Transforming and Supporting Patient Care - Health Professions ...

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190Chapter 8 – Profession of Dental HygieneUnder the Dentistry Regulation of the Drug and Pharmacies Regulation Act(DPRA),dental hygienists may perform a number of specified acts in thepractice of dentistry under the supervision or direction of a dentist,including three that involve the use of drugs. These are:• Topical application of anticariogenic agents, and other materialsdesigned to assist in the prevention of caries.• Application of topical anaesthetics.• Topical application of desensitizing agents. 11As well, the DPRA authorizes pharmacists to sell drugs to dental hygienistsfor use in the course of engaging in the practice of their profession. 12Education and Continuing CompetencyTo practise in Ontario, dental hygienists must be registered with the CDHO.Registration criteria differ depending on where the applicant was trained.Graduates from a program accredited by the Commission on DentalAccreditation of Canada (CDAC) or by the American Dental AssociationCommission on Dental Accreditation (ADACDA) must successfully pass theNational Dental Hygiene Competency Examination to be certified by theNational Dental Hygiene Certification Board (NDHCB).A graduate from a non-accredited program must have completed a two-yearcourse of study that the CDHO Registration Committee considers equivalentto an accredited program. The graduate must have a certificate issued byNDHCB, or have successfully completed a provincial written certificationexamination approved by the Registration Committee of the CDHO as wellas a provincial clinical competency assessment approved by theRegistration Committee.In Ontario, accredited dental hygiene education programs are offered incommunity or private colleges, for which high school graduates are eligibleto apply. The Ontario training programs take 18 to 24 months to complete.Competencies assessed by the NDHCBFive of the 151 competencies assessed by the NDHCB examination relate tothe ability of dental hygienists to assess pharmacological actions andinteractions and the oral manifestations of pharmaceuticals. 13 Threecompetencies deal with implementation: the dental hygienist is examinedon the actions, interactions and oral manifestations of pharmaceuticals, anddemonstrates the application of dentinal desensitizing agents andpharmacotherapeutics, excluding fluoride. No competencies are testedrelating to administering a drug or substance by injection or inhalation.11Ontario Regulation 547, s.50.12Drug and Pharmacies Regulation Act, R.S.O. 1990, c.H4, s.118(3).13National Dental Hygiene Certification Board. Blueprint for the National Dental HygieneCertification Examination. 2005. Available: http://www.ndhcb.ca/files/blueprint_en.pdf.HPRAC Critical Links January 2009
191Chapter 8 – Profession of Dental HygieneA set of the 2008 National Competencies were developed by the CDAC, theNDHCB and the Federation of Dental Hygiene Regulatory Authorities, DentalHygiene Education of Canada (DHEC) and the CDHA. 14 Although they havenot yet been adopted, the CDHO is currently promoting the adoption ofthese competencies in order to homogenize the practice of dental hygieneacross Canada and to facilitate the teaching of a core or basic curriculum.The competency framework consists of eight domains and an associatedlist of abilities within each domain. 15Overview of the Requests for ChangeThe CDHO and the ODHA are asking for two additional authorized acts thatthey state are important in realizing the potential of self-initiation. They areasking for the authority to provide “short term administration of a limitedgroup of anaesthetics and anxiolytics”• to manage pain that patients may anticipate or experience inthe course of treatment,• to deal with anxiety of individuals with dental phobia, and• to be able to respond to emergency situations. 16Administration of these drugs would include a requirement for theauthorized act of administering a substance by injection or inhalation.Dental hygienists are also asking for the authorized acts of prescribing,dispensing or compounding a drug, including antibiotics, smoking cessationagents and higher than over-the-counter (OTC) concentrations ofsubstances for home care such as fluoride.Request for Change: Administration of Drugs by Injectionor InhalationDental hygienists seek the authority to administer certain substances byinjection or inhalation so they can “manage client pain or anxiety duringperformance of dental hygiene interventions” and be able to respond toemergency situations.A proposed regulation under the Dental Hygiene Act, 1991 would enabledental hygienists with the requisite training to administer the following:By injection:1. Local anaesthetics, and2. EpiPen.14CDHO. Milestones. November 2008. Available:http://www.cdho.org/Publications/Milestones/Milestones_Nov08.pdf.15HPRAC meeting with CDHO and ODHA. November 27, 2008.16CDHO. Submission to HPRAC. 6.HPRAC Critical Links January 2009
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5Chapter 1 - An Introductionprofess
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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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100Chapter 4 - Critical Links: Prop
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240Chapter 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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