| Dental Hygienists |
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| Dental Hygienists |
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Dental Hygienists are important members of the dental health care team who work with dentists in the delivery of dental care to patients. Hygienists use their knowledge and clinical skills to provide dental hygiene care for patients. They use their interpersonal skills to motivate and instruct patients on methods to prevent oral disease and to maintain oral health. In Oregon, most Dental Hygienists work under the general supervision of a licensed dentist*. "General Supervision" means that the dentist has authorized the procedures to be performed for a patient but does not require that a dentist is present when the procedures are performed. Also, the authorized procedures may be performed at a place other than the usual place of practice of the dentist. The statute regulating Dental Hygiene is ORS 680.010 through 680.205 and the administrative rules are generally found in OAR 818, Division 35. Licensing and renewal information is found in OAR 818, Division 21.
*The exception to this statement is a Dental Hygienist who holds a Limited Access Permit which allows the Dental Hygienist to provide dental hygiene services without the supervision of a dentist in certain settings for patients who may not be able to otherwise access dental care services. See the section on Limited Access Permits, ORS 680.200 and OAR 818-035-0065 through 818-035-0100 for more information.
*The exception would also include a dental hygienist that determines the need for and appropriateness of sealants or fluoride and applies sealant or fluoride at locations and for persons described in ORS 680.205 (1) and (2)
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| What Do Dental Hygienists Do? |
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In the dental office, the dentist and the dental hygienist work together to meet the oral health needs of patients. Dental Hygienists may perform all of the services that dental assistants are allowed to perform. For example, Dental Hygienists may provide the following services in the dental office:
- Screen and assess oral health conditions,
- Review the health history,
- Record dental charting, including probings for periodontal condition;
- Take and develop dental radiographs (x-rays);
- Remove calculus and plaque (hard and soft deposits) from all surfaces of the teeth;
- Apply sealants and fluorides;
- Make impressions of patients´ teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs);
- Place and remove periodontal dressings;
- Prescribe, administer and dispense fluoride, fluoride varnish, antimicrobial solutions or resorbable antimicrobial agents; and
- Teach patients appropriate oral hygiene strategies to maintain oral health (e.g., toothbrushing, flossing and nutritional counseling).
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| Expanded Functions |
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Upon successful completion of an appropriate course of instruction, and submission of the appropriate documentation to the Board, a Dental Hygienist in Oregon may also:
- Administer local anesthesia;
- Use a high-speed handpiece to polish restorations;
- Apply temporary soft relines to full dentures, providing the patient is seen by the dentist within 14 days after the application;
- Administer nitrous oxide* under the indirect supervision of a licensed dentist. (Indirect supervision means the dentist has authorized the procedure and remains on the premises while the procedure is being performed.)
*There are additional rules that apply regarding obtaining a nitrous oxide permit, for administration of nitrous oxide, and additional continuing education requirements. See OAR 818-026-0040.
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| Restorative Functions |
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Upon successful completion of an appropriate course of instruction, and submission of the appropriate documentation to the Board, a Dental Hygienist under the indirect supervision of a licensed dentist in Oregon may:
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Place and finish a direct alloy or direct composit restoration;
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The patient must have given informed consent for the placement of the restoration by the Restorative Function Endorsement Dental Hygienist;
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Final restorations must be checked by the supervising dentist and documented in the chart before the patient is released.
See OAR 818-035-0072
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| Limited Access Permit |
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Independent Practice
A Dental Hygienist who holds a Limited Access Permit (LAP) may provide most dental hygiene services without the supervision of a dentist. The provision of services under a Limited Access Permit is limited to patients or residents of the following facilities or programs who, due to age, infirmity or disability, are unable to receive regular dental hygiene care:
- Nursing homes as defined in ORS 678.710;
- Adult foster homes as defined in ORS 443.705;
- Residential care facilities as defined in ORS 443.400;
- Adult congregate living facilities as defined in ORS 441.525; and
- Mental health residential programs administered by the Department of Human Services.
- Facilities for mentally ill persons, as defined in ORS 426.005;
- Facilities for persons with mental retardation, as defined in ORS 427.005;
- Local, state and regional correctional facilities and juvenile detention facilities.
- Public and nonprofit community health clinics.
- Homebound adults
- Students or enrollees of nursery schools and day care programs and their siblings under 18 years of age, Job Corps and other similar employment training facilities, primary and secondary schools, including private schools and public charter schools and persons entitled to benifits under the Womens, Infants and Children Program.
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| PROHIBITIONS |
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Dental Hygienists May Not:
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Diagnose and treatment plan other than for hygiene services;
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Cut hard or soft tissue with the exception of root planing;
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Extract any tooth;
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Fit or adjust any correctional or prosthetic appliance except as provided by OAR 818-035-0041(1)(c);
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Prescribe any drug, other than fluoride, fluoride varnish, antimicrobial solutions for mouth rinsing or resorbable antimicrobial agents;
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Administer or dispense an drugs except as provided by OAR 818-035-0030, OAR 818-035-0040, OAR 818-026-0060(11) and OAR 818-026-0070(11);
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Place, condense, carve or cement permanent restorations or operatively prepare teeth except as provided in OAR 818-035-0072
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Irrigate or medicate canals; try in cones, or ream, file or fill canals;
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Use the behavior management techniques of Hand Over Mouth (HOM) or Hand Over Mouth Airway Restriction (HOMAR) on any patient.
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| Education/Training |
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What Education/Training Does a Dental Hygienist Have?
Dental Hygienists have earned either an associate or bachelor’s degree from an approved Dental Hygiene program. Dental Hygiene programs are offered at community colleges, technical colleges, dental schools or universities and must be accredited by the American Dental Association Commission on Dental Accreditation.
Foreign trained graduates of dental hygiene programs may apply for the dental hygiene licensure examination, providing the applicant meets the Board´s requirements, by rule, as will reasonably assure that an applicantís training and education are sufficient for licensure.
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| State License Required |
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Dental Hygienists choosing to work in Oregon must first obtain a license issued by the Board of Dentistry. For information about the requirements for licensure, go to the section of this web site titled "Licenses and Permits."
Other sites regarding Dental Hygiene
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