Mississippi traditionally leads the nation in health professional shortage areas, which means that we do not have enough health-care providers for the population. One notable inclusion to this health disparity is the lack of dental coverage, especially in rural areas.
Based on analysis by the Kaiser Family Foundation, as of Sept 30, 2019, Mississippi has 145 Dental Care Health Professional Shortage Areas with a population of 1.8 million individuals. It is estimated that only 45% of the need is met, and 248 practitioners are needed to remove the HPSA designations.
Mississippi has the most restrictive policies in the nation for dentists and dental hygienists’ operating agreements. At this time, dental hygienists are only allowed to perform work on patients under the direct supervision of a dentist. This means that if a dentist is caught in traffic or takes a long lunch break, the hygienist cannot even sit the patient and begin a cleaning before the dentist is physically present in the clinical area. Further, a dental hygienist has no way to perform screenings or other preventive measures in the community setting outside of direct supervision of a dentist, of which Mississippi has very few outside of metropolitan areas.
The Oral Health Workforce Research Center performed workforce research across the nation in recent years and concluded, “Scopes of practice which allow dental hygienists to provide services to patients in public health settings without burdensome supervision or prescriptive requirements appear to increase access to educational and preventive care.”
Further, former Gov. Phil Bryant commissioned a Rural Health Task Force to analyze ways that Mississippi can improve its rural health care, and one of the many suggestions included that the Mississippi State Board of Dental Examiners investigate ways that dental hygienists can operate more freely in the state and allow dentists and dental hygienists to have more flexibility in their collaboration.
So what change took place to improve these problems? The board voted to change Regulation 13 to allow dental hygienists to move from direct supervision to general supervision under specific guidelines to ensure patient safety and compliance.
Allowing dental hygienists to practice under general supervision will free dentists from direct supervision and allow them to optimize patient care by focusing on patients with needs greater than the scope of practice of dental hygienists, fulfilling the need recommended by the U.S. Department of Health and Human Services as well as the Governor’s Rural Health Task Force.
This change also reflects the recommendation that the HHS presented less than one year ago.
Since this change was passed by the state Board of Dental Examiners, both dentists and dental hygienists alike have praised the decision and are excited for the opportunities that may unfold as a result.
The change will go before the Occupational Licensing Review Commission, consisting of the Mississippi governor, secretary of state and attorney general. For any dentists or dental hygienists who would like to share their support for this change, they may send correspondence to Chris Hutchinson at firstname.lastname@example.org.
We are excited to see how Mississippi moves forward in oral health access and quality-based outcomes as a result of this positive change.
• Catherine Dunn of Greenwood is president of the Mississippi Dental Hygienists’ Association.