Extracting a compromise - Legislators may have reached a deal on a dental health bill

A compromise has been reached that may allow an important dental health bill to reach the governor's desk. The measure, AB 1334 by Assemblyman Simon Salinas, D-Salinas, permits dental hygienists to clean patients' teeth independently without first getting a prescription from a dentist. The bill has faced opposition from the state's dentists, who have claimed that it poses a risk to patient health.

There is no evidence of that, and in fact the opposite is true. Studies in which hygienists have served 20,000 patients independently in pilot project settings over 16 years show no adverse impacts whatsoever.

We suspect the dentist's real concern here is economic. If hygienists work independently, outside a dentist's office as this measure allows, dentists may lose money. But for millions of poor Californians, particularly children who have no dental insurance, the Salinas bill would provide desperately needed access to dental care.

In the last weeks of the legislative session, dentists have offered to withdraw their opposition if the Salinas bill is amended to require hygienists working independently "to obtain written verification that every patient has been examined by a dentist or physician" no later than 18 months after a hygienist provides services. In other words the hygienists would provide a referral to the dentists after their work is done, not before. It's a reasonable compromise particularly given the fact that hygienists working independently routinely refer their patients to dentists anyway.

But for this compromise to work, dentists must be willing to serve the many poor patients hygienists in this program will send to them. In crafting this compromise, the California Dental Association has promised to seek the cooperation of its members. This is good news for untold thousands of Californians.