THE DENTAL HYGIENIST: THE FIRST HALF-CENTURY 1913 TO 1963

During the period 1913-1963, a sub-specialty of the dental profession called dental hygiene was created and developed into an integral part of the practice of modern dentistry. The concept of dental hygiene rests on the premise that dental disease can be prevented provided individuals practice certain preventive measures such as proper flossing and brushing of the teeth assisted by proper diet, the use of topical fluoride treatments and by the periodic performance of dental prophylaxis. Essential components to the accomplishment of the above steps are: motivation of the patient to conform to this regimen and effective instruction on how to perform his or her portion of it properly. In actual practice, the performance of dental prophylaxis and patient motivation and instruction are extremely time consuming. Dentists certainly can perform these functions but when they do so it is done at the expense of other dental operations which only graduate dentists are allowed to perform such as restorative dentistry and dental surgery. This study details how the dental profession created the sub-specialty of dental hygiene to perform the tasks of dental prophylaxis and patient instruction. Moreover, the reasons why women were chosen to fill the role of the dental hygienist are explained in the context of the economic, technical, sociological, philosophical, demographic, educational and sexual factors which shaped that decision. The story of dental hygiene in America, from the Fones School of Dental Hygiene in 1913 to the end of the first half-century of dental hygiene in 1963 is a story of a struggle for role definition and acceptance both within the dental profession and by the general public. Wars, periods of prosperity, economic depression and recession have caused either the acceleration or the retardation of the dental hygiene movement in America, but since 1913, the progress of dental hygiene as a concept and the progress of the dental hygienist as a member of the dental care delivery team has been, overall, steady and upward. Although the future of dental hygiene is apparently assured, the future of the profession is somewhat unclear as to what expanded functions the dental hygienist may be allowed to perform. Traditionally, dentists have been reluctant to delegate functions other than prophylaxis and patient instruction. Nevertheless, there is an overall pattern that suggests as the frontiers of dental technique and sophistication expand, dentists increasingly delegate those duties which, by comparison with new and complex techniques, seem routine. But, whatever the future holds for dental hygiene, that future will be influenced by economics, technological developments, the federal government and consumerism