~ from Margaret J. Fehrenbach, RDH, MS

Information provided on this site is designed to support, not replace, the relationship that exists between a patient or site visitor and his or her existing physician or dentist.  I will not give out any medical or dental advice online since I have been advised the following:  "If you establish a patient-provider relationship with an online participant, you owe that person a duty of care. If such a relationship exists and the participant is harmed because of the advice you provided, he or she could sue you claiming that you did not meet the standard of care. And because you acted outside the scope of your employment-you provided health-related advice while off-duty-your malpractice insurance might not cover you. Depending on state law, you also may put your license at risk if you provide health-related advice to a participant who lives in a state where you do not hold a license, or if your advice does not fall within the scope of your practice."

Dental Hygiene Profession 2018

Dental hygienists are a community of professionals devoted to the prevention of disease and the promotion and improvement of the public's health. Dental hygienists are preventive oral health professionals who provide educational, clinical, and therapeutic services to the public. Dental hygienists strive to live meaningful, productive, satisfying lives that simultaneously serve us, our profession, our society, and the world. Dental hygienists' actions, behaviors, and attitudes are consistent with our commitment to public service.

As the largest national organization representing the professional interests of the more than 150,000 registered dental hygienists nationwide, the ADHA is actively involved in the healthcare dialog in America.

For further information, contact the American Dental Hygienists' Association (ADHA) 

LATEST: The ADHA has released a landmark white paper, “Transforming Dental Hygiene Education and the Profession for the 21st Century.” This document offers dental hygienists insight into the changes taking place within dental hygiene education and the profession; provides detailed information on why the transformation is necessary; and what steps are being taken to best position dental hygienists to take advantage of future opportunities.

In addition, ADHA now notes in its Strategic Plan that “The new vision is that dental hygienists are valued and integrated in the broader health care delivery system to improve the public’s oral and overall health.”

Definition of Dental Hygiene Practice

Dental hygiene is the science and practice of the recognition, treatment, and prevention of oral diseases. The dental hygienist is a preventive oral health professional who has graduated from an accredited dental hygiene program in an institution of higher education, licensed in dental hygiene who provides educational, clinical, research, administrative, and therapeutic services supporting total health through the promotion of optimal oral health.

In practice, dental hygienists integrate the roles of clinician, educator, advocate, manager, and researcher to prevent oral diseases and promote health. Dental hygienists work in partnership with dentists.

Dentists and dental hygienists practice together as colleagues, each offering professional expertise for the goal of providing optimum oral healthcare to the public. The distinct roles of the dental hygienist and dentist complement and augment the effectiveness of each professional and contributes to a co-therapist environment. Dental hygienists are viewed as experts in their field, are consulted about appropriate dental hygiene interventions, are expected to make clinical dental hygiene decisions, and are expected to plan, implement, and evaluate the dental hygiene component of the overall care plan.

The dental hygienist establishes the dental hygiene diagnosis which is an integral component of the comprehensive dental diagnosis established by the dentist. Each state has defined its own specific regulations for dental hygiene licensure. 

Career Links to Programs and Related Sites   /  Become ADHA Member in Good Standing / ADHA Student Membership Page  ADHA Dental Hygiene Education  / Professional Links


Science of Health Promotion and Disease Prevention

As early as 1819, an American dentist, Dr. Levi Spear Parmly, emphasized the importance of preventive oral health practices. By 1845, the public began to recognize the value of prevention and the dental profession was encouraged to focus more on preventive oral health care. Though growing numbers of dentists in the early 1900's wanted to provide preventive oral health care to their patients, they were too busy dealing with high levels of tooth decay and gum disease and performing mechanical and surgical dental procedures.

This is when Dr. Alfred C. Fones -the "Father of Dental Hygiene" -recognized that teaching children appropriate oral health behaviors was an important key to the prevention of dental disease over a lifetime. Dr. Fones' original concept included an exclusive role to work as preventive specialists to promote the importance of mouth cleanliness. These early prevention specialists were called "dental hygienists" to draw attention to the importance of mouth cleanliness as a therapeutic regimen for the prevention and treatment of some oral diseases. Dr. Fones opened the first school of dental hygiene in 1913 at Connecticut, USA, almost 100 years after Dr. Parmly introduced "prevention" to the dental community.

This is the root of the dental hygiene profession and its focus on public health education.  The ADHA recognizes the professional roles of the dental hygienist to include, but not be limited to, those of clinician, educator, advocate, administrator/manager, and researcher, with public health being an integral component of all these roles.

Dental Hygiene Career Path Options (ADHA)


The Process of Care

The purpose of the dental hygiene process of care is to provide a framework where the individualized needs of the patient can be met; and to identify the causative or influencing factors of a condition that can be reduced, eliminated, or prevented by the dental hygienist.

The dental hygiene process of care has six components:

  1. 1.Assessment: Systematic collection, analysis and documentation of the oral and general health status and patient needs. The dental hygienist conducts a thorough, individualized assessment of the person with or at risk for oral disease or complications. The assessment process requires ongoing collection and interpretation of relevant data. A variety of methods may be used including radiographs, diagnostic tools, and instruments.

  2. 2.Dental Hygiene Diagnosis: Component of the overall dental diagnosis. The dental hygiene diagnosis is the identification of an existing or potential oral health problem that a dental hygienist is educationally qualified and licensed to treat. The dental hygiene diagnosis requires analysis of all available assessment data and the use of critical decision making skills in order to reach conclusions about the patients dental hygiene treatment needs.

  3. 3.Planning: Establishment of goals and outcomes based on patient needs, expectations, values, and current scientific evidence. The dental hygiene plan of care is based on assessment findings and the dental hygiene diagnosis. The dental hygiene treatment plan is integrated into the overall dental treatment plan. Dental hygienists make clinical decisions within the context of ethical and legal principles.

  4. 4.Implementation: Delivery of dental hygiene services based on the dental hygiene care plan in a manner minimizing risk and optimizing oral health.

  5. 5.Evaluation: Process of reviewing and documenting the outcomes of dental hygiene care, which occurs throughout the process of care.

  6. 6.Documentation: Complete and accurate recording of all collected data, treatment planned and provided, recommendations, and other information relevant to patient care and treatment.

The dental hygiene process of care as a cycle in which the dental hygienist might pass through each of these steps several times during a course of treatment. Over a period of months or years a dental hygienist may have evaluated his or her work several times, altering the diagnosis and plan numerous times as the patient's condition changes.

ADHA Standards For Clinical Dental Hygiene Practice  /  "Hyposalivation with Xerostomia Screening Tool" from ADHA and Margaret J. Fehrenbach, RDH, MS

  1. *From the ADHA Bylaws and Code of Ethics


Updated 6/1/2018  Production by Fehrenbach and Associates


Top 10 Things to Know About Your Dental Hygienist*

  1. 1.Highly Educated Professionals -- The minimum level of education for licensure is equivalent to a four-year degree with two years specializing in dental hygiene.

  2. 2.Committed to Expanding Access to Care -- Specially licensed hygienists can go into underserved communities and provide dental hygiene services to some of the millions of Americans who would otherwise have no access to dental care in certain states. However, some states limit this important access to care.

  3. 3.Screen for Oral Cancer -- Dental hygienists possess the skills to be the first healthcare professional to identify potential signs of oral cancer and refer a patient to a physician.

  4. 4.Promote Healthy Nutrition -- Dental hygienists can tell if a patient is eating poorly or is malnourished; they can then offer helpful advice and information.

  5. 5.Spot Signs of Eating Disorders -- Also related to nutritional issues, eating disorders can also be recognized in the mouth during examination.

  6. 6.Recognize Signs of Diabetes -- Dental hygienists can alert patients that they might be in danger from diabetes, and refer them to seek confirmation from a physician. Furthermore, dental hygienists are qualified to detect a wide range of other life-threatening conditions, including high blood pressure and HIV.

  7. 7.Promote Tobacco Cessation -- When examining patients who use tobacco products, dental hygienists will counsel them to quit and provide resources and information about steps they can take to stop tobacco use.

  8. 8.Prevent Periodontal (Gum) Disease -- By providing nonsurgical periodontal care and examining teeth and gums, dental hygienists play a major role in preventing common oral diseases and reducing the risk of many systemic diseases related to periodontal disease.

  9. 9.Understand the Link Between Oral Health and Emotional Health in Children -- Dental hygienists are passionate about promoting good oral health among children, who can often suffer speech impediments, social ridicule, diminished self esteem and other problems related to poor oral health.

  10. 10.Represented by ADHA, the Official Voice of Dental Hygiene -- Dental hygienists have been making continuous strides toward becoming the skilled, autonomous, and essential healthcare professionals that they are today (see above discussion). 

  11. *Courtesy of California Dental Hygienists' Association



Dental Hygiene Code of Ethics*

Dental hygienists recognize the importance of the following beliefs that guide our practice and provide context for our ethics:

  1. 1.To increase our professional and ethical consciousness and sense of ethical responsibility.

  2. 2.To lead us to recognize ethical issues and choices and to guide us in making more informed ethical decisions.

  3. 3.To establish a standard for professional judgment and conduct.

  4. 4.To provide a statement of the ethical behavior the public can expect from us.

The Dental Hygiene Code of Ethics is meant to influence us throughout our careers.  

It stimulates our continuing study of ethical issues and challenges us to explore our ethical responsibilities. The Code establishes concise standards of behavior to guide the public's expectations of our profession and supports existing dental hygiene practice, laws, and regulations.

By holding ourselves accountable to meeting the standards stated in the Code, we enhance the public's trust on which our professional privilege and status are founded.