THE LAGGARDS OF DENTAL HYGIENE
5. U.S. Department of Health and Human
Services. Oral Health in America: A Report of
the Surgeon General. Rockville, MD: U. S. Department of Health and Human Services, National
Institute of Dental and Craniofacial Research,
National Institutes of Health, 2000.
6. U.S. Department of Health and Human Services. A National Call to Action to Promote Oral
Health. Rockville, MD: U.S. Department of Health
and Human Services, Public Health Service,
Centers for Disease Control and Prevention,
and the National Institutes of Health, National
Institute of Dental and Craniofacial Research.
NIH Publication No. 03- 5303, May 2003.
7. The Role of Dental Hygienists in Providing Access to Oral Health Care. National Governors
Association Paper. 2014. http://www.nga.org/
8. FTC Staff Comment Before the Georgia
Board of Dentistry Concerning Proposed
Amendments to Board Rule 150.5-0.3 Governing Supervision of Dental Hygienists. http://
9. Scofield JC, et al. Disciplinary actions associated with the administration of local anesthetics against dentists and dental hygienists. J
Dent Hyg Winter 2005;79: 8.
10. Michigan House Legislative Analysis Section. Senate Bill 1009: Allow dental hygienists to
administer local anesthesia. Available at: www.
Accessed June 28, 2011.
11. Kanaa MD, Whitworth JM, Corbett JP,
Meechan JG. Articaine and lidocaine mandibular buccal infiltration anesthesia: prospective randomized double-blind cross-over study.
J Endod 2006;32:296-298.
12. Gansto GA, Gaffen AS, La wrence HP, et al.
Occurrence of paresthesia after dental local
anesthetic administration in the US. J Am Dent
13. Daublander M, Muller R, Lipp MD. The
incidence of complications associated with
local anesthesia in dentistry. Anesth Prog
14. Georgia Board of Dentistry Board Meeting.
June 18, 2010.
15. Professional Licensing Board 237 Coliseum
Drive Macon, GA 31217
Page 3 of 10 Board of Dentistry Minutes, Dental
Hygiene Committee - Ms. Pamela Bush, RDH.
16. Beazoglou TJ, et al. Expanded function
allied dental personnel and dental practice
productivity and efficiency. J Dent Educ 2012
Aug; 76( 8):1054-60.
17. Berwick DM. Disseminating innovations in
healthcare. JAMA 2003;289( 15): 1969-1975.
and enter a new era in policymaking, one
that reflects current standards of care and
enhances consumer well-being.
As the nation continues to move forward in its celebration of growth in the
delivery of dental hygiene services, those
few states holding dear their antiquated
practice acts will continue to be the laggards of dental hygiene. RDH
SUZANNE NEWKIRK, RDH, received her dental
hygiene degree from the University of Alaska,
Anchorage, in 1981. A recognized key opinion
leader in dental endoscopy, Suzanne has published numerous articles on DentistryIQ.com,
and has co-authored several dental textbook
chapters on minimally invasive nonsurgical
periodontal therapy with use of the dental
endoscope: “Minimally Invasive Periodontal
Therapy: Clinical Techniques and Visualization
Technology” by John Wiley & Sons, Inc., 2014,
and “Dental Hygiene: Application to Clinical
Practice,” publication date 2015. Ms. Newkirk
is as a Perioscopy Instructor and professional
speaker who has presented all over the nation
for doctor and dental hygiene study clubs, as
well as many large dental meetings. Suzanne
is the owner and moderator of the Perioscopy
Users Forum on LinkedIn.
LYNNE SLIM, RDH, BSDH, MSDH, is an award-winning writer who has published extensively
in dental/dental hygiene journals. Lynne is
the CEO of Perio C Dent, a dental practice
management company that specializes in
the incorporation of conservative periodontal
therapy into the hygiene department of dental
practices. Lynne is also the owner and moderator of the periotherapist yahoo group: www.yahoogroups.com/group/periotherapist. Lynne
speaks on the topic of conservative periodontal therapy and other dental hygiene-related
topics. She can be reached at periocdent@
mindspring.com or www.periocdent.com.
1. Bloomberg Visual Data: Bloomberg Best
(and Worst) Dental Health States. Worst dental
health: Mississippi. Over one-quarter of Mississippi seniors have no natural teeth. http://
2. Kishore M, et al. Evidence based dental care:
integrating clinical expertise with systematic
research. JCDR. 2014; 8( 2): 259-262.
3. Fones AC. Mouth hygiene: a textbook for
dental hygienists. 2nd ed. Philadelphia and
New York: Lea & Febiger; 1921.
4. Practice Act Overview and Direct Access
States Map. http://www.adha.org/scope-of-
there are no comparative studies showing
that infiltration injections are less likely
to cause adverse outcomes than nerve
block anesthesia. Reports demonstrate
that the adverse occurrences following
nerve block anesthesia can also happen
during infiltration injections. 11-13
In reviewing the publication, “
Utilization of local anesthesia by Arkansas dental
hygienists, and dentists’ delegation/satis-faction relative to this function,” Arkansas dental hygienists and dentists viewed
this expanded function “as necessary for
provision of quality dental hygiene care.”
The dentist employers reported that local
anesthesia provided by dental hygienists
“had a positive impact on scheduling, production, patient satisfaction, comfort, and
quality of care.” 15
Perhaps laggard states do not have
individuals in authority (such as dental
board and dental association members)
who are familiar with current literature,
such as the Journal of Dental Education’s
article, “Expanded function allied dental
personnel and dental practice productivity and efficiency.” This publication
clearly demonstrates that practices using
expanded function allied dental personnel treated more patients, and had higher
gross billings and net incomes than those
practices that did not. Thus “the more services delegated, the higher the practice’s
productivity and efficiency.” 16
It has been suggested that some laggard states have dental board (and/or state
dental association) members that exert
pressure on others from making changes
in local anesthesia rules and supervision
levels for dental hygienists even though
the recommended rule changes are scrupulously defensible. Sadly, while the mission of the BOD is to “protect the public,”
in laggard states they are the ones creating
undue harm to the public they have been
entrusted to protect by “keeping dental hygienists from practicing to the full extent of
their education and training.” 7
It is important and timely for decision makers in laggard states to develop
a new way of thinking (preferably using
evidence-based critical thinking skills)