Does the dental hygiene profession create a barrier by not pushing for bachelor’s and advanced degrees?

Sept. 1, 2017
Christine Nathe, RDH, advocates for degree completion for the dental hygiene profession.

By Christine Nathe, RDH, MS

Much is published about access to care in the dental literature. In fact, access to care and barriers that might prevent populations from accessing care are taught in dental hygiene school. Additionally, legislative initiatives aimed at improving access to care routinely highlight the role of dental hygienists in primary dental care, as well as the integration of dental hygienists in medical settings.

Recently, at a University of New Mexico, School of Medicine (UNM SOM) Health Profession’s Retreat, the keynote speaker, Martha Cole McGrew, MD, who is the executive dean at the university’s medical school, discussed current issues in medical care. What struck me was a statement she made about access to care for patients. She stated that, indeed, professions themselves sometimes create barriers to care. One example she gave was creating a myriad of visits a patient must complete to access physical therapy. This certainly does create a barrier to care. How many times has the complexity and number of visits deterred one of us from accessing medical care?

If this statement about creating barriers to care focused on dental hygiene care, what would the answer look like? How does dental hygiene create barriers to care? More importantly, how do we prevent barriers to care created by dental hygiene?

The first barrier that we help create is the education of future dental hygienists. Do we ensure that all dental hygienists graduate ready to assume roles in public health, with the skill sets to develop positions in primary care clinics, schools and community health centers? I do not think that any dental hygienist would be able to state that, as a profession, we do this. Updating the accreditation standards to ensure competence in these skill sets is mandatory if we want to ensure future dental hygienists can initiate practices in these settings.

Although the American Dental Hygienists’ Association (ADHA) has advocated for an entry-level BSDH degree, some in dental hygiene still oppose this progression. How do we help educate our own members that a well-rounded graduate will help advance our science and practice? The increase in continuing education courses, on both local and national platforms, focusing on the advancement of dental hygiene science, scholarly identity of a dental hygienists and the natural progression of health professions should be a focus of dental hygiene.

The profession should continue advocating for more dental hygienists to receive their MSDH degrees. Graduate level dental hygienists would have the foundation to provide leadership and expertise in dental health matters to government agencies, dental industry and consumer advocacy organizations.

Focus needs to continue on the three skills sets of dental hygienists, clinical skills, public health mindset and scholarly identity.

Dental hygienists should be publishing articles, tool kits and presenting continuing education courses on how to develop positions outside of the dental hygiene profession, especially those dental hygienists who have created such positions.

The brochures from the first dental hygiene meetings in Bridgeport, Conn., among the initial graduates of Fones School of Dental Hygiene focused on such job creations. The topics then included starting dental hygiene positions in schools, factories and hospitals. As part of the ADHA Transformation Initiative,1 the profession needs to be doing the same!

As a profession we need to work on taking down these barriers to care within our profession. When we work on this, we will improve access to care and hopefully, this will promote patients to access care! RDH

CHRISTINE NATHE, RDH, MS, is 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” (, which is in its fourth edition with Pearson. She can be reached at [email protected] or (505) 272-8147.