Nearly two decades have passed since Colorado lawmakers rewrote state law and allowed dental hygienists to open private, stand-alone practices in that western state.
Of the more than 2,700 licensed hygienists in Colorado today, just 20 are practicing without a dentist’s supervision in 17 stand-alone practices across the state, a new ADA study shows. Most of these practices, the study also shows, are located in affluent or middle-income areas where their effect on access to care for the indigent is negligible.
"These research findings counter the argument that permitting unsupervised dental hygiene practice will help solve the access problem," ADA President Richard Haught said of the study, titled "The Economic Aspects of Unsupervised Private Hygiene Practice and its Impact on Access to Care."
Added Dr. Haught, "For the most part, the hygienists identified in this report as working without a dentist’s supervision were not providing care in areas of greatest need. The report shows that relaxing supervision is not the answer to improving access to dental care for the indigent."
Unsupervised dental hygiene practice has not gained a stronger foothold in Colorado chiefly because certain economic incentives that might attract hygienists and patients are lacking, researchers say.
Hygienists for the most part have not found unsupervised practice more lucrative than working in a conventional dental office, the study shows, and patients who might be lured to these practices by the expectations of discounted fees are not finding them.
Produced in response to a 2002 ADA House of Delegates resolution, the two-year study is to be published in monograph form and widely distributed to legislators, government agencies and the dental community.
The study results from a collaboration of the ADA’s Health Policy Resources Center and RRC Inc., a Texas-based economic research and consulting firm. The study was the subject of a major report in the Feb. 7 issue of ADA News and can be read in full on the ADA’s Web site at "www.ada.org/prof/resources/topics/reports.asp".
