PRODUCTION AND ECONOMIC CONTRIBUTIONS OF DENTAL HYGIENISTS

Dental hygienists' contribution to total gross billings and production, measured in standard production minutes, was studied in 13 private practices that employed hygienists. Hygienists' treatment accounted for one fourth of total production and one eighth of all gross billings. These results, together with analyses of the use of available time, the range of procedures performed by hygienists, and the rate of return for these procedures, illustrate the utility of this type of information when assessing the possibility of changes in the dental hygiene profession. In the past five years, the literature concerning dental hygienists has included a number of contributions that focus on the status of and possible changes in the practice of dental hygiene. These contributions have discussed the general future of dental hygiene, 1–3 and the specific issues of professionalism, 4–6 advocacy, 7–8 and legal and political activity and knowledge. 9–11 In addition, several discussions of new forms of dental hygiene practice also have appeared in the hygiene literature, 12–17 as well as in the general dental literature. 18–20 Finally, surveys of dental hygienists have been reported frequently. 21–30 The content of this growing body of literature indicates that the profession of dental hygiene currently is undergoing an internal examination, and that several educators and practitioners are advocating the acceptance of increased responsibility by hygienists. While both the examination and advocacy undoubtedly will continue, and may engender heated debate within both the hygiene and dental communities, the most striking aspect of the discussions in the literature to date is their lack of empiricism; the conclusions and opinions offered do not seem to be based on careful analysis of information examining dental hygiene within the context of the practice of dentistry. During the same period that these discussions have appeared, only a few studies of dental practice have included information concerning hygienists' activities. 29,31–32 Yet any discussion of the current or future status of dental hygiene practice must be considered from this practical level. The American Dental Association's dental practice surveys indicate that the percent of independent dentists employing one or more hygienists either full‐ or part‐time increased from 24.6 percent in 1968 to 48.2 percent in 1979. 33–34 Despite this “doubling” in independent dentists' employment of hygienists in one decade, few data are available concerning the composition and volume of services provided by hygienists in private dental practices, or the proportion of total dental treatment and gross billings that these services represent. This paper presents detailed aggregrate data from a small number of dental practices concerning hygienists' production and economic contributions, explores the extent to which the use of hygienists in these practices may be representative of dental practices in general, and discusses some possible implications the data hold for the dental hygiene profession.