Polishing Teeth or Improving Health: Dental Hygiene and the Struggle for Professional Autonomy

The first dental hygiene program in Canada opened at the University of Toronto in 1951.  Only women were admitted.  Dentists welcomed dental hygiene: they regarded them as attractive helpmates who could take over the tedious tasks of cleaning teeth and educating patients on proper oral care.  The profession was under dentists’ control: in most provinces it was the dental board that licensed dental hygienists.  In the 1970s, in the hopes of improving access to dental care, dental hygiene moved into the Colleges in several provinces and there was an exponential increase in the number of hygienists.  At the same time, the feminist movement prompted many women to protest the gender inequalities of the workplace.  Dental hygienists began fighting for the self-regulation of their profession, and for the right to practice independently of dentists. Over the past quarter-century, dental hygienists in most parts of Canada have gained the right to self-regulate.  In many provinces, they can practice independently.  But there have been losses as well.  While the early dental hygiene programs were established at universities, most dental hygiene training now takes place at Colleges.  Dental hygiene leaders believe that a baccalaureate degree is necessary if dental hygiene is to fulfill its mandate as a profession geared towards the prevention of oral disease.  Moreover, the status of dental of dental hygiene remains low.  This paper will examine the struggles of dental hygienists to gain control over their profession and transform it into a field that emphasizes oral health and wellness.