Dave Marsh, a lobbyist for the Illinois Dental Society, recently offered a comment about dental hygienists that was quoted in the news media: “I just don’t feel anybody with a two-year associate’s degree is medically qualified to correct your health. They’re trained to clean teeth. They take a sharp little instrument and scrape your teeth. That’s what they do. That’s all they do.”1
As abhorrent and inaccurate as this comment is, there is an even bigger problem. The comment has pitted hygienists against dentists. However, I think this was meant to be a distraction. Any good lobbyist would know this comment would distract from the real issue, and proposed Illinois legislation expanding the scope of dental hygiene practice did indeed go nowhere as a result.
Though I will certainly address the inaccuracies of Mr. Marsh’s statement, I hope to also provide a different view. One that is at the core of many dental hygienists’ values ─ preventive dental/healthcare and the social disparities that are being ignored and overshadowed by Mr. Marsh’s comment.
When I read this article and saw this comment, I immediately sat down at my computer to compose a strongly worded yet respectful email to Mr. Marsh. I have zero regrets for my knee-jerk reaction, though, in retrospect, I wish I had waited a little longer to write the email as there were so many points I missed, some of which I would like to highlight here.
Lobbyists Like Dave Marsh Influence Public Perception
Most hygienists are aware of why this statement is disrespectful and factually incorrect. However, the general public has little understanding of our role in health care, as is evident in Mr. Marsh’s comments. I wanted to compile a list of the diseases we either screen for or assist in treating and diagnosing via “scraping teeth with a sharp little instrument.” Here is my preliminary list. I’m certain I have missed many.
- Cardiovascular disease
- High blood pressure
- Multiple cancers
- Alzheimer’s disease and dementia
- Rheumatoid arthritis
- Diabetes
- Inflammatory bowel disease
- Adverse pregnancy outcomes
- Non-alcoholic fatty liver disease
- Endothelial disfunction
- Metabolic alteration
- Aspiration pneumonia2
Honestly, the list goes on and on. What I find most interesting about this list is that it could double as the top diseases found in those with health disparities. For clarification, Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantages.”3 Two of the goals of Healthy People 2030 are, “Reduce the proportion of people who can’t get the dental care they need when they need it” and “Increase the proportion of low-income youth who have a preventive dental visit.”4
These points are important because the Illinois bill proposed that elicited the abhorrent comments by Dave Marsh was to expand care to millions of people living in “dental deserts.” Though I would personally like to rip Dave Marsh to shreds over his comment, I want to shine a light on how his comment and the pushback from the Illinois Dental Society will affect more than just dental hygienists; it will affect millions of people in Illinois and quite possibly more throughout the United States.
Long-term Effects of Roadblocks
When you dive into health disparities associated with access to dental care in nonmetro areas, you will find all states have no more than seven dentists per 10,000 people. More concerning is that seven states have one dentist per 10,000, and 10 have two dentists per 10,000 people.5 How can these dentists possibly reach the people in greatest need? Simply put, they can’t.
Instead of supporting more autonomy and allowing dental hygienists to practice at the top of their license, they are putting up a roadblock. This roadblock may feel personal to many hygienists, but I implore you to consider the bigger picture. This roadblock is blocking care for millions of people who live in rural communities and have multiple health disparities they must overcome.
Furthermore, not all dental hygienists have a “two-year associate’s degree,” as Mr. Marsh points out. Many have bachelor’s degrees; some have achieved even higher education, such as master’s degrees as well as doctorates. An interesting fact regarding a “two-year associate’s degree” is that to achieve this degree in the general sense, one must acquire 64 credit hours. However, dental hygiene programs that award an associate in science degree require 84 credit hours. Though this is obviously 36 credit hours short of a bachelor’s degree, I still feel it is noteworthy when faced with assertions that our education is subpar.
I would like to highlight that nursing programs require 72 credit hours to acquire an associate’s degree. I wonder if Mr. Marsh would be willing to assert that registered nurses are not “medically qualified to correct your health,” considering their education requires fewer credit hours? I seriously doubt it.
Who’s Really Insulted?
Though Mr. Marsh’s comments state a dental hygienist’s education doesn’t qualify them to “correct your health,” he couldn’t be further off the mark. Mr. Marsh is sitting in his nice office fighting a battle he can’t comprehend because he isn’t on the other side of that roadblock he just put up. You see, Mr. Marsh has access to health care and dental care. He doesn’t understand the struggle of many living in dental deserts.
Mr. Marsh’s comments were ignorant and factually inaccurate. But don’t be fooled; this isn’t about dentists versus hygienists and our abilities to provide care. His statement is really telling people in rural communities faced with multiple health disparities that they aren’t worthy of some form of access to dental care. For Mr. Marsh and the many dental societies across the country, dental care is a luxury, not a human right, and that is more abhorrent than any statement he could make about dental hygienists.
If you would like to voice your concerns regarding this matter, feel free to reach out to Mr. Marsh at dmarsh@isds.org. Until we take a stand, this type of pushback will continue.
The same article included a statement from a state senator, Dave Syverson: “We’ll have, before long, hygienists doing the work that, if they wanted to do, they should have gone to dental school for.”6 This is a misrepresentation of the goals of most hygienists.1 To add insult to injury, Senator Syverson’s cousin was the dental society’s past president, which could influence his stance on this topic. Personally, I have zero desire to do the tasks of a dentist; my role is preventive care.
The claim hygienists are overreaching and trying to impede upon the duties of dentists as a reason to block care to the underserved is a blatant violation of basic human rights. This bill encompasses everything I believe in ─ better access to care, primary and secondary prevention measures, as well as an opportunity to educate an underserved population that will likely never see a dentist willing to provide this type of care.
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References
- Hygienists Brace for Pitched Battles with Dentists in Fight Over Practice Laws. (2021, October 19). Kaiser Family News. Retrieved from https://khn.org/news/article/hygienists-brace-for-pitched-battles-with-dentists-in-fights-over-practice-laws/
- Hajishengallis, G., Chavakis T. Local and Systemic Mechanisms Linking Periodontal Disease and Inflammatory Comorbidities. Nat Rev Immunol. 2021; 21(7): 426-440. doi:10.1038/s41577-020-00488-6. Retrieved from https://www.nature.com/articles/s41577-020-00488-6
- Disparities. (n.d.). Office of Disease Prevention and Health Promotion. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
- Health Care Access and Quality. (n.d.) Office of Disease Prevention and Health Promotion. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality
- Rural Data Explorer 2019. Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/data-explorer?id=199&classification=Nonmetropolitan
- Senator Dave Syverson’s contact information can be found here: https://www.ilga.gov/senate/Senator.asp?MemberID=2798
