US dental hygienist association opposes new ADA resolutions

Dental Tribune International

Fri. 6. December 2024

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CHICAGO, US: The American Dental Association (ADA) Health Policy Institute has found that declining enrolment in dental hygiene programmes is creating a workforce shortage and restricting dental patient volumes by some 10%. In October, the American Dental Hygienists’ Association (ADHA) voiced opposition to three resolutions proposed by the ADA to fix the workforce woes. According to the ADHA, the new rules, which have since been passed by the ADA House of Delegates, pose a threat to dental educational standards, patient safety and the integrity of the dental hygienist profession.

Resolutions 401H-2024, 513H-2024 and 514H-2024 were passed by the ADA’s legislative body in November despite firm ADHA opposition. Resolution 401H-2024 urges the Commission on Dental Accreditation (CODA) to increase the ratio of dental students to faculty members with the aim of increasing dental hygienist class sizes and making education programmes more flexible. Resolution 513H-2024 encourages states to enable dental students and residents who have completed their hygienist competencies to practise as dental hygienists. Resolution 514H-2024 encourages states to license foreign-trained dentists to practise as dental hygienists.

In a written submission that urged the ADA to reject the resolutions, the ADHA said that changing faculty–student ratios risked diluting the quality of dental education and decreasing educator retention. Concerning Resolutions 513H-2024 and 514H-2024, it argued that dental students, dental residents and foreign-trained dentists do not necessarily possess the skills required to deliver preventive and therapeutic dental hygiene care to US patients and that non-CODA-accredited pathways to working as a dental hygienist pose a risk to patient safety and professional standards.

“Disheartening to see”

The ADHA represents some 220,000 registered US dental hygienists, and one member wrote on Instagram: “As someone who’s worked hard to overcome obstacles, including profound hearing loss, it’s disheartening to see the recent ADA proposal that would allow foreign-trained dentists to perform dental hygiene services without a licence.” Another user commented that more dental hygiene schools, lower tuition fees and higher acceptance rates were needed, not “international dentists doing hygiene on patients in the US”.

In an open letter to the healthcare community, ADHA President Erin Haley-Hitz emphasised: “[The] ADHA strongly believes that rather than diminishing professional standards and undermining a complementary profession, constructive efforts should be directed toward improving workplace culture, enhancing professional development opportunities and offering competitive benefits.”

Empowering US states to tackle staffing challenges

Citing urgency and a commitment to high standards in oral care, ADA President Dr Brett H. Kessler said that the new policies will empower US states to alleviate staffing problems. Responding to Haley-Hitz, Dr Kessler said that the ADA had aimed for a practical, responsible solution to the staffing shortage and clarified that the new resolutions will uphold professional and licensing standards. He explained, for example, that foreign-trained dentists applying for dental hygiene licences would be required to pass board examinations and that dental students and residents would have to meet state licensure requirements in addition to having completed the required competencies before being able to practise as dental hygienists.

Dr Kessler wrote: “To be clear: the ADA would not support, or encourage states to support and adopt, any legislation that compromises patient safety or undermines professional standards. These resolutions do not advocate for unlicensed practice; rather, they aim to address critical staffing gaps with appropriately vetted professionals who meet high competency standards.” The resolutions are non-binding and therefore give states flexibility to address their dental workforce needs, Dr Kessler added.

ADA Health Policy Institute data for the third quarter of this year found that 91.7% of dentists who were hiring within the three-month period found it either extremely or very challenging to recruit dental hygienists, down from 94.8% in the third quarter of 2022.

Topics:

Oral Hygiene

Tags:

American Dental Association American Dental Hygienists’ Association Dental employment Dental workforce

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