In March of 2025, the American Dental Hygienists’ Association (ADHA) announced its updated Standards for Clinical Hygiene Practice.
These latest amendments mark the fourth time these standards have been updated since they were first established by the ADHA in 1985. For four decades, these standards have helped guide dental hygienists through their scope of practice with evidence-based care modules and best practice tips.
While dental hygiene practice has remained the same, the updated standards bring personalized, patient-centered care to the spotlight.
These updated guidelines continue to emphasize the five core components of the Dental Hygiene Process of Care: Assessment, Diagnosis, Planning, Implementation, and Evaluation, along with comprehensive Documentation.
Here’s a closer look at the 2025 updates and how they affect dental hygienists.
One of the most notable changes in the 2025 Standards for Clinical Hygiene Practice is the more extensive expansion of the assessment phase in two areas: systemic disease and social determinants of health.
Research is constantly connecting various systemic health links with periodontal pathogens. Because systemic disease and conditions are ever-changing and more diseases are linked to oral health, the dental hygiene standards were amended to give systemic disease and conditions more focus and remind professionals that systemic links may influence a person’s dental assessment.
For example, laboratory test results and collaboration between a patient’s additional medical specialists may need to be considered when determining a patient’s oral health, such as glucose and platelet levels.
Social determinants of health should also be considered and are now included in the assessment because they play a part in a patient’s oral health. A social determinant of health is a nonmedical factor that influences a person’s overall health outcomes because it influences their access to care and thus could place them at a higher risk than others regarding their health.
Some examples of social determinants of health include economic status, transportation, culture, employment, financial status, and stress. Cultural considerations can determine how a patient cares for their oral cavity. Science has shown that stress can affect the inflammatory response in periodontal disease. In addition, certain ethnic groups are at a higher risk for oral health problems than others. Dental professionals who recognize these potential barriers could help provide more thorough care beyond clinical symptoms.
Finally, the clinical assessment for periodontal disease was updated to include the American Academy of Periodontology Staging and Grading guidelines for periodontal disease, including smoking, diabetes, and A1c. It reminds clinicians to assess implants for possible periodontal involvement.
The 2025 dental hygiene standards also changed the assessment verbiage from plaque to biofilm, as biofilm includes a more in-depth definition of the various microorganisms affecting the mouth. Plaque is a type of biofilm that is formed by bacteria and found on the teeth. Biofilm is a collection of microorganisms living in an intricate network all over the mouth that is difficult to eradicate and influences various oral diseases.
By expanding the assessment to include these various concepts and information, dental hygienists are better enabled to focus on a more comprehensive approach to care.
While dental hygienists cannot diagnose their patients in most states, they can help a dentist make an overall diagnosis by gathering essential data during the assessment. The 2025 standards reframe the diagnosis process to ensure that patients are given time and space to ask questions, reflect, and fully understand their oral health status.
The six-step process of diagnosis includes:
The planning standards of the 2025 dental hygiene guidelines reflect a more modern, collaborative approach to patient care. The planning standard is considerably more structured in the newer standards because it considers three main concepts to make the plan: measurable goals, intervention strategies, and allotted appointment times.
When dental hygienists plan to treat their patients, they should customize their treatment as needed to ensure the highest chance of success. Above all, it reminds dental hygienists that a treatment plan needs to be presented and reviewed by a patient so that they may give their informed consent.
During this presentation, the planning risks, benefits, and any lingering questions need to be discussed with the patient. The informed consent must be signed and documented in the patient’s chart.
During the implementation phase, the treatment is carried out. This care has been specifically designed and tailored to the patient’s needs based upon the assessment phases.
In 2016, the implementation standard of dental hygiene care was not as meticulous as the 2025 standards are. The new implementation phase highlights additional examples under the eight key steps. In addition, monitoring the patient’s comfort levels is no longer a suggested step; the professional is thought to monitor the patient’s comfort throughout the appointment process.
The implementation phase is still not considered a one-time approach; instead, it is continual as necessary to provide the recommended treatment.
The eight steps of implementation of the dental hygiene care plan are:
Evaluation now centers more explicitly on person-centered outcomes. After every treatment phase, hygienists are expected to reassess the patient’s progress, adjust the plan if needed, and document all findings and communications.
By following up, the professional can decide which treatment has been the most effective for the patient, what needs to be changed to help the patient improve their oral status, and what is not working for the patient.
Dental care should be subject to an individual’s evolving needs, so constant reassessment strategies help to ensure care is always aligned with the patient. A thorough health record will note these measurable goals and their underlying causes, what was discussed with the patient to improve the outcome, and the change in results.
The documentation standards remain mostly the same, reminding clinicians that the more detailed and legible your documentation in a chart is, the easier it is to discuss and share information among providers about a patient, and the higher protection it will ensure from any possible legal issues.
As the digital age includes more dental practices and clinics, the documentation standards will be amended to include more digital dental software, digital sharing platforms, and electronic health records.
In summary, these new standards help registered dental hygienists provide the utmost care to their patients, no matter where they practice. Because these new standards focus more on the patients, even those hygienists who are not practicing in a routine dental operatory setting can refer to the updated standards of care.
Dental hygienists who wish to learn more about the 2025 standards of care can refer to the ADHA. Webinars, podcasts, and an overview on their website have been released to inform all dental professionals and the public about the changing standards.