Inside Dentistry
June 2008
Volume 4, Issue 6

From the Editor

Gerard Kugel, DMD, MS, PhD

Dear Readers,

This month, Inside Dentistry explores the ongoing diligent efforts taking place between organized dentistry and organized hygiene to enhance workforce efficiency and ultimately improve access to care among underserved populations. Theirs is collectively an ambitious undertaking, one that has been wrought with occasional tension and controversy. Fortunately, at the heart of hygiene’s and dentistry’s efforts is a true mutual respect for the roles each professional provider plays in delivering patient care.

Respect. Dentists and hygienists respect and acknowledge each other’s value to the oral healthcare profession. Yet, the person in the problem-solving equation who demands the most respect is the patient. In recent months, and perhaps in response to such events as the tragedy of Deamonte Driver’s death and the decision regarding the litigation between the ADA and the Alaska Native Tribal Health Consortium/State of Alaska, different factions of oral healthcare are working even more diligently and collaboratively to develop models of workforce efficiency. These models are intended to best use the talents, education, and skills of oral health professionals who are respectively trained to perform certain and specific tasks in order to enhance the oral care and health of the public.

Contributing to the Problem. Along the road to realizing greater cooperation, political stumbling blocks and arguing have arisen. Contributing to the problem is a limited number of dentists and other professionals in key areas that could provide supervision, if that is a solution to be considered. Yet, access to care remains the key issue understood by everyone. Collaboration and communication are and should continue taking place within the profession as a basis for continued problem solving about how to work together to increase access to quality oral care for those who need it.

Multiple Laws, Inconsistent Needs. The decisions regarding who can do what and when—specifically dental hygienists and other dental auxiliaries—rest at the level and discretion of the states, and not every state allows a hygienist to perform the tasks that another does. For instance, some states allow expanded-duty dental hygienists who can perform certain operative procedures under the direct supervision of a dentist. Other states allow more tasks for dental assistants under expanded duty, but those are only associated with specific training, testing, and licensure in those specific areas. While there are individuals and groups trying to unite the country in terms of what’s provided in oral care and hygiene care, what’s needed in one area of the country may be vastly different from what’s needed elsewhere.

We hope that you enjoy this issue and find that it enlightens your understanding of the issues surrounding interactions between organized dentistry and hygiene, especially where they concern the ultimate goal of improving access to care. We also hope that it encourages you to reflect on how you can take open-minded steps toward inter-professional collaborations to improve workforce efficiency. Please send us your feedback to letters@insidedentistry.net. As I emphasize each month, your thoughts, opinions, and reactions continue to motivate us to improve our clinical content and coverage of topics affecting our profession. Thank you for reading and for your continued support.

With warm regards,

Gerard Kugel, DMD, MS, PhD
Associate Dean for Research
Tufts University School of Dental Medicine

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