Processes and Perspectives: The Work of Adha's Task Force on the Advanced Dental Hygiene Practitioner (Adhp) (Critical Issues in Dental Hygiene‪)‬

Since ADHA disseminated a document outlining specific competencies for an advanced dental hygiene practitioner (ADHP) in March 2008 (hereafter called "the ADHP competency document"), questions have arisen regarding the model underlying the ADHP's scope of practice and educational level, as well as reasonable paths for currently licensed dental hygienists to achieve these competencies. (1) The paper published in the current issue of JDH2 serves as the most recent description of an alternate model for an oral health midlevel provider; the author questions certain aspects of ADHP education and practice. Certainly, members of the ADHA Task Force would agree with many statements in the paper, especially that existing literature and a long history of practice in other countries strongly suggest that non-dentists can learn to provide care using treatment procedures traditionally limited to dentists, at a level of quality equal to dentists. In comparing the 2 proposals and evaluating the feasibility of each within the United States health care system, however, a critical reader must consider carefully: 1) processes used to develop the ADHP document and content of both proposals; 2) existing needs for dental care within U.S. populations likely to be served by the mid-level provider; 3) the cultural context of educational and care delivery systems into which the new U.S. mid-level provider must fit; and, 4) pragmatic issues surrounding adoption of a new provider. Thus, the purpose of this paper is to provide additional background regarding the processes and certain crucial perspectives used in developing the ADHP competency document.