Abstract：
The American Dental Hygienists\' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient\'s needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist, and maintain a provider-patient relationship. In 2000 there were nine direct access states; currently there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships which have influenced and advocated for direct access and the recognition of dental hygienists as primary health care providers. The National Governors Association (NGA) released a report in 2014 suggesting that dental hygienists be \"deployed\" outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies, and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential health care providers, prepared to deliver direct access to dental hygiene care.
摘要：
美国牙科保健员协会（ADHA）将直接访问定义为牙科保健员在没有牙医特定授权的情况下根据对患者需求的评估开始治疗的能力。在没有牙医在场的情况下治疗患者，并保持医患关系。2000年有9个直接访问州；目前有42个州授权某种形式的直接访问。通过强有力的宣传努力，ADHA在这些立法举措中发挥了重要作用。虽然研究和数据支持牙科卫生人员提供的直接预防/治疗护理的好处，许多障碍仍然存在。本文记录了主要的伙伴关系，这些伙伴关系影响并倡导直接获取和认可牙科卫生师作为初级卫生保健提供者。美国国家州长协会（NGA）在2014年发布了一份报告，建议将牙科卫生员“部署”在牙科诊所之外，作为增加口腔保健服务的一种策略，同时减少限制性牙科实践行为并增加牙科卫生员的实践范围。2021年12月发布的美国国立卫生研究院报告，美国的口腔健康,进一步支持更多机会获得牙齿卫生预防/治疗护理。本文还反映了与劳动力政策相关的机会和障碍，提供了有效的州政策的示例，并说明了专门为准备牙科卫生师在牙科诊所以外的环境中提供口腔健康服务而创建的教育课程。口腔卫生教育必须确保毕业生作为基本的医疗保健提供者做好未来准备，准备提供直接的牙齿卫生护理。
