Dental hygienist program expands access to preventive dental care

By Tom Lyons

UMass Medical School

January 15, 2013

Carol Gilmore had been a dental hygienist for about 10 years when the Halifax resident heard about a new program designed to allow experienced dental hygienists to practice independently in the community.

Following changes in Massachusetts law in 2009 and the adoption of new rules in 2010, the Public Health Dental Hygienist Program began operating in 2011 as a demonstration project through a grant from UMass Medical School.

The purpose of the program is to allow hygienists who meet certain standards to operate independently, in public health settings outside of dental offices. The goal is to increase access to basic dental care in the commonwealth, particularly among residents at highest risk for dental diseases, such as low-income children, seniors and the developmentally disabled.

“I became a dental hygienist because I wanted a career where I could make a difference,” said Gilmore. “This new program allowed me to make a bigger difference in my community, and it helped me take my career to a whole new level.”

Increasing access to dental care

According to the 2010 report The Health of Massachusetts, dental decay is the most common chronic disease among children, occurring at five times the rate of asthma. Another statewide survey reported that 59 percent of seniors living in long-term care facilities have untreated tooth decay.

While dental disease can be a problem for anyone, it disproportionately affects people of color and low-income groups. To address these findings and other dental disparities, public health dental hygienists perform their work in communities where access to care may be limited, either because of a lack of services or because of other barriers, such as low rates of dental insurance.

In settings such as schools, nursing homes, Head Start programs and residences of the homebound, public health dental hygienists provide preventive dental care to both children and adults. And their efforts are making an impact. During its first full year, the program served approximately 2,700 Massachusetts residents. In 2012, the number of people who received care topped 6,900—an increase of 155 percent.

Many of the patients served by public health dental hygienists have had limited access to dental care. Some older patients had never visited a dentist. When the program began in 2011, there were about 12 participating hygienists. Now, there are approximately 24 hygienists serving in every region of the state.

Gilmore and her practice partner, Liz Chouinard, were among the first group of dental hygienists in the state to be certified for the program. Together, they provide basic examinations, cleanings and other preventive services for patients at community locations throughout the Brockton area. For their pediatric patients, the hygienists also provide important education for them and their parents, and they often help parents find a dental home for their children with a dentist in the area.

“These dental hygienists perform such an important health service,” said Brent Martin, DDS, MBA, dental director for MassHealth, the Medicaid agency for Massachusetts. “They have proven that this program can assist patients, young and old, in getting the dental health care that they need, which is so important for good health. In addition, they also act as important bridges for continuing care and often refer patients to dentists in the area for ongoing services.”

For more information on the Public Health Dental Hygienist Program and how hygienists can participate, visit http://tinyurl.com/PHDental.