Expanding dental hygiene to include dental therapy: improving access to care for children

Oral Health in America: A Report of the Surgeon General, and the subsequent National Call to Action to Promote Oral Health contributed significantly to raising the awareness of the American public and the dental profession regarding the lack of access to oral health care by many Americans, especially minorities and low income populations, with resulting disparities in oral health. The problem is particularly acute among children. The current workforce of dentists in the United States is inadequate to meet the oral health care needs of children in terms of numbers of dentists, as well as their distribution, ethnicity, education, and practice orientation. Dental hygienists trained in an expanded scope of practice, can help address the workforce inadequacy. Dental therapists, educated in 2-year programs of postsecondary education, comparable to America's associate degree dental hygiene programs, have been used throughout the world to provide basic, primary oral health care for children. Research has documented that utilizing dental therapists is a cost effective method of improving access to care for children. Countries that have led the way in introducing dental therapists to care for their children are now integrating their separate 2-year curriculum in dental therapy and dental hygiene into a 3-year curriculum to prepare a clinician dually trained in both dental therapy and dental hygiene. This clinician is being designated an oral health therapist. Expanding the education of dental hygienists in the United States to include skills of the internationally acclaimed dental therapist can produce oral health therapists, individuals capable of addressing the basic preventive, restorative, and minor surgical needs of children, but also able to continue to address the preventive and periodontal needs of adults.