Why Dental Hygiene Needs More Independent Practitioners – And How to Get There

Freedom to Practice, Power to Heal!

For too long, dental hygienists have been constrained by outdated policies, restrictive legislation, and industry resistance that limit our ability to practice independently. These barriers aren’t just professional obstacles but public health failures, denying millions access to essential preventive care. It’s time to dismantle these restrictions and empower hygienists to serve communities, as Dr. Alfred C. Fones envisioned when he founded the profession in the early 1900s.

The Barriers to Independence

Outdated Legislation

Many states still require dentist supervision, preventing hygienists from providing care in nursing homes, schools, rural areas, and underserved communities. These archaic laws prioritize control over public health.

According to the ADA’s Health Policy Institute, 58 million Americans live in areas with dentist shortages. Yet, despite recognizing this crisis, the ADA—dominated by private practitioners—opposes independent hygiene practice, prioritizing protectionism over patient needs. Lobbying efforts block direct patient access to hygienists and restrict us from owning practices in both public and private sectors.

We are qualified, capable, and competent. Like other healthcare professionals, we deserve the right to choose where and how we serve.

Industry Resistance

Powerful dental associations argue that dental hygienists in independent practice compromise patient safety. In reality, opposition often stems from financial interests and a reluctance to shift power dynamics within the profession.

Some dentists claim that reducing supervision increases malpractice liability, but the evidence proves otherwise. Malpractice law holds providers accountable only for substandard care, and expanding hygienists' scope of practice does not raise legal risks for dentists. In fact, with less supervision, the direct legal ties between dentists and hygienists are minimized.

Independent practice isn’t a risk—it’s a solution. Removing unnecessary restrictions will expand access to preventive care and increase overall health outcomes.

Restricted Access to Care

The current system disproportionately harms low-income, elderly, and rural populations who struggle to find affordable dental care. Hygienists could be a lifeline in these areas, yet restrictive laws prevent us from stepping in.

Who Benefits from the Status Quo?

Opponents argue that ‘patient safety’ is at risk, yet decades of research prove otherwise. States where independent practice is allowed have seen improved oral health outcomes. In contrast, restrictive laws correlate with higher rates of tooth loss due to decay, highlighting the urgent need for preventive care.

If safety isn’t the real concern, what is? Follow the money. The dental industry thrives on limiting competition and concentrating financial power. By keeping hygienists under supervision, the system controls service delivery, restricts access, and keeps costs high.

The solution is clear: empower dental hygienists, expand access, and put public health first!

The Path Forward: How We Change the System

1. Legislative Advocacy: We must push for policy changes that eliminate restrictive supervision laws and expand dental hygienists' scope of practice. This means engaging with legislators, testifying at hearings, and supporting candidates who prioritize healthcare reform.

2. Professional Mobilization: Hygienists must unite to demand our rights. State and national hygiene associations should be at the forefront of this fight, organizing campaigns, raising awareness, and mobilizing members to advocate for legislative reform.

3. Licensure Reform: Standardizing licensure requirements across states and removing unnecessary bureaucratic hurdles will allow more hygienists to practice independently and serve communities without excessive red tape.

4. Business and Leadership Training: Independence requires more than clinical expertise; it demands business acumen. More programs should focus on equipping hygienists with the skills to establish and sustain their practices.

5. Collaboration with Public Health Initiatives: Partnering with medical professionals, community health organizations, and policymakers can help integrate independent hygienists into broader healthcare systems, improving overall patient outcomes.

Dental hygienists are more than auxiliaries—we are essential healthcare providers. The fight for independent practice is not just about professional advancement; it’s about healthcare justice. Real change requires policy change. We must demand better laws, educate lawmakers, and refuse to accept a system that prioritizes profit over people.

The time to act is now. If you’re committed to expanding access to care, advancing our profession, and ensuring every patient gets the care they deserve, it’s time to stand up and make a difference.

Advocate for change, mobilize your community, and take charge of the future of dental hygiene—because the future depends on us!

Until I Write Again,

In gratitude,

Shavonne R. Healy, MSDH, RDH

CEO, A Higher Learning