Current Florida Law Prohibits Kids’ Dental Care by Licensed Hygienists

Sep 29, 2008




As many as 90 Percent of Kids Eligible for Medicaid-Funded Dental Health Care May Go Untreated, Miss School

With support from the State Legislature, as many as 90 percent of Florida’s needy children could gain access to preventive dental health care. 

Favorable outcomes of direct-access dental health legislation passed by other states has made it possible for these underserved populations to comparable services.

Given legislative support, Florida-licensed dental hygienists could deliver this type of preventive dental care to Florida’s neediest.

Below are some statistics from the Florida Dental Hygienists’ Association on direct access care and several related charts are enclosed for your review. 

To view a map of those states affording direct access, click here.

To view a list of states where dental hygienists may provide services without the presence of the dentist in at least one setting outside the dental office, click here.

To view a United States map showing direct access in some settings other than a dental office, click here.

Should you have any questions or comments, please do not hesitate to contact Colodny Fass.



Preventive dental hygiene services, such as oral prophylaxis, fluoride applications, and sealants, can contribute to improving the oral health of Florida’s underserved populations.  For example, approximately 1.8 million children in Florida are eligible for Medicaid dental benefits. However, only 10% of dentists are Medicaid providers.   Nationwide, 51 million school hours are lost due to dental related illnesses, with the greatest impact on school-age children coming from low-income families.  Dental hygienists are licensed professionals who are educated in dental prevention and qualified to provide preventive services in all settings. However, current Florida statutes effectively restrict direct access delivery of preventive care by hygienists in public health settings.   

• Twenty-eight states, in one form or another, currently allow direct access to dental hygiene services in public health settings.  Since 1984, dental hygienists in the state of Washington have been providing unsupervised services in public health settings. In 2008, Maine passed comprehensive legislation allowing direct access to dental hygiene services.

• Levels of supervision range from individual preauthorization for services by a dentist (ID, NH) to unrestricted delivery of dental hygiene services (CO, CT MI, MO, NY, NV, PA, WI).

• Each state determines the types of services permitted, ranging from child prophylaxis, fluoride and sealants only (MO, NE) to comprehensive dental hygiene services, including adult prophylaxis, x-rays, periodontal scaling, and local anesthesia (WI, WA, TX, RI, PA, OR, OK, NV, MN, ME, CO, AK).  

• Requirements to provide these levels of care are determined by individual states and vary widely, from a dental hygiene degree and license (CO, RI, WI) to varying levels of education ranging from an Associate degree to a Bachelors degree and up to five years of experience (AK, AZ, CA, CT, ID, MO, ME, NM, OK, TX, WA).  In several states, permits must be applied for and granted by the Board of Dentistry (ID, KS, MI, MT, NV, OR).

• Treatment provided by these hygienists in public settings has been ongoing since 1984.  The results have been reported in the hundreds of thousands of procedures completed.  In New York alone, 100,000 children received care, 30,000 sealants were applied in 2005. 

Based on the favorable outcome of direct access legislation in other states, underserved populations are receiving preventive care.  With legislative support, Florida-licensed dental hygienists can be instrumental in delivering this critical care to underserved Floridians.

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