Marion C. Manski, RDH, MS, is an associate professor and director of the Dental Hygiene Program at the University of Maryland Baltimore (UMB) School of Dentistry. She is also the director of admissions and recruitment for the dental hygiene program. Manski has practiced clinical dental hygiene for more than 33 years. She has much experience in research, serving as the principal investigator on studies regarding sealants, caries prevention, and access-to-care issues.
Manski fought tirelessly with the Maryland Dental Hygienists’ Association to add local anesthesia and nitrous oxide administration to Maryland dental hygienists’ scope of practice. In 2009, Maryland dental hygienists gained the ability to administer local anesthesia infiltration only and, in 2012, nerve block anesthesia was added to the scope of practice. In 2010, the ability of dental hygienists to monitor nitrous oxide administration was added and, in 2016, the ability to administer it was included in Maryland dental hygienists’ scope of practice. She is the coordinator of the local anesthesia curriculum for dental hygiene students and teaches the continuing education certification course to licensed dental hygienists.
Manski was appointed by Governor Larry Hogan to serve on the Maryland Commission For Women. Her service to the community and her active involvement in legislation serves Manski well on this state commission, which advocates for women by advising the executive and legislative branches of government on women’s issues in Maryland. Manski is a member of Dimensions of Dental Hygiene’s Editorial Advisory Board.
What was the most challenging aspect of changing the Maryland dental hygiene practice act to include local anesthesia and nitrous oxide administration?
Before 2009, dental hygienists were not allowed to administer local anesthesia in Maryland. However, local anesthesia administration was part of most states’ dental hygiene practice acts, and I thought Maryland should be next. To begin, I enrolled in an out-of-state course to obtain the skills and knowledge needed to start teaching local anesthesia administration at UMB. Next, I obtained permission from the Maryland State Board of Dental Examiners to begin teaching the course to my colleagues and students. To accomplish this, I enlisted dentist colleagues to supervise the clinical sessions. Fortunately, these dentists were also active in their professional associations and state board. As such, they saw firsthand the value and quality of the education we were providing and were then easy to enlist as advocates for our cause. This was a great beginning, but we still needed legislation passed to allow dental hygienists to administer local anesthesia to patients in practice. With colleagues, I began the long and arduous process of assembling a broad-based coalition to support the passage of a bill that would allow dental hygienists to provide local anesthesia in Maryland.
We then made our case to a number of Maryland legislators. Our efforts were successful and several legislators supported the idea of allowing dental hygienists to administer local anesthesia. Within a year, the bill was passed. The following year, we used the same template to add the administration of nitrous oxide to Maryland dental hygienists’ scope of practice. Training faculty and appealing to established legislative champions and coalitions proved successful and, with perseverance, the practice act was amended.
What motivated you to advocate for change to the Maryland Dental Hygiene Practice Act?
Local anesthesia administration by dental hygienists was in many states by 2009. As a course director with local anesthesia as part of my class, my thought was to become more educated on the topic and learn how to administer local anesthesia. I returned from my local anesthesia course energized and ready to teach my own students. However, the law had not passed in Maryland, but I knew Maryland was more than ready. So I was proactive and asked the Maryland State Board of Dental Examiners permission to teach my students and faculty in a “lab setting”. This “pilot” created the core coursework for the future local anesthesia certification course and proved that dental hygienists in Maryland were in fact ready. Thus, by further educating my faculty, my students and myself, I was highly motivated to take it a step further in my state with my fellow colleagues to advocate for a change in scope of practice.
How can oral health professionals who live in states with less progress practices act become engaged on the local and state level to advocate for change?
The best way oral health professionals can become engaged on the local and state level to advocate for change is to become an active member of your professional association. I became involved actively in my association, as it advocates for our entire profession locally and nationally. It motivated me to be a leader, be involved, and be engaged. Meeting legislators, and then engaging them and educating them about our profession led to support for dental hygiene and furthering access to care. I worked with amazing mentors, networked and met many like-minded professionals, both in and out of the dental hygiene profession. Gathering these individuals created an amazing coalition of forward-thinking people who advocated for advancing scope and furthering access to care. I encourage my fellow colleagues to become involved—it’s an amazing journey and there is strength in numbers. As we say, “Better together!”
What do you envision the role of dental hygienists looking like in 15 years, using the traditional practice setting as the baseline for your response?
With the changing landscape of health care, I envision medicine and dentistry working together interprofessionally to meet the needs of our society. Practices will be interprofessional, in which the dental hygienist will serve as an integral part of a health care team and practice to their fullest extent of their education. Interprofessionally educated dental hygienists create a provider who collaborates not only in oral health care but in overall health care. Collaboration will occur with medical, dental, nursing, pharmacy, social work, and even law to create a treatment plan in the best interest of the client/patient. Expanding dental hygiene’s role as a primary provider and expanding scope of practice and working beyond the chair interprofessionally can reduce the barriers regarding access to quality oral health care, which is in the best interest of the patient’s health.