Dentists must fight superhygienist law

Oct 29, 2008

Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

Organized dentistry has failed us one more time and degraded our doctorate degree and our profession. The new law taking effect in 2011 of a "midlevel practitioner" that the Minnesota Senate voted in -- due to organized hygienists and their ability to effectively lobby their cause -- is a huge step backward for dentistry and dentists. It exploits the poor and undeserved residents of Minnesota.

How come a group of hygienists could organize and lobby before the legislators of Minnesota so much more effectively than dentists? Where was the ADA? Was it distracted by its effort to defend amalgam safety? I know several dentists from Minnesota and they are all upset. I empathize with the Academy of General Dentistry Minnesota President Mark Malterud, D.D.S., and his recent article, entitled "Lessons From Minnesota," in the AGD Impact October issue.

It is absurd to think that hygienists can perform at the level of a dentist. Where are the ethics? Do no harm? Also, isn't it standard of care that a general dentist must perform a specialty procedure at the same level of a specialist -- i.e., root canals or third molar extractions? Can a hygienist perform to the same level that we can? This is America, not a third world country. Yes, there are underserved people, but is providing care that could harm the individual solving the problem?

Lower income people often have complicated medical and dental problems. Can hygienists comprehend this without the education that we received? They lowered what we do to a blue collar level and make it sound like they can handle what we do without the training, and effectively sold this to the public and the legislators, who bought into this because they do not understand what we do.

When the patients are in pain, who will take the call? Most likely the emergency rooms. Allowing hygienists to practice will tax the system as poor people are accustomed to using the emergency room as a clinic. Now when the hygienists "fill" teeth I am sure many patients will end up with pain and go to the emergency room.

Oral surgeons and ENT doctors have misdiagnosed oral cancer and told patients to rinse with salt water instead of realizing the lesion was worthy of a biopsy. What will the diagnostic level be with hygienists? I feel they are not confident in their ability and this will severely impact treatment, even at the level of an occlusal restoration.

We have been more vilified in past Wall Street Journal articles than the Wall Street thieves responsible for the current financial crisis. The stereotype that we are money-hungry people is absurd. Our image needs to change, and until we have change at the ADA level, we will continue to be degraded. The lesson from Minnesota is a perfect example of this.

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