by Christine Nathe, RDH, MS
[email protected]
Recently, I read an interesting chapter by Pickett and Hanlon that described the historical evolution of public health as a science and practice, and the role of the medical profession in public health from past to present. Learning from history cannot be underestimated when looking for effective solutions to current public health issues. The lessons can certainly be applied to dental hygiene today.
History recorded the gross inadequacies of medical care in the early 1800s. Physicians were not educated in academic institutions like they are today. In fact, back then the prestige of the medical profession was at its lowest, and medical practice lacked uniform educational and practice standards. Medical education was largely proprietary in nature or based on apprenticeships, resulting in physicians who were poorly prepared, and their services were often of poor quality, not uniform, and cheap.
Although there were public health laws enacted to ensure basic sanitation and prevention of communicable diseases, there were no mechanisms to recognize noncompliance. Further, because of the greatly expanded population and subsequent issues this created, public health measures were not a priority so that other seemingly more pressing problems could be addressed. Adding to this mix was the low public expectation of medical care, and the lack of a unified voice for physicians to advocate for solutions for essential public health issues.
With the advent of accredited medical academic institutions, advanced education, and documented clinical standards, we now witness a socially accepted respect and prestige for physicians, and a much higher expectation for medical care than we had in the past. Also, when public health issues arise, we have professional physician associations that serve as a voice for the science and practice of medicine. I think we all agree that physician opinions and recommendations have significant credibility and are a powerful influence in dealing with public health issues in today's America.
Like medicine, dental hygiene has evolved and continues to advance in science, practice, and educational preparation since its inception in the early 1900s. In 2006, the American Dental Hygienists' Association (ADHA) focus groups reflected these advances when a diverse group of consumers from all over the country stated that they definitely place a positive value on the advice given by dental hygienists. Interestingly, they supported the importance of discussing their personal dental issues and treatment plans with their dental hygienist.
We need to closely watch what is happening in dental hygiene education today. The impact of proprietary schools opening in abundance must be carefully assessed. Many of these students will not be able to matriculate to regionally accredited universities, making it much more difficult for them to achieve bona fide baccalaureate and graduate degrees. Decreasing our education in dental hygiene will affect dentistry as a whole, and our unified voice on dental issues will be diminished, as will the well-earned respect and prestige that is now afforded our profession.
In other words, if we make the same mistakes that were made in the past, results will inevitably mirror that of the past. As a profession, we should be working not to accept the status quo and misguided direction education seems to be taking. We should be embracing advanced education for dental hygiene, and focusing on making dental hygiene care in the United States the highest quality provided by the most educated providers.
Columnist's note: A special thank you to Frankie Perry, UNM Public Health Faculty, for critically reviewing this column.
Source: Pickett G, Hanlon JJ (1990). Historical Perspectives In Public Health and Administration, pp. 21-46. St Louis: Times Mirror/Mosby College Publications.
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.prenhall.com/nathe), which is in its third edition with Prentice Hall. She can be reached at [email protected] or (505) 272-8147.
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