Transforming and Supporting Patient Care - Health Professions ...

199Chapter 8 – Profession of Dental HygieneAlberta dental hygienists have the authority to administer nitrous oxide forthe purposes of conscious sedation. This is considered to be an advancedpractice requiring training from a CRDHA-approved nitrous oxide/oxygenconscious sedation course, such as the continuing education course offeredby the University of Alberta on administering local anaesthetic. 35 Eligiblemembers must have their name listed in the CRDHA’s roster as beingauthorized to perform this restricted activity. 36Foundational EducationHPRAC’s review of education indicated that pharmacology courses in dentalhygienists’ studies provide an overview of pharmacological actions andinteractions; however, there is less exposure in the areas of anatomy,biochemistry and physiology. These courses are fundamental tounderstanding pharmacotherapeutics. Stakeholders have also identifiedissues with consistency of pharmacological education across communitycolleges and career colleges in Ontario.Proponents have indicated that post-community or career college trainingwould be required for dental hygienists to become competent to administerlocal anaesthesia and other drugs. In its submission, the CDHO states “tothe best of the College’s current information, approximately 300 dentalhygienists have provided the College with certificates indicating that theyhave successfully completed a course in pain management that includes theadministration of local anaesthetics.” 37 HPRAC heard from the CDHO thatthese individuals all received their training outside Ontario. Painmanagement courses are available in British Columbia, Alberta, theUniversity of Manitoba, Detroit Mercy Hospital and other locations in theUnited States and Great Britain.A review of some of these course outlines and study guides show they arecontinuing education courses, typically structured with a component ofself-study followed by lectures and hands-on training where the participantscan practice effective administration of local anaesthetics. 38,39 The in-personpart of the course can range in duration from two to four days. A review ofthe University of Manitoba’s Pain Management for Dental Hygienists studyguide indicates participants who attend this three-day training session aretaught to understand the physiological origin of pain as well as themechanism of pain. 40 Students are also taught various methods of paincontrol, head and neck anatomy as it relates to administration of localanaesthetics, pharmacology of dental anaesthesia, local and systemiccomplications with use of anaesthesia and armamentarium for localanaesthesia. As a part of the training students are expected to practiseapplication of local anaesthetics on each other.35College of Registered Dental Hygienists of Alberta. Restricted Activities Authorization. August2007. Available: http://crdha.ca/LinkClick.aspx?fileticket=wZumKWBsiYU%3D&tabid=56&mid=416.36Ibid.37CDHO. Submission to HPRAC: 10.38University of British Columbia. Continuing Dental Education, Winter/Spring 2009 Calendar.Available: http://www.dentistry.ubc.ca/continuing_education/programs/2008-09/UBC_CDE.pdf.39University of Detroit Mercy. School of Dentistry, Continuing Education. Available:http://www.dental.udmercy.edu/ce/calendar.php.40Lavigne, Salme E. Pain management for dental hygienists, study guide and lab manual. Universityof Manitoba.HPRAC Critical Links January 2009