Patients’ Perspective Regarding the Administration of Local Anesthesia by Dental Hygienist
Dental hygienists have been safely administering local anesthesia for over 40 years. Washington state was the first state to allow dental hygienists to administer local anesthesia in 1971. Since then 44 additional states have added the procedure to the scope of practice of dental hygienists. States that currently do not allow the administration of local anesthesia by hygienists include Texas, Delaware, Mississippi, Georgia, and North Carolina. As a dental professional, have you ever wondered what the patients’ perception of the dental hygienists that administer local anesthesia? A recent exploratory study published in October 2019 in The Journal of Dental Hygiene used a focus group to assess the patients’ perception.1
This exploratory study focused on three themes that included patient experience, patients’ perception, and future suggestions. The first theme, the patient experience had an overwhelming subtheme which was the value the participants placed on their time. Participants stated that there is a significant difference in the time saved when their hygienist administers LA versus waiting for the dentist to administer LA. Furthermore, many participants stated they prefer their hygienists to administer LA. They cite trust, rapport and comfort level as supporting factors to this preference. As a matter of fact, most participants described the administration of LA by their hygienist “more comfortable” than when their dentist administered LA.
The second theme, patients’ perception focused on the patient’s knowledge of educational requirements and clinical supervision as it applies to hygienists administering LA. It became blatantly apparent that the participants did not understand the educational requirements for hygienists administering LA. Two participants voiced their belief that assistants could administer anesthesia. There were a few disadvantages mentioned by participants when questioned about hygienists administering LA.
The third theme, future suggestions this theme focused on what patients ‘will come to expect of their dental experience as it applies to LA. Some participants mentioned that they would consider switching dentists if their dental hygienist was not administering LA. Some participants said they would voice their concerns to the dentist about the hygienist not administering LA. Participants unanimously supported legislation to allow changes in practice acts allowing hygienists to administer LA.
Half of the participants admitted to having a more positive experience when their hygienists administered LA when compared to their experience when their dentists administered LA. The three main points that contributed to the participant’s better experience were “patients’ value not being rushed, a slower injection technique, and being talked through the experience”. The study highlighted “implication for dentists” which recommends dentists practicing in states that do not allow dental hygienists to administer LA should consider patients’ perceptions and consider working towards an overall patient-centered care model. This would include allowing hygienists to administer LA.
After reading the article, do you believe local anesthesia administration should be allowed for all licensed hygienists? In your opinion, what are the reasons some states have yet to approve this scope of practice for hygienists? If you are a hygienist licensed and providing care in a state that does not allow administration of LA, how does that limitation make you feel as it applies to your ability to provide care for your patients?
Smith AM, Gurenlian JR, Freudenthal J, Appleby KM. Patients’ Perspective Regarding the Administration of Local Anesthesia by Dental Hygienists. J Dent Hyg. 2019;93(5):40–47.
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