Why is there a push for graduate education in dental hygiene?

Because too many people need the care that hygienists with advanced degrees offer.

by Christine Nathe, RDH, MS

Founded in 1913 by Dr. Alfred C. Fones, the profession of dental hygiene was developed to work collaboratively with the profession of dentistry to ensure optimum oral health for the public.1-4 Since the early 1900s, society has undergone many changes that have directly affected the dental care delivery system. These include the rapid growth in dental insurance, patients’ rights issues, dental workforce cyclic changes, saturation of the dental care products’ market, the development of numerous dental hygiene and treatment modalities, as well as the constant changes in the economy, political environments, and global interactions.

Fortunately, today’s Americans value wellness, prevention, and healthy teeth, which are synonymous with the practice of dental hygiene. Because of these trends, dental hygienists’ roles in dental disease prevention are more valuable than ever before.

Because of dental hygiene’s increasing importance, it has become necessary to supply the public with a cadre of dental hygiene professionals equipped with the knowledge and skills necessary to effectively deliver dental hygiene. As the discipline evolves, graduate education in the science of dental hygiene is becoming increasingly important for both the profession and society.

Graduate education in the RDH sciences

All professions are responsible for developing the knowledge necessary for the delivery of services. Dental hygiene is no exception. The American Dental Hygienists’ Association (ADHA) regularly holds national conferences focusing on dental hygiene research and theory development.5 One major proposal during the last conference was the need for dental hygiene scholars to focus on dental hygiene theory development.6 The most appropriate settings for this are the graduate programs that offer terminal degrees in dental hygiene.

Nationally, the majority of faculty members in dental hygiene hold a terminal degree in dental hygiene.7 The effect of the degree on the quality and credibility of our educational system is apparent since a master’s degree is considered the minimal preparation for a qualified faculty member.8

Shortage of graduate-level dental hygienists

The shortage of master’s prepared dental hygienists is particularly evident in the United States. Recent studies have found that there are not enough master’s prepared dental hygienists to fill the faculty needs of the undergraduate programs.9-11 See Table 1 for a listing of master of science degree in dental hygiene programs in the United States.

This shortage poses a threat to the quality of oral health care in America. Although dental diseases are preventable, dental health in the nation is still an issue.12 Although more than 80 percent of 17-year-old children experience dental decay, the burden of the disease is not evenly distributed.13 A startling statistic is that more than 80 percent of dental decay is found in 25 percent of the population.14 These children come from low-income households, ethnic minorities, and often have special needs.

The consequences of this problem are alarming. More than half (57 percent) of parents report unmet dental needs of their children, nearly five times the number reporting the need for eyeglasses.15 Untreated dental disease results in children who have constant pain, difficulty eating, difficulty speaking, chronic infections, increased use of pain medicine, and embarrassment over the aesthetic condition of their teeth. Emergency and operating room staffs regularly see large numbers of children presenting with unrelenting toothaches and caries beyond dental office management.16 Emergency visits usually consist of antibiotic therapies and can require hospitalization if not treated effectively.17

Unfortunately, the children who need dental care the most are not receiving it. Dental hygiene treatment can help alleviate this problem, especially in states where dental hygienists can provide outreach care. Hygienists can work outside dental offices to offer preventive and promotional programs in schools, day care centers, preschools and Early Head Start and Head Start programs. They can work with dentists to help attain urgent and restorative treatment for young patients.

Oral health and its relationship to total health underscore the need for quality graduate education in dental hygiene. Research has linked periodontal disease to heart and lung disease, diabetes, premature and low birth weight babies, and a number of other systemic diseases.18 With their advanced degrees, graduate dental hygienists could work to help prevent and control these diseases.

Justification for the graduate degree

Every goal from the Oral Health section of Healthy People 2010 can be accomplished by utilizing the skills of dental hygienists.19 Dental hygienists prepared at the master’s level would be able to teach dental hygienists, dentists and dental assistants to meet these objectives. They would be in key positions to help meet these goals through intervention with the public. They would have the foundation to provide expertise in dental health matters to government agencies, dental industry and consumer advocacy entities.

Dental hygiene is an emerging discipline. Given the recent attention to dental care delivery and the supportive documents written by the U.S. Surgeon General, society is realizing that dental hygiene is necessary for the prevention of diseases and the wellness of the population. Dental hygiene calls attention to the value of prevention. Since its inception, dental hygiene has worked to increase access to dental care provided by educated dental hygiene professionals, decrease barriers to the optimum level of dental hygiene care, and continue to provide care based on the dental hygiene sciences. Graduate level dental hygienists, experts in the dental hygiene sciences, are needed to meet these objectives.

The purpose of the master of science degree programs in dental hygiene are to encourage dental hygienists to teach, conduct research, and provide care as advanced dental hygiene practitioners. Oral health remains a major unmet need in the United States. Graduate prepared dental hygienists are needed to teach in dental hygiene programs, develop programs to prevent dental diseases, and conduct research that will have a positive effect on the prevention and treatment of dental diseases.

Christine Nathe is author of “Dental Public Health” (www.prenhall.com/nathe). She is associate professor and graduate program director at the University of New Mexico, Division of Dental Hygiene, in Albuquerque, N.M. She can be reached at [email protected].

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