title: Complexities of Providing Dental Hygiene Services in Community Care Settings.
abstract: Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits.
  
  
  
  Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.'
  
  
  
  An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice.
authors.affiliation: BSDH, MPH, JD, Department of Patient Management, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA. Electronic address: zarkowp1@udmercy.edu.
authors.forename: Pamela
authors.initials: P
authors.lastname: Zarkowski
authors.affiliation: DDS, JD, MHSA, Department of Patient Management, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA.
authors.forename: Mert N
authors.initials: MN
authors.lastname: Aksu
mesh_terms: D003729:Dental Care; D003756:Dental Hygienists; D003815:Dentists; D006297:Health Services Accessibility; D006801:Humans; D009910:Oral Hygiene; D024382:Professional Role
keywords: Access to care; Ethical; Legal; Scope of practice