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188Chapter 8 – Profession of Dental HygieneAuthorized ActsIn the course of engaging in the practice of dental hygiene, a member isauthorized, subject to the terms, conditions and limitations imposed on hisor her certificate of registration, to perform the following:1. Scaling teeth and root planing including curetting surrounding tissue.2. Orthodontic and restorative procedures. 5The act of scaling teeth and root planing, including curetting surroundingtissue, must be performed in accordance with any requirements prescribedin the regulations, and may be performed either:(a) on the member’s own initiative, if none of the contraindicationsprescribed in the regulations to performing the procedure arepresent, and if the member ceases the procedure if any of theprescribed contraindications to continuing the procedure arepresent, or(b) if the procedure is ordered by a member of the RCDSO. 6For orthodontic and restorative procedures, the procedure must be orderedby a member of the RCDSO.RegulationsThe CDHO Council may make regulations, subject to the approval of theLieutenant Governor in Council and with prior review by the Minister, asfollows:(a) specifying drugs that a member may use in the course of engagingin the practice of dental hygiene;(b) prescribing requirements for performing scaling teeth and rootplaning, including curetting surrounding tissue, which requirementsmay include the educational and experiential qualifications thatmust be obtained in order for a member to undertake thoseprocedures on the member’s own initiative;(c) prescribing contraindications to a member performing orcontinuing to perform on the member’s own initiative theprocedures of scaling teeth and root planing, including curettingsurrounding tissue. 7A regulation made under clause (a) may specify individual drugs orcategories of drugs. 85Dental Hygiene Act, 1991, S.O. 1991, c. 22, s.4.6Ibid: c. 22, s.5(1).7Ibid: c. 22, s.12(1).8Ibid: c. 22, s.12(2).HPRAC Critical Links January 2009
189Chapter 8 – Profession of Dental HygieneIf a patient has not received clearance from a physician or dentist, a dentalhygienist may not independently proceed with scaling teeth and rootplaning, including curetting surrounding tissue, if contraindications exist.The contraindications are:1. Any cardiac condition for which antibiotic prophylaxis isrecommended in the guidelines set by the American HeartAssociation (AHA), as those guidelines are amended from time totime, unless the member has consulted with either the patient’sphysician, dentist or registered nurse in the extended class (RN(EC))and determined that it is appropriate to proceed if the patient hastaken the prescribed medication per the AHA guidelines.2. Any other condition for which antibiotic prophylaxis isrecommended or required.3. An unstable medical or oral health condition, where the conditionmay affect the appropriateness or safety of scaling and root planing,including curetting surrounding tissue.4. Active chemotherapy or radiation therapy.5. Significant immunosuppression caused by disease, medications ortreatment modalities.6. Any blood disorders.7. Active tuberculosis.8. Drug or alcohol dependency of a type or extent that it may affect theappropriateness or safety of scaling and root planing, includingcuretting surrounding tissue.9. High-risk of infective endocarditis.10. A medical or oral health condition with which the member isunfamiliar or that could affect the appropriateness, efficacy of orsafety of the procedure.11. A drug or combination of drugs with which the member is unfamiliaror which could affect the appropriateness, efficacy or safety of theprocedure. 9In addition, a member may not perform the procedure of scaling teeth androot planing, including curetting surrounding tissue, if the member is indoubt as to the status or accuracy of the medical or oral history of thepatient. 109Ontario Regulation 218/94, s.7(1) made under the Dental Hygiene Act, 1991, S.O. 1991, c. 22.10Ontario Regulation 218/94, s.7(2) made under the Dental Hygiene Act, 1991, S.O. 1991, c. 22.HPRAC Critical Links January 2009
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5Chapter 1 - An Introductionprofess
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16Chapter 1 - An Introductionprofes
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18Chapter 1 - An Introductionwithin
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20Chapter 2 - Excellence in Health
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56Chapter 3 - A New Drug Approvals
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88Chapter 4 - Critical Links: Propo
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102Chapter 5 - Scope of Practice of
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238Chapter 10 - Profession of Midwi
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250Chapter 11 - Profession of Natur
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274Chapter 12 - Profession of Nursi
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310Chapter 13 - Profession of Optom
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340Chapter 14 - Profession of Pharm
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366Chapter 15 - Profession of Physi
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378Chapter 16 - Profession of Respi
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394Chapter 17 - Conclusionscontinui
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396Chapter 17 - Conclusionsincluded
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398Chapter 18 - Summary of Proposal
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