Dental Hygienists as Advanced Practitioners
Dental hygienists are popularly known to work together with dentists in cleaning and examining patients' teeth. It is through examining the teeth of their patients that dental hygienists are able to detect that a particular patient has signs and symptoms of oral diseases. Through this, dental hygienists are able to provide patients with preventive dental care. They could either remove tartar or polish the teeth of the patient. Aside from that, they are also responsible in assessing the oral health of the patient and report their findings to the dentists. Also, they are tasked to document the treatment plans of the patients and educate them so that patients are able to improve their good oral health
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and maintain it as well. However, Pignatelli (2016) asserted that more than 300, 000 children under the coverage of MassHealth were not able to see a dentist over the last year. That is why different bills were drafted by Representatives and Senators so as to resolve the issue at hand. Primarily, the bill seeks to provide the residents in Massachusetts a more accessible and affordable oral healthcare. In line with this assertion, this paper seeks to develop a workable institutional policy that protects both the dentists and the dental hygienists once the latter is given the opportunity to become an "Advanced Practitioner." Dental Care Problems in Massachusetts Stitzel (2015) contended that in Massachusetts, dental disease is experienced by the following: residents who have low income; individuals who belong to the racial and ethnic minorities; people with disabilities; senior citizens who are under a long-term care; and those who live in rural areas and inner cities. These groups struggle to access dental care may it be due to the absence of the dentists in their area, or they find it difficult to travel from one place to another just to see a dentist, or simply because they cannot afford one. To make the situation worse, an estimate of 290, 000 individuals, between the ages 1 and 21, although enrolled in MassHealth, were unable to see a dentist in the year 2014 (Stitzel, 2015). To Stitzel (2015), one reason behind this crisis is the fact the most dentists in Massachusetts are unwilling to accept Medicaid. As a result, the adults' dental condition in Massachusetts is worsened. Stitzel (2015) also mentioned that almost half of the population of adults has untreated tooth decay in the year 2010. In 2009, Massachusetts seniors also suffered the same problem (Stitzel, 2015). When people are unable to receive proper dental care, more of them are rushed into hospital emergency rooms (ERs) because their dental condition is not prevented. This is burdensome for the state's Medicaid program, MassHealth considering that millions are spent to pay the emergency room dental care for adults. From 2008 to 2011, the state paid for an estimate of $11.6 million for the dental care services alone (Stitzel, 2015). Stitzel (2015) asserted that the dental delivery system in Massachusetts is inefficient, much more for those who need it the most. This is way various bills are enacted so as to resolve this dental care issue. Priority Legislations involving Dental Care Because of the dental problems, several legislations are sought to be prioritized. For one, HB249/SB2076 or also known as An Act Establishing an Advanced Dental Hygiene Practitioner Level of Practice seeks to create an Advanced Dental Hygiene Practitioner (ADHP) in Massachusetts (American Dental Hygienists' Association, n.d., p.). This proposed legislation aims to provide the residents in Massachusetts a more accessible and affordable oral health care (American Dental Hygienists' Association, n.d.). To make this possible, the proposed ADHP would be professionally licensed. Meaning, the dental hygiene practitioner is required to complete a master's-level program of 12-18 months under an accredited post-secondary institution (American Dental Hygienists' Association, n.d.). Aside from that, the practitioner must have also practiced under the supervision of a dentist for a minimum of 500 hours, and that he was able to establish an agreement under the said dentist a collaborative agreement (American Dental Hygienists' Association, n.d.). This way, Massachusetts is able to save thousands of dollars since the practitioners will be given the authority to provide both preventive and restorative dental care services. Second, HB2000/SB1193 or also known as An Act Relative to Dental Hygienists will allow dental hygienists to have a special permit, so that they are able to use nitrous oxide to their patients, so long as a dentist is supervising them (American Dental Hygienists' Association, n.d.). To make this efficient, a certification to administer oxide should be approved by the Board of Registration in Dentistry (BORID) (American Dental Hygienists' Association, n.d.). This way, patients are able to receive the quality dental care services that they deserve. Third, HB952/SB489 or otherwise known as An Act Relative to Public Health Dental Hygienists seeks to forbid malpractice insurance providers from denying coverage to dentists who work with dental hygienists. And lastly, An Act Relative to Public Health Dental Hygienists or HB1989/SB1121 allows public health hygienists to bill private insurance since many clients carry with them private insurances (American Dental Hygienists' Association, n.d.). All of these bills seek to ensure that the problem on dental care is resolved, and that residents in Massachusetts are able to receive quality dental care services. The Policy Process The process of policy making is very vital since it is where the resolution of a particular issue is properly made. Since the problem is already defined, it is now important to consider the policy design. Considerably, a policy design involves the means through which legislative policies are realized. Thus, feasibility is of paramount consideration. Meaning, practical mechanisms should be determined as to achieve the policy goals. In the aspect of dental care issues in Massachusetts, different factors must be considered: the dentists, the dental hygienists, the patients, and the delivery of dental care services. The Dentists Unfortunately, many Massachusetts residents are unable to receive proper dental care because aside from mobility problems and financial crisis, only 4 out of 10 dentists are practicing their profession, thus, leaving almost half of the cities and towns in Massachusetts with dentists who are unwilling to accept MassHealth eligible patients (American Dental Hygienists' Association, n.d.). As a result, these patients are left with no choice but to endure their worsened dental situation. Aside from that, the Massachusetts Department of Public Health claimed that only 26% dentists were active as MassHealth Providers in 2013 (as cited in American Dental Hygienists' Association, n.d.). This phenomenon led to the shortage of dental health professionals in Massachusetts, with unmet dental needs of over 244, 000 people (American Dental Hygienists' Association, n.d.). Worse, 47% percent of eligible MassHealth children were unable to receive dental services in 2014 (American Dental Hygienists' Association, n.d.). That is why most of those who suffer from dental problems are rushed in hospitals because their dental condition is not prevented. Evidently, the number of dentists is not enough to accommodate all of the residents who need dental care services. As such, it is important that dental hygienists become advanced practitioners. This way, the delivery of dental care services is made effective, especially to those who need it the most. However, dentists must be consulted because giving dental hygienists the opportunity of becoming advanced practitioners entail competition on the part of the former. To avoid this, the government must also regard all possibilities of ensuring that both interests of the parties involved are protected. The Dental Hygienists Undeniably, dentists undergo rigorous training and hardships before they are given the title as doctors.
As such, it is only right that if the policy to be implemented gives dental hygienists that authority to act like dentists, the potential advanced practitioners must meet certain requirements. The first important requirement is that dental hygienists must complete either 12-month or 18-month dental practitioner education program which will ensure that they are able to perform the dental care services efficiently or effectively (The Journal of Excellence, 2015). Aside from that, the dental hygienist must have also practiced under the supervision of a licensed dentist (American Dental Hygienists' Association, n.d.). This way, there is an assurance that the practitioner is indeed capable, and that there is a proof that would allow him to practice in the best of his ability. It is also important to consider that a practitioner has a written collaborative agreement with a licensed dentist or an institution he is under before he performs a dental care procedure (American Dental Hygienists' Association, n.d.). This way, the practitioner is able to administer and dispense the proper medications under the supervision of a dentist. It should be made clear that a dental hygienist should not exceed in the authorized scope of practice he is only entitled to
perform. The Patients Since most of the patients deprived from dental care services are under Medicaid, it is only right that dental hygiene practitioners are reimbursed for the services that they provide. The government must also see to it that patient who are who have low income; those belonging to the racial and ethnic minorities; individuals who belong to the racial and ethnic minorities; people with disabilities; senior citizens who are under a long-term care; and those who live in rural areas and inner cities are given easier access to dental care (Stitzel, 2015). The absence of the dentists in their area should not hinder them from improving and maintaining their dental health and condition. This is the very reason why the bill proposing dental hygienists to become advanced practitioners is made. The Delivery of Dental Care Services The proposed policy will improve the preventive care of Massachusetts and aside from that; the Commonwealth is able to save thousands of dollars (American Dental Hygienists' Association, n.d.). The delivery of dental care services must be efficient to the extent that there would be lesser emergency room visits in Massachusetts. The policy alone should be made fiscally prudent as to increase the access to preventive services of the dental care (American Dental Hygienists' Association, n.d.). The creation of Dental Hygiene Practitioner (DHP) does not intend to create two standards of care. As a matter of fact, there are already two standards of care: those who have the money to find and avail the dental care services of a dentist, and those who are not financially stable to afford one (American Dental Hygienists' Association, n.d.). The Policy Adoption and Implementation Now that the policy process is discussed, it is important the policy adoption is also made effective. Once it is adopted, the implementation should also be made efficient. If not, the creation of the legislation of dental care services would become futile. Evidently, the public officials who drafted the bill are aware of the current need. Massachusetts residents should not be deprived of dental health care because providing them with such is one of the many responsibilities of the government. Interested stakeholders must be consulted and that agreement between them and the government must also ensure the success of the policy sought to be implemented. Evaluation Within a span of 5 years from its implementation, evaluation must be conducted. This is to determine whether the policy implemented has become effective in meeting the needs of the people. As such, the outcome measures must focus on the number of patients who were able to acquire dental care services and the efficiency of the dental hygienists as advanced practitioners, and the advantage of these practitioners in the public health care system. The safety of the patients must be guaranteed. Conclusion Dental hygienists should have an advanced training so that they can perform procedures that dentists could only do (Salsberg, 2013). Problems on patient's safety and adequacy will not be a setback as long as hygienists are able to meet all of the necessary requirements and training provided in the bill. Besides, many Massachusetts residents are unable to receive proper dental care since only 4 out of 10 dentists are practicing their profession. Aside from that, some of these dentists are unwilling to accept patients who are MassHealth eligible. Thus, it is high time for dental hygienists to become advanced practitioners as to meet the dental issues of the people, which dentists alone are unable to meet. This way, the government in Massachusetts is able to provide its residents proper and dental care services of quality. To top it all, the proposed legislation is also beneficial to government of Massachusetts because the creation of Dental Hygiene Practitioner (DHP) would mean that it is able to save thousands of dollars since the dental hygienists practitioners will be given the authority to provide both preventive and restorative dental care services. Clearly, the law seeks to improve the quality health care in Massachusetts and improve the residents’ dental health care and condition. References American Dental Hygienists' Association. (n.d.). "An act establishing an advanced dental hygiene practitioner level of practice" HB249/SB2076 [Sponsors: Rep. William “Smitty” Pignatelli/Sen. Harriette L. Chandler]. Print. American Dental Hygienists' Association. (n.d.). Talking points in support of S.2076, “an act establishing a dental hygiene practitioner level of practice”[sponsors: rep. william “smitty” pignatelli/sen. harriette l. chandler] presently before the joint committee on healthcare financing. Print. Pignatelli, S (2016). "Smitty" Pignatelli: A way to assure dental care for all. The Berkshire Eagle. Retrieved from http://www.berkshireeagle.com/opinion/ci_29918812/%22smitty%22-pignatelli:-a-way- to-assure-dental-care-for-all. Salsberg, B. (2013). Bill sees role for dental practitioners in mass. WBUR News. Retrieved from http://www.wbur.org/2013/03/10/bill-dental-practitioners Stitzel, J. (2015). Pew expert testifies on behalf of dental hygiene practitioners in Massachusetts. The Pew Charitable Trusts. Retrieved from http://www.pewtrusts.org/en/research-and- analysis/speeches-and-testimony/2015/09/pew-expert-testifies-on-behalf-of-dental- hygiene-practitioners-in-massachusetts. The Journal of Professional Excellence. (2015). Legislating the midlevel practitioner. Retrieved from http://www.dimensionsofdentalhygiene.com/2015/Perspectives_Supplement/Policy_and_ Regulation/Legislating_The_Midlevel_Practitioner.aspx.
A dental hygienist is a very important role in any dental office. As stated by a dental assistant, “Dental hygienists work closely with the dentist as well as hands on with the patients. They assist dentists with operative procedures such as fillings and extractions, and making molds of patients teeth” (Wilson, Jennifer). A large part of their job is teaching patients proper dental care to ensure a lifetime of healthy teeth. This includes proper brushing and flossing techniques. According to the job out look, a day as a dental hygienist can include taking x-rays, cleaning and scaling teeth, charting treatment plans, putting sealants on teeth, taking impressions of teeth and completing information about the patient’s oral and medical history (Summary). In some states dental hygienist are allowed to give local anesthetic and place and remove sutures (Delivering Local Anesthetic). According to advantages of becoming a dental hygienist, hygienists spend more hands on time with the patients than the dentist does. These are some of the instruments that dental hygienists use on a daily basis: toothbrush, scaler, mirror, ultrasonic scaler, explorer, suction, computer, salvia ejector, rubber cap polisher, dental models, x-ray machine and probe. The dental hygienist uses a toothbrush to remove soft plaque from the teeth. Plaque is a soft coating on the teeth that contain bacteria. The bacteria can cause tooth decay and gum disease. The amount of plaque on the teeth gives the hygienist an idea of how well the daily brushing and flossing of the patient’s teeth are completed on a regular basis. The scaler is used to remove hardened plaque or calculus from the teeth. The mirror is used to look closely at the surfaces of the teeth a...
Dental hygiene is amongst many professions that come with an increased risk of injury. In fact, evidence suggests that the incidence of dental professionals acquiring musculoskeletal disorders is reaching 96%. According to the Occupational Safety and Health Administration (OSHA), these complications are a result of “repetitive motion or awkward posture for more than 2 hours at a time, unassisted frequent manual handling (eg, scaling an area using the same strokes), and unassisted forced manual handling (eg, heavy calculus removal using hand-activated instruments)”. These complications not only affect the quality of life for the
Some people tend to believe that a dentist is all about pulling teeth, filling gaps, and drilling holes in a mouth. That may be true, but this is more about the person that treats a patient prior to a dentist drilling into a mouth. Dental Hygienists provide more than just the basic examination. They also give advice on how to properly brush and floss, the types of foods to avoid, and give examples of what teeth could look like if not taken care of correctly. A dental hygienist provides preventive, therapeutic, restorative and educational interventions to promote optimal oral health.
According to the book, “Clinical Practice of the Dental Hygienist”, a dental hygienist is a dental health specialist whose primary concern is the maintenance of oral health and the prevention of oral disease. A career as a dental hygienist provides a wide range of challenges where in the dentist office, the dental hygienist and dentist work together to meet the oral health needs of their patients. There are many things that dental hygienists do that you may not realize when you think you are just going in to get your teeth cleaned.
They then should look over the charts at the patient’s situation with their teeth and see what medical treatment they need. They then bring the patient in and perform the treatment. Lastly, they charge the patient for the certain treatments, like the cleaning, and then for say a filling, they will charge them separately, and then the patient will leave. Soon after, they will start all over again. Furthermore, there are a lot of skills required to be a Dental Hygienist, but yet simple ones.
When most people think of dental hygienists, the first and only thing they think about it cleaning and whitening teeth. However, that is mainly what dental hygienists do, but they also learn to do a lot more than that. According the occupational outlook handbook, hygienists clean teeth, examine patients for signs of oral diseases such as gingivitis, and provide other preventative dental care. They also educate patients on ways to improve and maintain good oral health. As explained on American Dental Association, the dental hygienist...
The best description of a dental hygienist is a professional whose main job is to teach their patients necessary oral hygiene skills and provide great dental care. They perform various tasks around a dentist’s office such as applying fluoride treatments, removing plaque and stains, taking x-rays, removing sutures, placing temporary fillings, and evaluating the patient’s overall health (“Dental Hygienist” Coin Career). Dental hygienists do not just work in a dental office, but they also can work at schools, nursing homes, health clinics, and many other dental settings. Close contact is necessary when doing this job. Working with people is an everyday thing in this profession, so one must be able to communicate and get along with their clients very well. Having certain traits such as excellent hand-eye coordination and great motor skills are very important to posses since dental hygienists work on their patients mouths (Porterfield 4). Communication is vital since dental hygienists are constantly teaching patients how to hav...
There are many opportunities out there for hygienists to deliver the health care message to not only the individuals that cannot afford to go to the dental office, but also the individuals like older citizens and disabled individuals and to different schools around the nation. With that being said, it is not only just the hygienist job to provide that information. Other healthcare professionals are expected to come together and commonly agree on accurate information to specific individuals. “Healthcare professions, including dental hygienists, nurses and physicians should be communicating with each other and working collaboratively for common health care goals. This is the way that we should be practicing and also educating the future” (Pera). It is important to educate children now and get it in their heads that taking care of their teeth and gums and also their body in general is a good way to be successful not just now, but in the future as well. In order to do so, all health care professions are required to step up and come together to inform the young children in schools as well as the underprivileged people who lack the knowledge
As a future dental hygienist, I want to be able to help educate people about dental hygiene, prevent cancers and help rural communities overcome oral diseases and cancers. Dental Hygienist usually work in dentist office's, some of the responsibilities of a dental hygienist are removing tarter, stains and plaque from teeth, they take dental x-rays and access patient oral health and report findings to the dentist.
Most patients that come into the dentist are coming for a reoccurring problem. Each time they leave there not aware of what is causing them to have the same issues. A part of the dental hygienists job is to catch what is being done wrong and to fix it with the treatment plan. The treatment plan is set up for you to follow so that you don’t continue to do the same things and risk your health. It helps keep the patient on a routine and educate them on the importance of oral health. The treatment plan is based on a series of questions to make it a specific treatment plan custom to the patient’s needs.
It's important for any high school student to have an idea or plan of what they want to pursue in the near future. Most students want to go into the medical field, become a professional athlete, a lawyer, etc. Many talk about becoming a dentist, but not a dental assistant. Simply because they feel like it's not that big of a title of being a dental assistant as compared to a dentist. Little do they know dental assistants play a big role as well in the office. A dental assistant does many tasks and duties that help benefit the dentist and also the patients.
Did you know that the dental assisting profession has been projected to grow 18 percent during the years of 2014 through 2024, which is much faster than the average for all other occupations? And from there who knows, the sky's the limit. But what exactly does a dental assistant do?
As I started my new journey of becoming a dental hygienist, I came into the program with no background of dental. I came into this program with an open mind and willing to embrace new concepts as well as develop new skills. During my time at the Canadian Academy of Dental Hygiene (CADH), I learned that as a dental hygienist that I am committed to promoting and helping each individual achieve their optimal oral health goals. In support of my client’s goals, I may assume any or all of the roles included in the dental hygiene scope of practice. My goal throughout this program was to help my clients achieve their optimal oral health goals through education, health promotion and providing preventive and clinical therapy.
Having shadowed a dental hygienist prior to that of a dental assistant I didn’t know what to expect their job to be. Although I did assume a dental assistant’s job consisted of handing instruments to the doctor during the various procedures so I was surprised to see just how many responsibilities they have. Each dental clinic has different expectations of what they require their dental assistant to do in my shadowing experience they were responsible for: preparing the room prior to the patients arrival, greeting the patient upon arrival and inviting them into the operation room, confirming dental history with the patient, briefing them on the procedure they are about to have and what to expect, answering the clients questions to the best of their abilities, assisting the doctor in the procedure and aiding with any tasks required of you, when the patient is ready to leave helping them to look presentable and explaining what to expect after that kind of procedure, updating and verifying dental records, and sanitizing and sterilization of the room and all instruments after departure of
Introduction: In Canada, general dental health is not part Canada’s national system of health insurance (Medicare) (1) except for some dental surgical procedures that are performed at hospitals. Since Oral health does not come under the Health Act about ninety-five percent of the oral health care services are offered on a fee-for-service basis. Oral health care is under provincial or territorial jurisdiction like other health care services and publically financed dental care programs provide the remaining five percent of oral health care services (2). Thus, majority of Canadians receive oral health via privately owned dental clinics. Privately owned dental care gives these services providers control over dental service charges, types of available treatment for the patients and number of follow-up appointment for treatments or routine care. Service users pay for the dental expenses from their own pockets or utilize insurance coverage (1).