Full Title: Advancing Dental Hygiene Practice: Regulatory, Educational, and Policy Pathways

Authors: Theekshana Fernando, DrPH, MBBS, MPH, Sage Shirey, MA, Simona Surdu, PhD, MD, Jean Moore, DrPH, FAAN

JDH Issue: October 2026

Program Track: Research

Abstract: Purpose: Purpose Developments in dental hygiene (DH) practice over the past decade have influenced the professional landscape, particularly regarding scope of practice (SOP), access to care, and workforce utilization. The purpose of this study was to explore how recent regulatory changes, care delivery innovations, and technological advancements have impacted DH practice, identify persistent barriers, and recommend strategies to advance DH SOP. Methods: This qualitative study employed semi-structured key informant interviews with national DH leaders. Purposive sampling was used to recruit members of the American Dental Hygienists’ Association Board of Directors to ensure diverse expertise and leadership perspectives. Five of the 15 invited participants were enrolled in the study. Virtual interviews were conducted in May and June 2025. Transcripts were verified for accuracy and analyzed using thematic analysis with both deductive and inductive coding approaches. Results: Four primary themes emerged: 1) regulatory constraints and representation on dental boards, 2) barriers to care delivery in underserved communities, 3) impact of technology, and 4) strategic recommendations for expanding SOP. Participants described significant variation in state laws, limited DH representation on dental boards, and a disconnect between education and legal practice authority. Regulatory barriers were reported to constrain care delivery in community-based settings. Technological innovations, including teledentistry and digital diagnostics, were viewed as enhancing care but limited by cost and reimbursement challenges. Key recommendations included establishing independent DH regulatory boards; expanding educational pathways to enhance professional recognition and care capacity; advancing licensure portability through interstate compacts; and increasing Medicaid reimbursement and direct reimbursement to dental hygienists. Conclusion: Despite progress in DH practice and innovation, regulatory variability and structural barriers continue to limit professional autonomy and access to preventive oral health services. Coordinated policy reform is needed to fully leverage dental hygienists as essential contributors to a prevention-focused oral health system..

Learning Objectives:

• Analyze how scope-of-practice regulations influence dental hygienists’ professional autonomy, workforce mobility, and delivery of preventive care.
• Evaluate regulatory, financial, and technological barriers affecting dental hygiene services in underserved and community-based settings.
• Recommend policy and professional strategies that support expanded dental hygiene practice and improved access to preventive oral health services.

CE Credit Hours: 2.0

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The American Dental Hygienists’ Association is an approved provider of dental continuing education as recognized by the Dental Board of California, Provider #5238.