Dental hygienists are experiencing rapid changes that are redefining their clinical roles, professional identity, and career paths. New technologies, expanded scope of practice, and a shifting healthcare landscape are opening doors beyond traditional operatory settings. At the same time, the profession is confronting long-standing challenges around autonomy, compensation, and workforce sustainability.
By embracing technological innovations and initiating broader conversations about patient-centered care and interprofessional collaboration, today’s hygienists are navigating a complex but exciting transformation. Voices from across the field are making it clear: The profession is not only adapting to change but actively shaping the future of oral health.
As the dental hygiene profession continues to evolve, leaders like Lancette VanGuilder, BS, RDH, PHEDH, CEAS, FADHA, president of the American Dental Hygienists’ Association (ADHA), are helping to shape a future defined by autonomy, expanded practice settings, and recognition of dental hygienists as essential healthcare providers. With nearly three decades of experience as a clinician, educator, business owner, and policy advocate, VanGuilder brings a wide-angle view to the forces reshaping the field.
“We are not stagnant,” VanGuilder says. “We are progressing very fast.” She characterizes the current moment as a transformation from a procedure-
centered model focused narrowly on teeth, to a provider-centered model in which hygienists are recognized as prevention-focused healthcare professionals bridging the gap between oral and systemic health.
One of the most significant trends VanGuilder sees is the push for professional autonomy and self-regulation. While dental hygiene is one of the few health professions not self-regulated, she notes that is beginning to change. “More states are pursuing self-regulation,” she says. “Nurses have been self-regulated for over 110 years. It’s time for hygienists to have the same professional oversight.”
VanGuilder believes that autonomy is foundational not just for professional growth, but also for improving public health outcomes. As she explains, “My vision for hygienists is that they can serve the public in every setting where health happens.” For her, that means hospitals, schools, medical clinics, wellness centers, and more. “If we are still relying on people to come into the dental office, take time off work, away from their families, we’re only reaching a small percent.”
While regulatory change is one area of transformation, cultural and digital shifts are also redefining how hygienists engage with both peers and the public. Ashley Leavitt, RDH, who has practiced in five states during her 15-year career and now works full time in private practice in Eugene, Oregon, sees social media as a surprising but powerful trend shaping the profession. “In the last year the number of dental influencers has increased, and this is a great deal of exposure for our profession,” Leavitt says. “On a public level, it’s helping improve dental literacy. On a professional standpoint, it’s allowing for ideas to be shared, techniques to be discussed, updates on laws, advocating for our profession, and so on.”
Leavitt also notes a shift toward expanded roles for hygienists in areas traditionally dominated by other healthcare providers. “Oregon just passed a measure allowing hygienists to offer Botox for dental-related issues, and this is huge,” she says. “Nurses have been able to do this for years, and it’s been frustrating that dental hygienists couldn’t as well. I’m excited to see what doors open for myself in this new field that hygienists are getting to enter.”
Nevada, where VanGuilder lives and practices, serves as a case study in expanded opportunity. In addition to working in a private dental practice, she owns a mobile dental hygiene business and provides care independently through a nonprofit she founded. “In Nevada, I have full scope of practice. I don’t work with a dentist. I don’t have a collaboration agreement. It’s truly independent practice,” she says.
Stephanie Pajot, RDH, BS, has more than 20 years of clinical experience in periodontics, laser dentistry, and implants, and she has contributed to numerous continuing education programs. She emphasizes growing awareness among hygienists of their economic value and a willingness to speak up about it. “There is a clear and growing trend across dental groups on social media, where dental hygienists are increasingly recognizing their professional value,” Pajot says. “They’re reassessing whether their employers acknowledge their contributions as both key team members and revenue generators.”
Pajot says meaningful change will require systemic alignment with other healthcare professions. “My hope is that we move toward aligning compensation and benefits for dental hygienists comparable to other healthcare professionals, such as nurses,” she says. “We have a dental hygienist shortage for a few reasons, and this may be one of them. Some employers assume hygienists have a spouse who provides benefits, but that is not always the case. There may also be a need for reform in dental insurance fee schedules and annual maximums to better reflect the economic realities of today.”
Alongside this growing awareness of professional worth, dental hygienists are also taking on increasingly diverse clinical responsibilities. VanGuilder is enthusiastic about the profession’s expanding clinical scope. “We’re seeing hygienists deliver vaccines, prescribe medications, perform myofunctional therapy, and even administer Botox and dermal fillers in some states,” she notes. In addition, she says, many are using AI-driven technologies, salivary diagnostics, and screening tools for conditions such as heart disease, diabetes, HPV, and sleep-disordered breathing. ADHA, for its part, has adopted policies supporting hygienists as “early risk detectors” for airway health, reflecting the profession’s growing role in whole-body care.
Kari Carter-Cherelus, RDH, DA, a speaker and educator who supports hygienists in building sustainable, burnout-resistant careers, highlights the increasing range of roles available to today’s clinicians. “Hygienists are stepping into public health roles in community clinics and schools, corporate and industry positions as key opinion leaders and clinical educators, alternative clinical settings, AI implementation, and even research, technology, and entrepreneurship,” she says. “This diversification not only strengthens our profession but also broadens our impact on both oral and overall health.”
Carter-Cherelus hopes to see the profession continue to break down barriers to mobility and leadership. “That includes an expanded scope of practice with increased autonomy, stronger collaboration with other healthcare providers, and more opportunities for hygienists to step into leadership roles,” she says. “I’d also like to see nationwide license portability and more flexible work schedules, giving hygienists the freedom to practice across state lines and create careers that support both professional growth and work-life balance.”
As hygienists explore new career paths, innovations in daily practice are also reshaping patient care approaches. Michelle Strange, MSDH, RDH, founder of Level Up Infection Prevention and host of the video podcast A Strange Curiosity, says the evolution of technology is changing daily practice in real ways. “Something I have integrated into clinical practice and use almost every day is desiccation therapy,” she says. “I’m finding that this is really upping my game for my patients who have good home care but are still bleeding or are periodontally involved.”
Strange also sees a larger cultural shift underway in the way hygienists approach care. “I talk a lot about patient-centered care and moving away from provider or ego-centered care,” she says. “We need to look at the patient as an individual and tailor care, tailor our conversations, and understand what their barriers are—whether it’s fear, finances, time, or just ambivalence. I’d really like to see us become a little bit more kind to our patients.”
Interprofessional collaboration is also gaining ground. Hygienists are increasingly part of broader healthcare teams, working alongside physicians, nurses, and specialists. According to VanGuilder, this shift reflects not only evolving health system needs, but also the aspirations of hygienists themselves. “They want the opportunity to work in all settings where health happens,” she says.
Amanda Hill, BSDH, RDH, CDIPC, a consultant, speaker, and educator known as the “Waterline Warrior,” sees the rise of prevention-first dentistry as the most meaningful change in the profession. “Hygienists are finally embracing their role as prevention specialists,” she says. “There are so many more opportunities now to prevent disease, instead of just continuing to do bloody prophies or chase disease.”
Hill points to minimally invasive options like silver diamine fluoride, Curodont, and glass ionomer, along with adjuncts like Perio Protect and desiccants, as part of the profession’s move away from reactive care. “We can do a lot more to help optimize our patients’ health and stop babysitting disease,” she says. “That will change somebody’s overall health. We understand that now.”
Joy D. Void-Holmes, RDH, BSDH, DHSc, a voice in education, inclusion, and clinical innovation, sees technology as a major catalyst reshaping dental hygiene. With nearly 30 years of experience and as the founder of drjoyrdh.com, she champions a vision of empowered, tech-savvy hygienists fully embracing their role in oral-systemic care.
Void-Holmes, who goes by “Dr. Joy,” identifies two critical trends driving that shift: artificial intelligence (AI) and salivary diagnostics. “AI is transforming the dental hygiene profession in ways that were once unimaginable,” she says. “It’s enabling hygienists to determine clinical attachment loss with greater accuracy and conduct more comprehensive periodontal assessments.”
Though initially viewed as a dentist-centered tool, AI is now being integrated directly into hygiene workflows, helping hygienists elevate their diagnostic role and improve patient outcomes, Dr. Joy says. She’s equally enthusiastic about saliva as a diagnostic medium, especially as research continues to uncover biomarkers linked to both oral and systemic conditions. “Saliva is rapidly gaining recognition as a powerful diagnostic tool,” she explains. “It contributes to caries-risk assessment and offers a non-invasive pathway to earlier disease detection.”
Beyond clinical innovation, Dr. Joy is also thinking about long-term professional sustainability. She hopes to see hygienists more fully empowered to practice to the top of their scope and to become equipped with the training to do so confidently. “Hygienists must advocate for their role as highly trained healthcare providers,” she says, encouraging advanced education that enables clinicians to move beyond the traditional ‘scale and polish’ model.
This mindset, Dr. Joy says, will be key to expanding practice settings and ensuring hygienists are recognized as leaders in oral and maxillofacial health. “The future of dental hygiene lies in embracing innovation, advocating for professional autonomy, and continually striving to elevate the standard of care,” she says.
VanGuilder emphasizes that this changing landscape is also driving innovation and entrepreneurship among hygienists. “They’re opening their own practices or wellness centers. They’re creating new revenue streams, leading teams, and taking ownership of their professional narrative,” she says.
Though workforce shortages persist in some areas, VanGuilder says hygienists remain a “ready-made workforce—college educated, licensed, and dedicated to promoting public health.” With the highest number of dental hygiene graduates in history entering the field this year, she is optimistic about the profession’s long-term stability and growth.
Two developments likely to support that growth are the recently enacted Dentist and Dental Hygienist Compact (DDH), which increases license portability across state lines, and the updated Standards for Clinical Dental Hygiene Practice, which VanGuilder calls a “modern, evidence-based framework” that reflects the profession’s evolution since the last major update in 2016.
Ultimately, VanGuilder sees the future of dental hygiene as deeply tied to autonomy, interprofessional collaboration, and recognition. “Dental hygienists are essential healthcare providers,” she says. “We are driving advocacy, building strong relationships, and making a bold push for policies that recognize our full scope of practice and autonomy. This is how we truly improve health.”
The dental hygiene profession is advancing on multiple fronts, including clinical innovation, expanded scope of practice, increased public visibility, and active policy engagement. The new generation of hygienists is stepping into leadership roles and reshaping the definition of care delivery. Their message is clear: dental hygiene is not merely an extension of dentistry, but a critical component of the future of healthcare.
