Written Protocol

Written Protocol

Do you have the desire to work in an alternate setting? Have you heard of Written Protocol?

Click the link to be redirected and learn more.
Written Protocol Toolkit

Click here to access the TN Board of Dentistry’s Application for Dental Hygienists to Practice Under Written Protocol.


Written Protocol Success Stories

Introducing Suzanne DuVall and Celeste Holmes

> View Hope Smiles – Testimonials


Suzanne DuVall

We first learned about the new written protocol for TN dental hygienists when we each received an email from the local dental hygiene association. Celeste and I immediately brought it to the attention of our employer, Dr. Kemp.  Because we share a common interest in serving others, he was completely supportive.  The timing was perfect due to the upcoming opening of our Nashville Dream Center dental clinic.  The purpose of this clinic is to serve the dental needs of our local population here in Nashville. So we took the initiative to keep on top of the application process so that we could help   others as soon as possible.



Celeste Hammond

In the beginning, the funding that helped us serve these patients was solely through donations from Dr. Kemp’s nonprofit, Hope Smiles. Our nonprofit has recently received a grant to assist us with the cost associated with serving people in our clinic.  Currently we are depending on dental professionals to work at the dream center on a volunteer basis. The clinic has also been equipped through donations from several dental supply companies.  We have six dental chairs as well as the equipment and instruments to treat patients in a number of dental services. We have two cavitron units, a statim for sterilization, and a NOMAD portable X-ray machine.  At the clinic, we practice infection control to the absolute highest standard.

The population that is being served at the Dream Center includes mostly members of the surrounding neighborhoods.  It is an inner city neighborhood with people from every walk of life. These patients include children, their parents, friends of the family, and other family members. We also treat men and women that currently reside in transitional treatment residential centers. Our services impact this population drastically and help their transition back into society after drug addiction, abuse, and/or being imprisoned.  Providing dental care to these people is life changing for them.

Listed below are the services completed at the Dream Center dental clinic since it opened in July 2013.

620 teeth extracted
158 fillings
72 cleanings
123 exams
90 x-rays

Total treatment cost = $194,108

Working at the Dream Center clinic has affected us by having the opportunity to use our professional skills and knowledge to impact people’s lives in a positive way. Serving patients that otherwise would have no access to dental care means so much to us.  It is life changing for them as well as for us. Interacting with these patients and learning about their lives is incredibly rewarding. We are so fortunate to work in a profession in which we can serve patients on a daily basis.

“I would encourage anyone to go by and visit the Dream Center, as well as volunteer.  The time I have spent there with patients has blessed and humbled me more than I ever imagined.  I look forward to my next volunteer day at the Dream Center.” Suzanne DuVall, RDH

“The joy I experience when I am able to give something to someone who can’t give me anything in return is indescribable.” Celeste Hammond, RDH, EFDA

If you are interested in volunteering at the Dream Center dental clinic, contact Gradi Ellis at gradi@hopesmiles.org, or call 615-324-3904.

You can also check out the Hope Smiles website:  www.hopesmiles.org.

Introducing Debbie Long



I do not have a “story” regarding written protocol at all. I have practiced Dental Hygiene for 33 years in the same rural location, Maynardville, TN.  For the past 26 years, my employer (John C. Osborn, DDS) and I have also served the needs of the elderly in three nursing homes in the Knoxville area. Because the nursing facilities do not have dental equipment or treatment rooms, we do the best we can, bedside. For example, SRP and brushing, simple extractions, partial or denture repairs, adjustment, limited exams, are primarily the extent of the treatment we can render. The Written Protocol has allowed me (following an exam by my employer) to do oral screenings and “cleanings” monthly or quarterly for the resident without Dr. Osborn having to be present for each visit. The billing is still done through Dr. Osborn. The services provided are minimal at best, but because the nursing facilities are not required to provide even daily oral health care, my screenings and Dr. Osborn’s exams are often the only oral health care a resident may have for months or years.

All of my residents are geriatric. I see approximately 40-50 residents (mostly quarterly) at 3 different facilities. Could I do this without Dr. Osborn or would I want to…. absolutely not! These residents are compromised physically, mentally, and/or emotionally. Their medication lists are extensive, consisting of 20-30 drugs in many cases. Their surgical histories are lengthy. Family relationships can range from total abandonment of their loved one to totally demanding to the point that many family members cannot be satisfied with any treatment provided. Why do we do this? Because we think of each of these residents as if they were our own grandparents and because we realize we will be needing someone to care for us someday as well.

Debbie Long, RDH