As a licensed dental hygienist with over a decade of experience spanning private practice, public health, holistic, biological, and periodontal specialties, I have witnessed firsthand the potential for dental hygienists to transform oral health care delivery. My journey culminated in the ownership of a mobile dental hygiene practice, which was designed to provide convenient, affordable, and efficient care directly to patients, particularly those underserved by traditional dental models.
Despite the incredible scope of practice we are afforded in Colorado, there remains a glaring lack of support from our dental and dental hygiene associations for those of us practicing as direct access hygienists mid-level practitioners). We have been entrusted with the responsibility to care for patients independently, yet we face constant barriers when it comes to receiving business, and administrative support, guidance on how to sustain a mobile practice, and collaboration with other dental professionals to help close the oral health care that patient need for oral and systemic health.
The current systems in place do not adequately address the business side of being a direct access provider. The lack of infrastructure—from billing assistance to partnership opportunities with private practices, FQHCs, Sliding scale clinics and nonprofits—has left many of us struggling to deliver comprehensive care. While we operate with the clinical confidence to treat patients within our scope, the absence of meaningful collaboration with dentists to complete treatment plans for all demographics is a significant gap in care.
As a direct access mobile hygienist, I have experienced emotional, financial, and physical tolls due to the system’s inability to support us in ways that align with our scope of practice. The pressure to provide care efficiently while navigating complex administrative and business challenges without the resources or backing from our professional associations has led me to a difficult decision: I must sell the main asset of my business to cover outstanding debts. This reality is not unique to me—many others in our profession face similar struggles.
I propose that our associations take immediate action to remedy these shortcomings. It is essential that we foster a system that encourages and facilitates collaboration between direct access dental hygienists and dentists (no matter their practice type or business status). Together, we can ensure that every American, regardless of financial status, age, or demographic, receives comprehensive and affordable oral health care. Direct access hygienists are ready to take on this challenge, but we cannot do it alone. We need the infrastructure, support, and partnerships to ensure success—for the benefit of both our profession and our patients.
This is not just about policy; this is about preserving the integrity of oral health care delivery in Colorado and beyond.