Transforming and Supporting Patient Care - Health Professions ...

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216Chapter 9 – Profession of Dentistryconclude that this framework serves the public well, and they do not see arisk of harm to the public in retaining the current authorities to prescribedrugs.The ODA supports the need for flexibility in prescribing. They say that thebroad authority to prescribe drugs “recognizes the varying needs of dentalpatients to have access to a comprehensive range of drugs to manage theiroral health and overall health needs as it relates to their dental treatment”.Like the RCDSO, the ODA agrees that dentists have worked within aframework that enables them to match individual patient needs with themost appropriate pharmacotherapy. 7The proponents also note that pharmacotherapy is an essential componentof the modern practice of dentistry and practitioners safely and effectivelyprescribe and administer drugs to their patients every day. As well,pharmacotherapy is a core component of the education curriculum andforms a substantial portion of dentists’ continuing education. 8 The ODAnotes that local, national and international speakers provide continuingeducation courses on a broad range of topics, including those specific toprescribing drugs and patient safety. 9The RCDSO also states that the College regularly addresses contemporaryissues including advancements in pharmacotherapy with its membersthrough a variety of means of communication, including its quarterlymagazine, Dispatch.What HPRAC FoundEducational BackgroundHPRAC’s review of dentistry education in Ontario found that it is providedat a high level, and that graduates are competent to safely and effectivelyuse and prescribe drugs in practice. Dental programs have extensivegeneral pharmacology courses at levels comparable to medical students. Allprograms offer courses in general medicine relating to how commonillnesses impact dental care. Most programs offer two courses inanaesthesia.HPRAC heard from proponents that dentists use a wide variety of drugs intheir practices, and from virtually all therapeutic classes, with theexception perhaps of hormones. HPRAC was told that dentists practicing in7Ontario Dental Association. Submission to HPRAC: Review of Non-Physician Prescribing andAdministration of Drugs Under the Regulated Health Professions Act. November 12, 2008: 2.8Ibid: 1.9Ibid: 2.HPRAC Critical Links January 2009
217Chapter 9 – Profession of Dentistryparticular specialties would require the authority to prescribe drugs thatmight be thought of as being outside the scope of practice of primary caredentists, (e.g., chemotherapeutic drugs) but would nonetheless be requiredin the course of practice of some specialist members of the profession.HPRAC agrees that moving to designated classes of drugs in regulationwould serve no practical purpose and would not provide substantial benefitto the public.Ensuring on-going CompetenciesHPRAC found that the RCDSO provides information to its members onappropriate use of drugs on an ongoing basis as part of continuingeducation. Dentists participate in continuing education programming toremain current in the prescription and administration of drugs. In 2008,RCDSO circulated the proposed draft Quality Assurance Regulation tomembers and external stakeholders. The proposal included requirementsfor continuing education, practice enhancement, peer consultation, and anannual declaration. 10Managing the Risk of HarmThe RCDSO has recently updated guidelines on the Use of Sedation andGeneral Anaesthesia in Dental Practice, based on the work of the College’sQuality Assurance Committee. The guidelines state that:Sedation or general anaesthesia may be indicated to treat patientanxiety associated with dental treatment, to enable treatment forpatients who have cognitive impairment or motor dysfunction whichprevents adequate dental treatment, to treat patients below the age ofreason, or for traumatic or extensive dental procedures. Thesetechniques are to be used only when indicated, as an adjunct toappropriate non-pharmacological means of patient management. 11Members who use sedation or general anaesthesia in practice must havesuccessfully completed a training program in the specific modality, and thedental facility must be suitably staffed. Clearly recorded patient medicalhistories, including information concerning illnesses, hospital admissions,current medications, allergies and an appropriate physical examinationmust be completed for each patient prior to the administration of any formof sedation or general anaesthesia. Dentists and staff must be prepared torecognize and treat adverse responses using appropriate equipment anddrugs as necessary.10RCDSO. Proposed Draft Quality Assurance Regulation to be made under the Dentistry Act, 1991S.O. 1991, c.24. www.rcdso.org/pdf/con_ed/Proposed-Draft-Quality-Assurance-Regulation-June2008.pdf. 2008.11RCDSO. Guidelines on the Use of Sedation and General Anaesthesia in Dental Practice.January 2005. www.rcdso.org/pdf/guidelines/Guidelines_sedation_01_05.pdf.HPRAC Critical Links January 2009
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Table of ContentsCritical Links:Tra
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5Chapter 1 - An Introductionprofess
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14Chapter 1 - An Introductiondate.
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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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100Chapter 4 - Critical Links: Prop
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102Chapter 5 - Scope of Practice of
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164Chapter 7 - Professions of Chiro
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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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