Iowa' Public Health Supervision Dental Hygienists: Employment Factors and Patient Referrals

In an effort to improve access to care to underserved populations, Iowa allows eligible hygienists to provide hygiene services in public health settings without prior exam from a dentist. The state of Iowa implemented the Public Health Supervision Dental Hygiene (PHSDH) model in 2004. In this model, a written agreement is used where a supervising dentist authorizes and delegates services for the hygienist to provide in public health settings, which may include screenings and non-invasive therapeutic and preventive services. When other states have evaluated the impact of their direct access dental hygienists, most have found improved opportunities for underserved populations to gain access to dental care but have also faced barriers like finding a supervising dentist and reimbursement challenges.

There is limited research on public health supervision dental hygiene workforce models. The goal of this study was to examine the employment environment and experiences of the current PHSDH workforce in Iowa.