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Current Trends in Dental Hygiene Across America and in Georgia

The ADHA/GDHA strives to provide members with the most up-to-date information about the practice of dental hygiene at the state level as well as a national perspective on the profession.

In 2017, President Trump, through Executive Order, directed his Administration to facilitate the development and operation of a health care system that provides high-quality care, at affordable prices for Americans. The Report, “Reforming America’s Healthcare System Through Choice and Competition” was published in December of 2018, and was written by the:





The Report identifies actions that States or the Federal Government can take to develop a better functioning health care system. Findings in the report recommend that dental hygienists be authorized:

  • Direct Reimbursement

  • To Facilitate Telemedicine

  • License Portability

  • To practice to the top of their license using their full skill set

As of 2019, 42 states have authorized dental hygienists direct access to patients.  With the passage of HB 154, Georgia is one of them.


Direct Access Means that Dental hygienists can:

  • Initiate treatment in at least one setting outside of the private dental practice

  • Work without the presence of a dentist

  • Work without a dentist referral

  • Work without a prior dental exam

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In 1998, CA and WA State became the first states in the country to authorize dental hygienists to bill and receive reimbursement directly from Medicaid.  As of 2019, 18 states now authorize Dental Hygienists direct reimbursement.

By 2019, more than half of the country has enacted telemedicine Parity Laws. 36 states currently have Parity Laws and 3 states have proposed a Parity bill for Insurance Coverage of Telemedicine. 

In 2017, the American Dental Association (ADA) CDT Code Maintenance Committee added 2 Teledentistry codes to the code-set for the first time ever. The first code is defined as: A real-time encounter, also known as synchronous.  The second code is defined as: Asynchronous, meaning that information is stored and forwarded to a dentist for subsequent review. Both codes are accepted by Medicaid as billable codes in Georgia.


In October 2018, the Coalition For Modernizing Dental Licensure was founded and is Chaired by the 2017 ADA Past President, Dr. Joseph Crowley. The purpose of the Coalition is to improve the dental licensure process and increase initial licensure portability. The Coalition is advocating for licensure reform to eliminate single encounter, procedure-based patient examinations and replace them with clinical assessments that have stronger validity and reliability evidence and increase initial licensure portability to allow for professional mobility and improve access to care.


In April 2019, Arizona became the first state in the nation to grant automatic reciprocity for occupational licenses.

In 2014, the National Governors Association published an issue brief, titled, “The Role of Dental Hygienists in Providing Access to Oral Health Care”. The Brief recommends that all states:

  • Consider doing more to allow dental hygienists to fulfill the needs of the public by freeing them to practice to the full extent of their education and training.

  • Change supervision rules and reimbursement policies so that dental hygienists are able to provide preventive services outside of dentists’ offices.

  • Create a dental hygiene advanced-provider model (also known as a Dental Therapist) that involves training for hygienists to perform an expanded scope of practice with less supervision.


In 2015, one year after the Brief was published, the Commission on Dental Accreditation (CODA) adopted Accreditation Standards for Dental Therapy.

4 years after the Governors Brief was published, the Report “Reforming America’s Healthcare System Through Choice and Competition”, recommended that “All states authorize dental therapy and consider ways in which [dental hygiene] licensure and scope of practice can increase access and drive down consumer costs while still ensuring safe, effective care”.

In 2019, the ADHA published information on Expanding Access to Care through Dental Therapy 

As of 2019, 12 states have adopted DT legislation in the U.S. and 22 states are exploring it.

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