The Heart of the Hygienist: Dental Hygiene’s Role in Public Health by Casandra Smith, RDH, AS

Conventional in-office treatment is simply impossible for some people for a myriad of reasons: a lack of insurance coverage and/or financial obstacles being the most common.

Currently, an estimated 108 million Americans are living without dental coverage.1 However, lack of transportation, disabilities, and language barriers are also access-to-care issues for many people. It is for these reasons that public-health services are a necessity. Organizations willing to bridge these access-to-care gaps may be the only way these people will receive the hygiene treatment they need.

Dreaming with my eyes open
I admit, I was once that new dental hygiene student dreaming of a fancy office with all the high-tech gadgets. It wasn't until I began to treat patients in the hygiene clinic of my college that I realized that the public-health field might just be in my career plan.

During my time in the clinic, I treated many patients from underserved communities. Most of these patients were very embarrassed about the condition of their oral health, and often even apologetic for their inability to obtain regular hygiene treatment. While treating these patients, I got to know them and listened to their stories.

They all came from different walks of life, but they had one common thread—limited access to care. All had tried to receive some type of dental treatment at one time or another but were unable to do so, due to obstacles too large for them to overcome. After treatment, these patients were extremely grateful. I received many hugs and heard “thank you” many times, and even witnessed a few tears of joy. It was then that I realized what an important, positive impact a dental hygienist can make on a community.

Reaching out
Currently, I am working with the County Sealant Program, traveling to elementary schools and placing dental sealants on the teeth of second graders and sixth graders. Every school year, I see children with abscesses, rampant decay, and poor oral hygiene.

Some of these children get to see a dentist only when they are in pain, so of course they associate needles and pain with the dentist. These children have extreme dental fear, and it is my job to make them feel comfortable and safe while they're in my hygiene chair. This means I have accumulated an arsenal of funny voices, funny faces, and dental jokes, because making a child smile helps to chip away at that fearful exterior and allows me an opportunity to give him or her some oral-hygiene education and place much-needed sealants. Since most of these children have no dental insurance, I know that every dental sealant placed is very important.

Ways to help
Even though many people believe that being a clinician is the only way a dental hygienist can become a part of the public-health field, there are actually many ways a hygienist can overcome access-to-care issues and help the public receive hygiene treatment. The following chart depicts the many professional roles that work together to further public health.

Educator: Teaches hygienists and future hygienists how to create and implement outreach programs, as well as how to assess and provide adequate nonsurgical periodontal therapy to the public.

Researcher: Conducts research to detect populations in need, enhance treatment modalities, and improve efficacy and efficiency to better the oral health of the population.

Administrator/Manager: Creates and implements public-health programs aimed at improving the oral health of the underserved.

Advocate: Lobbies to change laws, helps form public policy, and protects public-health funding to help eliminate access-to-care issues.

Clinician: Assesses oral-health needs and provides nonsurgical periodontal therapies in a public-health setting.

No matter what role a dental hygienist plays in public health, it is a significant one. Each role helps to grow public health, but when all the roles work together, the boundaries of public health can be transcended.

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Casandra Smith works as a dental hygienist in private practice, as well as with the Dental Sealant Program administered through the Maricopa County Office of Oral Health (in Arizona). She enjoys volunteering and hopes to one day develop and implement a mobile dental-hygiene outreach program.

Sally Gross, Member Services Specialist
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