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THX D~NTAL H Y C I ~ I S T IN PUBLIC HXALTH PROGRAMS*

Elizabeth Warner**

The e a r l i e s t concept of the dontal hygionis t ' s ro le in the dental health f i e l d was primarily one o f public service, hygienists graduated in 1913, ten young women were employed by the c i t y of Bridgeport , Connecticut , t o provide prophylactic treatments and oral hygiene ins t ruc t ion for school children,

Out of the f i r s t c l a s s of

Since that time, the dental hygienist's public health a c t i v i t i e s have oxpanded and s h e , i s now employed f o r service in official and voluntary heal th agencies, a6 well a s in school hea l th programs. public health service w a s opened f o r the dental bygienist wi th the discovery o f top ica l f luoride application a0 a preventive dental procedure, advanced t ra ining programs fm dental hygienists have made it possible t o e q a n d the scope o f her public hea l th dut ies , espooially in the area o f dental heal th oducation.

An importmt new area of

Also,

A report rocently submitted by the Subcommittee on Xducational Qualifi- cat ions of Public Health Dental Sygfeniste, Committes on Professlonal Education of the American- Public Health Association, provides a comprehensive description of the poten t ia l functions of denta l hygienists working, under the supervision o f dent ie t s , in public health programs.

Cl inical services which.may be provided by dental bygionists i n public haalth programs include dental prophylaxia and other oral hygiene rnea~wee, Lpplication of c a r i e s preventive measures such as topical . f luor ide applications, and the demonstration of new preventive procedures to other hygienists aad alliod heal th worker a,

I n planning f o r community denta l heal th programs, bygienista may assist in dental surveys, including the col lect ion, recording, analysis and interpreta- t i on of the data t o the community. d o n t a l hygienists may be concerned with both professional and lay groups. Dental hygienists plan and conduc t prc-service and in-service t ra ining programo i n denta l heal th f o r other public heal th personnel, and school personnel. Plan- ning and carrying out dental public heal th a c t i v i t i e s and f i e l d exper ien%a fo r student hygicnists and nurses a l so m a y be a function of the public health dental hygienist. She m a y serve as a dental hea l th advisor f o r community heal th education programs having dental heal th aspecte such as well-child conforencos, oxpectant parent c las8es , and similar programs oponsored by tho health department

Educational a c t i v i t i e s o f public health

I n school dental heal th programa, dental hygienists may provide c l i n i c a l services such as dental inspections; they may maintain r e f e r r a l and fol low- through systems f o r dental care, serve as resource persons in dental health t o teachers and o ther school personnel, and provide schools with dental health educational materials fo r classroom uae,

*Originally published i n Dental Health Memorandum, July 15, 1956, **Supervising Dental Hygienist, Division of Dental Public Health, U. S. Fublic Bealth Service, Department o f Health, Education, and Wolfars.

This description of functions includes a l l the a c t i v i t i e s in which dental hygienists might be engaged i n dental public health programs. involved in a part icular public health dental hygiene posit ion a re determined by the administrative policy and program of the health agency by which the dental hygienist is employed, and the background of education and experience and the consequent capabi l i t i es of the dental hygienist assigned t o tho job.

The dutiee

From the time o f i t 3 inception as a prac t ica l , unorganized course o f training, dental hygiene education has evolved through a one year course of study t o i ts present s t a tus as a etandardized two year col legiate curriculum. During the past f iye years, the bachelor's degreo program in dental hygiene has become increasingly popular. I t i s t h i s program which provides the great- e s t potent ia l for educating public heal th dent& Wgienists. uniform curriculum has been established f o r the two years o f college work, i n addition t o the dental hygiene curriculum, which aro included i n the degree program. The quality and quantity of public health education which the degroe graduate receives usually is in proportion to tho f a c i l i t i e s fo r such e d u c e t ian available i n the particular school. However, even in those schools which have the poten t ia l for providing excellent public hoalth t ra ining f o r the i r degree graduates, only a few have begun t o take f u l l advantage of the i r resources i n th i s area. As a consoquence, the present degree graduate has a broader background of education than the c e r t i f i c a t e graduate bu t , i n most instances, she is not proportionately be t te r prepared specif ical ly f o r public health work. educators w i l l evaluate the objectives of the degree program, a B has been done for the c e r t i f i c a t e course, and develop curricula, accordingly. Another important factor in the potent ia l development o f the public health dental hygienist i s the extent to which her services are accepted by public health dentists. This f ac t will influence the actual extenaion of dental public health services, as well as tho numbor of trained public health dental hygienists who w i l l f ind suff ic ient sa t i s fac t ion i n public heal th jobs t o enter and remain in the f i e l d , With the exception of ce r t a in c l in i ca l procedures in public health dental care programs, well trained dental hygienists legally and technically can carry out most of tho other a c t i v i t i e s associated with dental public health programs. cffectivo than the dent is t . In heal th education programs, f o r example, the hygienist ' 8 background of t ra ining in educational methods plus a concept of dental theory which i s l ike ly t o be closer to lay understanding of dental health f a c t s than that of the dent i s t , a re asse ts i n her ro le as dental health oducator. Delegation of such duties to auxiliary personnel is important in thc extension of improved dental public health servicoa t o a greator percentago of tho population.

To date, no

Within tho next few years, i t seems l i k e l y that dental hygiene

In some instancGs, the dental hygienist may be more

A review of s ta te dental program8 i n 1955 showed that there were approxi- mately 70 dental hygienists, as compared t o 140 dent i s ta , on the s t a f f = of s t a t e health departments. being carr ied on in s t a t e dental programs arc of such a technical nature that thog require the special sk i l l a of dent i s t s o r that dent is ta are being employod t o carry on many a c t i v i t i e s which could be done as well by auxiliary peroonnol. Undoubtedly, the l a t t e r i s true to somo degree. Through discriminate ut i l iza- tion of dontiots ' s k i l l s and increaoed and completo u t i l i za t ion of dental

These figures imply e i ther that many of the ac t iv i t i e s

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hygienists ' skills i n dental public heal th programs, the buying power of the public heal th dol lar can be increasod and dental public heal th services can be extended to more people.

The potent ia l contribution o f dental hygienists 50 publis heal th pograms i s mcch g e a t e r than presently realized. dental hygienists and the development of a more comprehensive scope o f service f o r dentai hygienists i n public heal th a re ossenfial t o increased and improved u t i l i z a t i o n of t h i s group o f public heal th workers. The two f ac tb r s are inter- re la ted and dependent upon each other and the development of both w i l l t o stimulated by pressure from public heal th den t i s t s for a greater sunply o f be t t e r trained pLblic heal th dental hygienists.

Better public health t7aining f o r