A New Midlevel Dental Provider in Oregon:

Dental Hygienists' Perceptions

Courtney Gallaway, SDH; Janet Lee, SDH; Kathryn Bell, RDH, MS; Amy Coplen, RDH, MS
Pacific University School of Dental Hygiene Studies, Hillsboro, Oregon
ABSTRACT RESULTS DISCUSSION
Objectives: As the U.S. continues to face an increasing demand for oral
DEMOGRAPHIC INFORMATION INTEREST IN BECOMING A MIDLEVEL POVIDER BASED ON LOCATION Over half of the dental hygienists in Oregon
healthcare, many states are examining alternative provider models as
well as the role of the dental hygienist to meet their access to care crisis. Male Female
n=2
surveyed in this study agree that a new midlevel
Clatsop
The purpose of this study was to assess Oregon dental hygienists Gender (n=444) 10 2% 434 98% Columbia
n=2
n=18
provider is needed in the state.
opinions on scope of practice limitations of dental hygienists, perceived Tillamook n=32 n=1 n=2
Wallowa The majority of dental hygienists in this study
n % Washington Multnomah Hood Umatilla
need for a mid-level provider in Oregon, and personal interest in River Morrow n=2

becoming a midlevel provider. Methods: A survey was mailed in Expanded Practice Permit n=4
Yamhill
n=14
Clackamas n=1
Sherman
n=1
Gilliam
Union agree or strongly agree that if a midlevel provider
182 41% n=17
were to be introduced in the state of Oregon, that
December 2013 to a 30% (1231) sample of dental hygienists registered in Holders (n=444) Polk Marion
Wasco

Baker
Oregon which included all expanded practice permit holders (351). All ADHA Members (n=444) 164 37%
n=2
Lincoln n=1
Jefferson
Wheeler
individual should be a registered dental hygienist.
n=4 Grant
other survey recipients were randomly selected from the total 4101 Benton
Linn

registered dental hygienists in Oregon. The 32-question survey was Crook Opinions on the necessary training for a midlevel
MIDLEVEL PROVIDER NEED AND INTEREST LEVEL n=8
developed in consultation with the chair of the Oregon Dental n=16
Lane
Deschutes provider varied depending on the level of
Hygienists Association government relations counsel and had four n % education of those surveyed with the majority
categories: Scope of practice, midlevel provider, current practice, and A midlevel provider is believing that a bachelors degree was sufficient.
n=1 n=5
demographics. A total of 444 surveys were returned for a response rate needed (n=439) 258 59% Coos Douglas
Harney
Malheur

of 36%. The study was approved as exempt by the Pacific University IRB. Lake

Personal interest in The most popular avenue of education was an

Results: Over half (59%) of DHs surveyed believe a midlevel provider is n=4

needed in the state. Those who believed a midlevel provider was becoming a midlevel 186 43%
n=1
Curry
n=2
Josephine
n=9
Klammath online course with a clinical internship.
Jackson
needed were significantly higher among individuals holding an expanded provider (n=433) The least feasible option for dental hygienists
practice permit and members of the American Dental Hygienists interested in pursuing further education to
Association (ADHA) (p<0.0001). Ninety-one percent (n=400) of become a midlevel provider was a traditional
MOST FEASIBLE AVENUE OF NEED FOR A MIDLEVEL PROVIDER BASED ON
respondents agreed or strongly agreed that if a midlevel provider was
introduced in Oregon it should be a registered dental
EDUCATION IF INTERESTED IN ADHA MEMBERSHIP n=437 onsite program.
BECOMING A MIDLEVEL PROVIDER P<0.0001
hygienist. Forty-three percent (n=186) of respondents were interested n=181 Dental hygienists who had a personal interest in
in becoming midlevel providers. Forty-seven percent (n=203) of
respondents believed the education for a midlevel provider should becoming a midlevel provider were located all over
consist of additional training ending in a bachelors degree. The majority the state of Oregon.
of those interested in becoming a midlevel provider (74%, n=137) prefer
to gain their education through online teaching with a clinical internship. ADHA members and those who held an expanded
Conclusion: Dental hygienists in Oregon believe there is a need for a practice permit were more likely to believe a
midlevel dental provider. An overwhelming majority of all responding % add up greater than 100 because participants midlevel provider was needed in the state, which
were instructed to check all that apply
dental hygienists believe that provider should already be a registered
may indicate a greater interest in the
dental hygienist. Those interested in developing a curriculum for a
midlevel provider should consider including online teaching with a OPINION ON LEVEL OF TRAINING FOR MIDLEVEL PROVIDER BASED ON LEVEL advancement in the profession for those who
clinical internship component. OF EDUCATION n=430 meet that criteria.
NEED FOR A MIDLEVEL PROVIDER BASED ON HOLDING
P<0.001
METHODS AN EXPANDED PRACTICE PERMIT n=437
P<0.0001 CONCLUSIONS
This study was approved by the Pacific University IRB.
A 32-question survey was developed in consultation The findings of this study indicate many dental
with the chair of the Oregon Dental Hygienists hygienists in Oregon believe there is a need for a
Association government relations chair. midlevel provider.
A 30% sample of dental hygienists from the state was A large pool of individuals interested in becoming
selected which included all dental hygienists who held a midlevel provider exists across the state.
an expanded practice permit.
With increasing legislation supporting pilot programs
A total of 4101 surveys were mailed and 444 surveys
to explore implementation of alternative workforce
were returned for a response rate of 36%.
models in oral healthcare across the country, flexible
The response rate of Expanded Practice Permit (EPP)
modes of delivering education should be explored.
holders was 51% (n=182).