The illusion of health is not health.  Changing state law to legalize what is currently prohibited – with good reason – would not only be poor public policy, it would mislead state residents while denying them the level of dental care that everyone deserves and should have a right to expec t. Pending legislation at the State Capitol (HB5303) would remove a longstanding safeguard: that dental hygienists practicing outside a clinical setting may not perform certain services without a dentist’s supervision. In its place, the revisions to state law would allow hygienists, after just two years of practice, to provide care independently in private residences—without a dentist present, and without the diagnostic tools necessary for a full evaluation. That is not a minor shift. It is a meaningful departure from how healthcare is safely delivered. The stated goal is to allow homebound patients the opportunity to receive dental care from licensed dental hygienists. Yet the manner in which this bill is written will not guarantee that outcome but will allow for circumventing of the scope of practice for dental hygienists. Dental hygienists are highly valued members of a dental care team. Their role is essential. But it is also distinct. Dentists undergo significantly more extensive training to diagnose disease, interpret findings, and determine appropriate treatment. The role of each member of the dental team is clearly defined and synchronized to provide optimal patient care. Even the bill’s own language reflects the limits of hygiene practice, describing services as “educational, preventative, and therapeutic.” Important, yes —but limited. Expanding where care is delivered without expanding the diagnostic capacity that makes care meaningful creates a gap that can put patients’ health at risk. Oral health is inseparable from overall health, as the U.S. Centers for Disease Control and Prevention has consistently emphasized. That makes this proposal more than a technical policy change —it is a public health decision. And one that deserves the full measure of ongoing public health oversight. Proponents describe the bill as expanding access. In reality, it risks delaying diagnosis. Preventive care is not simply a cleaning; it is the early detection of disease. Without a comprehensive exam—including diagnostics like taking x-rays—serious conditions can and will go unnoticed until they are more advanced, more costly, and more dangerous. We have seen the consequences of delayed dental care. Severe infections that begin in the mouth can escalate quickly, sometimes with tragic results. These are not hypothetical risks; they are well-documented realities. The bill is well-intentioned. Expanding access to care is a goal worth pursuing. But intention alone does not ensure good policy. A model that fragments care, reduces oversight, and lowers diagnostic standards is not a step forward. There are practical concerns that cannot be ignored. Infection control in dentistry depends on a highly regulated clinical environment. Dental offices operate under strict sterilization and safety protocols. Private homes do not. Moving care into uncontrolled settings increases the risk of contamination, particularly for vulnerable patients. There are additional concerns and unanswered questions. Is there adequate and proper sterilization and infection control? Are devices such as cavitrons, autoclaves, suction devices readily available? What about medical emergencies? Are defibrillators and oxygen available? What about dental emergencies? And where is responsibility for liability – both the hygienist’s against malpractice and the patient’s against injuries sustained in conjunction with a home visit? Connecticut has long maintained a healthcare framework grounded in quality, oversight, and patient safety. That standard should not change. The idea that “something is better than nothing” may sound pragmatic, but in healthcare, it can be dangerously misleading. If the state is committed to improving access to dental care, it should do so thoughtfully —by strengthening, not weakening, the systems that ensure patients receive comprehensive, coordinated treatment. This proposal does not meet that standard. As chairperson of the state’s dental commission, I am charged with protecting the public. This bill as written will create a hazard to the public. Better to take the time to get it right than to move forward with a substantive change that would compromise care. Public health deserves more than the illusion of access. It deserves real, safe, and complete care —for everyone. Peter S. Katz, DMD is Chairman of the Connecticut State Dental Commission, where he has served since 2005. ...read more read less