The journal Health Affairs’ latest issue is focused on oral health in the United States. Among the themes explored in the issue are the divide between dental and medical care and how this is contributing to inadequate oral healthcare—“one of the largest unmet health needs in the United States.” In addition, the issue looks at the role of dental hygienists in the provision of care to fill access gaps, the integration of dental care into federally qualified health centers (FQHCs), the cost-effectiveness of community water fluoridation efforts, and the benefits of school-based dental sealant programs.

The American Dental Hygienists’ Association (ADHA) put out a press release welcoming the Health Affairs focus on oral health, pointing out  “the enormous impact oral health has on the overall public health system in the U.S.” The ADHA is a long-time advocate of evidence-based oral health management strategies for the prevention of oral and systemic diseases, including the association between periodontal (gum) disease and heart and lung disease, diabetes, premature, low birth weight babies, and many other conditions.

The 2000 Surgeon General’s report, Oral Health in America, called attention to this association and stated that, if left untreated, poor oral health is a “silent X-factor promoting the onset of life-threatening diseases which are responsible for the deaths of millions of Americans each year.”  As such, the ADHA believes “that integrating dental hygienists into the healthcare delivery system as essential primary care providers to expand access to oral health care will help improve the public’s overall health.”

Given this, the ADHA argues that proper dental hygiene diagnosis is critical in identifying and treating early risk factors for more serious health concerns. Over the past two decades, the ADHA has collaborated with the New York Center for Health Workforce Studies (CHWS) and School of Public Health at the State University of New York-Albany (SUNY) to update the Dental Hygiene Professional
Practice Index (DHPPI). In her Health Affairs article, Margaret Langelier and her SUNY coauthors
examined the increase of dental hygienists’ scope of practice between 2001 and 2014 and
found a positive correlation between a state’s more autonomous scope of practice and the
oral health of that state’s adult population. According to the ADHA, far too often scope of practice limitations impedes the ability of dental hygienists to provide the full spectrum of services they are
educated to deliver. By reducing supervisory requirements for dental hygienists, it is ADHA’s
hope that the gap between dental and medical care narrows for the benefit of patients.

ADHA advocates the inclusion of dental hygienists in the development of federal, state, and
local policies that support improved oral health and wellness.