New white paper outlines diagnostic decision-making as fundamental to dental hygiene care and urges standardized terminology
CHICAGO, Feb. 10, 2026—The American Dental Hygienists’ Association (ADHA) today released “Dental Hygiene Diagnosis: Defining the Essential Role of Diagnostic Decision-Making in Dental Hygiene,” a white paper that establishes dental hygiene diagnosis (DHDx) as a fundamental component of professional practice and calls for standardized terminology across state practice acts.
The white paper highlights inconsistency in how states recognize dental hygiene diagnosis: only three states — Colorado, Oregon, and Maine — explicitly reference DHDx in their dental practice acts, while 42 states allow dental hygienists to independently provide prophylaxis without prior dentist evaluation, demonstrating that states already rely on dental hygienists’ clinical judgment. The paper builds on ADHA’s 2016 white paper on the same topic, incorporating a decade of new research, updated state practice act data, and expanded focus on social determinants of health as a diagnostic category.
“Dental hygienists diagnose every day. That work is central to keeping patients safe,” said Lancette VanGuilder, ADHA president. “This white paper sets the record straight: diagnostic decision-making isn’t new for dental hygienists. It’s time our practice acts reflected that.”
The white paper reviews two models for implementing DHDx in clinical practice: the Dental Hygiene Diagnosis Model developed by Gurenlian and Swigart, which categorizes diagnostic statements into ten domains including systemic health, behavioral health, and social determinants of health; and the Human Needs Model developed by Darby and Walsh, which identifies eight categories of patient needs that form the foundation for diagnosis and care planning.
“Dental hygiene diagnosis goes well beyond periodontal classification,” said Dr. JoAnn Gurenlian, ADHA’s director of education, research and advocacy. “We assess oral cancer risk. We identify social determinants affecting a patient’s access to care. These are diagnostic decisions, and they affect outcomes. This white paper documents that.”
ADHA recommends:
- Dental hygienists adopt DHDx terminology as an essential component of ethical practice
- State dental practice acts incorporate standardized terminology for DHDx
- Dental hygiene educators integrate the full range of DHDx categories into curricula
- Commission on Dental Accreditation (CODA) reinstate DHDx within accreditation standard 2-13
The white paper was authored by Darlene J. Swigart, EPDH, MS, FADHA; Krista L. Beaty, MS, RDH; and Toni McLeroy, CRDH, MSDH, FADHA, and is available for download at adha.org/whitepapers.
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