IDEAS home Printed from
   My bibliography  Save this paper

Dental Hygiene Regulation and Access to Care



By specializing in preventative oral healthcare, dental hygienists (DHs) have the potential to improve oral health in the United States. DHs decrease the cost and increase the availability of oral healthcare beyond what would be provided by dentists alone. Yet laws and regulations in many U.S. states prevent DHs from fulfilling their potential. A prior study by Wing et al. (2005) found that states that impose more restrictions on the functions DHs are permitted to perform resulted in lower DH wages and poorer oral health outcomes. This study adds entry restrictions, including educational and licensure requirements, to the analysis by developing a model in which a state’s entry and practice restrictions jointly affect the DH labor market and access to care. After evaluating anecdotal evidence from four case studies, we estimate the effect of variations in entry and practice restrictions across the U.S. using a three stage least squares (3SLS) estimation method. The results are consistent with the hypotheses that entry restrictions reduce employment rates, practice restrictions reduce productivity and wage rates, and wage and employment rates are endogenous to each other and jointly influence access to care. The implication for states seeking to improve oral health is that both entry and practice laws and regulations must be considered jointly in order to significantly improve access to care.

Suggested Citation

  • Tanya Wanchek, 2009. "Dental Hygiene Regulation and Access to Care," Working Papers 2009-02, Center for Economic and Policy Studies, revised 23 Jul 2009.
  • Handle: RePEc:vac:wpaper:wp09-02

    Download full text from publisher

    File URL:
    Download Restriction: no

    File URL:
    Download Restriction: no


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Morris M. Kleiner & Kyoung Won Park, 2010. "Battles Among Licensed Occupations: Analyzing Government Regulations on Labor Market Outcomes for Dentists and Hygienists," NBER Working Papers 16560, National Bureau of Economic Research, Inc.
    2. Michele Pellizzari & Giovanni Pica, 2010. "Liberalizing Professional Services: Evidence from Italian Lawyers," Working Papers 372, IGIER (Innocenzo Gasparini Institute for Economic Research), Bocconi University.

    More about this item


    Oral health; dental hygiene regulation; occupational licensure;

    JEL classification:

    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • K23 - Law and Economics - - Regulation and Business Law - - - Regulated Industries and Administrative Law
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

    NEP fields

    This paper has been announced in the following NEP Reports:


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:vac:wpaper:wp09-02. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (William M. Shobe). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.