FTC: Ga. hygienists' services shouldn't be restricted

Jan 4, 2011

The Federal Trade Commission (FTC) is urging the Georgia Board of Dentistry to reject a proposal that would prohibit dental hygienists from providing basic preventive dental services in approved public health settings except under the indirect supervision of a dentist.

There is no evidence that such supervision is necessary to prevent harm to dental patients, and the proposed rule amendments likely would raise the cost of dental services in Georgia and reduce the number of people receiving dental care, according to a letter sent by the FTC to Georgia's licensing board.

Emma Rebecca Carlon, DDS, president of the dentistry board, said the board will discuss the letter at a meeting January 7 but declined to comment further.

The FTC said it is especially concerned that the proposed changes to the rule, which could be interpreted to restrict hygienists from performing services such as sealant and fluoride treatments at approved facilities unless a dentist had previously examined the patient and ordered the treatment, would harm the state's most vulnerable consumers.

The lack of dental care is a particular problem for children in rural and low-income communities, and dental hygienists play an important role in delivering care to these communities, the FTC noted. In addition, Georgia's notice announcing the proposed amendments cites no evidence that allowing hygienists to continue to perform these types of dental services in facilities without direct supervision has harmed, or will harm, patients.

The Georgia Dental Association also urged the board to reject the restriction, saying an exemption should be made allowing hygienists to apply fluoride varnish in school or community based programs, according to a letter sent by the association on Jan. 5 to the dental board.

The access-to-care crisis has spurred heated debate in dentistry over new workforce models. Some argue the issue is the result of a dentist shortage, while others say it is a matter of maldistribution. Some believe that midlevel providers are a logical -- and proven -- solution, while others contend that they will be unable to provide adequate care.