Elevating Dental Hygiene: A Call for Credentialing Clarity and Global Standards

As registered dental hygienists, we advocate for the highest standards available in our education programs, to protect the public, and our profession. As the shortage of hygienists looms, discussions of allowing nonaccredited dental hygiene programs has many of us angered, and rightly so. The Commission on Dental Accreditation (CODA) exists for a reason - to keep dental students, and the public, safe. Allowing hygiene students who graduate from non-accredited programs to become licensed direct patient care providers is a public health concern that risks patient safety and lowers professional educational standards (1). 

National Network of Healthcare Hygienists supports the ADHA and IFDH stance on dental hygiene program (CODA) accreditation being mandatory to licensure.

In addition, we call to raise awareness on the importance of post-licensure accreditation.

As a profession, we are adamant about our pre-licensure accreditation standards, but our current approach to post-licensure education (certificate programs and certifications) falls short of published global accreditation standards.

Questions to Ponder:

1. Why do we fight so hard to ensure quality before licensure, and not after?
2. How could our professional autonomy expand if our post-licensure certificate programs and certifications followed published, global standards for high levels of quality assurance for all stakeholders, like those that exist in nursing?

It's time to candidly discuss how our current certification landscape may undermine our credibility. As dental hygienists expand roles beyond traditional offices into hospitals, long-term care, and public health, clear, internationally recognized credentials are paramount. This article highlights discrepancies between dental hygiene post-licensure training programs and global standards like ISO 17024 (for personnel certification) and ASTM E2659 (for certificate programs). My hope is to encourage reconsideration of our terminology and a proactive pursuit of robust accreditation, strengthening our profession. 

Our governing bodies are not going to require this of us...that would provide us with too much leverage for autonomy. We must require it of ourselves.

The Current Landscape: A Misnomer and Its Consequences

In the dental hygiene field, the terms certificate and certification are often used interchangeably—but they’re not the same. As the profession evolves and strives for broader recognition in interprofessional settings, it’s essential that we use the correct terminology, follow globally recognized standards, and maintain the credibility of our credentials.

This starts with understanding the difference between a certificate program and a certification, and why many dental “certifications” would be better positioned—and more respected—as accredited certificate programs.

A true professional certification involves a rigorous independent external audit, and ongoing third-party assessment on published global standards that are completely different than the standards for approved dental CE. A certification can require applicants to be educated, often requiring proof via a certificate, but they cannot specify the training program. Curriculum requirements are made public and many different training programs emerge to satisfy the educational requirements. The distinction is crucial. Mislabeling can confuse and diminish our perceived professionalism, especially in interdisciplinary healthcare where credentialing standards are stringent. Without a clear, globally recognized framework, our credentials suffer in portability and recognition, hindering career advancement and limiting opportunities in emerging sectors.

The Standards

1. Standard ISO/IEC 17024 for Personnel Certification

ISO/IEC 17024 sets international requirements for organizations certifying persons (2). It ensures consistency, impartiality, and competence, fostering confidence in issued certifications. Accreditation to ISO/IEC 17024, often through bodies like ANSI National Accreditation Board (ANAB), signifies adherence to these benchmarks (3), providing global assurance of validity and reliability. For dental hygienists, an ISO/IEC 17024-accredited credential signals independently and rigorously verified competence, vital for interprofessional collaboration and recognition in diverse healthcare settings. This is akin to how nursing, by embracing ISO 17024 standards, has significantly expanded its capacity for autonomy and specialization within the broader healthcare system.

EXAMPLE: There are currently no accredited certifications in the field of dental hygiene, but the International Association of Orofacial Myology (IAOM) is in process of accrediting their Orofacial Myologist Certification (COM®) on the standard ISO/IEC 17024. There are over a dozen 28 hour training programs that satisfy the educational requirement to apply. The IAOM does not sponsor or manage the training. They manage the written proficiency exam, on-site evaluation and awarding/renewal of certification only.

2. Standard ASTM E2659 for Quality Certificate Programs

ASTM E2659 provides a robust framework for organizations offering certificate programs (4). It distinguishes quality programs from mere attendance certificates (ex: dental CE certificate), guiding development and administration with focused learning outcomes and assessment. ASTM E2659 accreditation ensures adherence to 168 quality guidelines. Embracing this standard for our specialized educational programs would bring clarity and credibility, ensuring a "certificate" signifies verified skill acquisition.

EXAMPLE: The Oral Systemic Educator Certificate Program™ for registered dental hygienists grants the credential Certificate Holder in Oral Systemic Education™ (CH-OSE™) and is accredited through ANAB on the standard ASTM E2659. The training, assessment and certificate are all managed by National Network of Healthcare Hygienists.

A Call for Clarity and Broader Recognition

It is imperative to re-evaluate our terminology. By accurately labeling programs as "certificate programs," training programs can pursue ASTM E2659 accreditation, providing an internationally recognized framework for validating our training, which in turn; enhances credibility, increases portability, improves interprofessional collaboration, and protects against misrepresentation.

This clarity is critical as dental hygienists increasingly work outside traditional offices. In hospitals, long-term care, and public health, a universally understood and accredited credentialing system is essential. An ASTM E2659-accredited certificate or an ISO 17024-accredited certification provides immediate assurance of quality and competence, facilitating integration and expanding opportunities.

The Path Forward: A Call to Action

The time for change is now. I urge our professional organizations, educational institutions, and individual practitioners to embrace a future where dental hygiene credentials are robust, universally recognized, and respected. This means:

1. Reconsider Terminology:  Accurately distinguish between "certifications" and "certificate programs." Program developers need to do research prior to labeling their program, and they should also take courses on instructional design, consult with a psychometrician for proper assessment development, and understand the differences between dental continuing education standards and training program standards. They are vastly different.
2. Understand the Current Post-Licensure Landscape: ADA CERP, AGD PACE and AADH approve CE providers. They do not accredit individual programs. Learn the difference between their standards, and the ones mentioned in this article. Download and print them. Highlight key differences. Taking dental CE has not gotten us one step closer to governing ourselves. Once we know better we must do better.
3. Pursue Accreditation: Advocate for ISO/IEC 17024 for true personnel certifications and ASTM E2659 for specialized educational programs. If you offer a comprehensive dental CE program, consider pivoting it to a certificate program, and apply for accreditation when you have enough data, or partner with an organization that can pursue the distinction for you.
4. Have Patience: Actively educate employers, policymakers, and the public about these standards, but know that accreditation takes time – often two to three years post publication. A new program that is not yet accredited is not necessarily a bad one, as long as the developers are aware of the global standards and are working towards them.
5. Advocate for a Post-Licensure Board of Dental Hygiene: The nursing field has three post-licensure accreditation boards that manage quality assurance of post-licensure programs -- both certificates and certifications. It is time for a new professional dental hygiene (post-licensure) accreditation board to be established.

By taking these steps, we can solidify our profession's standing as an indispensable component of the broader healthcare system, ensuring our expertise is recognized and valued in every setting.

I am willing to discuss these topics with any thought leader or program developer who feels overwhelmed. I have been where you are! If you want an objective person to view your program details as they stand and give you feedback, I am qualified and willing. Let's form a "dental hygiene post-licensure accreditation task force" of developers who help each other for the good of our profession. Email me at [email protected] to begin.

To gain autonomy, we must work together to raise our professional standards, before and after licensure.

 Join the Oral Health Awareness Project

About the Author

Jamie Dooley, RDH, BIS

Jamie Dooley is an award-winning program developer, thought leader, and change agent. She worked 15 years full time as a clinical hygienist before securing her Bachelor of Integrative Studies in 2012, with a focus on healthcare & nonprofit management, from Ferris State University. She found she excelled at developing innovative programs and managing complex projects. After spending 6 years in public health launching a dental Medicaid clinic, developing a school-based sealant program that served 12 low-income schools, and piloting oral health integration in a large healthcare system, she started National Network of Healthcare Hygienists in 2018. Her goal is to introduce new programs and systems to the medical model which include registered dental hygienists as important members of interdisciplinary care. 

References

1. 1. Maisonet, L., & Montoya, B. (2025, June 26). A dangerous shortcut: The push for nonaccredited paths to dental hygiene. RDH Magazine. https://www.rdhmag.com/career-profession/inspiration/article/55299631/a-dangerous-shortcut-the-push-for-nonaccredited-paths-to-dental-hygiene

   2. International Organization for Standardization. (2012). ISO/IEC 17024:2012 – Conformity assessment – General requirements for bodies operating certification of persons. https://www.iso.org/standard/52993.html

   3. ANSI National Accreditation Board (ANAB). Personnel Certification Accreditation: ISO/IEC 17024. https://anab.ansi.org/accreditation/personnel-certification/

   4. ASTM International. (2018). E2659 Standard Practice for Certificate Programs. https://www.astm.org/e2659-18.html