Standards and Policies

The eight Practice Standards are part of the College’s bylaws and contribute to the legal framework for dental hygiene practice in British Columbia.

Dental hygienists have a legal and professional responsibility to be familiar with the Practice Standards and the Policies. By reviewing them regularly, dental hygienists may self-evaluate their practice and identify areas for continuing competency focus.

The Standards

PRACTICE STANDARD POLICY #1

Practice Standard

A dental hygienist must obtain informed consent from the client or the client's representative before initiating dental hygiene care.

Policy

1.1 Dental hygienists must obtain informed consent from the client or the client's representative before providing any services, by physical indication or verbal statement, following applicable laws (see the following policies in the Interpretation Guidelines section of the website: Informed Refusal to Consent, Consent of Minors to Treatment, and the summary of BC’s Adult Guardianship Laws). 

 

PRACTICE STANDARD POLICY #2

Practice Standard

A dental hygienist must practice safely.

Policy

2.1 When contacting blood or saliva, dental hygienists must practice recognized infection control as outlined by current resources as amended from time to time (refer to “CDC Infection Control Guidelines for Dentistry” by the Centers for Disease Control and Prevention, “Recommendations for Implementation of Infection Control Procedures” by the Canadian Dental Association,* and the CDHBC Infection Prevention and Control Guidelines).

* Publications change from time to time. Dental hygienists are encouraged to obtain a current copy of any resources noted in the Practice Standards Policies from the College office or from www.cdc.gov and www.cda-adc.ca.

2.2 Dental hygienists must protect the client. In a clinical setting this should include:

  • Draping the client with a lead apron and thyroid collar during exposure to x-rays; and
  • Providing safety glasses for the client if there is any danger from splatter or materials; and
  • Providing hearing protection for the client if he/she is sensitive to the noise of practice setting equipment.

2.3 Dental hygienists must use potentially hazardous materials (such as radiation and disinfectants) safely, according to manufacturers' recommendations and government guidelines (refer to the Workplace Hazardous Materials Information System (WHMIS) guidelines and sections 8 and 9 of Health Canada’s “Safety Code 30” document).

2.4 When dental hygienists own their practice, dental hygienists must store and dispose of potentially hazardous wastes and materials safely, according to government guidelines (refer to the Workplace Hazardous Materials Information System (WHMIS) guidelines).

2.5 When dental hygienists are responsible for radiography equipment, dental hygienists must comply with all aspects of the Radiation Protection Program.


PRACTICE STANDARD POLICY #3


Practice Standard

A dental hygienist must assess the client's needs.

Policy

3.1 Dental hygienists must collect baseline assessment data* as appropriate for the client (or supplement data collected by another health professional), and update the data as required. In a clinical setting, this should include:

  • demographic information
  • the client’s concerns, if any
  • medical and dental history information
  • vital signs, if indicated
  • head and neck examination data
  • intra-oral soft tissue examination data
  • periodontal examination data
  • dental and occlusal examination data that impacts on health
  • diagnostic results/interpretations (e.g. from radiographs, bacterial and enzyme tests, etc)
  • oral hygiene routines and techniques
  • the client’s anxiety and pain levels.

* The extent of data collected will vary with the different practice settings and with clients who have specific needs or conditions. Professional judgment must be used to determine the data that is needed to assess each client. 


PRACTICE STANDARD POLICY #4


Practice Standard

A dental hygienist must analyze the assessment information and make a dental hygiene diagnosis.

Policy

4.1 Dental hygienists must establish a dental hygiene diagnosis by interpreting the dental hygiene assessment findings and discussing the implications of the findings with the client or the client’s representative. In a clinical setting this should include the implications of conditions that are abnormal or unhealthy, and conditions that require special care.

4.2 Dental hygienists may determine short and long-term dental hygiene prognoses.


PRACTICE STANDARD POLICY #5


Practice Standard

A dental hygienist must plan for the dental hygiene care to be provided, based on the assessment data and dental hygiene diagnosis.

Policy

5.1 Dental hygienists must endeavor to integrate the dental hygiene treatment plan with the dentist's plan for the client’s comprehensive dental care.

5.2 When indicated, dental hygienists must consult with the client’s dentist, and may consult with other applicable health care providers, in order to integrate the plan for dental hygiene services into the client’s total health care plan.

5.3 Dental hygienists must discuss the dental hygiene plan for services with the client or the client’s representative. In a clinical setting this should include:

  • oral health and wellness information and techniques
  • treatment options
  • pain and anxiety control options
  • the number of appointments recommended
  • the recommended time interval between appointments
  • services to be provided at each appointment
  • short-term goals that could result from the recommended services and how they will be evaluated
  • risks of the recommended services
  • recommendations for future referrals to dentists and other health care providers, if applicable
  • risks of the client declining the recommended services.

5.4 Dental hygienists may discuss long-term goals with the client or the client’s representative including evaluation of the goals.

5.5 Dental hygienists may discuss fees associated with the plan.


PRACTICE STANDARD POLICY #6


Practice Standard

A dental hygienist must implement the plan consented to or adjust the plan in consultation with the client or the client's representative.

Policy

6.1 Dental hygienists must attempt to reduce a client's anxiety and, if indicated for the provision of clinical services, offer pain control.

6.2 Dental hygienists must discuss, as the plan is implemented, any proposed changes to the plan (based on client response or evaluation of services), and again obtain informed consent.


PRACTICE STANDARD POLICY #7


Practice Standard

A dental hygienist must evaluate while dental hygiene care is being provided, and at the completion of care, to determine if the desired outcome has been achieved.

Policy

7.1 At the completion of the planned services, dental hygienists must explain to the client the need for any follow-up or maintenance dental hygiene care and recommend a time interval to the next dental hygiene appointment or meeting.

7.2 Dental hygienists must, if indicated, recommend referral to dental and other applicable health care professional(s). 


PRACTICE STANDARD POLICY #8


Practice Standard

A dental hygienist must document the dental hygiene care provided, following protocols of the practice setting.

Policy

8.1 Dental hygienists must label all client records with the client's name and the date.

8.2 Dental hygienists must record accurate details of the dental hygiene care provided, including:

  • baseline assessment data
  • an interpretation of dental hygiene assessment findings (or a dental hygiene diagnostic statement)
  • a plan for services, particularly if the client needs or desires more than one appointment
  • notes about the services provided (in a clinical setting this would include pain control method(s) used and the type and amount of any agents used)
  • amount of time spent with the client, when appropriate
  • evaluation findings and next appointment planning details
  • precautions and instructions given (if any)• possible risks (if any) of services planned and of not receiving the recommended services

8.3 Dental hygienists must make legible and objective record entries, in ink, initial or sign entries and corrections, and make corrections so that the original entry is still legible.

8.4 Dental hygienists must record details of pertinent discussions and communications with the client and other health professionals, and maintain copies of correspondence.

8.5 Dental hygienists must document and initial the client’s informed refusal to consent to any recommended aspect of care (the client may give a physical indication or verbal statement of refusal).

8.6 When the dental hygienist owns the client's records, dental hygienists must retain records in a secure manner for no less than 16 years after the last client appointment*.

8.7 If electronic records are kept, the entries should be non erasable and secure with the registrant’s name or initials included in the entry.

* The CDHBC's policy for the retention of dental hygiene records is the same as the CDSBC's standard for the retention of dental records. Dental hygienists who own clinics or mobile practices, own their clients' records. One of the issues affecting dental hygienists is the length of time it is necessary to retain records in the event of litigation arising from treatment. The College recommends that dental hygienists who own clinics obtain legal advice regarding this issue. Special rules apply in respect to minors and adults under a disability. (For additional information see the: The Limitation Act