Illinois hygienists denied opportunity to practice more widely

Kaiser Health News published an article on what might appear to be an obscure policy battle between Illinois dentists and dental hygienists. At issue is whether or not dental hygienists can perform their work in nursing homes, prisons, and mobile dental vans without the supervision of dentists. Not surprisingly, dental hygienists would like that autonomy whereas the Illinois State Dental Society has argued that "it would be dangerous for hygienists to treat nursing home residents, who are often elderly and sick."

On the face of it, the position of the state dental society seems ludicrous, especially when their proposed solution is to raise taxes to reimburse dentists at higher rates for seeing Medicaid patients. I suspect Medicaid reimbursement is indeed too low, but the proposed policy does not ask dentists to take on more work for free or reduced payment. The policy question simply expands the venues in which dental hygienists can work without a supervising dentist (which is already allowed in a variety of contexts and in other states). The article quotes a researcher who found that "as dental hygienists gained more autonomy, fewer people had teeth removed because of decay or disease." It seems the burden of proof should be on the dental society that this expansion of autonomy poses a credible safety threat.

It seems that the Illinois State Dental Society may have won this round -- not through research, but through lobbying efforts. From a distant viewpoint, it sure seems like the Illinois State Dental Society favors denying access to useful services for its own financial interests.