Date of Award

Spring 2026

Document Type

Thesis

Degree Name

Master of Science in Dental Hygiene (MSDH)

Department

Dental Hygiene

Committee Director

Emily Ludwig

Committee Member

Jessica Suedbeck

Committee Member

Tara Newcomb

Abstract

Background: A perceived shortage of dental hygienists in the United States has been linked to delays in preventive care and concerns about declining oral health outcomes. In response, some states have proposed alternative pathways permitting internationally trained dentists, dental students, and oral preventive assistants (OPAs) with limited or inconsistent education requirements to provide dental hygiene services. Limited evidence exists regarding whether these strategies would effectively address access to care and workforce challenges. Concerns have also been raised about the potential effects of expanding scope of practice for providers with limited education or training on patient safety and quality of care. Objective/Purpose: This study aims to examine the perceptions and attitudes of Virginia dentists and dental hygienists toward alternative dental hygiene providers, as well as dentists’ level of comfort with these providers practicing within their own offices. Methods: This IRB approved, cross-sectional study (2350175-2) utilized a convenience sample of 9,771 Virginia dentists and dental hygienists recruited via email distribution lists obtained from the Virginia Board of Dentistry. The survey instrument, adapted from previously validated questionnaires, assessed attitudes toward alternative dental hygiene providers performing dental hygiene procedures. Analyses compared responses between dentists and dental hygienists, as well as between ADA-member and non-ADA member dentists using independent samples t-tests. Differences in dentists’ reported comfort levels with alternative providers in their own practices were evaluated using repeated measures analysis of variance. Results: Findings suggest dentists had a neutral perception of need for internationally trained dentists, dental students, and OPAs to perform dental hygiene procedures, whether the dentist was an ADA member or non-ADA member. Dentists were more comfortable employing internationally trained dentists and least comfortable employing an OPA. Conclusions: Dentists’ neutral perception towards alternative providers indicates that they may not be in favor of these providers. Further, dentists were more comfortable with employing internationally trained dentists which suggests adequate training is important for providing care. Therefore, allowing dental hygienists practice to the full extent of their scope may be a more effective and acceptable way to expand access to care, rather than relying on alternative provider models.

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DOI

https://doi.org/10.25777/wa2y-tb80

ISBN

9798197810588

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