Dental hygienist

Last updated
Dental hygienist
Dental Hygienist.jpg
Occupation
Activity sectors
Dentistry
Description
CompetenciesBiomedical knowledge, manual dexterity, critical thinking, analytical skills, and communication
Education required
Associates of Dental Hygiene or Bachelors Degree in Dental Hygiene

A dental hygienist or oral hygienist is a licensed dental professional, registered with a dental association or regulatory body within their country of practice. Prior to completing clinical and written board examinations, registered dental hygienists must have either an associate's or bachelor's degree in dental hygiene from an accredited college or university. Once registered, hygienists are primary healthcare professionals who work independently of or alongside dentists and other dental professionals to provide full oral health care. They have the training and education that focus on and specialize in the prevention and treatment of many oral diseases.

Contents

Dental hygienists have a specific scope of clinical procedures they provide to their patients. They assess a patient's condition in order to offer patient-specific preventive and educational services to promote and maintain good oral health. A major role of a dental hygienist is to perform periodontal therapy which includes things such periodontal charting, periodontal debridement (scaling and root planing), prophylaxis (preventing disease) or periodontal maintenance procedures for patients with periodontal disease. The use of therapeutic methods assists their patients in controlling oral disease, while providing tailored treatment plans that emphasize the importance of behavioral changes. [1] Some dental hygienists are licensed to administer local anesthesia and perform dental radiography. [2] Dental hygienists are also the primary resource for oral cancer screening and prevention. [3] In addition to these procedures, hygienists may take intraoral radiographs, apply dental sealants, administer topical fluoride, and provide patient-specific oral hygiene instruction. [4]

Dental hygienists work in a range of dental settings, from independent, private, or specialist practices to the public sector. [5] [6] Dental hygienists work together with dentists, dental therapists, oral health therapists, as well as other dental professionals. Dental hygienists aim to work inter-professionally to provide holistic oral health care in the best interest of their patient. Dental hygienists also offer expertise in their field and can provide a dental hygiene diagnosis, which is an integral component of the comprehensive dental diagnosis. [7]

Job description and duties

In the dental office, the dentist and the dental hygienist work together to meet the oral health needs of patients. Since each country has its own specific regulations regarding their responsibilities, the range of services performed by hygienists varies. Some of the services provided by dental hygienists may include:

Dental hygienists salary

Jobs for dental are well paid almost on all states of the United States. The median annual wage for dental hygienists was $77,810 in May 2021. [9] The median annual wages for dental hygienists in the top industries in which they worked were as follows:

Offices of dentists$77,810
Offices of physicians$77,290
Government$64,110

[10] States with the highest employment level in Dental Hygienists:

StateHourly mean wageAnnual mean wage (2)
California$52.02$108,200
Texas$36.53$75,970
Florida$35.18$73,180
New York$40.19$83,600
Pennsylvania$34.48$71,710

[11] Top paying states for Dental Hygienists:

StateHourly mean wageAnnual mean wage (2)
Alaska$55.53$115,510
California$52.02$108,200
Washington$51.06$106,200
Oregon$45.40$94,420
Nevada$43.01$89,460

[11] Metropolitan areas with the highest employment level in Dental Hygienists:

Metropolitan areaEmployment (1)Employment per thousand jobsLocation quotient (9)Hourly mean wageAnnual mean wage (2)
Los Angeles-Long Beach-Anaheim, CA10,1501.781.21$50.41$104,840
New York-Newark-Jersey City, NY-NJ-PA9,5701.100.75$44.00$91,530
Chicago-Naperville-Elgin, IL-IN-WI6,9601.641.12$38.24$79,540
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD4,7901.801.23$39.90$83,000
Dallas-Fort Worth-Arlington, TX4,4401.240.84$36.37$75,660

[11] Top paying metropolitan areas for Dental Hygienists:

Metropolitan areaEmployment (1)Employment per thousand jobsLocation quotient (9)Hourly mean wageAnnual mean wage (2)
Santa Maria-Santa Barbara, CA2601.350.92$60.46$125,750
San Jose-Sunnyvale-Santa Clara, CA2,0101.881.28$58.97$122,660
San Francisco-Oakland-Hayward, CA3,2701.460.99$57.37$119,320
Anchorage, AK2901.811.23$55.90$116,270
Santa Rosa, CA4602.411.64$55.64$115,730

[11]

Periodontal treatment

Gum disease is caused by a sticky film of bacteria called plaque. Plaque is always forming on teeth, but if it is not cleaned well, the bacteria in plaque can cause gums to become inflamed. When this happens, the gums pull away from the teeth and form spaces called pockets. Plaque then gets trapped in these pockets and cannot be removed with regular brushing. Untreated gum disease can lead to bone and tooth loss. If the periodontal pockets are too deep a deep cleaning (scaling and root planing) is necessary to remove the plaque in these pockets. [12]

Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health. The maintenance phase involves continuous care, at patient specific levels. [13]

Timeline of dental hygienists

Training

Australia

Dental hygienists in Australia must be graduates from a dental hygiene program, with either an advanced diploma (TAFE), associate degree, or more commonly a bachelor's degree from a dental hygiene school that is accredited by the Australian Dental Council (ADC) under the Australian Health Practitioner Regulation Agency. [26]

In Australia it is a legal requirement for dental hygienist and oral health therapist graduates to be registered with the Dental Board of Australia before practising their scope in periodontology in any state or territory in Australia. [27]

The Dental Hygienists' Association of Australia (DHAA) Inc., established in 1975, is the peak body representing registered dental hygiene service providers in Australia. A dental hygienist does not need to be employed by a dentist but can independently assess patients and make treatment plans within their scope of practice whilst working in the community. Practising as an autonomous decision maker, and working within the scope of only what they are "formally" trained in. The National Law requires the same level of professional responsibility from dental hygienists, oral health therapists and dental therapists as it does from dentists, dental specialists and dental prosthetists in that all practitioners must have their own professional indemnity insurance and radiation licences. They are also required to complete 60 hours of mandatory continuing professional development in a three-year cycle. [28] [29]

A Bachelor of Oral Health is the most common degree program. Students entering a bachelor's degree program are required to have a high school diploma or equivalent. Most Bachelor of Oral Health programs now qualify students as both dental hygienists and dental therapists, collectively known as oral health therapists. [30]

Canada

Dental hygienists in Canada must have completed a diploma program, which can take from 19 months to 3 years to complete. All dental hygiene students must pass a NDHCB examination after graduation. [31] This examination is offered three times per year, January, May and September. Three universities in Canada offer Bachelor of Science degrees in Dental Hygiene: Dalhousie University, [32] University of Alberta, [33] University of British Columbia. [34]

Dental hygiene across Canada is a well-respected career with many opportunities. These possibilities include working in clinical, administration, education, research and public health positions. The wages vary throughout the country; from approximately $32 per hour in some areas to as high as $55 per hour in others. A surplus of new dental hygiene graduates in recent years has resulted in a decrease in wages in some regions. [ citation needed ]

Some of the downfalls to practicing in different provinces are the different regulations. For instance, in BC, the hygienist cannot provide treatment without the patient receiving a dental exam in the previous 365 days unless the practicing hygienist has an extended duty module (resident-care module). In AB, BC, MB and SK, hygienists also administer local anesthesia if qualified to do so.Home College of Dental Hygienists of British Columbia / Saskatchewan Dental Hygienists Association HOME In Ontario, dental hygienists may take further training to become a restorative dental hygienist. Registered dental hygienists must register every year by December 31. Ontario dental hygienists must also prove continuing competence by maintaining a professional portfolio yearly. In Ontario, dental hygienists are registered with the College of Dental Hygienists of Ontario. [35] [36]

Dental hygienists in BC, ON, NS and AB are able to open their own private clinics and practice without a dentist on staff.

New Zealand

Dental hygienists are no longer trained in New Zealand. Instead, training has been combined with that of dental therapists to train oral health therapists. Dental hygienists were first domestically trained in 1974 for use in the New Zealand Defence Force. The 1-year course was taught by the Royal New Zealand Dental Corp at the Burnham army base outside Christchurch. [22] Hygiene training was briefly offered at the Wellington School for Dental Nurses in 1990 as 2-week a supplement to Dental Therapy students training. [22] However, this was quickly discontinued. [22]

The first independent non-military training began in 1994. [22] Otago Polytechnic began offering a 15-month Certificate in Dental Hygiene in Dunedin. [22] In 1998, the programme was modified to be a 2-year Diploma. [22] Otago Polytech stopped offering the course in 2000. [22] The following year, University of Otago began offering a 2-year Diploma in Dental Hygiene qualification. [22] In 2002, the university added a 3-year Bachelor of Health Sciences (endorsed in Dental Hygiene) degree alongside the Diploma. [22]

From 2006, [22] New Zealand dental hygienists and now oral health therapists have been trained at either University of Otago in Dunedin (at the country's only Dental School) or at Auckland University of Technology. [37] Until official establishment of the oral health therapy scope in late 2017, the qualifications (Bachelor of Oral Health at Otago, Bachelor of Health Science (Oral Health) at AUT) enabled graduates to register and practise as both a dental hygienist and a dental therapist. [22]

In order to practise, dental hygienists and oral health therapists must register and annually recertify with the Dental Council of New Zealand. [38] One dental hygienist is represented on Council for a 3-year term. [39]

The representing body for dental hygienists was the New Zealand Dental Hygienists' Association. [25] The association was founded in 1993, [24] and is affiliated with the International Federation of Dental Hygienists. [40] In 2021 the association merged with the New Zealand Dental and Oral Health Therapists Association to become the New Zealand Oral Health Association.

United States

Dental hygienists in the United States must be graduates from a dental hygiene program, with either an associate degree (most common), a certificate, a bachelor's degree or a master's degree from a dental hygienist school that is accredited by the American Dental Association (ADA). [41]

All dental hygienists in the United States must be licensed by the state in which they practice, after completing a minimum of two years of school and passing a written board known as the National Board Dental Hygiene Examination as well as a clinical board exam. After completing these exams and licenses, dental hygienists may use "R.D.H" after their names to signify that they are a registered dental hygienist. [42] [43] Dental hygienists also have to become licensed in the state in which they intend to practice. State licensure requirements vary, however most states require an associate degree in Dental Hygiene, successful completion of a state licensure examination, as well as a clinical examination also typically administered by the state.

Dental hygienists school programs usually require both general education courses and courses specific to the field of dental hygiene. General education courses important to dental hygiene degrees include college level algebra, biology, and chemistry. Courses specific to dental hygiene may include anatomy, oral anatomy, materials science, pharmacology, radiography, periodontology, nutrition, and clinical skills. [ citation needed ]

A Bachelor of Science in Dental Hygiene is typically a four-year program. Students entering a bachelor's degree program are required to have a high school diploma or equivalent, but many dental hygienists with an associate degree or certification enter the bachelor's degree programs to expand their clinical expertise and help advance their careers. [ citation needed ]

Graduate degrees in the field of dental hygiene are typically two-year programs and are completed after the bachelor's degree. Common graduate courses in dental hygiene include Healthcare Management, Lab Instruction, and Clinical Instruction.[ citation needed ]

In addition, the American Dental Hygienists' Association has defined a more advanced level of dental hygiene, the Advanced Dental Hygiene Practitioner otherwise known as a dental therapist.

Dental hygienist students perform practical oral examinations free of charge at some institutions which have expressed a shortage in recent years. [44]

Direct access to care with a dental hygienist

The dental hygienists in some parts of North America can provide oral hygiene treatment based on the assessment of a patient's needs without the authorization of a dentist, treat the patient in absence of a dentist, and also maintain a provider-patient relationship.

India

The Dental Hygienist Course in India is a full-time 2-year diploma course. The Dental Hygienist course is regulated and controlled by the Dental Council of India. After completing the course, a dental hygienist should register with a state dental council. Any registered dental hygienist in one state may practice as in any other. The Federation of Indian Dental Hygienists Association is the primary national body representing the dental hygienist profession in India, however, some state dental hygienist associations also work at the state level. In India, dental hygienists do not need to be employed by a dentist but can have their own clinic.



Canada

British Columbia

1995 - A client must have seen a dentist within the previous 365 days in order for the hygienist to provide dental hygiene treatment.

2012 - New bylaws offers an exemption from the 365-day rule if hygienists are registered in the Full Registration (365 Day Rule Exempt) class. [45]

Alberta

2006 - Dental hygienists are able to offer their services in many practice settings including independent practice. [46]

Manitoba

2008 - If the dental hygienist has practiced for more than 3000 hours, and the client does not have a complex medical condition then the hygienists do not require the supervision of a dentist. [47]

Ontario

2007 - Registered dental hygienists in Ontario who have been approved by the College of Dental Hygienists of Ontario can practice independently. [48]

United States

California

1998 - Registered dental hygienist in alternative practice (RDHAP): RDHAPs may provide services for homebound persons or at residential facilities, schools, institutions and in dental health professional shortage areas without the supervision of a dentist. RDHAPs can provide patient care for up to 18 months and longer if the patient obtains a prescription for additional oral treatment from a dentist or physician . [49]

Colorado

1987 - Unsupervised practice: Hygienists may have their own dental hygiene practice; there are no requirement for the authorization or supervision of a dentist for most services. Colorado is currently the only state where this is approved. Case was won by JoAnn Grant, a dental hygienist from Fort Collins, CO. [50]

Connecticut

1999 - Public health dental hygienist: dental hygienists may practice without supervision in institutions, public health facilities, group homes, and schools as long as they have two years of work experience. [51]

Maine

2008 - Independent practice dental hygienist: A dental hygienist licensed with an independent practice may work without the supervision of a dentist, providing that the dental hygienist has to complete 2,000 work hours of clinical practice during the two years prior to applying for an independent license, as well as a bachelor's degree from a CODA accredited dental hygiene program or complete 6,000 work hours of clinical practice during the six years prior to applying for an independent license, as well as an associate degree from a CODA accredited dental hygiene program. [52]

Michigan

2005 - PA 161 Dental hygienist: hygienists with grantee status can work in a public or nonprofit environment, a school or nursing home that administers dental care to a low-income population. Dentists collaborating with dental hygienists do not need to be present to authorize or administer treatment. However, dental hygienists must have the availability to communicate with a dentist in order to review patient records and establish emergency protocols. Hygienists need to apply to the state department of community health for grantee status. [53]

Washington

1984 - Unsupervised practice: dental hygienist practice without the supervision of a dentist is allowed in hospitals, group homes, nursing homes, home health agencies, Health and Human Service state institutions, jails, and public health facilities as long as the hygienist refers their patients to a dentist for treatment. Hygienists must have at least two years of work experience within the last 5 years. [54]

Notable dental hygienists

See also

Further reading

Related Research Articles

<span class="mw-page-title-main">Dentistry</span> Branch of medicine

Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.

<span class="mw-page-title-main">Periodontal disease</span> Disease of the tissues surrounding the teeth (periodontium)

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Halitosis may also occur.

<span class="mw-page-title-main">Dentist</span> Health care occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

<span class="mw-page-title-main">Geriatric dentistry</span> Delivery of dental care to older adults

Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. Older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, the elderly form a distinct group in terms of provision of care.

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<span class="mw-page-title-main">Dental assistant</span> Medical profession

Dental assistants are members of the dental team. They support a dental operator in providing more efficient dental treatment. Dental assistants are distinguished from other groups of dental auxiliaries by differing training, roles and patient scopes.

A dental auxiliary is any oral health practitioner other than a dentist & dental hygienist, including the supporting team assisting in dental treatment. They include dental assistants, dental therapists and oral health therapists, dental technologists, and orthodontic auxiliaries. The role of dental auxiliaries is usually set out in regional dental regulations, defining the treatment that can be performed.

<span class="mw-page-title-main">Denturist</span>

A denturist in the United States and Canada, clinical dental technologist in the United Kingdom and Ireland, dental prosthetist in Australia, or a clinical dental technician in New Zealand is a member of the oral health care team and role as primary oral health care provider who provides an oral health examination, planning treatment, takes impressions of the surrounding oral tissues, constructs and delivers removable oral prosthesis treatment directly to the patient.

<span class="mw-page-title-main">Buccal exostosis</span> Medical condition

A buccal exostosis is an exostosis on the buccal surface of the alveolar ridge of the maxilla or mandible. More commonly seen in the maxilla than the mandible, buccal exostoses are considered to be site specific. Existing as asymptomatic bony nodules, buccal exostoses don’t usually present until adult life, and some consider buccal exostoses to be a variation of normal anatomy rather than disease. Bone is thought to become hyperplastic, consisting of mature cortical and trabecular bone with a smooth outer surface. They are less common when compared with mandibular tori.

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Bleeding on probing (BoP) which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).

<span class="mw-page-title-main">Oral and maxillofacial radiology</span>

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<span class="mw-page-title-main">Dental public health</span> Prevention of oral disease and promotion of oral health

Dental Public Health (DPH) is a para-clinical specialty of dentistry that deals with the prevention of oral disease and promotion of oral health. Dental public health is involved in the assessment of key dental health needs and coming up with effective solutions to improve the dental health of populations rather than individuals.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay and gum diseases, including gingivitis, and periodontitis.

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

Gingivitis is a non-destructive disease that causes inflammation of the gums; ulitis is an alternative term. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that are attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

Special needs dentistry, also known as special care dentistry, is a dental specialty that deals with the oral health problems of geriatric patients, patients with intellectual disabilities, and patients with other medical, physical, or psychiatric issues.

In the United States and Canada, there are twelve recognized dental specialties in which some dentists choose to train and practice, in addition to or instead of general dentistry. In the United Kingdom and Australia, there are thirteen.

Esther Mae Wilkins was an American dental hygienist, dentist and author of the first comprehensive book on dental hygiene, Clinical Practice of the Dental Hygienist. The dental instrument known as the Wilkins/Tufts Explorer was named after her.

References

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  3. ↑ "Be part of the change". Oral Cancer Foundation. Oral Cancer Foundation. Retrieved 27 September 2017.
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  47. ↑ "The Dental Hygienists Act". Statutory Publications. Retrieved 1 April 2014.
  48. ↑ "Health Professions Regulatory Advisory Council" (PDF). Archived from the original on 1 December 2021. Retrieved 1 April 2014.{{cite web}}: CS1 maint: unfit URL (link)
  49. ↑ "RDHAP Application Instructions". Archived from the original on 7 April 2014. Retrieved 1 April 2014.
  50. ↑ "Direct Access States" (PDF). ADHA . Retrieved 1 April 2014.
  51. ↑ "20 Professional and Occupational Licensing, Certification, Title Protection and Registration" . Retrieved 1 April 2014.
  52. ↑ "Public Laws" . Retrieved 1 April 2014.
  53. ↑ "Public Health Code Excerpt" . Retrieved 1 April 2014.
  54. ↑ "Washington State Legislator" . Retrieved 1 April 2014.
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