Dental Hygienists

The first dental hygienists were trained by dentists themselves. But, in 1913, Alfred C. Fones opened the Fones Clinic for Dental Hygienists in Bridgeport, Connecticut. It was the first dental hygiene school. In 1915, the first state legalized the practice of dental hygiene.

Although the profession has existed since the beginning of the 20th century, dental hygienists were not particularly common before recent advances in the field. Discoveries in chemistry and the biomedical sciences have led to the development of dental radiography and improved dental instruments, materials, and treatment techniques. In addition, the discovery that fluoride helps prevent tooth decay has created more work for dentists because fluoride treatments enable many more people to keep their teeth throughout their lives. In recent decades, with greater public awareness of the importance of dental care, more and more companies have begun providing dental insurance to employees.

These developments in the field of dental care have resulted in a greater workload for dentists. As they have taken on more patients and performed more dental services, they have had less time for completing routine cleanings and instructing patients on oral hygiene. As a result, many states have passed direct access laws that allow dental hygienists more latitude to practice independently from a dentist in certain situations. The American Dental Hygienists' Association defines direct access as “the ability of a dental hygienist to initiate treatment based on their assessment of a patient’s needs without the specific authorization of a dentist, treat the patient without the presence of a dentist, and maintain a provider-patient relationship.” As of 2024, 42 states had approved direct access care—an increase of 14 states since 2008. Alabama, Delaware, Hawaii, Louisiana, Mississippi, New Jersey, North Carolina, and North Dakota are the only states that do not yet allow direct access for dental hygienists. As a result of direct access laws, dental hygienists have become important members of many dentistry practices.