Monday, October 25, 1999

Hygenists bristle at proposed changes

By MELISSA KOSSLER
NEWS-JOURNAL STAFF WRITER

Dental hygienists, who often spend more time with patients than the dentist, may soon cut their teeth on the job, rather than in the classroom.

The American Dental Association has opened the door for alternative training programs that could allow dental assistants to become hygienists via on-the-job training.

Dental hygienists, who undergo two years of schooling, including 600 hours of supervised clinical dental hygiene instruction, clean teeth and gums and take and develop X-rays. Dental assistants spend one year learning how to assist the dentist and offer office support.

The hygienist program is different in "scope and depth," said Mary Pryor, director of the dental assistant and dental hygiene programs at Daytona Beach Community College.

The possible change has dental hygienists bristling. Hygienists feel future hygienists need the same amount of schooling or more, especially since the field has become more complicated because of the increasing complexity of overall health.

"The value of the traditional education is being thorough and being consistent and taking the amount of time to absorb the critical functions of dental hygiene," said Jan Siegal, a registered dental hygienist and president of the Volusia County Dental Hygiene Association. "Not to mention the fact that we use sharp instruments in the patient´s mouth."

In Florida, the only alternative hygienist training program currently being considered is distance learning a correspondence-type course that would use videotapes or the Internet to teach students, said Howard Bell, a former longtime member of the Florida Dental Association´s Council on Dental Education. The pilot program is being drafted for St. Petersburg Junior College. The school has applied for grant funding, Bell said.

The program is "virtually identical" to traditional programs, he said. The main difference is students would take classes at home at their convenience and do their lab work in large blocks of time throughout the course. The students would have to travel to a school setting periodically for the clinical part of the course, he said.

Siegal, who was unfamiliar with the details of the proposed St. Petersburg program, said including hands-on training under the supervision of a teacher is a crucial element of dental hygiene training.

Dental hygienists are more concerned about another type of training that is occurring in Alabama and being talked about around the country, she said. That program allows dentists to train dental assistants to become dental hygienists in their offices.

The American Dental Hygiene Association opposes this because of the on-the-job training component, the reduced course work and the dentist serving as teacher.

"We do not want to see any relaxation of the education," said Tracey Remark, a registered dental hygienist.

The Alabama Dental Hygiene Program and its precursor programs have enjoyed success for 25 years, Bell said. Alabama dental officials initiated the program because of a shortage of hygienists in some areas of the state, he said. The program is open to dental assistants, who have spent a year working with a dentist.

The students are people who are already in the field and already have dental skills," Bell said. They don´t go off to school to learn their new skills. A dentist agrees to teach them."

Dentists wishing to train students must take a course on how to teach the skills.

The ADA views alternate education plans as an opportunity to open the profession up to more people. The concern is there are shortages of hygienists in pockets throughout the country, Bell said.

Siegal and the ADHA disagree there is a lack of hygienists. Ten or 15 years ago, the number of hygienists was a concern, Siegal said.

"It´s very rapidly turned into a situation where a hygienist can´t really find a job," she said.

The ADHA has accused dentists of pursuing alternate education programs to provide a cheaper labor pool. Bell disagrees. In Alabama, where both programs exist, hygienist trained by dentist are not viewed as a cheap labor source, he said.

Hygienists across the country are mounting campaigns against the proposed changes. Hygienists are being urged to write their legislators and encourage their patients to do the same.

And locally, Remark, a Daytona Beach city commissioner, initiated a resolution supporting the current education standards for hygienists.

Siegal had stickers printed with the words, "I saw my RDH today," to pass out to patients after their teeth cleaning. She wants to educate patients about hygienists and their schooling, particularly during October, which is National Dental Hygiene Month.

"We´re referred to as the girl that cleans the teeth, the tech, the nurse, the assistant´ all those words just couldn´t be more inappropriate given what each of us has done to obtain our licenses," Siegal said.

1. Dental hygienist -- Dental hygienists are trained to remove deposits from tooth surfaces; provide methods of oral physiotherapy; expose, process and mount X-rays; provide oral health instructions and acquire knowledge as well as methods of infection control practice. They are licensed professionals who, under the supervision of a licensed dentist, provide oral health care services and treatment to patients in dental offices and health facilities.

At the end of their education, hygienists take national boards and state licensing exams. In Florida, they are required to take 24 hours of continuing education every two years.

2. Dental assistant -- The dental assistant takes a one-year program with training to pass and receive instruments; expose, process and mount X-rays; provide oral health care instructions; mix dental materials; maintain patient records and order supplies; prepare instruments for sterilization; and acquire knowledge of infection control practices. They must pass a certification test.

In Florida, they are required to take 24 hours of continuing education every two years. Under a new proposal, dental assistants could become hygienists with one year of on-the-job training and a class session weekend each month.

The Job Center » On Course for College » Food For Thought » Meet Me At The Mall »