ASPECTS OF QUALITY OF DENTAL HYGIENE CARE IN SUPERVISED AND UNSUPERVISED PRACTICES

Objective: The purpose of this study was to assess aspects of the qual ity of care provided by dental hygienists in a California demonstratio n project in which hygienists treated patients independent of dentists ' supervision. Methods: The structure and process of care were evaluat ed in nine independent practices using site visits and reviews of 25 r ecords at each practice. The findings were compared to evaluations of six general dentist practices reviewed for a government agency and ins urance company during the same time period Patient satisfaction was as sessed by a questionnaire. Results: The structural aspects of the unsu pervised hygienist practices were generally acceptable and surpassed t he dentist practices in most areas, including infection control. For p rocess, the hygienist practices had high percentages of acceptable car e and were significantly better than the dentist practices in several areas, including follow-up to medical findings, updating the medical h istory at recall, and documenting the evaluation of the periodontal st atus and soft tissues. Ninety-eight percent of patients expressed sati sfaction with their care in hygienist practices. Conclusion: Under the circumstances of the demonstration project and the methods used to as sess the quality of care, the study showed that independent dental hyg ienist practice did not increase the risk to the health and safety of the public.