# Reforming Dental Hygiene Education in Fresno, CA: Challenges and Opportunities - Canonical: https://33rdsquare.com/reforming-dental-hygiene-education-in-fresno-ca-challenges-and-opportunities/ - Published: 2024-04-08 - Author: Charlene Farwell - Categories: [School](https://33rdsquare.com/category/education/school/) --- As a Higher Education Reform Expert based in the United States, I continually analyze the postsecondary landscape across the country, identifying fields ripe for improvement. One area warranting closer examination is dental hygiene programs, specifically in the Fresno, California region. While the current associate‘s degree offering has demonstrated success, there is room for significant development to improve access and equip more professionals to serve vulnerable populations. ## The Vital Role of Dental Hygienists Dental hygiene is a crucial healthcare profession focused on preventive oral care and patient education. As described by the American Dental Hygienists‘ Association (ADHA), dental hygienists "provide preventive, educational and therapeutic services supporting total health for the control of oral disease and the promotion of oral health" (ADHA, 2023). They work alongside dentists conducting tasks like teeth cleanings, dental x-rays, sealants, fluoride treatments, and more. Their role is vital for promoting good oral health and helping patients maintain healthy teeth and gums. The U.S. Bureau of Labor Statistics (BLS) projects that employment for dental hygienists will grow 10% between 2021-2031, higher than the average across all occupations (BLS, 2022). This substantial job growth can be attributed largely to greater utilization of preventive dental services and expanded coverage for these services through various public and private health insurance policies. As more dental patients seek preventive care and dentists themselves work fewer hours as they approach retirement age, the workload conducted by dental hygienists expands significantly (ADHA, 2020). Educating more professionals to meet this increasing demand and adequately serve vulnerable populations with poor dental care access is imperative. ## The Stringent Requirements for Licensure To qualify for licensure and clinical practice, dental hygienists must complete specialized postsecondary education through certificate or degree programs accredited by the American Dental Association‘s Commission on Dental Accreditation. The majority of dental hygienists hold associate‘s degrees granted by community or technical colleges. However bachelor‘s and master‘s programs are also available for those pursuing higher levels of training (BLS, 2022). Degree-granting programs in dental hygiene cover topics like oral anatomy, microbiology, radiography, periodontology, pain management, clinical procedures, and supervised hands-on practice. Students gain extensive experience with digital imaging, dental sealants, administering anesthetics, teeth cleaning methodology, and patient education strategies (ADHA, 2020). After completing an accredited dental hygiene program, graduates must pass both a computerized National Board Dental Hygiene Examination and a regional or state clinical board examination to apply for licensure (ADHA, 2020). Passing rates across both exams average around 90% nationally (ADHA, 2020). ## The Oral Healthcare Situation in Fresno, CA Fresno is the fifth most populous city in California, home to over 530,000 residents with a median household income of $48,000, compared to $80,000 statewide (Census Bureau, 2021). Nearly 30% of Fresno residents live below the federal poverty line. Furthermore, California‘s Health Places Index shows Fresno County ranking near the bottom statewide across an array of health indicators like life expectancy, access to care, housing stability, and more (California Health and Human Services, 2022). Rates of oral disease prevalence also tend to be higher in poorer communities (CDC, 2021). Expanding and strengthening dental hygiene training in Fresno presents a major opportunity to build the local workforce so more residents can access oral healthcare. A study published in the _Journal of Dental Hygiene_ highlighted the link between preventative services provided by dental hygienists employed at safety net clinics and improved health outcomes for underserved patients (Langelier, Wing & Continelli, 2016). The clinics studied showed increased rates of oral exams and teeth cleanings as well as "reductions in patients needing urgent dental treatment" after bringing on full-time dental hygienists (Langelier et al., 2016). ## Evaluating Local Program Options and Outcomes Currently in Fresno, options are severely limited for pursuing dental hygiene education and training locally. Fresno City College is home to the only dental hygiene associate‘s degree pathway in the region. This two-year, 78-unit program admits just 36 students each fall from a competitive applicant pool. The Commission on Dental Accreditation recently granted Fresno City College the maximum seven-year reaccreditation following a rigorous site evaluation (FCC, 2021). This achievement along with stellar student outcomes data signifies an exceptional program: - Graduates demonstrated a 100% first-time pass rate on the National Board Dental Hygiene Examination in four out of the last five years, higher than state and national averages (Fresno City College, 2022). - Over the past 5 cohorts, an average of 94% of graduates passed the California state clinical board exam required for licensure on their first try, again beating average pass rates (Fresno City College, 2022). - A Fresno City College alumni survey found 100% of responding graduates are employed in the dental hygiene field (Fresno City College, 2022). Fresno City College‘s dental hygiene graduates clearly gain the competencies needed for professional success. However, restricted program capacity along with wider regional limitations curb education access and hinder workforce expansion: - With just 36 openings each year, hundreds of prospective students are denied enrollment locally. Graduates report wait times averaging 4-5 years to start the program given huge demand (Fresno City College, 2022). - Lack of qualified faculty, clinical facility limitations, reduced public funding, and inadequate scholarship/grant availability prevent growth (Rogers, 2022). - There are no bachelor‘s programs in dental hygiene offered regionally, preventing professional development and creation of advanced clinician/leader roles (Fresno City College, 2022). Boosting funding, resources, institutional partnerships, and diversifying program options could expand access drastically. ## Key Areas for Reform and Development To better serve student and healthcare needs in Fresno, the following priorities for improving the local dental hygiene education landscape show promise: ### Increasing Program Capacity With current infrastructure and funding constraints, Fresno City College cannot physically accept more students without major facility and staffing expansions. Constructing a dedicated clinical training center equipped with the latest technology along with recruiting more seasoned faculty could broaden capacity immensely. Community partnerships for hands-on learning can supplement on-campus clinics. Telehealth simulations using instructor-led virtual reality when in-person placement is unfeasible boosts experiential learning as well. Financial incentives like tuition credits may help recruit dentistry preceptors (Rogers, 2022). The California state budget last year included $130 million in workforce funding specifically for healthcare vocational programs like dental hygiene (California Legislative Analyst‘s Office, 2022). Channeling a portion of these funds along with other revenue streams into local capacity building is prudent. ### Enhancing Affordability The high costs associated with clinical education can exclude students from lower socioeconomic backgrounds. Fresno City College‘s dental hygiene program costs over $7,100 for California residents (Fresno City College, 2023). Additional expenses for equipment, materials, and licensing exams tally thousands more. Medi-Cal now reimburses for roughly 300 dental hygiene services, meaning safety net clinics can hire more practitioners (Chaparro, 2022). Securing higher Medi-Cal patient revenue helps fund education programs and salary packages used to attract talented graduates. State and federal financial aid specifically for healthcare fields makes school more accessible for talent from all economic strata. Reasonable benchmark tuition pricing also helps. If free community college comes to fruition nationally or statewide, the game changes completely. ### Diversifying Degree Options Instead of Fresno City College operating the only regional pathway, a collaborative dental hygiene academy could offer varied programs. Linking associate‘s, bachelor‘s, and master‘s opportunities between multiple area institutions provides flexibility while widening eligibility via credited transfers. Degree diversity also enables professional growth locally. Online and hybrid learning options must expand post-pandemic too. This convenient format maintains robust enrollment and allows students to train anywhere. Emerging research shows web-based curricula and telehealth simulation actually produce equally competent clinicians compared to traditional instruction when applied judiciously (Rogers, 2022). Integrating dental therapy and dental health coordinator roles that can be filled with shorter training programs broadly boosts team capabilities also (ADHA, 2020). Stakeholders must align what education level best suits each provider responsibility. ### Prioritizing Community Partnerships Institutions, health centers, tribal networks, public agencies, and professional groups all have vested interest in optimized dental hygiene training and enhanced care access. The Fresno State Rural Health Research Institute is a prime example of an entity that could collaborate on rural community program development, clinical rotations, and recruitment given its focus areas (Fresno State, 2022). Unity between stakeholders creates connectivity between education priorities and healthcare demands. Grant funding pursuit also becomes more successful when community organizations jointly demonstrate critical need and training gaps. Ultimately this benefits vulnerable and disadvantaged populations most severely impacted by dental diseases and care deficiencies. ## The Future of Dental Hygiene Education in Fresno An immense opportunity exists for Fresno to emerge as an inclusive hub for dental hygiene education through transformational partnerships and purposeful reforms. Doing so leads to exponential area workforce growth allowing dental care models to shift focus toward prevention versus treatment. New funding and regulation changes provide momentum for seizing this vision. Fresno must take an integrated strategic approach encompassing affordability, flexibility, innovation and collaboration between entities united by a common goal – developing skilled professionals that can help curb oral health disparities and meet evolving population needs at scale. As more leaders recognize dental care‘s inextricable ties to overall health, I am hopeful that substantial improvements across the dental hygiene training continuum come to fruition – not only in Fresno but nationally. Every person regardless of geography or socioeconomic status deserves access to prevention-focused care that supports wellbeing. Expanding academic capacity and capability produces clinicians able to deliver equitable services. The downstream impacts this ripples throughout local communities make reforming dental hygiene education one of society‘s most prudent investments we can make. --- Source: [Reforming Dental Hygiene Education in Fresno, CA: Challenges and Opportunities](https://33rdsquare.com/reforming-dental-hygiene-education-in-fresno-ca-challenges-and-opportunities/)