CHAPTER 1 Historical Perspectives on Dental Hygiene and Periodontology C o p y r i g h t © 2 0 1 4 , 2 0 0 7 , 2 0 0 1 , 1 9 9 6 b y S a u n d e r s , a n i m p r i n t o f E l s e v i e r I n c .
C HAPTER 1 Historical Perspectives on Dental Hygiene and Periodontology Copyright © 2014, 2007, 2001, 1996 by Saunders, an imprint of Elsevier Inc.
Dec 19, 2015
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
CHAPTER 1
Historical Perspectives on Dental Hygiene and Periodontology
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an im
print of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT
Evidence of Periodontal Disease Anthropology, the study of humanity, provides
insights into dental diseases. In 1948, anthropologist B. W. Weinberger described
a study of prehistoric skulls with teeth that showed extensive dental caries, evidence of alveolar bone resorption, periapical abscesses, supernumerary teeth, and impacted teeth.
2
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT (CONT.)
Treatment of Periodontal Disease Anthropologic expeditions to Mesopotamian sites
in Iraq found relics, such as gold toothpicks, dating back to approximately 3000 BCE.
3
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT (CONT.)
Treatment of Periodontal Disease (Cont.) A twentieth-century study of periodontoclasia, an early term for periodontitis, suggested that Hippocrates (460-377 BCE), a Greek physician,may have provided one of the first known effective periodontal treatments. Hippocrates was also the first person known to
prescribe a dentifrice.
4
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT (CONT.)
Treatment of Periodontal Disease (Cont.) Aristotle (348-322 BCE) described “scrapers” used
for teeth cleaning. Surviving examples show that these instruments were
similar to modern scalers.
5
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT (CONT.)
Treatment of Periodontal Disease (Cont.) Fiber sticks, recorded in
Babylonian, Chinese, Greek, and Roman literature, were the earliest known toothbrushes.
These toothbrushes were made from trees or bushes with bark containing a cleansing substance that acted as a kind of dentifrice. 6
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ANCIENT EVIDENCE OF PERIODONTAL DISEASE AND ITS TREATMENT (CONT.)
The Middle Ages Albucasis (936-1013 BCE), a Moorish surgeon
from Spain, described removing foreign substances (dental calculus) from teeth using a set of 14 scrappers that he designed.
Johannes Aranculus (1412-1484) related diet to oral health and disease.He recommended avoiding desserts and sweets such as honey.
7
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF MODERN DENTISTRY
Modern dentistry began in Europe. At that time, dentists were trained by
apprenticeship, learning by watching and assisting an established dentist.
8
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF MODERN DENTISTRY (CONT.)
Andreas Vesalius (1514-1564), a Flemish anatomist, and Bartolomeo Eustachio (1520-1574), an Italian anatomist, were responsible for early anatomic studies of the teeth.
Anton van Leeuwenhoek (1632-1723), a Dutch naturalist, discovered dentinal tubules when looking through his invention, the microscope.
9
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF MODERN DENTISTRY (CONT.)
Pierre Fauchard (1678-1761) is known as the “father of modern dentistry.” Fauchard recognized the importance of oral health and
described cleaning teeth in Le Chirurgien Dentiste, first published in 1728.
John Hunter (1728-1793), a surgeon and anatomist in London, England, recognized that dental caries were initiated on the outside of the tooth on the surfaces where food collected.
10
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF MODERN DENTISTRY (CONT.)
The pilgrims brought barber-surgeons to America in 1638.
The barber-surgeons provided bloodletting and tooth extraction services, along with shaving and hair treatments.
Paul Revere was among several of the early dentists.
11
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ESTABLISHING FORMAL DENTAL EDUCATION: 1800 TO 1900
During the early 1800s, dentists discovered that the apprentice method of learning in the office of a preceptor, a clinician-teacher, was inadequate.
In 1939, Paul Roscoe Stillman, a clinical researcher in the field of periodontology, stated that to be a profession, dentistry had to combine science and technological arts.
12
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ESTABLISHING FORMAL DENTAL EDUCATION: 1800 TO 1900 (CONT.)
The first dental school, the Baltimore Collegeof Dental Surgery, was opened in 1840. Five students attended the first class.
In 1867, Harvard University established a dental department. This department helped create respect for dentistry
among the medical professions. Between 1840 and 1867,13 more dental schools
were established.
13
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
INTERRELATIONSHIP OF EARLY PERIODONTICS TO DENTAL HYGIENE
In 1845, in the United States, John M. Riggs stated periodontal disease was a curable disease; with proper surgical treatment, 90% of the cases could be cured. Curettage was his original contribution to therapy.
Leonard Koecker, a nineteenth-century surgeon-dentist in London, is considered to be the first periodontist.
In an 1877 report to the American Dental Association (ADA), F. H. Rehwinkel renamed periodontoclasia to pyorrhea alveolaris. Pyorrhea became a commonly used term that is still
used today.14
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF THE PROFESSIONOF DENTAL HYGIENE
Alfred C. Fones is considered the founder of the role of the dental hygienist.
In 1898, Dr. Fones attended a meeting of the Northeastern Dental Society, during whichDr. D. D. Smith, a dentist, described his systemof prophylaxis (cleaning of the teeth).
Dr. Fones implemented this system in his own office.
15
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF THE PROFESSIONOF DENTAL HYGIENE (CONT.)
In 1906, Dr. Fones taught his dental assistant cousin, Irene Newman, to instruct and treat his patients to maintain their mouths in a clean state.
Ms. Newman’s first patients were children, and she only polished teeth.
Later, she began to scale teeth with instruments but was only permitted to remove gross deposits.
16
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENT OF THE PROFESSIONOF DENTAL HYGIENE (CONT.)
Dr. Fones customized an educational program that was presented at the National Dental Association Meeting in Cleveland, Ohio, in July 1911.
He established the first school for dental hygienists in Bridgeport, Connecticut, in 1913.
17
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
FIRST DENTAL HYGIENE SCHOOLS
Dr. Fones’ school graduated hygienists for 3 years before colleges and universities began to train dental hygienists in 1916.
18
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
FIRST DENTAL HYGIENE SCHOOLS (CONT.)
Robin Adair, an oral surgeon with both medical (MD) and dental surgery (DDS) doctoral degrees, presented “The Introduction of Oral Prophylaxis into Dental Practice” to the Florida State Dental Societyin June 1911.
In 1917, Adair opened the fourth dental hygiene program in the United States, in Atlanta. Only 17 students attended the program at that time.
19
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
LICENSURE AND REGULATION
Dentists were first granted licenses by public agencies in 1841.
By 1889, all states had adopted laws that eliminated the preceptorship training; as a result, all dentists completed formal education.
20
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
LICENSURE AND REGULATION (CONT.)
Connecticut was the first state to regulate dental hygiene practice, extending licensure and verification of educational credentials to hygienists in 1915.
New York, Massachusetts, and Maine adopted laws regulating dental hygiene practice in 1917.
21
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
SCHOOL PROGRAMS FOR CHILDREN From 1900 to 1930, the
philosophy was that a clean tooth would not decay.
Because of this belief, many school dental health education programs were established to teach toothbrushing and to promote preventive measures.
Three of these programs also educated dental hygienists in their clinics: Guggenheim and Eastman in New York state and Forsyth in Boston, Massachusetts.
22
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
RECOGNITION OF PERIODONTICSAS A SPECIALTY
Only a small percentage of the dentists of the early 1900s accepted the philosophy of treatment and prevention of periodontal diseases.
Pyorrhea alveolaris was commonly accepted asa systemic disease that should be treated by a physician.
23
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
RECOGNITION OF PERIODONTICSAS A SPECIALTY (CONT.)
In 1914, two women dentists, Grace Rogers and Gillette Hayden, formed the American Academy of Periodontology in Cleveland, Ohio.
The first textbook devoted to periodontal disease, A Textbook of Clinical Periodontia, was written by Paul Roscoe Stillman and John Oppie McCall, Jr., and published in 1922.
24
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
RECOGNITION OF PERIODONTICSAS A SPECIALTY (CONT.)
The first periodontal specialty programs were established in the 1940s.
Many early periodontists developed their own scalers.
25
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
INSTRUMENTS FOR EVALUATING ANDTREATING PERIODONTAL DISEASES
The periodontal probe began to be used in the 1950s for measuring probing depths, and, for the first time, periodontal destruction was quantified.
Periodontal probes varied in design and were often named after the dentist or school where they were developed.
26
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
INSTRUMENTS FOR EVALUATING ANDTREATING PERIODONTAL DISEASES (CONT.)
Examples of probes include the: Marquis Michigan Goldman-Fox World Health Organization (WHO)
The WHO probe is associated with an international system for evaluating periodontal treatment needs, known as the Community Index of Periodontal Treatment Needs (CIPTN).
27
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
INSTRUMENTS FOR EVALUATING ANDTREATING PERIODONTAL DISEASES (CONT.)
In the early 1960s, powered scalers using sonic or ultrasonic frequencies became available for calculus removal.
28
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENTS IN THE TREATMENTOF PERIODONTAL DISEASES
During the middle 1800s, Dr. John M. Riggs was a leading authority on periodontal disease and its treatment in the United States.
He originated and described treatment for the cure of inflammation of the gums, now called gingivitis.
He also originated and described treatment for the absorption of the alveolar process, which was known as “scurvy of the gums” and is now called periodontitis.
His treatment in 1845 emphasized calculus removal and subgingival curettage to reduce inflammation.
29
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
UNDERSTANDING THE CAUSESOF PERIODONTAL DISEASES
In 1894, G. V. Black, considered the “father of American dentistry,” published an article on periodontal disease, which he called “Phagedenic Pericementitis.”
He concluded that the disease process was a “purely local affectation of an infectious character” related to the “glands of the periodontal membrane.”
Black is considered among the early leaders in the science of dentistry.
30
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
UNDERSTANDING THE CAUSESOF PERIODONTAL DISEASES (CONT.)
T. B. Hartzell, the author of many articles on periodontal disease and its treatment, considered streptococcal infection to be an etiologic factor.
In 1935, he urged dentists to use the microbial principles of Pasteur and Dulaux.
Hartzell called periodontal disease a “germ ferment disease” in which the destruction of the periodontal membrane and surrounding bone and tissues was the result of bacteria.
31
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
OCCLUSION AND PERIODONTAL DISEASES
Occlusion and its contribution to the causes of periodontal disease has been controversial and widely discussed for decades.
Currently, occlusion is thought to be a contributor to the periodontal disease process but not a causative agent.
32
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
SYSTEMIC INFLUENCESON PERIODONTAL DISEASES
Around 1918, the relationship of nutrition to periodontal disease was explored.
Percy Howe provided information about the effectsof dietary deficiencies on the condition of the tissues that support the teeth.
33
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DEVELOPMENTS IN TREATMENT
Arthur D. Black, the son of G. V. Black, promoted surgical resection of diseased gingiva and bone tissue.
Dr. A. W. Ward developed surgical instruments and created an adherent antiseptic and sedative cement to cover the cut tissues during healing. Ward’s periodontal pack is still used today.
34
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
PERIODONTAL EDUCATION IN SCHOOLS OF DENTISTRY
A gradual increase in the hours of instruction of periodontology, the science of periodontics, has occurred in dental schools. 1941: 2.1% of curriculum time 1954: 4.25% of curriculum time 1987: 7.1% of curriculum time 2008 to 2009: 8.4% of curriculum time
Curriculum guidelines were initiated in 1985.
35
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
SPECIALTY PROGRAMSIN PERIODONTOLOGY
The ADA recognized periodontology as a specialtyin 1947.
In 1950, a board was created to certify specialists.
36
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
GROWTH OF RESEARCH
In the 1960s, research verified that periodontal diseases were infectious.
In 1984, Sigurd Ramfjord, a teacher and researcher in periodontology, voiced his concern about the lagof time between the publication of research findings and their application in clinical practice. One example: Restorations subgingivally placed had
been a known periodontal hazard for more than 20 years.
37
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DENTAL HYGIENE IN DENTAL EDUCATION PROGRAMS
In 1992, for the first time, it was recommended to dental students that they “consult with and refer to dental hygienists those patients needing nonsurgical periodontal therapy and supportive periodontal treatment (more commonly termed maintenance care or recall).”*
Dental schools also started to place an emphasis on preventive measures and oral health for children.
*Sources: Curriculum guidelines for periodontitis. J Dent Educ. 1985; 49:611-615
Curriculum guidelines for periodontitis. J Dent Educ. 1992: 56:773-778
38
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND
In the early 1900s, dentists: Realized that delegating the duties of oral hygiene
instruction was a cost-effective way to maintain the oral health of their patients.
Recognized that providing individual preventive care was time consuming.
Many also held a strong belief in social causes, particularly promoting oral health among children.
39
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND (CONT.)
These realizations by dentists led to the employment of dental hygienists in educational programs in the public schools, along with the introduction of dental hygiene services to private dental practices.
40
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND (CONT.)
From 1913 to 1923, 11 programs were initiated to teach dental hygienists.
A professional society, the American Dental Hygienists’ Association (ADHA), was established, and a professional journal, the Journal of the American Dental Hygienists’ Association, was published.
41
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND (CONT.)
By 1923, 969 students had graduated from dental hygiene programs and 24 states had established licensure systems for dental hygienists.
From 1924 to 1935, an emphasis was placed on dental hygiene care in children’s programs because of the extensive poverty in the United States during the Great Depression of the 1930s and rampant childhood caries.
42
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND (CONT.)
The Children’s Bureau was created in 1912 and housed in the U.S. Department of Labor in Washington, DC.
It provided grants to the Bureaus of Maternal and Child Health throughout the United States to educate mothers about child care, including oral health. 43
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
ROLE OF DENTAL HYGIENISTS INPERIODONTICS: 1913 AND BEYOND (CONT.)
The Social Security Act of 1935 provided traineeships in public health for dental hygienists.
Numerous public health dental hygienists who earned advanced degrees through the support of Maternal and Child Health programs went on to originate and chair new dental hygiene programs.
44
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE
This museum display of a dental office is typical of the ones in which the first dental hygienists would have worked.
45
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE (CONT.)
In 1956, 15,649 dental hygienists practiced. Average age: 35.9 years Practiced full time: 78.2% Employed by private dentists: 68.6% Employed by government agencies: 26.5% Employed by other sources: 4.9%, including 2% who
worked in dental and dental hygiene schools Gross annual earnings for 1953 through 1954:
Private practice: $3658Public health positions: $3484Education positions: $4400
46
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE (CONT.)
In the early 1980s, 30 years later, the profile of a dental hygienist was: 29-year-old woman Associate of Arts degree 10 years of experience Married Shared a joint income Lived in a small urban or suburban community
47
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE (CONT.)
In the 1980s, the dental hygienist also: Treated between 6 and 10 patients each day. Was allowed 30 to 35 minutes for each visit. Worked between 30 and 40 hours per week. Was paid on a daily basis totaling approximately
$15,000 per year.
48
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE (CONT.)
In 2002 and 2003, approximately 148,000 dental hygienists practiced in the United States, with the majority in dental practices.
By 2011, over 177,000 dental hygienists practicedin the United States, with more than 170,500 in dentist’s offices.
49
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CHANGES IN DENTAL HYGIENE PRACTICE (CONT.)
In 2009, the ADHA reported that: 55% of dental hygienists were between 40
and 59 years of age. 35% were 39 years old or younger. 98% were women. 87% were white, non-Hispanic. 42% worked 31 hours per week or more.
27% worked 21 to 30 hours per week.30% worked 20 or fewer hours per week.
50
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE
These surveys highlight the statistical changes that have occurred in dental hygiene.
Early dental hygiene graduates wore starched white uniforms, white stockings, and caps.
Dental hygiene and dentistry were practiced standing up by the side of the dental chair.
51
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
In the early 1960s, the advent of four-handed dentistry was introduced.
The dentist and dental assistant worked while seated at the head of the reclined patient.
Dental hygienists also learned to practice sitting down. 52
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
The introduction of the fully reclining (contoured) dental chair came shortly after the 1960s.
The reclining type of chair promoted the use of the Trendelenburg position for the patient. The patient’s brain is lower
than the heart, which precluded fainting while providing good access, light, and visibility for the practitioners. 53
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
Advances in equipment and technology over the years include: Computer-controlled local anesthesia delivery system Intraoral camera Automated voice-activated periodontal probing systems Digital radiography Video-based counseling and educational systems with
flat-panel monitors
54
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
Advances in equipment and technology over the years include (Cont.): Phase contrast microscopy Chairside laboratory tests for malodor and anaerobic
periodontal pathogens Periodontal endoscope and other calculus-detecting
fiberoptic probes Computer- and web-based periodontal risk calculator
55
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
Advances in equipment and technology over the years include (Cont.): Ultrasonic- or air-polishing devices with built-in sterile
irrigation systems, fiberoptic illumination systems, and thin, probelike microultrasonic inserts
Wrist blood pressure cuff Magnification loupes with illumination Ergonomic hygiene stools and ergonomic dental chairs
with built-in back massager
56
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
CARE DELIVERY TECHNIQUES IMPROVE (CONT.)
Improvements in safety include: Protective eyewear in the 1960s Routine use of latex gloves in the 1980s
57
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
EXPANDING ROLE OF THE DENTAL HYGIENIST
In the late 1960s and early 1970s, the number of dental hygiene programs significantly increased in the United States.
Experimental programs trained dental hygienists in skills that included local anesthesia administration, placement and carving of amalgam restorations, placement and finishing of composite restorations, placement and removal of periodontal sutures and periodontal packs, and gingival curettage.
These skills became known as expanded-duty dental hygiene skills.
58
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DENTAL HYGIENE PRACTICES
In 1986, Colorado passed a law allowing dental hygienists to provide many of their services without the supervision of dentists.
In 1998, California gave approval for the graduates of the Health Manpower Pilot Project to become Registered Dental Hygienists in Alternative Practice (RDHAP). All licensed dental hygienists in California are now able
to gain this additional education and become licensed as RDHAPs.
59
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
DENTAL HYGIENE PRACTICES (CONT.)
In addition, interest is growing in the Advanced Dental Hygiene Practitioner, a mid-level specialist who can assist the dental hygiene workforce to have a greater effect on meeting the oral health needs of the population.
Models now exist in Alaska with the Dental Health Aid Therapist (DHAT) and in Minnesota with the Dental Therapist and Advanced Dental Therapist programs.
60
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
RESPONSIBILITIES OF THE PROFESSION OF DENTAL HYGIENE
Dental hygiene provides a wide range of practice options, and they are growing.
Dental hygiene has expanded to include all the roles articulated by the ADHA, a broad and encompassing view of the profession of dental hygiene. 61
Copyright ©
2014, 2007, 2001, 1996 by Saunders, an
imprint of E
lsevier Inc.
Related Documents
