We have started 2025, and it has already brought many changes to our daily professional lives. Some seasoned dental professionals retired at the end of 2024 and decided to go on a different path in 2025. Some dental professionals recently graduated in December and are beginning their careers in dentistry.
Tracee S. Dahm, MS, RDH.
Across the nation, all of us wait to see how the issue of fluoridated water will play out as a new president has taken office and there have been rumblings within his potential administration picks of removing fluoride from the water supply. Finally, 2025 will change our professional lives because a compact license for dentists and dental hygienists may go into effect this year.
The Dentist and Dental Hygienist Compact (DDHC) license is also known as the Privilege Compact, because it will allow already licensed dental professionals from one state to practice in any state that adopts this compact.
The DDHC first surfaced in the news in January 2023. At that time, the National Center for Interstate Compacts at the Council of State Governments collaborated with the U.S. Department of Defense, the American Dental Hygienists' Association, and the ADA to outline this compact. After the DDHC was drafted, at least seven states had to enact the Privilege Compact through legislation. Fifteen months later in April 2024, Maine became the seventh state to agree to participate in this compact.
Now, more work is still required. Each state in the compact requires an appointee to discuss and implement a data collection system to monitor all dental professionals who wish to apply for and hold this licensure.
The data collection will hopefully help ensure that dental professionals uphold all standards needed to maintain privileges to practice in the states in the DDHC. In January 2025, two years after the initial start of the privilege compact, 10 states have now agreed to be a part of this compact license. In addition, 13 more are considering adopting the DDHC. There is no starting date for professionals to apply for the DDHC.
While dentistry has been around for centuries, some modern-day dental team members never thought they would see the day that a compact license would allow dental providers to practice with one license rather than apply to each state they wanted to work in. As we began to lose more licensed professionals to retirement, the industry quickly realized there would eventually be more dental patients than dental providers. Burnout and the COVID-19 pandemic compounded the dental workplace shortage exponentially. Now, we are years into a frightening time where many dental providers have no hygienist to treat their patients.
One of the compelling arguments that called for a dental compact license to be drafted was that allowing licensed practitioners to have more opportunities to practice in more states would possibly reduce the shortage because many dental professionals are already practicing near state borders and cannot cross because they are not licensed in the neighboring state.
In addition, military spouses find it difficult to practice as they are often forced to relocate, which hinders their ability to practice in a new state. Once again, it was argued that having one dental compact license could reduce the workplace shortage because military spouses, or anyone forced to relocate to new states frequently, could quickly begin practicing in a new area if they were already licensed in another state.
While it is normal for change to bring about emotions, it is interesting to consider that, while we are at the forefront of the start of something new in dentistry, something that many of us thought would never come to be (one license to practice across multiple states) despite the excitement, we are experiencing other emotions. Some dental professionals are deeply concerned about the DDHC and do not support it. They are worried that the current drafted standards are insufficient and should be held to a higher standard.
There have been arguments posed that many states have different educational requirements for dentistry, such as lasers, continuing education requirements, autonomy, and local anesthesia. Until the credentials have more specific rather than generalized language, some professionals want another dental compact license to be considered.
Other emotions regarding the DDHC are high due to other changes happening to dental hygienists. With so many dental clinics and offices unable to provide care, vast changes have been happening to dental hygiene practice. Recently, the ADA decided to change who could practice dental hygiene to reduce the dental professional shortage. The ADA also suggested that some dental hygiene schools increase the number of graduates per class. Some dental professionals hoped that before resolutions enacted by the ADA were designed and drafted such as these, a dentistry compact license would have solved the shortage problem.
Surprisingly, many dental professionals are unaware that a DDHC license is close to being fully activated. Some have not even heard of it or its progress. In addition to the DDHC, another dental compact license is in the draft stages: the Interstate Dental and Dental Hygiene Licensure Compact (IDDLC). I encourage professionals to look up both the DDHC and the IDDLC to learn about their states' progress toward adopting these compact licenses and to understand their differences in design further.
No matter which way you look at it, changes are coming to dental hygiene. While we can all agree that we need more providers to improve access to care, there is no clear solution as to how we bring more providers into the workforce. Hopefully, with time, an agreement will be reached so that a compact license of some sort will be granted. More pertinent is the pressing issue of how dental patients will receive care while we figure out how to get more providers.
Editor's note: References available upon request
Tracee S. Dahm, MS, RDH, is an adjunct clinical instructor for the North Idaho College School of Dental Hygiene in Coeur d’Alene, ID. She also works in private practice. Dahm has published articles in several dental journals, magazines, and a textbook. Her research interests include trends in dental hygiene and improving access to dental care for the underserved. She can be reached at [email protected].
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
