Nevada considers alternative training pathway for hygienists
Nevada faces a critical shortage of dental hygienists, leaving many communities—especially rural and underserved areas—without adequate access to preventive dental care. The alternative training pathway for dental hygienists, introduced in Governor Lombardo’s recently introduced health care access legislation (Sections 77-79), is a bold step to address Nevada’s critical need.
A dire shortage of dental hygienists
Nevada’s dental hygiene workforce is stretched thin. With only about 1,500 hygienists serving a population of 3.2 million—roughly half the national average—many residents struggle to access routine dental care. The state’s two dental hygiene programs produce just 30 graduates annually, far too few to meet demand. The biennial workforce assessment mandated by Section 7 of the legislation confirms these shortages, particularly in rural counties and underserved urban neighborhoods. Without action, oral health disparities will persist, leading to higher rates of dental disease and costly emergency treatments.
Breaking down barriers to licensure
Traditional dental hygiene programs, requiring two to four years of study, are time-intensive and costly, deterring potential candidates. The alternative training pathway offers a supervised, hands-on training course under a licensed dentist, bypassing the need for an accredited degree. Candidates must still pass rigorous competency, written, and clinical exams to ensure quality, but this streamlined route reduces financial and time barriers. By making licensure more accessible, the pathway can rapidly increase the number of qualified hygienists, especially for those who might otherwise be excluded due to economic or geographic constraints.
Expanding access to preventive care
The pathway doesn’t just add hygienists—it empowers them to do more. Hygienists licensed through this route can practice in non-traditional settings, like community clinics, schools, or mobile dental units, reaching populations with limited access to dental offices. They’re also authorized to prescribe and dispense additional preventive agents, such as fluoride treatments and sealants, enhancing their role in preventing dental issues before they escalate. This expanded scope is critical for addressing oral health disparities, particularly among low-income and rural Nevadans who face higher risks of untreated dental conditions.
A targeted, data-driven solution
The pathway is activated only during bienniums when Section 7’s workforce assessment documents a shortage, ensuring it’s a precise response to real needs. This data-driven approach prevents oversaturation while directing resources where they’re most needed. Coupled with funding opportunities from the Nevada Health Care Workforce and Access Program (Sections 2-18), the pathway can support training initiatives, making it a sustainable solution to bolster the dental workforce.
Expanded Function Dental Assistant legislation proposed and paused
Assemblymember Heidi Kasama and health care lobbyist Paul Klein championed legislation to authorize Nevada’s Expanded Function Dental Assistants (EFDAs) to perform coronal scaling—a preventive procedure to remove soft plaque and stains traditionally handled by hygienists. Requiring national certification and dentist supervision, this proposal aimed to alleviate Nevada’s strained dental workforce and enhance access to care in underserved areas, though it faced opposition from the hygienists’ association, which some criticize for prioritizing professional exclusivity over addressing shortages.
Despite opposition from hygienists, legislators wanted to see the EFDA training programs fully operational before expanding their duties. The legislation was paused until the EFDA training at Truckee Meadows Community College (TMCC) launches, with advocates determined to advance EFDA roles once training is established.
A Targeted, Data-Driven Solution
Both the hygienist pathway and the EFDA expansion are tied to the Section 7 workforce assessment, which identifies shortages and guides resource allocation. The hygienist pathway is activated only during bienniums with documented shortages, ensuring precision. Similarly, the EFDA legislation targets areas with limited access to hygienists, leveraging a larger pool of dental assistants to fill gaps. Coupled with funding from the Nevada Health Care Workforce and Access Program (Sections 2-18), these initiatives can support training and implementation, making them sustainable solutions.
A healthier Nevada
The alternative training pathway for dental hygienists is a game-changer for Nevada’s oral health landscape. By addressing workforce shortages, lowering barriers to licensure, and expanding access to preventive care, it tackles the root causes of dental care inequities. Nevada must fully implement and support this legislation to ensure every resident—regardless of location or income—can achieve a healthier smile. The time to act is now.
