Objectives: The objective of this study was to estimate if variation in state-level scope of practice for dental hygienists was associated with children’s oral health outcomes.

Methods: This study used the Dental Hygiene Professional Practice Index (DHPPI) to measure the state-level scope of practice for dental hygienists. Demographic characteristics and oral health status of children were extracted from the National Survey of Children’s Health. Several data sources were used to describe the supply of dental practitioners and other state-level sociodemographic and geographic characteristics. Multilevel logistic modeling was employed to assess the association between state specific scopes of practice for dental hygienists and oral health outcomes in the population of children in each state.

Results: The expanded scope of practice for dental hygienists was associated with the favorable outcome of having excellent or very good teeth in children with preventive dental visits compared to children who did not receive preventive services within the past year. A 10-point increase in a composite DHPPI score was associated with a relative increase of 3.6% (P=.039) in the likelihood of having excellent or very good teeth in children with recent preventive dental visits compared to other children. Much stronger associations were observed in the separate analyses of the regulation (53.2%, P=.015) and supervision components of the DHPPI scores (7.1%, P=.020).

Conclusions: The study findings indicated that a more expansive dental hygiene scope of practice was positively and significantly associated with favorable children’s oral health among those with recent dental office visits.