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Bill would allow some dental hygienists to treat patients without a dentist’s oversight.

If newly introduced legislation passes, dental hygienists may be able to treat patients independent of dental supervision.

Mct file photo

A local state representative has introduced a bill that would expand the role of dental hygienists, allowing them to act independently in public settings such as schools and nursing homes.
Rep. Eddie Day Pashinski (D-Luzerne), who introduced the bill, said the intent is to follow Gov. Ed Rendell’s lead in encouraging preventive health care through expanding the roles of nurse practitioners, midwives and pharmacists.
“It’s the new paradigm for medicine – preventative programs. Too often people wait until they are sick or have a toothache. It’s less costly and less injurious to have a tooth cleaned, or a cavity found and filled than to wait until it degrades to an abscess,” Pashinski said. “Healthy mouth, healthy body.”
The bill creates a new level of dental hygienist called a dental hygiene practitioner, and would require such practitioners to complete 1,800 hours of education under a dentist’s supervision. On completion of training, a dental hygiene practitioner would be able to do radiological procedures, teeth cleaning and filling.
Pashinski said the bill effectively would allow a dental hygienist – with the proper training – to go into schools or nursing homes, for example, and provide preventive services. Such a measure can help those people who might otherwise not seek dental care at all, he said.
“In a lot of these kids we’re finding no dental hygiene in the home, and it can create other problems. If we as a society take care of ourselves, then it is going to be least costly to the system,” Pashinski said.
He said the bill is in its earliest stages, and it is clear that there is going to be a lot more discussion with the Pennsylvania Dental Association and representatives of the Pennsylvania Dental Hygienist Association. As is typical of proposed bills, some points need to be negotiated.
For example, there is the issue of extended-function dental assistants. They do not undergo the same amount of training as dental hygienists, and typically are paid less, but can clean teeth as long as they do not go below the gum line. Pashinski said a negotiating point on the bill is to extend the scope of practice of the dental assistants within the supervision of dentists.
Dr. Richard Grossman, Kingston, a local trustee for the Pennsylvania Dental Association, agreed the bill is still in its infancy, but said as a whole, dentists support it.
“We’re all on the same page, we just want to make sure the public is being well-served and we are very concerned about preventative care,” Grossman said.
He said the bill does not put the dental hygienists in a competing role with dentists, so dentists do not view hygienists as competition. Concerns focus on there being enough oversight, and, he added, it could be a positive move to have dental hygienists visiting clinics, nursing homes and other public places where there are people who may not regularly be getting dental care.
However, Grossman added, “I’m not sure if there is even enough hygienists to take care of that.” There are only three dental schools in Pennsylvania, Grossman explained — University of Pennsylvania, Temple University and University of Pittsburgh — and most students are from out of state. He added that the average age of dentists in the state is somewhere around 55, meaning that many are close to retirement age.
“We’re very happy Rep. Pashinski has consulted with us, and we really want what is in the public’s best interest,” Grossman said. That could include having certified dental assistants do polishing on children up to the age of 17, with the ability to apply fluoride to the teeth, and asking dental hygienists to get additional education if they are going to be on their own in a public setting, Grossman said.