Regarding Dr. Neiburger`s thought-provoking letter, there are several points to which I would like to respond. Dr. Neiburger states that "para-hygienists" are being produced by preceptorship in order to fill the void of classically trained dental hygienists. He also suggests that due to the demand for hygienists their compensation is higher, which he seems to feel is unfair to the dentists, insurers, and patients. He states "that if hygiene is to continue, it must become more productive for the dentist and his or her patients. That means quality work which is faster, less expensive, and more efficient." I agree, but not with Dr. Neiburger.
Nowhere in his drawn-out letter on the shortcomings of licensed professional hygienists does he suggest a remuneration to the patient or the insurance company for the service provided by the $10 per hour "para-hygienist" or dentist doing "high-speed quality prophys." I would think that, by reducing the expense of hiring a registered hygienist and pushing patients through at a 30-minute pace, the reduction in overhead costs to the dentist would then be passed on to the consumer, as well as the insurance companies that "cannot afford hygiene as we know it."
Dr. Neiburger fails to mention that along with the rising costs of hygiene that rote dentistry itself has become unaffordable for most people without insurance and that insurance companies themselves have put a limit on the amount of coverage they will provide for most services.
Therefore, based on the theory of the need for highly trained dental personnel to provide services that are faster, less expensive, and more efficient, I suggest a class of expanded function dental hygienist to be trained "in office" or "para-dentist" to cut and fill restorations. Do not delude yourself, Dr. Neiburger. Drilling and filling requires no exceptional skills. Most patients and insurance companies will not recognize the difference.
Certainly, if the average dental assistant with less than a college degree can be trained to provide dental hygiene functions that take an average of four years of college, a well-trained, licensed dental hygienist would have no trouble learning on-the-job dentistry.
Suzanne M. Newkirk, RDH
Mill Creek, Washington