I only had an MBA, they would have paid me for my services at double what I had performed at.

But they have such an entrenched idea of what hygienists should or can be that they can’t see past it.

And the only way I see that this changing is if we change the educational structure or if we have more hygienists who are stepping up to become attorneys.

Jessica Atkinson

Let’s see here. Legislation 101, become an attorney.

Taking on state association leadership

Derik J. Sven

I do think that that’s something that there should be a pathway out there that should have more attention drawn to it, to the hygiene community, that this is a viable pathway and it has real career potential, especially for people who are looking at options to stay employed outside of clinical.

If you have a JD after your name, you have huge options for consulting gigs at big firms. The larger consulting firms actually want an MD, a DDS, or a JD.

If you come in with a PhD and an RDH, you’re not even going to be considered.

You have a JD after your name, all kinds of doors open up for you.

Want to talk about legislation 101? Ready.

So I am president of the Virginia Dental Hygienists’ Association. I did not seek out that role. I had no intention of getting involved in state politics.

However, I went to attend a House of Delegates meeting and I got a floor nomination from people that had come to one of my webinars and they were like, we want Derik to be next state president.

Nobody else was nominated and nobody else wanted the job.

So I reluctantly went ahead and took the position, not realizing how much of a front-and-center focus Virginia is going to have in 2025 and 2026.

Trying to move autonomy forward in Virginia

Derik J. Sven

When I received the nomination, because I had been so feverishly studying academically dental hygiene autonomy, I told the House of Delegates that was my intention.

I would be leading on our already established policies on dental hygiene autonomy.

And I don’t think everyone fully understood what I was saying, because I think a lot of hygienists don’t fully understand dental hygiene autonomy from just an academic standpoint.

But what we also ended up finding is that the culture that the state associations, I think particularly in the South, have of just reacting when the dental association tells them to react.

It was a very foreign concept that someone would come in saying, we have some proactive legislation to do here. We want to move dental hygiene autonomy forward.

So I made a membership video to all of the state chapter on what my intentions were on dental hygiene autonomy, and it went viral all over the place. I did not see that happening.

And the dental association caught wind of it. And they immediately started a campaign to discredit me, saying that I was crazy and that look at these crazy hygienists, they think that dental hygiene autonomy is a solution to workforce issues, which it is.

That’s what the academic literature shows. There’s almost 80 peer-reviewed research studies on dental hygiene autonomy or dental hygiene autonomy–adjacent. It’s a very well-established concept.

But, you know, that came out. So the dental association started attacking me personally in that arena.

Assessing lobbyists and legislative strategy

Derik J. Sven

And what we ended up finding out in very short order is that the dental association, behind the dental hygienists’ association’s back, had been pursuing OPA legislation and working the legislature for almost a year and a half before I stepped into the leadership arena.

So we were already behind, if you will.

And the lobbyists that we had been using at the time were not really great at moving conversations or political dynamics forward.

So that’s something that all state chapters should be looking at—is are their lobbyists really having their best interests at heart or are they just sitting back reporting what’s going on in the legislature?

Are they really there working for you or are they just there as a reporter? Because those are two very different types of lobbyists.

That’s something that needs to be looked at for any new state leaders.

I had to let go of the lobbying team that was on when I came in. It’s like, you guys are not performing to task. You do not have our best interests at heart. Nice working with you, but we don’t need your services anymore.

And we hired a really, really good lobbyist. Did cost a bit more for us to have, but he’s been doing a fantastic job.

However, we started behind the eight ball. The dental association already had a year and a half, you know, a leg up on us.

Facing legislative setbacks

Derik J. Sven

And while we did attempt moving dental hygiene autonomy legislation forward, we could not get a single legislator to listen to us.

We could not get a sponsor for our bill. The bill was filed, but it didn’t go anywhere.

So we tried. We made a credible move on dental hygiene autonomy, but the dental association, again, they have big pockets and they have their white coats and titles, and hygienists have not been—we could not get a word in edgewise on this.

Every single time we tried to talk to legislators on the bills that the dental association had put out, we were shut out of conversations.

I had one legislator, after showing her all the peer-reviewed evidence and what our research had shown and what our goals were, her response to me was, “Too bad, so sad. I don’t really care.”

I’m like, they already had a predetermined idea of what was going to be happening.

And the dental association is now, unfortunately—the bill is almost to the governor’s desk. It’s passed every single subcommittee and committee with little to no one voting against it.

And now our last shot is to see if the governor will veto it. But that’s, again, a Hail Mary.

Jessica Atkinson

Hey, I’m a fan of Hail Marys, and it is encouraging to see dental hygienists band together and have our voice be heard even when some experience has been that our voice hasn’t been heard.

And we’re just really glad you came on today to highlight some of the concerns and potential opportunities for dental hygienists in legislative arenas to have our voice heard.

And our podcast, me and Dave here, we just would like to thank you for being on this platform and having your voice heard. And the more we talk about it, the more that needle can move.

Why the work continues

Derik J. Sven

I don’t want other states to be looking at this going, oh, it didn’t work in Virginia on the first try.

I was just on Southern California’s Dental Hygiene Association’s roundtable. They had me on speaking about dental hygiene autonomy legislation.

And as I was—other members of the roundtable were on—the California RDHAP model, it actually took 20 years for them to get it passed.

Legislation does not happen in one sitting. It often is a multi-year endeavor.

And if we don’t start now, start somewhere, we’re not going to continue to advance our careers or our profession.

So don’t be dismayed. It’s the first year.

Virginia is going to continue fighting for dental hygiene autonomy and increase access to care. But yes, we did have a major setback this year.

Jessica Atkinson

Not yet.

Derik J. Sven

It’s still a setback for the fact that we’ve had to fight it, but yeah, we’re still hopeful that it can be contained.

Closing reflections

David Torres

I’m not fond of periodontal disease or patients walking in with their teeth in their hand, but I’m really grateful that happened to you because that was a catalyst for you to be who you are right now.

And I think you’re such an asset and you’re such an important person to our everyday hygienists out there listening.

And so I just want to thank you for doing everything that you’re doing and most importantly, not giving up and using that to even motivate you further and knowing that we keep on keeping on, right?

And so thank you for coming in over here and sharing all those amazing stories.

Definitely would like to hear you go out there and continue and promote this, which is essentially what we need out there.

We talked a lot about a lot of important things, but is there anything else that you think that we didn’t talk about that should be worth noting in this episode?

Legislation 101 in three points

Derik J. Sven

Well, I mean, I could talk for another hour if you wanted me to.

Jessica Atkinson

I am looking at the recorder, but I was like, we maybe should have done two episodes.

Derik J. Sven

If I was going to summarize legislation 101, it would be:

• first, assess your lobbying team.
• second, have a proactive plan.
• and third, do not trust the dental association’s state chapter farther than you can throw them because they do not have your best interests at heart and they are likely already working behind the scenes to compromise legislation the hygienist association might be moving forward on.

David Torres

Noted. Thank you, Derik.

Derik J. Sven

You’re welcome.