LEGISLATIVE ACTIVITY

What is the Oklahoma Dental Hygienists' Association's position on this new level of health care worker?
The CDHC conflicts with the State Dental Act and longstanding Oklahoma Dental Hygienists' Association policy on education, licensure and scope of practice. ODHA is strongly opposed to lowering of educational standards, the elimination of National written and Clinical testing and state licensure for anyone who will provide clinical and invasive services to the public. ODHA opposes the proposal by the ADA to provide two standards of care…one for private dental patients who can access the private dental office and another for those who cannot.

Could the CDHC be a concern for Oklahoma?
Yes, the proposed CDHC program is a serious concern for the educational system, the accredited dental hygiene programs and most of all, the unsuspecting public.

What is the training involved for the CDHC?
Upon completion of high school or the GED equivalent, the CDHC candidate will participate in a 12-18 month non-accredited training program, designed by the American Dental Association not an educational institution. This program is to be taught by a teleconference course from an out of state Junior College. Once the candidates are trained, they will not receive a degree or be tested or licensed by the state before they treat the public. According to the ADA, they propose the CDHC will provide services in urban, rural and Native American settings.

What clinical skills will the CDHC provide?
The CDHC will perform a variety of clinical treatments, including operation of radiographic equipment, application of sealants and fluorides, coronal polishing, scaling (removing tartar and plaque with sharp curettes and scaler instruments) on periodontal Type 1 gingivitis patients and removal of decay using a hand excavator without local anesthesia and placement of temporary fillings as palliative treatment. However, these are currently procedures provided only by dentists and dental hygienists.

Unfortunately, the University of Oklahoma had been enlisted by the ADA to provide the site for a CDHC pilot training program. The ADA is providing funding for the program. The program will train persons to work on Indian land and possibly federally funded health care clinics. The trainees cannot provide any services outside of these settings or in private dental offices because by Oklahoma Law, only Dental Hygienists and Dentists with college degrees and licenses from the State, may provide the listed treatment procedures.

In each of the 50 states and the District of Columbia, dental hygienists are licensed health care professionals. The ODHA advocates the utilization of licensed dental hygienists as the most qualified professionals to provide much needed preventive services to those in dentally under served areas. Since Dental Hygienists are already educated and licensed, they would be the most appropriate solution to the access to care issue.

According to a recent law change, licensed dental hygienists are permitted to treat patients in numerous treatment facilities but due to over-restrictive supervision language, patients are not able to receive badly needed preventive treatment by dental hygienists. Attempts to rectify this language has been met with opposition by the Oklahoma Dental Association. Instead, the Oklahoma Dental Association currently supports the creation of a substandard program to train another health care worker who will not be licensed, tested or obtain a degree, to treat the most vulnerable members of the public.

To print copy, click here

ATTENTION: This is a copy of the CDHC grant from the ADA. Also included is the curriculum being planned for the 'certification' program at OU. Please read the information in detail. This document will open with your Adobe Reader. Click here for document.

The Board of Dentistry has appointed a 6-member Dental Hygiene Advisory Committee. The role of this Committee will be to assist and advise the Board of Dentistry with all dental hygiene-related issues. The first Committee appointees are:

Louenda Nesbit - Chair
Kelly Sanders - Member
Jennifer Campbell - Member
Penny Pannell - Member
Julie Gillispie - Member

Please express appreciation to these individuals for the time they will volunteer on your behalf!

Board of Director Minutes - January 11, 2008

Lobby Day - March 2007

Oklahoma Dental Hygienists meet with Senators Mike Morgan and Glenn Coffee in the lounge at the state capitol.
Left to right: Angela Craig, Amy Regan, Angie Dakin, Colleen Kirkpatrick, Donna Brogan,
Kathy Franklin, Glenda Dennis, Bonnie Flanagan
Also present at the Capitol but missed the picture were Jennifer Campbell, Joy Cook,
Sharon Swisher and our lobbyist Tommy Thomas

• The Advanced Dental Hygiene Practitioner is an answer to the oral health crisis in America by safely providing cost-effective, diagnostic, preventive, therapeutic and restorative services* directly to the un-served public.
• ADHA is establishing this new position to make a positive impact on the lack of access to oral health care plaguing millions of people in the U.S., as well as part of ADHA's commitment to the Surgeon General's Report on Oral Health and the National Call to Action to Promote Oral Health.
• The ADHA House of Delegates, representing more than 120,000 dental hygienists across the country, recognized the need for ADHA to lead the effort to address the public's unmet oral health needs and thereby approved the development of an advanced dental hygiene practitioner.
• ADHA recognizes that much of the restorative aspect of the ADHP's responsibilities will require some widespread changes with regard to scope of practice enhancements.
• The dental hygiene profession is already on the frontline of defense against disease; however, due to current state practice acts, there are unwarranted barriers imposed that do not allow the public direct access to preventive care and education from dental hygienists.
• The U.S. is experiencing a crisis shortage of dentists available to treat millions of Americans, including a concentration of un-served populations in both rural and inner city areas who are unable to obtain care because there are not enough dentists practicing in those areas.
• Government statistics reveal a projected decline in the number of dentists while there is a projected growth in the dental hygiene profession. It is clear that dental hygienists will be able to make a huge impact through the expanded role of the ADHP.
• While the ADHP could be applicable in any setting, the ADHP is expected to work in hospitals, nursing homes, public health or wherever there is a need for this position.
• The concept of an ADHP, pioneered by ADHA, is not the first of its kind in the health care industry. Precedent has been set in the nursing profession with positions that include: certified nurse midwife, nurse practitioner, clinical nurse specialist and certified registered nurse anesthetist. The nursing profession moved toward the development of advanced practice nurse through recognition of unmet public health needs.
• Our nation's more progressive states, which have already expanded the role of dental hygienists, have recognized that the traditional oral health delivery system does not work for many segments of our population. In a certain number of states, dental hygienists can already do some restorative procedures.
• The ADHP will be able to work with a host of public health and medical professionals in a variety of settings. This collaborative working partnership will offer patients and clients a well-rounded approach to health service.
• We expect that a number of like-minded organizations interested in increasing the public's access to oral health care will be interested in working with ADHA.
• In October, ADHA announced its support of actions taken by the American Dental Association (ADA) that demonstrated its openness to the ADHP as an ADHA-initiated solution to the severe oral health care access crisis in the U.S. These actions included the ADA's House of Delegates' referral of three ADHP-related resolutions proposed by its Board of Trustees at the ADA's annual meeting.
• ADHA believes that oral health care-a fundamental component of total health care-is the right of all people. Yet 40 percent of Americans are not getting the care they need. A number of factors inhibit access to care, the most evident being the inability to pay for care.
• Lack of access to oral health care is a critical issue in the U.S. due to disparities in the health care delivery system. This is documented in ADHA's 2001 access to care position paper, which follows the Surgeon General's 2000 report, Oral Health in America, which called untreated poor oral health a "silent X-factor promoting the onset of life-threatening diseases which are responsible for the deaths of millions of Americans each year."
• An abundance of research has identified periodontal disease as a risk factor for heart and lung disease; diabetes; premature, low-birth weight babies and a number of other systemic diseases. Also, routine oral health exams can uncover symptoms of diabetes, osteoporosis and low bone mass, eating disorders and HIV.
• ADHA recommends several solutions to the access to care issue. One is to develop partnerships among health care organizations, state and federal government and other interested groups to educate the public on the importance of oral health and the integral role it plays in total health. Another solution is for states to recognize licensed dental hygienists as Medicaid providers. And yet one more solution would be to relax state practice acts to allow more dental hygienists to provide oral health care to those who are not currently receiving it.

Defined as follows:
Independent Practice/Practitioner - A dental hygienist who provides dental hygiene services to the public without the specific authorization of a dentist through direct agreement with each client in accordance with the state dental hygiene/dental practice act. (The dental hygienist practices dental hygiene independently from the dentist)

Self-Regulation - Regulation of the practice of dental hygiene in which licensed dental hygienists, who are graduates of accredited dental hygiene programs, are authorized by state government to define the dental hygiene scope of practice and to license, regulate and discipline dental hygienists. (Dental hygienists would govern all aspects of their profession, like Nursing)

It is ODHA Policy that we do NOT want to nor have we attempted to obtain Independent Practice.

Important news…
The Oklahoma Board of Dentistry has updated their Continuing Education policy. In a statement submitted by Linda Campbell, Executive Director, "…all continuing education hours submitted above the thirty hours required for dental hygienists will not be recorded or maintained by the Board office."

The new recording period began July 1, 2004 and will end June 30, 2007. It is important to maintain your own records of all CE courses in case of a Board of Dentistry audit. Because there are limits on how many hours of CE allowed per Category (A - D), you should check with the Board of Dentistry when submitting your hours for the appropriate category.

SUMMARY OF NEW LAWS PASSED IN 2003

The Oklahoma Dental Hygienists' Association is pleased to advise you of new provisions in the laws of the Oklahoma State Dental Practice Act. These new laws relate to licensed dental hygienists and the expansion of public and private access to dental hygiene care. This is a new frontier ready for exploration by pioneer health care providers, dental hygienists, and dentists.

On May 5, 2003, Governor Brad Henry signed House Bills 1443 and 1445 into law. These laws made provisions for licensed dental hygienists to provide dental hygiene treatment in a variety of settings under distinctive circumstances and with less restriction. These provisions may enable you or your association to obtain professional dental hygiene services within your sphere of health care. At the end of this letter, you will find contact information for questions regarding dental hygiene services should your circumstances meet the criterion of the new laws.

Following is a description of the provisions for dental hygienists to practice along with the conditions relating to delivery. Please read this information carefully to determine if these new laws would enable you to enlist the services of dental hygienists within your field of health care.

• A treatment facility may employ dental hygienists whose services shall be limited to the examination of teeth and the teaching of dental hygiene

  This allows a dental hygienist to perform dental screenings or dental hygiene examinations, as well as teach oral hygiene, in a variety of settings and with no supervision restrictions. These services may be done on a voluntary basis.

• Dental hygienists may practice dental hygiene under the supervision of a dentist in a treatment facility.

  Dental hygienists are no longer restricted to practice in a dental office. A treatment facility is defined as: A federal, state or local public health facility; A private health facility; A group home or residential care facility servicing the elderly, handicapped or juveniles; A hospital; A nursing home; A penal institution; operated by or under contract with the federal or state government; A public or private school; A patient of record's private residence; An accredited dental college; An accredited dental hygiene program; or such other places as are authorized by the rules of the Board.

• Without supervision restrictions and by written authorization, a dentist may authorize procedures to be performed in a treatment facility by a dental hygienist with these qualifications:
  • The dental hygienist has at least two (2) years experience in the practice of dental hygiene,
  • The authorization to perform the procedures is in writing and signed by the dentist, and
  • The procedures are performed during an initial visit to a person in a treatment facility

  This allows a dental hygienist to perform dental hygiene procedures to a person on an initial visit without having to comply with the supervision requirements of a dentist having previously seen and examined the person or being present during the performing of the procedures. This does not include advanced procedures for dental hygienists, which require direct or indirect supervision.

• In addition to the previous, the following requirements must be met:
  • The person upon whom the procedures are performed must be referred to the authorizing dentist after completion of the procedures performed
  • A dental hygienist may not perform a second set of procedures on a person pursuant to this subsection until the person has been examined and accepted for dental care by the authorizing dentist.
  • The treatment facility wherein any procedure is performed by a dental hygienist shall note each such procedure in the medical records of the person upon whom the procedure was performed.

  These provisions ensure that a person has access to dental care by a dentist and that accurate records of dental hygiene treatment are made.

These new laws provide more flexibility for hygienists and dentists to reach children, the elderly, the needy, and other under-served populations with preventive oral health care.

In summary, dental hygienists may now go into virtually any setting to perform dental hygiene examinations and screenings without supervision. And, by written authorization of a dentist, a dental hygienist may go into a treatment facility, and upon initial visit, provide dental hygiene services to an individual. These are new broadened parameters for dental hygiene care in Oklahoma and we want you to help us explore the possibilities!

If you have questions or would like more information, please contact the Board of Dentistry in Oklahoma City at 405-524-3592. You may contact any of the officers of the Oklahoma Dental Hygienists' Association by email and someone will be glad to respond to your questions or requests.

Thanks for all you do to promote better health in Oklahoma!