Expanded Scopes of Practice for Dental Hygienists Associated With Improved Oral Health Outcomes for Adults

Dental hygienists are important members of the oral health care team, providing preventive and prophylactic services and oral health education. However, scope-of-practice parameters in some states limit their ability to provide needed services effectively. In 2001 we developed the Dental Hygiene Professional Practice Index, a numerical tool to measure the state-level professional practice environment for dental hygienists. We used the index to score state-level scopes of practice in all fifty states and the District of Columbia in 2001 and 2014. The mean composite score on the index increased from 43.5 in 2001 to 57.6 in 2014, on a 100-point scale. We also analyzed the association of each state’s composite score with an oral health outcome: tooth extractions among the adult population because of decay or disease. After we controlled for individual- and state-level factors, we found in multilevel modeling that more autonomous dental hygienist scope of practice had a positive and significant association with population oral health in both 2001 and 2014.