ETIKA PSIKG
Fakultas Kedokteran Gigi Universitas Gadjah Mada
elastria_widita@ugm.ac.id
History of Dental Hygiene
As a dentist in the early 1900s, Dr. Alfred Civilion
Fones was concerned about the number of patients
losing their teeth due to dental caries and
periodontal disease. Convinced that the removal of
plaque, calculus and sugared substances from the
surfaces of the teeth and gingival margins could
reduce or prevent tooth loss, he began a crusade to
persuade others in the dental and medical fields that
some dental diseases could actually be prevented.
This vision of disease prevention was almost
unknown in a field where tooth extractions were
frequent treatments for dental problems.
Against the support of many health professionals, in
1906, Dr. Fones trained Irene Newman to be the first
dental hygienist in the world. Her purpose was to
provide preventive dental cleanings or prophylaxes
to his patients. The results were successful. So
successful, that he spent much of his time during the
next years spreading the word about this new
member of the dental team. In 1913, he opened
the Fones School of Dental Hygiene in Bridgeport,
Connecticut and the philosophy of teaching dental
disease prevention had then begun. The
Encyclopedia Britannica states, “dental hygiene was
the most important development of the dental art
appearing in 1911-1922”.
This new vision of Dr. Fones was two-fold. Not only
did he think it important for dental hygienists to
work in private dental offices with patients who
could afford its services, he thought it equally
important that dental hygienists provide outreach
services to those who could not afford private dental
care. He and Irene Newman instilled in their
students the benefits of both private and public
health dental hygiene. To this day, dental hygiene
programs in the United States are required to have a
clinical and public health component. In other
words, prevention and access to care continue to
remain the philosophy of dental hygiene.
Positive actions have been taken in recent years in
Connecticut to address the access to care issues
specific to the state. The Connecticut General
Assembly passed legislation that formalized its
commitment to improving access to oral health care
by addressing a number of policy issues that impact
the delivery of oral health care service. In 2007,
there was the passage of higher Medicaid provider
rates. The limited number of dentists in Connecticut
who provide services to the underserved is
significant. Nationally, dental hygienists are listed
among the top ten fastest growing health care
occupations with the Bureau of Labor Statistics (BLA)
predicting that the current population of over
150,000 dental hygienists will grow by 30 percent by
2016. Conversely, the dental profession is growing
at a much slower rate, with the number of dentists
who retire annually, approximately 6,000, outpacing
the approximately 4,000 dental school graduates
that enter the workforce each year. BLS data notes
that the population of dentists is not anticipated to
be able to meet the growing health care needs of
the country over the next ten years.
The Advanced Dental Hygiene Practitioner (ADHP)
model developed by the American Dental Hygienists’
Association (ADHA) is a mid-level oral health
provider designed to serve as the oral health
equivalent to the nurse practitioner. ADHA began
the process to establish the new provider in 2004
and over the past four years has solicited input for
stakeholders in oral health on the development of
the draft ADHP competencies.
The ADHP will increase utilization of finite health
care resources and will enable more patients to be
seen and referred to dentists or other health care
professionals for comprehensive care. ADHPs are
envisioned to work in collaboration with dentists and
other members of the oral health care team to
deliver quality oral health care services in a variety
of public health settings, such as community health
centers, school-based health clinics, Head Start or
pre-school programs, long-term care facilities, and
hospitals. The demand for oral health services is
particularly acute in such venues and the advanced
dental hygiene practitioner can help fill the need in
underserved communities.
The ADHP concept takes into account the workforce
realities our country, and Connecticut specifically,
are facing. The model leverages the talents and
expertise of the existing dental hygiene workforce by
adding a new provider to the oral health care team.
The ADHP will be a licensed dental hygienist
educated at the Master’s-level and will have an
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ETIKA PSIKG
Fakultas Kedokteran Gigi Universitas Gadjah Mada
elastria_widita@ugm.ac.id

expanded role in treating patients by providing

diagnostic, preventive, restorative, and therapeutic
services directly to the public.

As society places an ever-growing demand on dental

disease prevention and access to care, the dental
hygiene profession continues to be in the forefront
of providing services to those who can and cannot
afford the care. The State of Connecticut is known
for its invention of the hamburger, the submarine,
the sewing machine, the subway sandwich, the
telephone, the Frisbee, wiffle ball, and more. Let’s
never forget that our State is also known for the
inventor and as the birthplace of dental hygiene.

Written by Meg Zayan, RDH, MPH, EdD

http://www.cdha-
rdh.com/home/historyofdentalhygiene.html

A Dental Hygienist dental diseases

What is a dental hygienist?
Dental hygienists are educated and trained members
of the health care team who support the important
role of preventing disease and treating disease as
part of maintaining good overall health.
Across the world there are approximately 500,000
dental hygienists in over 30 countries who are
providing care for children and adults of all age
groups.
5. Apply fluoride or other material to help
prevent tooth decay and/ or stop tooth
decay
6. Help reduce halitosis (bad breath)
7. Support smokers and tobacco users who
wish to quit
8. Work in nursing homes, schools, clinics,
assisted living facilities, dental offices, and
numerous other settings
Maintaining a healthy lifestyle, effective home care
and regular visits with a dental hygienist are
essential to maintaining a smile for a lifetime!

What does a dental hygienist do? Community Health

A dental hygienist provides a range of services and
education to support the overall health of their
Oral health care services provided by dental
clients. Besides individualized home care, these may
hygienists in the community environment can help
include, but are not limited to:
develop improved health outcomes for families, the
1. Assess a person’s health and oral health
aged and special needs patients. In addition to
status and disease risk to create a dental
providing a significant source of education,
hygiene
treatment provision and the ongoing support of
treatment plan
health messages, community health programs can
2. Provide dietary advice to reduce the risk of
reflect the goals of government and other health
tooth decay and erosion
care advocates.
3. Evaluate and treat periodontal (gum)
disease
4. Remove dental plaque, calculus (tartar) and http://www.ifdh.org/dt/IFDH_What_is_a_Dental_Hy
staining to reduce the risk of common genist.pdf

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ETIKA PSIKG
Fakultas Kedokteran Gigi Universitas Gadjah Mada
elastria_widita@ugm.ac.id
What is dental hygiene?
Int J Dent Hygiene 5, 2007; 13–21
Cobban SJ. Edgington EM. Compton SM. An argument
for dental hygiene to develop as a discipline
The Canadian Oxford Dictionary (9) describes a
Dental Hygienist as a person trained and
licensed to act as a dentist’s assistant,
specializing in oral hygiene, and cleaning and
scaling teeth. It is unfortunate that the
Dictionary describes a dental hygienist as a
dentist’s assistant as dental hygienists do not
function in that capacity in practice. It further
defines a Hygienist as a specialist in the
promotion and practice of cleanliness for the
preservation of health, and Hygiene as the
branch of knowledge that deals with the
maintenance of health and the conditions and
practices conducive to it.
The word hygiene derives from Greek
mythology, from Hygieia the goddess of health,
cleanliness and sanitation. She was one of the
daughters of Asclepius, the god of healing (15).
She was associated with the prevention of
sickness and the continuation of good health,
and was typically represented as a young
woman feeding a huge sacred snake which is
wrapped around her body. Her sacred snake is
depicted with the rod of Asclepius as the
symbol for medicine.
The origins of the practice of dental hygiene
bear many similarities to the mythology. Early in
the 20th century Fones, a dentist, saw a need
for preventive oral hygiene programmes for
children, and developed a plan to prepare
women to provide this preventive care (16). He
opened the first school of dental hygiene in
1913. In 1934, he wrote of dental hygienists
that ‘She must regard herself as the channel
through which dentistry’s knowledge of mouth
hygiene is to be disseminated.’ (16, p. 3).
Although the use of the term ‘dental nurse’
was then in common use, Fones did not like the
association, at the time, between ‘nurse’ and
‘disease’ and preferred the term ‘hygienist’
because of its association with health and
prevention of disease. The oral health
promotion and disease prevention foundations
of dental hygiene are consistent with the health
promotion and disease prevention perspective
associated with Hygieia. Dental hygiene has
progressed considerably since it originated.
In 1982, the University of Manitoba hosted the
first conference on dental hygiene research,
inviting leaders from both Canada and the USA
to consider the role of research in further
development of dental hygiene (17). In 1984,
the American Dental Hygienists Association
(ADHA) sponsored a conference to articulate
the evolving functional roles of dental
hygienists. Outcomes of that conference
suggested a view of the dental hygienist as a
licensed professional within a healthcare team.
They identified roles and functions used by all
dental hygienists as including clinician, oral
health educator, manager, consumer advocate,
change agent and researcher.
The ADHA also convened a theory development
panel in 1992. This panel conceptualized dental
hygiene as ‘…the study of preventive oral
healthcare, including the management of
behaviours to prevent oral disease and promote
health.’ (7). The panel went on to identify the
major concepts studied in a discipline of dental
hygiene would be health/oral health, dental
hygiene actions, the client, the environment,
their interactions and the factors that affect
them. These major concepts in turn can be used
to derive theoretical and conceptual
frameworks to guide research that contributes
to a metaparadigm that is dental hygiene.