Dental Hygienists and Dental Therapists

Dear Dr. Alvares:

I was very interested to read the “Critical Issues” and “Commentary” articles about Pediatric Oral Health Therapists in the January 2004 issue of the Journal of Dental Education (vol. 68, no. 1). I have been interested in the concept of dental therapists ever since I spent several months touring Australia and visiting dental hygiene programs there. Australia trains both dental hygienists and dental therapists, who currently provide services as discussed by Dr. Nash: dental hygienists in private practice prevention, and dental therapists providing restorative services for children in (mostly) school-based settings.

However, I learned that there is a growing movement there to combine the two training programs and cotrain these professionals in an effort to broaden the reach and scope of those who practice within the school-based clinic practices traditionally occupied by the therapists. There was significant discussion when I was there about offering “short courses” that would train currently practicing dental hygienists as dental therapists and vice versa. At least one of the dental schools had that option already in place.

In many ways, this approach makes very good sense. I appreciate Dr. Nash’s comment that dental hygienists are “too valuable” to lose in the private practice prevention role they already have; however, there may be dental hygienists who are interested in broadening their skills and impact on oral health status. Obviously, these dental hygienists already have much of the knowledge and are proficient in many of the skills that would be taught in a dental therapist program. To require “full course” dental therapist education may limit the opportunity of some of these dental hygienists to participate. In addition, as Dr. Nash already points out, training some dental hygienists as therapists could make these professionals more quickly available and make training less expensive.

Australia has at least begun the process of realizing that a dental therapist and a dental hygienist have much in common and is putting systems in place to co-train them and provide opportunities for additional training of practicing professionals in both areas to broaden their potential positive effect on the oral health of the public.

I would argue that such a system, if developed in the United States, should do no less.

—Charlotte J. Wyche, R.D.H., M.S.

Associate Professor, Dental Hygiene
University of Detroit Mercy School of Dentistry
8200 West Outer Drive, P.O. Box 19900
Detroit, MI 48219-0900
313-494-6691; wychecj@udmercy.edu