Dental hygiene’s century-long journey to the world stage: professional pride

This year, 2023, marks two very important anniversaries for our profession: the 100th anniversary of the American Dental Hygienists’ Association (ADHA) and the 60th anniversary of the Canadian Dental Hygienists Association (CDHA). Although the first school of dental hygiene was formally established in 1913 by Dr. Alfred Fones in Bridgeport, Connecticut, ADHA was not founded until 10 years later in 1923.¹ Canada followed suit in 1951 when the first school of dental hygiene was established at the University of Toronto. CDHA was created 12 years later in 1963.²

I was fortunate this past July to attend ADHA’s 100th anniversary celebrations in Chicago. As part of the festivities, the association presented a historical timeline of the profession, tracing the evolution of dental hygiene care from the first in-office training of a dental assistant to perform prophylaxis under the supervision of a dentist to an international community of dental hygienists working to improve oral health outcomes around the world. The ADHA celebrations led me to reflect on how much we truly have accomplished as a profession over the past century. I feel very proud to be a dental hygienist.

As part of my personal reflection, I discovered that dental hygiene is now a recognized profession in 34 countries. Collectively, we are represented by the International Federation of Dental Hygienists (IFDH). But let’s not forget that Canada was instrumental in founding this international federation in 1986.³ That was 37 years ago, so we are up for another important anniversary in 3 short years. Another point of pride for Canada is that the current IFDH president is a Canadian dental hygienist, the second Canadian to hold this position on the world stage. Congratulations to Wanda Fedora!

What does all this mean? You might think, OK, that’s nice to know historically, but most of us are still practising clinically so how do these accomplishments affect our day-to-day working lives? In Canada, in particular, we have seen some major changes over the past 60 years thanks to the strong support and advocacy of CDHA, such as the ability to practise independently in many provinces and in a variety of health care settings, to administer local anesthesia in most provinces, to continue our dental hygiene education if desired to the bachelor’s and master’s degree levels in our own discipline, and most importantly, to promote ourselves as a self-regulated health profession, which is unique when compared to dental hygiene in other countries.

In addition, dental hygiene has, from the beginning, focussed on oral disease prevention and oral health promotion. These goals remain the hallmarks of our profession globally, despite the challenges of implementing preventive oral care strategies in the broader health care system. Interestingly, a resolution passed at the 74th Assembly of the World Health Organization (WHO) in 2021 encouraged oral health care providers to shift their focus from a “pathology-driven treatment approach to a more health-centered preventive approach.”⁴ This resolution was followed by a report, published in 2022, entitled Global oral health status report: Towards universal health coverage for oral health by 2030 in which WHO stated: “The primary focus of oral health professionals’ activities should therefore be on delivering evidence-based preventive care and minimally invasive interventions, supporting patients in effective self-care practices and acting as advocates for policies to promote population oral health.”⁵

This call for a preventive approach to oral health care was heard clearly by IFDH, which subsequently partnered with the European Dental Hygienists Federation (EDHF) to draft and submit a joint statement to WHO in support of its global oral health action plan. In addition, IFDH organized Global Oral Health Summits in 2021 and 2022 to explore how dental hygienists could help reduce the burden of oral diseases worldwide. A third summit will take place this fall on November 4. CDHA members can register free of charge for this virtual event at https://ifdh.org/global-oral-health-summit-2023/. Highlights of the previous summits are also available on IFDH’s website. Speakers at these inspiring summits have included key oral health leaders from numerous countries, such as Dr. Benoit Varenne, WHO Dental Officer, Oral Health Programme. It makes me proud to see our profession now on the world stage, making a difference in oral health globally.

On the home front, the persistent efforts of CDHA over the last 60 years to raise awareness of the profession and explain the critical role that dental hygienists play in our health care system are reaping rewards. The federal government has now recognized dental hygienists, along with dentists, as eligible providers under the interim Canada Dental Benefit and the forthcoming Canadian Dental Care Plan. CDHA was even invited to launch the interim Benefit (for children under 12 years of age), and we have a seat at the table, alongside dentists, in discussions about the details and roll-out of the long-awaited national dental care plan.

I do believe that the dental hygiene profession has come a long way since its inception. We all, as dental hygienists, need to reflect on and understand our history, as well as to acknowledge the important work carried out by our organized leadership through our professional associations to educate elected officials and the public about our role in the health care system. Without CDHA’s action and persistence in advocating for our profession, none of these changes would have been possible. Thus, I say thank you to CDHA for their ongoing guidance and leadership and thank you to IFDH for putting us on the world stage. Change takes time, but I believe we have reached a turning point in our profession and have become a well-respected partner in the health care arena. We should all be proud to be a part of this dynamic group of oral health professionals!

The key to success is action and the essential in action is perseverance.

—Sun Yat-Sen