March 2006 ■ Journal of Dental Education 263 Access to Care and the Allied Oral Health Care Workforce in Kansas: Perceptions of Kansas Dental Hygienists and Scaling Dental Assistants Tanya Villalpando Mitchell, R.D.H., M.S.; Ralph Peters, Ph.D.; Cynthia C. Gadbury-Amyot, B.S.D.H., Ed.D.; Pamela R. Overman, R.D.H., Ed.D.; Lauren Stover, R.D.H. Abstract: Access to oral health care continues to be a problem in the United States. Research has called for innovative approaches to improve access to oral health care and reduce oral health care disparities. Successful alternate approaches have been reported. In 1998 the Kansas Legislature passed a proposal to enhance access to care and manpower needs by allowing dental assistants to provide supragingival scaling, a service traditionally assigned to dental hygienists. In 2000, Mitchell et al. investigated the perceptions of Kansas dental hygienists and scaling dental assistants in relation to House Bill 2724 (HB 2724), which allows dental assistants to perform coronal scaling. The intent of the study was to collect baseline data in relation to HB 2724. The purpose of the present study was to follow up on the impact of HB 2724 six years after legislation. Both groups report satisfac- tion with their professions: scaling dental assistants believe the delivery of care in Kansas has changed, and areas of Kansas previously noted as dental health professional shortage areas are now served by either a registered dental hygienist or scaling dental assistant. Prof. Villalpando Mitchell is Assistant Professor and Junior Clinic Coordinator, Division of Dental Hygiene, University of Missouri-Kansas City School of Dentistry; Dr. Peters is Associate Professor and Director of Analysis and Planning, University of Missouri-Kansas City School of Dentistry; Dr. Amyot is Professor and Director, Division of Dental Hygiene, University of Missouri-Kansas City School of Dentistry; Dr. Overman is Associate Dean for Academic Affairs, University of Missouri-Kansas City School of Dentistry; and Ms. Stover is a degree completion student and practicing dental hygienist in Kansas City, Missouri. Direct correspondence and requests for reprints to Professor Tanya V. Mitchell, University of Missouri-Kansas City School of Dentistry, Division of Dental Hygiene, 650 E. 25 th Street, Room 415, Kansas City, MO 64108; 816-235-2049 phone; 816-235-2157 fax; villalpandot@umkc.edu. This project was funded by the Rinehart Foundation at the University of Missouri-Kansas City, School of Dentistry. Key words: dental hygiene, dental assistants, access to care, perceptions, legislation Submitted for publication 7/28/05; accepted 11/17/05 I n 2000, the U.S. Surgeon General released the report Oral Health in America: A Report of the Surgeon General, demonstrating that oral health disparities exist across all age groups. 1 The report emphasized to policymakers, community leaders, pri- vate industry, health professionals, the media, and the public that oral health is crucial to general health and well-being. In April 2003, the Department of Health and Human Services released A National Call to Action to Promote Oral Health in response to the surgeon general’s report. 2 The goals of the call to action were to promote oral health, improve quality of life, and eliminate oral health disparities. Five specific actions with implementation strategies were discussed: 1) change perceptions of oral health; 2) overcome barriers by replicating effective programs and proven efforts; 3) build the science base and ac- celerate science transfer; 4) increase oral health workforce diversity, capacity, and flexibility; and 5) increase collaborations. Programs that have over- come barriers in access to care caused by geographic isolation, poverty, insufficient education, and lack of language skills, including outreach efforts and community service activities conducted through den- tal schools and other health professional schools and residency programs, were to be recognized and imi- tated. By increasing collaborations among all sec- tors of society—the public, private practitioners, and federal and state government personnel—oral health programs could be designed, implemented, and moni- tored with people who have the knowledge and ex- pertise to follow such programs. 2