2022 Public Health Dental Hygienist Activity Report

Oral health is a crucial part of overall health. Good oral health and hygiene can improve overall health, lowering the risk of complications due to several serious diseases, such as diabetes, cardiovascular disease, and preterm or low-weight births. In too many places in Illinois, oral health care is inaccessible and consequently oral health problems too often go untreated, thereby burdening individual lives as well as the health care system.

A PHDH is a dental hygienist who can provide early care to patients in a public health setting, such as a federally qualified health center (FQHC); a federal, state, or local public health facility; Head Start; a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) facility, a certified school-based health center, or at school-based oral health program. In 2023, legislation added the public health settings of long-term care facilities and prisons.

A PHDH is an individual with at least two years of dental hygiene experience or the equivalent of 4,000 clinical hours as a dental hygienist. In addition, 42 hours of continuing education are required in advanced areas specific to public health dentistry. Twenty-nine of those hours must be in medical emergencies in the dental office, pediatric dentistry, pharmacology, medical record-keeping, oral pathology, and geriatric dentistry. Five hours (of the individuals’ choice) must be in geriatric dentistry, cultural competency, nutrition for geriatric and special needs patients, communication techniques with non-English speaking patients, and teledentistry. Additionally, an eight-hour in-person review course and PHDH certification exam are required.

Public health dental hygienists working with a collaborating dentist can provide early access to care and benefit many individuals in a variety of other ways. In 2022, 8,219 children, senior citizens, those with developmental disabilities, and those with low income were served by PHDHs. In 2022, local health departments utilized PHDH the most followed by FQHCs. Free community-based dental clinics, WIC facilities, and other state-licensed facilities can benefit from further expanded use of PHDH.

With PHDH in place, 8,219 individuals of all ages had early access to dental care this past year. Those 6-13 years of age and 19-64 years of age were provided greater access by PHDH. Individuals 65 years of age and older were least affected by PHDH, followed by those 14 – 18 years of age and those birth – 5 years of age.

Several strategies should be considered to increase access to oral health care through the PHDH program. These include:

• Increasing recruitment of PHDPs to public health settings with fewer numbers of PHDH, such as WIC facilities or free community dental clinics
• Increasing the rate of pay for PHDH when working in a public health setting
  
• Wider adoption of the PHDH model to allow dental practices in public health settings to stay open when dentists are out of the office
  
• Making expenses incurred by PHDH in the course of certification eligible for employer reimbursement
  

Many Illinois communities struggle with recruiting and retaining oral health and other types of health care providers, and this is especially difficult in rural areas of the state. Large parts of the state do not have a dental provider, let alone one that participates in Medicaid. The IDPH Office of Rural Health calculated that 75 of the 102 counties have a federal Health Professional Shortage Area (HPSA) designation. This designation is based on a shortage of dentists that serve low-income and Medicaid-eligible residents in the HPSA. The state’s population is already challenged with accessing timely oral health care and with individuals living longer, which indicates the need for oral health services will continue. Public health dental hygienists are the missing piece underserved individuals need to gain access to care. Their efforts are dedicated to improving access through specific settings for low-income, uninsured, or Medicaid-insured individuals.