What is a Dental Hygienist?

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The American Dental Hygienists Association (ADHA) defines dental hygienists as oral health professionals who are responsible for preventing and treating oral diseases. Regardless of the state in which they practice, dental hygienists must be state licensed, which requires graduating from a college or university dental hygienist program and passing a written national board examination and state clinical examination.

Unlike dental assistants, whose job duties must generally be performed under the direct supervision of a licensed dentist, dental hygienists perform much of their work independently, with only general supervision from a licensed dentist.

Dental hygienists are an important part of dentist-led teams. Their work removes a considerable burden from the dentist, freeing up the dentist to perform more advanced procedures. Therefore, it is quite common for dental hygienists to perform many of the preventive dental procedures in an office, such as teeth cleaning and fluoride application.

Responsibilities and Job Duties of Dental Hygienists

These state-licensed dental health professionals may be allowed different responsibilities and duties depending on the state in which they practice. However, basic services performed by dental hygienists, according to the American Dental Association (ADA), include:

  • Applying preventative materials to the teeth (fluorides and sealants)
  • Counseling/educating patients on oral hygiene strategies and good nutrition
  • Making impressions for study casts
  • Patient screenings, including oral health assessments, oral health history review, oral cancer screening, head and neck inspections, and taking of vital signs
  • Performing documentation and office management
  • Removing calculus and plague from teeth
  • Taking and developing dental radiographs

In addition to the above named job functions, state requirements may allow these dental professionals to perform duties under either direct or general supervision of a licensed dentist. For example:

In Arizona, dental hygienists are permitted to perform prophylaxis, x-rays, topical anesthesia, fluoride, and pit and fissure sealants with the prior authorization of a licensed dentist, although the dentist need not be present when the services are performed. These licensed dental professionals are also allowed to perform the following under a dentist’s direct supervision:

  • Local anesthesia
  • Administration of nitrous oxide
  • Placing and removing periodontal dressings
  • Placing and removing sutures
  • Soft tissue curettage

California dental hygienists, on the other hand, are permitted to perform all of the above job duties under the general supervision of a licensed dentist, with the exception of the administration of local anesthesia, the administration of nitrous oxide, and soft tissue curettage, which must be performed under direct supervision.

Some states, like Georgia, have much stricter laws in place regarding the allowable duties of dental hygienists. For example, dental hygienists in Georgia are not allowed to perform the following:

  • X-rays
  • Local anesthesia
  • Administration of nitrous oxide
  • Placing sutures
  • Treatment planning

They are, however, permitted to perform the following tasks under direct supervision:

  • Prophylaxis
  • Topical anesthesia
  • Fluoride treatment
  • Pit and fissures sealants
  • Root planning
  • Soft tissue curettage
  • Removing sutures
  • Placing and removing periodontal dressings

On the other end of the spectrum, dental hygienists in Kansas have a much broader list of allowable job duties, with most functions permitted to be performed under the general supervision of a licensed dentist. The only function that needs to be completed under the direct supervision of a licensed dentist in Kansas is the administration of local anesthesia, and the only function not allowed to be performed is the placement of sutures.

Education, Training, and Licensing Requirements for Dental Hygienists

Dental hygienists generally receive their education through colleges and universities, dental schools, junior colleges, and technical schools. The minimum requirement for state licensure of dental hygienists is an associate degree, which takes about two years to complete. The conclusion of any dental hygiene program is a clinical externship, which allows students to apply their skills and knowledge in a dental care setting through supervised patient experiences.

An associate’s degree in dental hygiene allows dental hygienists to take the state-required licensure examinations and become state licensed, which is a requirement in all states.

Beyond an associate’s degree, dental hygienists often pursue college or university programs that result in a bachelor’s or master’s degree in dental hygiene. Upon completion of an associate’s degree in dental hygiene, dental hygienists can expect to complete a bachelor’s degree program in another two years, and a master’s degree in another four years. Although advanced degrees in dental hygiene are not required to practice dental hygiene, they may be required or preferred for careers in teaching or research or for clinical practice in schools or public health programs.

The American Dental Association’s (ADA) Commission on Dental Accreditation (CODA) serves as the sole accrediting body for dental hygiene programs in the United States. There are currently 330 CODA-accredited dental hygiene programs throughout the country.

Examination and Licensure for Dental Hygienists

In addition to achieving an associate’s degree in dental hygiene from an accredited institution, individuals interested in becoming dental hygienists must successfully pass a state-authorized licensure examination, as well as the National Board Dental Hygiene Examination. Generally, the national examination assesses a candidate’s knowledge of the practice of dental assisting, while state or regional examinations are typically designed to assess a hygienist’s clinical skills.

Other typical requirements for state licensure as a dental hygienist include the successful completion of a state jurisprudence examination and CPR certification.

A state license is required to legally practice dental hygiene in the U.S. Dental hygienists who achieve state licensure are permitted to use the acronym RDH to identify themselves as Registered Dental Hygienists.

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