CHICAGO, US – A recent report from the American Dental Association (ADA) Health Policy Institute reveals a concerning decline in enrolment in dental hygiene programs, contributing to a workforce shortage that is limiting patient care by approximately 10%. In response to this issue, the ADA passed three resolutions in November aimed at addressing the staffing crisis. However, these resolutions have sparked strong opposition from the American Dental Hygienists’ Association (ADHA), which argues that the proposals could jeopardize dental education standards, patient safety, and the integrity of the dental hygienist profession.
The resolutions—401H-2024, 513H-2024, and 514H-2024—were approved by the ADA House of Delegates despite the ADHA’s vocal opposition. Resolution 401H-2024 calls for the Commission on Dental Accreditation (CODA) to increase the student-to-faculty ratio in dental hygiene programs to expand class sizes and offer more flexible education models. Resolution 513H-2024 advocates for allowing dental students and residents who have completed hygiene competencies to practice as dental hygienists. Resolution 514H-2024 encourages states to license foreign-trained dentists as dental hygienists.
In a statement urging the ADA to reconsider the resolutions, the ADHA warned that altering faculty-to-student ratios could compromise the quality of education and reduce the retention of experienced educators. The association also expressed concerns over the qualifications of dental students, residents, and foreign-trained dentists to provide safe and effective dental hygiene care. According to the ADHA, the use of non-CODA-accredited pathways for dental hygienist licensure could endanger patient safety and professional standards.
“Disheartening to see,” said one ADHA member on social media, sharing their frustration over the potential for foreign-trained dentists to perform dental hygiene services in the US without a proper license. Another member called for more dental hygiene schools, lower tuition fees, and increased acceptance rates, rather than relying on international dentists to fill staffing gaps.
In a letter to the healthcare community, ADHA President Erin Haley-Hitz reiterated the association’s stance, advocating for measures that would enhance professional development, improve workplace culture, and provide competitive benefits, rather than eroding standards in dental hygiene education.
ADA Responds: A Practical Solution to Staffing Shortages
Despite the ADHA’s objections, ADA President Dr. Brett H. Kessler defended the new resolutions, emphasizing their intent to empower states to address critical staffing shortages in dental hygiene. Dr. Kessler clarified that the resolutions were designed to be a practical solution, with safeguards in place to ensure that high professional standards are maintained.
Dr. Kessler assured the public that foreign-trained dentists seeking dental hygiene licenses would still need to pass board examinations and meet state licensure requirements. Similarly, dental students and residents would have to demonstrate completion of the necessary competencies before practicing as hygienists. He stressed that the ADA’s aim was not to compromise patient safety, but rather to offer a flexible approach for states facing staffing challenges.
“These resolutions do not advocate for unlicensed practice,” Dr. Kessler emphasized, “but rather seek to address staffing gaps by allowing appropriately vetted professionals to step into these roles, while maintaining high competency standards.”
The resolutions are non-binding, meaning they provide states with the flexibility to tailor solutions to their specific workforce needs without imposing national mandates. As the dental industry grapples with workforce shortages and evolving educational pathways, the debate over how to address these challenges continues to unfold.
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