Title: Examining Dental Hygienists’ Scope of Practice and Dental Care Access
Melanie Simmer-Beck (Presenter)
University of Missouri-Kansas City
Anthony Wellever, Consultant
Patricia Kelly, University of Missouri-Kansas City
JoAnna Scott, University of Missouri-Kansas City
Objectives: To determine if Federally Qualified Health Center (FQHC) participation in school-based care is associated with more autonomous registered dental hygienist (RDH) scopes of practice (SOP) and whether the proportion of patients who received dental care at FQHCs is associated with RDH SOP regulations.
Methods: The 2014 Universal Data Set reported the percent of FQHC patients who received services in school-based health centers and the percent of patients who received dental services. The 2014 Dental Hygiene Professional Practice Index (DHPPI) was used to characterize each state’s RDHs’ SOP. Access to care was determined using the percentage of publicly insured children who live within 15 miles of a dentist from the ADA Health Policy Institute. Descriptive statistics were used to summarize the sample. Linear regression was used to test associations.
Results: DHPPI was significantly associated with FQHC participation in delivering school-based care in states with ‘high access to care’ (slope = 0.04, p<0.01). The percent of FQHC patients who were provided dental services ranged from 6.9% in South Carolina to 52.8% in Florida with a state mean of 21.5%. DHPPI was significantly associated with the percent of patients who received dental services (slope = 0.01, p=0.03). States with ‘high access to care’ (80% or more of publicly insured children living within 15 miles of a DDS) were significantly associated with DHPPI and percentage of dental care provided by FQHCs, but not in states with ‘low access to care’. States with ‘direct’ DHPPI supervision regulations had a 5.65% lower and states with ‘collaborative’ DHPPI supervision regulations had a 4.46% higher percentage of dental care provided by FQHCs (p<0.01 for both). The association between DHPPI SOP and percentage of dental care provided by FQHCs was significant (p<0.01) in states with ‘high access to care' and not significant in states with 'low access to care'.
Conclusions: Less restrictive RDH SOP appears to have a positive association with dental care access.