International profiles of dental hygiene 1987 to 1998: a 19-nation comparative study

Aim: Development of an international longitudinal database to examine patterns, trends and changes in dental hygiene. Method: Three surveys of national dental hygienists' associations, mainly members of the International Federation of Dental Hygienists. Data were collected by mail in 1987, 1992 and 1998, using a 40-item questionnaire. Sample size increased over time; results presented are based on responses for 13, 15 and 19 countries respectively. Preliminary tabulations were circulated to respondents for validation. Results: Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, education and professional organisation, the profession was more similar than dissimilar. Greater variation was evident in terms of numbers, distribution, workforce behaviour, predominant work setting and remuneration. While apparent change over the relatively short period 1987 to 1998 was viewed with caution, several observations were of particular interest: marked increases in the supply of dental hygienists, scope of practice and range of practice settings, accompanied by a decline in mandated level of work supervision. A slight but gradual increase in independent dental hygiene practice also was noted. Conclusion: By 1998 the profiles reflected the vast majority of the world's population of dental hygienists. While rate of change varied across the countries examined, the nature of the change tended to be consistent, resulting in a continuing homogeneity in the profession worldwide. Changes and emerging trends should continue to be monitored in terms of improved access to quality oral health services and technical efficiency in the provision of those services.