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

Why do dental hygienists in some states practice independently while others face significant restrictions? This episode examines the structural, cultural, and legislative forces shaping scope of practice—and what it means for clinicians navigating real-world care.

Key Takeaways

  • Regional culture—not political affiliation—is the strongest predictor of dental hygiene autonomy across states.
  • Ethical conflicts in clinical practice, including underdiagnosis and inappropriate treatment planning, remain a significant driver of professional frustration and burnout.
  • Legislative change is typically a multi-year process that requires proactive strategy, not reactive advocacy.
  • Legal literacy—and increased representation of hygienists in law and policy—may be critical to shifting long-term power dynamics.
  • Current dental education models may contribute to misunderstanding between roles, suggesting a need for more integrated, prevention-focused training pathways.

Legislation may feel distant from daily clinical care, but its influence is often closer than it appears—shaping both what is possible and what is permitted in practice.

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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

About the Author

David Torres, CRDH

David Torres, CRDH, cohost of A Tale of Two Hygienists, is an experienced dental hygienist with over a decade of clinical expertise, specializing in patient education, preventive care, and the integration of modern dental technologies. Known for his passion for teaching, campus recruiting, and coaching, David is dedicated to elevating patient experiences while helping dental professionals improve efficiency, workflow, and long-term success.

Jessica Atkinson, MEd, BSDH, RDH

Jessica Atkinson, MEd, BSDH, RDH

Jessica Atkinson, MEd, BSDH, RDH, is the COO of Hygiene Edge and an assistant professor of dental hygiene at Utah Tech University. She has been in the dental field for 23 years with experience in the front office, dental assisting, hygiene, and education. Jessica has presented nationally and internationally, is the recipient of the St. George Area Chamber of Commerce Element Award and the Utah Tech College of Health Sciences Outstanding Service Award, is a past president of the Utah Dental Hygienists’ Association, and a member of the ADHA.

Derik J. Sven, MBA, MPH, RDH, CDT, FADHA

Derik J. Sven, MBA, MPH, RDH, CDT, FADHA

Derik has nearly two decades of experience as a board-certified lab tech and restorative hygienist. He holds undergraduate degrees in dental hygiene and health care administration, as well as master’s degrees in public health and business administration. He’s currently pursuing his doctorate in health science at George Washington University School of Medicine in Washington, DC, where his research focuses on advancing the autonomy of dental hygienists and the broad integration of dental therapists into the health-care system. He’s an inaugural fellow of the ADHA and president of Virginia's chapter.

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