Recent ADHA policy updates address the scope of practice, education standards, licensure exams, and workforce issues shaping the future of dental hygiene.
By Noelle Copeland, RDH
The American Dental Hygienists’ Association (ADHA) recently adopted several updated policy positions addressing the scope of practice, educational standards, licensure examinations, and workforce sustainability within dental hygiene. These updates were highlighted in a recent industry report outlining key changes to ADHA policy priorities and their potential impact on the profession.
While these policy statements don't immediately alter state practice acts or regulatory frameworks, they offer insight into the organization’s advocacy direction and broader goals for the future of dental hygiene. For dentists, hygienists, educators, and practice leaders, these updates provide an important window into how workforce models, licensure pathways, and educational expectations may evolve in the coming years.
1. Full Practice Authority and Scope of Practice
Among the most widely discussed updates is ADHA’s continued support for Full Practice Authority (FPA) for dental hygienists. Under this model, hygienists could evaluate patients, diagnose conditions within their scope, order and interpret diagnostic tests, and initiate treatment plans as permitted by state regulations.
Supporters suggest that expanding hygienists’ ability to practice at the top of their licensure could help address persistent access-to-care challenges, particularly in rural or underserved communities. Preventive oral healthcare remains a critical component of overall health, and workforce shortages in dentistry continue to affect many regions across the United States.
At the same time, any expansion of practice authority would depend on state-level legislation and regulatory oversight. Dentistry has historically functioned within a collaborative care model, and changes to scope-of-practice frameworks require careful consideration of patient safety, professional accountability, and coordination among members of the dental team.
2. A Proposed Doctoral Entry-Level Degree
Another policy position drawing attention is ADHA’s support for transitioning dental hygiene to a doctoral-level entry degree by 2032, as described in the association’s policy announcement outlining new and updated ADHA initiatives.
Currently, most hygienists enter the field through accredited associate or bachelor’s degree programs. A doctoral-entry model would align dental hygiene with other healthcare professions that have transitioned to doctoral-level education, including pharmacy, physical therapy, and advanced nursing practice.
Advocates of the change suggest doctoral-level training could strengthen research capacity, leadership development, and interdisciplinary healthcare integration. As oral health continues to gain recognition for its connection to systemic health conditions, including cardiovascular disease, diabetes, and adverse pregnancy outcomes, there is growing interest in preparing oral health professionals to participate more fully in integrated healthcare environments.
However, transitions of this magnitude also raise important questions regarding program accessibility, educational costs, and potential workforce implications. Any shift toward doctoral-level entry would require collaboration among accrediting bodies, academic institutions, and regulatory authorities.
3. Modernizing Dental Hygiene Licensure Examinations
The ADHA policy updates also recognize the Dental Hygiene Licensure Objective Structured Clinical Examination (DHLOSCE) as a valid pathway for entry-level licensure assessment. Details regarding this assessment model are outlined in the DHLOSCE examination framework and candidate guide.
Unlike traditional patient-based clinical examinations, the DHLOSCE utilizes simulated clinical cases, digital patient scenarios, and three-dimensional models to evaluate clinical decision-making and competency. Patient-based licensing examinations have long raised ethical concerns because they often require candidates to recruit patients with untreated disease solely for evaluation. Simulation-based assessments allow examiners to measure clinical reasoning and competency without creating these ethical challenges.
The DHLOSCE is also associated with the emerging Dental and Dental Hygienist Compact, which aims to improve multistate licensure mobility for dental professionals.
4. Workforce Sustainability and Professional Support
Several of the recently adopted policies also focus on supporting the long-term sustainability of the dental hygiene workforce.
These initiatives include support for:
- Confidential diversion programs for clinicians experiencing substance use or mental health challenges.
- Expanded inclusion policies supporting individuals with disabilities entering the profession.
- Workforce strategies designed to improve recruitment and retention within dental hygiene.
Like many healthcare professions, dentistry continues to face workforce challenges related to staffing shortages, burnout, and the physical demands of clinical care. Dental hygienists in particular often experience musculoskeletal strain associated with the repetitive and ergonomic demands of clinical practice.
5. Dental Therapists and Expanding Workforce Models
The ADHA policy updates also reaffirm support for dental therapists as part of broader efforts to expand access to oral healthcare services. Dental therapists receive specialized training to perform certain preventive and restorative procedures within a defined scope of practice.
Several states have implemented dental therapy programs, particularly in communities where access to oral healthcare providers is limited. Supporters view dental therapists as a potential strategy for addressing disparities in preventive and basic restorative care.
References
- American Dental Hygienists' Association. (2026, February). ADHA policy manual: Fiscal year 2026. https://www.adha.org/wp-content/uploads/2026/02/ADHA-Policy-Manual_FY26_02-26.pdf
- American Dental Hygienists' Association. (2026). ADHA adopts ten new and updated policies for FY26 [Press release]. ADHA Newsroom. https://www.adha.org/newsroom/adha-adopts-ten-policies-fy26/
- National Conference of State Legislatures. (n.d.). Dental hygienists with direct access. https://www.ncsl.org/scope-of-practice-policy/practitioners/oral-health-professionals/dental-hygienists-with-direct-access
- Joint Commission on National Dental Examinations. (n.d.). Dental hygiene licensure objective structured clinical examination (DHLOSCE) candidate guide. American Dental Association. https://jcnde.ada.org/-/media/project/ada-organization/ada/jcnde/files/dhlosce_candidate_guide.pdf
- Joint Commission on National Dental Examinations. (n.d.). Dental hygiene licensure objective structured clinical examination (DHLOSCE). American Dental Association. https://jcnde.ada.org/dhlosce
- Dental and Dental Hygienist Compact. (n.d.). Interstate compact for dental and dental hygiene licensure. https://ddhcompact.org/
Author: Noelle Copeland, RDH, is a health science writer with 30 years of clinical experience in healthcare. Her work focuses on translating complex medical and oral health topics into clear, evidence-based education for professional and consumer audiences.
