Can Your Dental Hygienist Be an Oral Health Therapist?

To answer this question, you first need to know what an oral health therapist does.

Origin

The profession originated in Australia, according to a piece on InTech, as an extension of both the dental hygienist and dental therapist to address the dental needs of the underserved, especially those in rural and low-income areas. This position is now recognized in many countries worldwide. In the United States, health care providers who can work as an oral health therapist most often begin their training as a dental hygienist. From there, they can continue their education to achieve this mid-level position. Currently, only three states in the country have approved the role, with seven states reviewing legislation in hopes to include it in their regular dental practices.

A Changing Practice

According to the American Dental Hygienist Association (ADHA), dental hygienists are educated and licensed per the standards of the state in which they work. Like dentists, their primary role is to provide preventive care to patients with the goal of optimizing their oral health, and most often work in a dental practice. However, the ADHA hopes to transform the profession so that it meets its intended purpose: to reach any patient who has limited resources and/or access to dental care. Thus, the oral health therapist or advanced-practice dental hygienist is in transition; you might consider it dentistry's version of a nurse practitioner.

Qualifications

Although the term for an oral health therapist may vary, Minnesota, Maine and Alaska all have approved programs for this person. In Minnesota, the Advanced Dental Therapist (ADT) can be educated through a dental hygiene program or through a dedicated ADT program, and all graduates will obtain a Master's degree. In Maine, dental hygiene therapy is an extension of an accredited dental hygiene program. And in Alaska, the therapist model requires a two-year education certificate with a sponsorship from a tribal area. They practice independently and only in tribal areas of the state under remote supervision of a dentist.

Although these states differ in education and area of expertise, the general scope of care is both preventative and restorative. This can include:

  • Preventative services normally performed by a dental hygienist
  • Assessment of the mouth
  • Administration of local anesthesia and nitrous oxide
  • Simple cavity preparations and restorations
  • Basic tooth extractions
  • Formation of stainless steel crowns for baby teeth and
  • Management of urgent dental trauma

Oral health therapists can also prescribe anti-inflammatory medications, analgesics, antibiotics and preventive agents such as Colgate® PreviDent®, a toothpaste for those who have crowns, a high risk for cavities and other special cases.

All of these services need to be supervised by a licensed dentist, either directly, wherein the dentist is present; or indirectly, through general supervision. With the latter, the dentist must review or collaborate treatment. Ultimately, the dental therapist can treat pain and disease and make the referral to a dentist for follow-up care if necessary.

Need for Oral Health Therapists

Although it is new to the United States, the role of an oral or dental therapist has been well established for years in other countries. In America, this concept seems like a home run for both the practitioner and the patient. RDH magazine suggests the ADHA model for the Advanced Practice Dental Hygienist (ADHP) is the "next logical transition" for providing care to dental patients who would not normally have access to it. Additionally, in 2009, Congress passed the Children's Health Insurance Program (CHIP), specifically geared to children who were raised in low-income families. Part of this program looks to the dental hygienist to fill gaps in care for the diminishing population of dentists. However, USA Today reports there is resistance from the American Dental Association (ADA) to allow these mid-level roles, arguing that its general purpose isn't equipped to handle the many conditions under which people struggle to receive care.

The next time you see your dental hygienist, ask him or her about this role in your dental office or clinic. What services can they perform for you and your family? Do they think this concept will improve public health? Starting a dialogue and recognizing the need for an oral health therapist may be an important first step to giving everyone a chance for a healthy mouth and body.

About the author: Donna Rounsaville, RDH, BS, has been a dental hygienist in private practice for 31 years. She has used her experience with the prevention of dental problems and the importance of healthy eating to educate children in local schools in her hometown of Flemington, New Jersey. Donna is also passionate about infection control and office safety for dental workers, providing yearly training to her office colleagues. Active with the Girl Scouts as a leader and with children's liturgy at her church, Donna uses her communication and leadership skills to motivate young people in her community. She has been writing for Colgate since 2013.