Independent Hygienist Practices
Dental hygienists perform many procedures to treat patients’ oral health, such as “removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth,” “applying preventive materials to the teeth (e.g. sealants and fluorides),” “teaching patients appropriate oral hygiene strategies to maintain oral health; (e.g., tooth brushing, flossing and nutritional counseling),” etc. (“Dental Hygienist”). Dental hygienists work in traditional dental clinics, hospitals, nursing homes, etc., interacting with a wide variety of people (“Dental Hygienist”). However, hygienists can work independently, including running their own practice, after considering a variety of factors.
Dental hygienists can work independently but must deal with state law. Hygienists could work with autonomy and even open their own clinic in states that allow direct access care, which is “‘the ability of a dental hygienist to initiate treatment based on their assessment of a patient’s needs without the specific authorization of a dentist, treat the patient without the presence of a dentist, and maintain a provider-patient relationship’” (Collins 2017). Fortunately, there are 40 states that allow direct access care (Collins 2017). Even so, they still have to adhere to their states’ laws (Collins 2017). For instance, in some states, according to Jamie Collins, “a clinical practicing hygienist in Idaho and Washington states,” says, “a hygienist may practice independently with the requirement that the patient must be seen by a dentist every 12 to 18 months for an exam, and documentation must be provided and kept for records” (2017). Meanwhile, in Colorado, hygienists can run their practice normally, but “[in] less progressive states, hygienists are mandated to practice only with onsite supervision of a dentist” (Turner 2018). Independent hygienists could also include mobile services for the elderly, who cannot go to a dental clinic (Collins 2017).
Like other dentists, independent hygienists have to consider other factors when starting their own practice. For instance, hygienists have to consider “lease negotiations, attorneys’ fees (if used to set up the business), equipment purchases (chair, sterilizer, compressor, suction, X-ray head, sensors), supplies, initial advertising costs, software,” insurance networks, employees, advertisements, etc. (Rhoades 2014). Along with these logistics, hygienists could “[expand] their educational background to match up to the expertise of owning their own dental practice. There may be loan forgiveness programs in place to accommodate hygienists returning to school to become practicing dentists in many regions” (Lanthier 2016). However, based on a sample size from “a popular dental social media site,” many dentists were against autonomous hygienist practices, stating worries about their “economic viability,” safety, and competition from them (Turner 2018). These dentists also stated that hygienists help attract their patient base (Turner 2018). Other dentists on the site believes that these practices “may initiate a new dental model fostering improved oral health literacy and patient-provider relationships” (Turner 2018). These hygienists could help more patients receive treatments and services in other communities (Turner 2018).
Depending on their state, hygienists can have their own independent practices and may profit, but starting and operating them can be difficult.