Dental hygienists balk at legislation

A bill in the Missouri General Assembly would let dental assistants remove plaque.
Wednesday, February 18, 2004 | 12:00 a.m. CST; updated 11:49 p.m. CDT, Monday, July 21, 2008

A bill that would expand the responsibilities of dental assistants, including allowing them to clean teeth, has drawn protest from Missouri dental hygienists.

Dental assistants with at least three years of clinical experience and who have completed a minimum of 72 hours of clinical training would be permitted to remove tartar and plaque from patients’ teeth under the proposed bill.

Currently, dental assistants work under the supervision of dentists and are only allowed to perform reversible dental procedures. Dental hygienists, who perform cleanings and take X-rays, are graduates of accredited college-level programs. They also must pass a national written exam and a regional clinical exam before being allowed to practice.

Sen. John Cauthorn, R-Mexico, the sponsor of the bill, said the idea started among dentists in rural Missouri who were concerned about a shortage of dental hygienists.

“Our rural areas have been devastated for lack of services,” Cauthorn said. “This bill will free up dentists and cut down the wait time to provide better health care.”

Missouri dental hygienists oppose the bill because of the differences in training provided to dental assistants and dental hygienists, said Debra Henderson, president of the Missouri Dental Hygienists’ Association and a practicing dental hygienist.

“We are 100 percent opposed to the bill,” Henderson said. “It’s a public-safety issue when a dental hygienist has over 2,000 hours of ... clinical training, and trying to teach (dental assistants) in 72 hours to do what we do.”

Henderson said the bill also would be difficult to enforce.

“Dental assistants are not registered or licensed by the state of Missouri,” she said. “So how do you know if they have three years of experience?”

Henderson said there are better alternatives to solving the problem of a shortage of dental hygienists than changing the responsibilities of dental assistants.

“Our philosophy is distance-learning programs and satelliting education to (rural) areas,” Henderson said.

Dr. Jake Lippert, executive director of the Missouri Dental Association, said that while most dentists support the bill, the organization is also looking for ways to educate and bring more dental hygienists to rural areas.

The association recently donated $25,000 to Missouri Southern State University’s dental hygiene program to develop distance-learning programs.

“Dentists working in bigger cities have more access to dental hygienists and can do more complex dental care because they can have more chair time,” Lippert said.

Also, the Missouri Dental Association is looking into broadcasting existing dental hygiene programs and developing courses over the Internet.

Lippert said he understood the dental hygienists’ concerns but said a lot of the organization’s members need assistance for the minor cases.

“We’ve heard the complaint that all dentists are looking for is cheap help,” he said. “But what they are really looking for is help.”

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