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{{Short description|Medical professional}}
{{multiple issues|
{{Infobox Occupation
{{cleanup|reason=capitalization, style|date=July 2014}}
| name = Dental hygienist
{{more footnotes|date=September 2010}}
| image = Dental Hygienist.jpg
| caption =
| competencies = Biomedical knowledge, manual dexterity, critical thinking, analytical skills, and communication
| formation = Associates of Dental Hygiene or Bachelors Degree in Dental Hygiene
<!------------Details------------------->
| activity_sector = Dentistry
}}
}}
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 [[Oral hygiene|dental hygiene]] from an accredited college or university. Once registered, [[Hygiene|hygienists]] are primary healthcare professionals who work independently of or alongside [[dentist]]s 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.


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]]), [[Dental prophylaxis|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.<ref name="dhaa.info">Dental Hygienists' Association of Australia Inc. (1999). A professional Body Addressing Training, Uniformity of Practice and Growth of the Dental Hygienist Profession. Retrieved from {{Cite web |title=Information - DHAA: Dental Hygienists' Association of Australia Inc. Supporting uniformity of Practice & growth of the dental hygienist profession |url=http://www.dhaa.info/information-1/ |archive-url=https://web.archive.org/web/20140518000747/http://www.dhaa.info/information-1/ |archive-date=2014-05-18 |access-date=2014-05-17}} Print. Local dental regulations determine the scope of practice of dental hygienists respectively</ref> Some dental hygienists are licensed to administer [[local anesthesia]] and perform [[dental radiography]].<ref>{{Cite web |title=Response to the Dental Board of Australia's Preliminary Consultation on the Draft Scope of Practice Registration Standard and Guidelines |url=https://www.ismilespecialists.com/Response%20Dental%20Board%20Australia%202013%20for%20Hygienist |access-date=24 May 2014}}{{cbignore|bot=medic}}{{Dead link|date=August 2018|bot=InternetArchiveBot|fix-attempted=yes}}</ref> Dental hygienists are also the primary resource for oral cancer screening and prevention.<ref>{{Cite web |title=Be part of the change |url=http://oralcancerfoundation.org/ocf-rdh-part-change-campaign/ |access-date=27 September 2017 |website=Oral Cancer Foundation |publisher=Oral Cancer Foundation}}</ref> In addition to these procedures, hygienists may take intraoral [[radiograph]]s, apply [[dental sealants]], administer topical [[fluoride]], and provide patient-specific [[oral hygiene]] instruction.<ref>{{Cite web |title=American Dental Association-Dental Hygienist- Job Description |url=http://www.ada.org/en/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist |access-date=24 May 2014}}</ref>
[[image:Dental hygienist.jpg|thumb|right|300px|Dental hygienist holding a scaler]]
A '''dental hygienist''' is a licensed dental professional who is registered with a dental association or regulatory body within their country of practice. They are a primary healthcare professional who works independent of, or alongside [[dentist]]s and other dental professionals in a team to provide full oral health care. They have the training and education that focus and specialise in the prevention and treatment of oral disease. They can choose to work in a range of dental settings from independent practice, private practice, specialists practices to public sector; and can also work in residential aged care facilities.<ref>{{cite web|last=Australian Dental Association|first=|title=Dental Hygienist|url=http://www.ada.org.au/dentalprofessionals/hygienist.aspx|publisher=Australian Dental Association|accessdate=16 March 2014}}</ref><ref>{{cite web|last= American Dental Association|first=|title=Dental Hygienist|url=http://www.ada.org/en/home-ada/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist|publisher= American Dental Association|accessdate=16 March 2014}}</ref>


Dental hygienists work in a range of dental settings, from independent, private, or specialist practices to the public sector.<ref>{{Cite web |last=Australian Dental Association |title=Dental Hygienist |url=http://www.ada.org.au/dentalprofessionals/hygienist.aspx |archive-url=https://web.archive.org/web/20140225062002/http://www.ada.org.au/dentalprofessionals/hygienist.aspx |archive-date=25 February 2014 |access-date=16 March 2014 |publisher=Australian Dental Association}}</ref><ref>{{Cite web |title=Dental Hygienist |url=http://www.ada.org/en/home-ada/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist |access-date=16 March 2014 |publisher=American Dental Association}}</ref> Dental hygienists work together with [[dentist]]s, [[dental therapist]]s, 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.<ref>{{Cite web|url=http://www.adha.org/downloads/adha_standards08.pdf|archive-url=https://web.archive.org/web/20121107041807/http://www.adha.org/downloads/adha_standards08.pdf |title=Standards for Clinical Dental Hygiene Practice |website=American Dental Hygienists' Association |archive-date=November 7, 2012}}</ref>
Dental hygienists have a specific scope of clinical procedures they provide to their patients. They assess a patients condition in order to offer patient-specific preventative and educational services to promote and maintain good oral health. The use of therapeutic methods assists their patients in controlling oral disease, while providing tailored treatment plans that emphasize the importance of behavioral changes .<ref name="dhaa.info">Dental Hygienists' Association of Australia Inc. (1999). A professional Body Addressing Training, Uniformity of Practice and Growth of the Dental Hygienist Profession. Retrieved from http://www.dhaa.info/information-1/ Print. Local dental regulations determine the scope of practice of dental hygienists respectively</ref> In most jurisdictions, hygienists work for a dentist or dental specialist, and some are licensed to administer [[local anesthesia]] and perform [[dental radiography]].<ref>{{cite web|title=Response to the Dental Board of Australia's Preliminary Consultation on the Draft Scope of Practice Registration Standard and Guidelines|url=http://www.dentalboard.gov.au/.../default.aspx?record=WD13%2F11727&dbid=AP&chksum=JAA1Jz1zashi0txE1BLImA%3D%3D|accessdate=24 May 2014}}</ref> The major role of a dental hygienist is to perform periodontal therapy which includes things such periodontal charting, periodontal debridement ([[scaling and root planing]]), [[prophylaxis]] (cleaning) for patients with [[periodontal disease]]. In addition dental hygienists are able to perform examinations, make [[diagnosis]], take intraoral [[radiograph]]s, [[dental sealants]], administer [[fluoride]], and provide patient specific [[oral hygiene]] instruction.<ref>{{cite web|title= American Dental Association-Dental Hygienist- Job Description |url=http://www.ada.org/en/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist|accessdate=24 May 2014}}</ref> They are also able to work at an orthodontic clinic and can perform many tasks there. Such as selecting and sizing of orthodontic bands for [[dental braces]], the removal of orthodontic appliances and are able to make [[dental impression]]s for the construction of study casts and [[mouthguard]]s.<ref name="dhaa.info"/>


== Job description and duties ==
Dental hygienists work together with other dental professionals, with a higher number working at general practices with [[dentist]]s, [[Dental therapist]]s and oral health therapists. A smaller number work at specialist practices alongside [[orthodontist]]s and [[periodontists]]. They help with the contribution of an interdisciplinary approach, aiming to provide optimum oral health care to their patients. Dental hygienists also aim to work interprofessionally 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.<ref>[http://www.adha.org/downloads/adha_standards08.pdf American Dental Hygienists' Association - Standards of Practice]</ref>


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:
Other areas that relate to dentistry that dental hygienists can be involved in are:


* patient screening procedures; such as assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse
• Research:
* taking and developing dental radiographs (x-rays)
They can carry out clinical studies and trials alongside specialists in teaching institutions.
* removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth
* applying preventive materials to the teeth (e.g., sealants and fluorides)
* teaching patients appropriate oral hygiene strategies to maintain oral health
* counseling patients about good nutrition and its impact on oral health
* making impressions of patients' teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs)
* performing documentation and office management activities<ref>{{Cite web |title=Dental Hygienist |url=https://www.ada.org/en/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist |access-date=2019-04-15 |website=www.ada.org}}</ref>


=== Dental hygienists salary ===
• Professional Education:
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.<ref>{{Cite web |title=Dental Hygienists : Occupational Outlook Handbook:: U.S. Bureau of Labor Statistics |url=https://www.bls.gov/ooh/healthcare/dental-hygienists.htm |access-date=2022-06-21 |website=www.bls.gov |language=en-us}}</ref>
They are able to provide education by teaching and training dental hygiene students and dental assistants. They can also choose to present research at a variety of different events and seminars within their industry.
The median annual wages for dental hygienists in the top industries in which they worked were as follows:

{| class="wikitable"
• Community health:
|Offices of dentists
They provide assistance and group talks in community dental clinics, residential care, hospitals and nursing homes. For example: helping clients that suffer from medical and mental disorders.
|$77,810

|-
• Australian Defence Force:
|Offices of physicians
They are able to provide dental services with the Army, Navy and Air.
|$77,290

|-
• Marketing and Sales:
|Government
They can promote dental products and services through dental companies as a dental company representative.
|$64,110

|}
<ref name="dhaa.info"/>
<ref>{{Cite web |title=Dental Hygienists : Occupational Outlook Handbook:: U.S. Bureau of Labor Statistics |url=https://www.bls.gov/ooh/healthcare/dental-hygienists.htm#tab-5 |access-date=2022-06-21 |website=www.bls.gov |language=en-us}}</ref>

States with the highest employment level in Dental Hygienists:
== Treatment Phases of Periodontal Therapy ==
{| class="wikitable"
[[image:Dental hygienist at work.jpg|thumb|right|200px|A dental hygienist at work]]
!State
Periodontal therapy is a continuous cycle requiring regular evaluation and maintenance to optimise treatment outcomes. The treatment is normally carried out by a Dental Hygienist or Oral Health Therapist, but involves all members of the dental team and can include specialists throughout the course of care.
!Hourly mean wage
There are six phases undertaken by dental professionals when undertaking periodontal therapy, which are as follows;<ref name="Nield-Gehrig" >, J. and D. Willmann, Eds. (2008). Foundations of Periodontics for the Dental Hygienist.</ref>
!Annual mean wage (2)

|-
===Systemic Pre-Phase===
|California
This includes, but is not limited to;
|$52.02
*A full review of the patient's medical history to identify the patients systemic health, as well as establishing a provisional diagnosis. The provisional diagnosis is generated following a comprehensive oral examination, data collection and radiographic interpretation.
|$108,200
*An [[ASA physical status classification system]] is used to indicate future treatment options for the patient, whilst considering the implications of risk factors, such as medical conditions (i.e. [[endocarditis]], [[diabetes]], [[smoking]]). This also allows the dental clinician to begin planning all non-surgical therapy.
|-
*All emergency treatment should be addressed first, this includes emergency periodontal treatment;<ref name="Nield-Gehrig"/>
|Texas
*The patients compliance should be established during this phase as optimal oral hygiene practices need to be employed in order to assist with treatment planning and, long-term goals and results;<ref name="Nield-Gehrig"/>
|$36.53
|$75,970
|-
|Florida
|$35.18
|$73,180
|-
|New York
|$40.19
|$83,600
|-
|Pennsylvania
|$34.48
|$71,710
|}
<ref name="auto">{{Cite web |title=Dental Hygienists |url=https://www.bls.gov/oes/current/oes291292.htm#nat |access-date=2022-06-21 |website=www.bls.gov |language=en-us}}</ref>
Top paying states for Dental Hygienists:
{| class="wikitable"
!State
!Hourly mean wage
!Annual 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
|}
<ref name="auto"/>
Metropolitan areas with the highest employment level in Dental Hygienists:
{| class="wikitable"
!Metropolitan area
!Employment (1)
!Employment per thousand jobs
!Location quotient (9)
!Hourly mean wage
!Annual mean wage (2)
|-
|Los Angeles-Long Beach-Anaheim, CA
|10,150
|1.78
|1.21
|$50.41
|$104,840
|-
|New York-Newark-Jersey City, NY-NJ-PA
|9,570
|1.10
|0.75
|$44.00
|$91,530
|-
|Chicago-Naperville-Elgin, IL-IN-WI
|6,960
|1.64
|1.12
|$38.24
|$79,540
|-
|Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
|4,790
|1.80
|1.23
|$39.90
|$83,000
|-
|Dallas-Fort Worth-Arlington, TX
|4,440
|1.24
|0.84
|$36.37
|$75,660
|}
<ref name="auto"/>
Top paying metropolitan areas for Dental Hygienists:
{| class="wikitable"
!Metropolitan area
!Employment (1)
!Employment per thousand jobs
!Location quotient (9)
!Hourly mean wage
!Annual mean wage (2)
|-
|Santa Maria-Santa Barbara, CA
|260
|1.35
|0.92
|$60.46
|$125,750
|-
|San Jose-Sunnyvale-Santa Clara, CA
|2,010
|1.88
|1.28
|$58.97
|$122,660
|-
|San Francisco-Oakland-Hayward, CA
|3,270
|1.46
|0.99
|$57.37
|$119,320
|-
|Anchorage, AK
|290
|1.81
|1.23
|$55.90
|$116,270
|-
|Santa Rosa, CA
|460
|2.41
|1.64
|$55.64
|$115,730
|}
<ref name="auto"/>


===Initial Phase: Non-Surgical Periodontal Therapy===
===Periodontal treatment===
Non-surgical periodontal therapy is concerned primarily with disease prevention, and is accomplished through patient and clinician cooperative interaction. It is normally accomplished with the incorporation of patient education and [[motivational interviewing]], and if appropriate may include discussions regarding nutrition and/ or [[smoking cessation]].<ref name="Nield-Gehrig"/> The various treatments involved in this phase include;
* Debridement
* Antimicrobial Therapy
* Correction of Local Risk Factors
* [[Fluoride]] Therapy
* [[Caries]] Control and Placement of Temporary Restorations
* Occlusal Therapy
* Minor Orthodontic Treatment
If disease is present, secondary prevention may be necessary, the cause of disease should be identified and noted, and the relevant professional movement should be identified and patient instruction for [[dental plaque]] control established in an attempt to reinstate a healthy oral condition.
Therefore, mechanical and chemical plaque control are involved in this phase. This may be via;
* [[Dental plaque|Plaque]] Disclosing Agents
* Manual/ Electric Toothbrushes
* Toothbrushing Techniques
* Interdental Aids
* [[Dentifrices]]
* Chemical Plaque Control (Antimicrobial [[Mouthwashes]])


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.<ref>{{Cite web |title=Scaling and Root Planing for Gum Disease - American Dental Association |url=https://www.mouthhealthy.org/en/az-topics/s/scaling-and-root-planing |access-date=2019-04-15 |website=www.mouthhealthy.org}}</ref>
===Re-Evaluation of Non-Surgical Periodontal Therapy===
This phase is continuous throughout treatment, allowing the dental professional along with the patient to monitor the patients oral health status and assists in recognising the need for change/ amendment to the previously formulated treatment plan, according to the patients specific needs.<ref name="Nield-Gehrig"/>
Treatment is monitored using accurate periodontal charting and clinical observation of hard and soft tissues by the dental professional.
The results of the periodontal charting and clinical observation dictates what follows the non-surgical periodontal phase.
The three generalised outcomes that may result are essentially;
* The patient progresses straight to the Maintenance Phase
* The patient returns to the Non-Surgical Periodontal Therapy Phase, until such a time as their periodontal status is satisfactory
* The patent advances to the Corrective Phase


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.
===Corrective Phase: Surgical Periodontal Therapy===
The corrective phase is not needed for all patients, but is dictated by the outcomes of the re-evaluation phase, encompassing all indicated;<ref name="Nield-Gehrig"/>
* [[Periodontal]] surgery
* [[Endodontic]] surgery
* Placement of [[dental implants]]


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.<ref>{{Cite web |title=Non-Surgical Periodontal Treatment {{!}} Perio.org |url=https://www.perio.org/consumer/non-surgical-periodontal-treatment |access-date=2019-04-15 |website=www.perio.org |archive-date=2019-12-02 |archive-url=https://web.archive.org/web/20191202130411/https://www.perio.org/consumer/non-surgical-periodontal-treatment }}</ref>
===Supportive Periodontal Therapy/ Restorative Therapy===
As with the Corrective Phase, Supportive Periodontal Therapy is not needed for all patients, but is too dictated by the outcomes of the re-evaluation phase. It includes all required;
* [[Dental restorations]]
* Fixed and removable prosthesis
A re-evaluation of the overall response to treatment should be conducted at the end of this phase before continuing onto the Maintenance Phase.


==Timeline of dental hygienists==
===Maintenance Phase===
* 1906: [[Alfred Fones]] trained his chairside assistant<ref name=sch>http://www.bridgeport.edu/print/2309.asp? {{webarchive|url=https://web.archive.org/web/20060903064509/http://www2.bridgeport.edu/print/2309.asp |date=2006-09-03 }}"History of the Fones School of Dental Hygiene" Web page at the University of Bridgeport Web site, accessed December 17, 2007</ref> (and his cousin), [[Irene M. Newman]], to clean teeth and perform other preventive treatments on children, making her the world's first dental hygienist.<ref>Most sources, and the more authoritative sources, say 1906, although the web site for Central High School in Bridgeport, on two separate Web pages, says 1905</ref><ref name=cent>http://bridgeport.ct.schoolwebpages.com/education/components/scrapbook/default.php?sectiondetailid=22838 {{Webarchive|url=https://web.archive.org/web/20060307145756/http://bridgeport.ct.schoolwebpages.com/education/components/scrapbook/default.php?sectiondetailid=22838 |date=2006-03-07 }} Web page titled "Dental Hygiene Movement Started in Bridgeport, Connecticut" at the web site of Central High School in Bridgeport, Connecticut, accessed December 17, 2007</ref>
The Maintenance Phase involves continuous care, at patient specific levels. It includes all measures used by the dental team and patient to stop the disease reoccurring, with the objective of keeping the dentition functioning for was long as possible in the oral cavity.<ref name="Nield-Gehrig"/>
* 1913: [[Alfred Fones]] began the first school for dental hygienists in Connecticut.<ref name="Danner">{{Cite web |last=Danner |first=V |title=Looking back at 75 years of the Journal; former editors reflect on their time with the Journal |url=http://www.highbeam.com/doc/1G1-84667626.html |archive-url=https://web.archive.org/web/20140611123751/http://www.highbeam.com/doc/1G1-84667626.html |archive-date=11 June 2014 |access-date=16 March 2014 |publisher=Journal of Dental Hygiene}}</ref>

* 1915: Connecticut amended its dental practice act to include the regulation of dental hygienists.<ref name="Danner" />
==History of Dental Hygienist==
* 1917: [[Irene M. Newman]] received the world's first license as a dental hygienist in Connecticut in 1917.<ref name=adahist>{{cite web|url=http://www.ada.org/public/resources/history/timeline_20cent.asp |title=ADA.org: History of Dentistry in the 20th Century |access-date=2005-11-27 |archive-url=https://web.archive.org/web/20060208053550/http://www.ada.org/public/resources/history/timeline_20cent.asp |archive-date=2006-02-08 }} Web page titled "History of Dentistry/ Innovations in Techniques and Technology—The 20th Century" at the American Dental Association Web site, accessed December 17, 2007</ref>
{{Unreferenced section|date=April 2014}}
* 1923: The first meeting of the [[American Dental Hygienists' Association]] took place.<ref name="Danner" />
* In the late 1800s dental disease prevention methods became popular amongst dentists and dental nurses, with dentists being trained to perform routine prophylaxis treatment in the fight against dental disease. During this period D. D. Smith of Philadelphia demonstrated the prophylactic methods to his colleagues and patients and the acceptance of his theories become increasingly popular.<ref name="Danner">{{cite web|last=Danner|first=V|title=Looking back at 75 years of the Journal; former editors reflect on their time with the Journal|url=http://www.highbeam.com/doc/1G1-84667626.html|publisher=Journal of Dental Hygiene|accessdate=16 March 2014}}</ref>
* 1950: The [[University of Toronto]] established the first dental hygiene program in Canada.<ref>{{Cite journal |last=Johnson |first=Patricia M. |title=International profiles of dental hygiene 1987 to 2006: a 21-nation comparative study |year=2009 |volume=59 |issue=2 |pages=63-77; quiz 62 |url=http://www.ifdh.org/dt/IDJ-Apr-09-2076-Johnson-pp63-771.pdf |access-date=16 March 2014 |journal=International Dental Journal |pmid=19489285 |archive-date=11 June 2017 |archive-url=https://web.archive.org/web/20170611085025/http://www.ifdh.org/dt/IDJ-Apr-09-2076-Johnson-pp63-771.pdf |url-status=dead }}</ref>
* In 1898 Smith presented a lecture on his system of periodic oral prophylaxis, which required patients to attend regular visits for prophylactic treatment and education sessions around oral home care.<ref name="Danner"/>
* 1959: [[Esther Wilkins|Esther Mae Wilkins]], an American dental hygienist and [[dentist]], authored the first comprehensive book on dental hygiene, ''Clinical Practice of the Dental Hygienist'', the first edition of which was published in 1959.<ref name="tuftsnow">{{cite news|last= Flaherty|first=Julie|date=March 13, 2012|title=By the Book|url=http://now.tufts.edu/articles/book|newspaper= Tufts Now|access-date=December 13, 2016}}</ref>
* In 1906 one of his followers Alferd C. Fones took a great interest into Smith’s theories and began to train his cousin, Irene Newman, to act as an apprentice, scaling and polishing teeth as well as giving instructions on how to keep their mouths clean with daily home care practices. She was then to become the first recognised dental hygienist.<ref name="Danner"/>
* 1964: The [[American Dental Hygienists' Association]] deleted the word "female" from its constitution and [[by-law|bylaws]].<ref name="A Centennial Celebrate of Dental Hygiene">{{Cite journal |last=Marsh |first=Lynn |title=Dental Hygiene in Progress |url=http://www.dimensionsofdentalhygiene.com/2013/100_Year/Features/Dental_Hygiene_in_Progress.aspx |access-date=7 July 2015 |journal=Dimensions of Dental Hygiene |archive-date=13 June 2016 |archive-url=https://web.archive.org/web/20160613232229/http://www.dimensionsofdentalhygiene.com/2013/100_Year/Features/Dental_Hygiene_in_Progress.aspx}}</ref>
* In 1910 the Ohio College of Dental Surgery offered a formal course for “dental nurses.” However, dentists in Ohio strongly opposed the formal training school, and those who completed the coursework were never allowed to practice. The course was soon to be discontinued in 1914 due to the backlash from the dental community.<ref name="Danner"/>
* In 1913 the term dental hygienist was devised and Alfred Fones began the first school for dental hygienists in Connecticut<ref name="Danner"/>
* 1965: [[Jack Orio]] graduated from the [[University of New Mexico]], making him the world's first male dental hygienist.<ref name="A Centennial Celebrate of Dental Hygiene"/>
* 1974: Dental hygienists were first trained in New Zealand 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, New Zealand|Burnham]] army base outside [[Christchurch]].<ref name="Coats">{{Cite web |last=Coats |first=Dawn E |title=Dental Therapists and Dental Hygienists Educated for the New Zealand Environment |url=http://www.jdentaled.org/content/73/8/1001.full.pdf |access-date=16 March 2014 |publisher=International Dental Journal }}{{Dead link|date=January 2024 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>
* 1914 the first legal dental hygienists graduated from Dr. Fones’ dental hygiene program and legally allowed to provide patients with prophylaxis treatment.
* 1975: The dental hygiene profession was introduced in Australia.<ref>{{Cite web |title=Dental Board of Australia - Registration Standards |url=http://www.dentalboard.gov.au/Registration-Standards.aspx |access-date=23 May 2014}}</ref>
* In 1915 Connecticut amended the dental practice act to include the regulation of dental hygienists and other states followed amending dental hygiene regulations outlining the scope of practice of a dental hygienist.<ref name="Danner"/>
* 1993: The New Zealand Dental Hygienists' Association was founded.<ref name="NZDHAwelcome">{{Cite web |title=New Zealand Dental Hygienists' Association: Welcome to NZDHA |url=http://nzdha.co.nz/ |access-date=24 Oct 2014}}</ref><ref name="NZDHAaboutus">{{Cite web |title=New Zealand Dental Hygienists' Association: About us |url=http://nzdha.co.nz/about-us/ |access-date=24 Oct 2014 |archive-date=24 October 2014 |archive-url=https://web.archive.org/web/20141024024115/http://nzdha.co.nz/about-us/ |url-status=dead }}</ref>
* 1923 the first meeting of the American Dental Hygienist Association took place <ref name="Danner"/>
* 1994: The first independent non-military training for dental hygienists in New Zealand began in 1994.<ref name="Coats" />
* 1950 Dental hygienists were recognised in Canada and the University of Toronto established the first dental hygiene program in the country.<ref>{{cite web|last=Johnson|first=Patricia M.|title=International profiles of dental hygiene 1987 to 2006: a 21-nation comparative study|url=http://www.ifdh.org/dt/IDJ-Apr-09-2076-Johnson-pp63-771.pdf|publisher=International Dental Journal|accessdate=16 March 2014}}</ref>
* 1965 over 15,400 dental hygienists were working in America <ref name="Danner"/>
* 1974 Dental hygienists were employed by the government of New Zealand to treat members of the New Zealand army.<ref name="Coats">{{cite web|last=Coats|first=Dawn E|title=Dental Therapists and Dental Hygienists Educated for the New Zealand Environment|url=http://www.jdentaled.org/content/73/8/1001.full.pdf|publisher=International Dental Journal|accessdate=16 March 2014}}</ref>
* 1975 Dental hygiene profession was introduced in Australia.<ref>{{cite web|title= Dental Board of Australia - Registration Standards |url=http://www.dentalboard.gov.au/Registration-Standards.aspx|accessdate=23 May 2014}}</ref>
* 1994 dental hygienists in New Zealand to work publically and privately.<ref name="Coats"/>
* 2006 Auckland University of Technology Bachelor of Health Science (Oral Health):3years (dual-degree in Dental Hygiene and Dental Therapy)<ref name="Coats"/>

== Global oral hygiene education and legislation timeline==
{|border="5" cellpadding="5" cellspacing="0" style="margin: 1em 1em 1em 0; background: #f9f9f9; border: 1px #aaa solid; border-collapse: collapse; font-size: 95%;" width=98%
|-
!width=15%|<br>Country
!width=10%|First Year of Training
!width=10%|First Year of Legislation of Practice
!width=10%| No. of programmes in 2001
|-----
| USA
|1913
|1907ȸ 1917†
|234
|-----
| Norway
|1923
| 1979
|3
|-----
| Canada
|1951
| 1947ȸ 1952†
|27
|-----
| Japan
|1948‡ 1951
| 1948
|125
|-----
| United Kingdom
|1954
| 1954
|19
|-----
| Nigeria
|1961
| 1993
|none
|-----
| R. of Korea
|1965
| 1973
|27
|-----
| The Netherlands
|1968
| 1974
|4
|-----
| Sweden
|1968
| 1991
|9
|-----
| Denmark
|1972
| 1986
|2
|-----
| South Africa
|1972
| 1969
|6
|-----
| Switzerland
|1973
| 1975§ 1991§
|4
|-----
| Australia
|1975
| 1972
|5
|-----
| Finland
|1976
| 1972
|2
|-----
| Italy
|1978
| 1988
|17
|-----
| Israel
|1979
| 1978
|3
|-----
| Iceland
|Educ. Abroad
| 1978
|none
|-----
| China (Hong Kong)
|1982
| 1982
|1
|-----
| Portugal
|1983
| 1983
|1
|-----
| Spain
|1989
| 1986
|25
|-----
| New Zealand
|1993
| 1988
|1
|-----
| Latvia
|1996
| 1996
|1
|-----
| Czech Republic
|1996
| 1996
|1
|-----
|}
* ȸLegal recognition of profession in first State or Province.
* †First license issued.
* ‡First training at US Allied Headquarters.
* §For selected cantons first; in 1991 for all cantons.
<ref name="Danner"/>
<ref name="Coats"/>
<ref name="Johnson">{{Cite journal |url= |title=Performance by gender in a stop-smoking program combining hypnosis and aversion |last1= Johnson |first1=D.L. |last2=Karkut |first2=R.T. |date=October 1994 |journal=Psychological reports |volume=75 |pages=851–7 |issue=2 |doi= 10.2466/pr0.1994.75.2.851 |pmid= 7862796}}</ref>
<ref>{{cite web|title= Dental Board of Australia - Registration Standards |url=http://www.dentalboard.gov.au/Registration-Standards.aspx|accessdate=25 May 2014}}</ref>


==Training==
==Training==


===Australia===
===Australia===
{{see also|Dental therapist}}
{{See also|Dental therapist}}
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).<ref>{{cite web|title= Australian Health Practitioner Regulation Agency - Approved Programs of study|url=http://www.ahpra.gov.au/Education/Approved-Programs-of-Study.aspx?ref=Dental%20Practitioner|accessdate= 25 May 2014}}</ref>
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]].<ref>{{Cite web |title=Australian Health Practitioner Regulation Agency - Approved Programs of study |url=http://www.ahpra.gov.au/Education/Approved-Programs-of-Study.aspx?ref=Dental%20Practitioner |access-date=25 May 2014 |archive-date=27 March 2020 |archive-url=https://web.archive.org/web/20200327080712/https://www.ahpra.gov.au/education/approved-programs-of-study.aspx?ref=dental%20practitioner }}</ref>


In Australia it is a legal requirement for dental hygienists/ 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.<ref>{{cite web|title= Australian Health Practitioner Regulation Agency - Accreditation Standards|url=http://www.ahpra.gov.au/Education/Accreditation-standards.aspx|accessdate= 25 May 2014}}</ref>
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.<ref>{{Cite web |title=Australian Health Practitioner Regulation Agency - Accreditation Standards |url=http://www.ahpra.gov.au/Education/Accreditation-standards.aspx |access-date=25 May 2014 |archive-date=10 June 2020 |archive-url=https://web.archive.org/web/20200610071106/https://www.ahpra.gov.au/Education/Accreditation-standards.aspx }}</ref>


The Dental Hygienists’ Association of Australia (DHAA) Inc., established in 1975, is the peak body representing registered dental hygiene service providers in Australia.
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.
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 therapist]]s as it does from [[dentist]]s, 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.<ref>{{cite web|title= Dental Board of Australia - Guidelines on continuing professional development |url=http://www.dentalboard.gov.au/Codes-Guidelines/Policies-Codes-Guidelines.aspx|accessdate=23 May 2014}}</ref><ref>[http://www.dhaa.info/about-1/archive/I], The Dental Hygienists’ Association of Australia Inc. June 2013
The National Law requires the same level of professional responsibility from dental hygienists, oral health therapists and [[dental therapist]]s 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.<ref>{{Cite web |title=Dental Board of Australia - Guidelines on continuing professional development |url=http://www.dentalboard.gov.au/Codes-Guidelines/Policies-Codes-Guidelines.aspx |access-date=23 May 2014}}</ref><ref>http://www.dhaa.info/about-1/archive/I {{dead link|date=September 2017 |bot=InternetArchiveBot |fix-attempted=yes }}, The Dental Hygienists' Association of Australia Inc. June 2013
'''Response to the Dental Board of Australia's Preliminary Consultation on the Draft Scope of Practice Registration Standard and Guidelines.''' Pages 2-12</ref>
‘’’Response to the Dental Board of Australia’s
Preliminary Consultation on the Draft Scope of Practice Registration Standard and Guidelines.’’’ Pages 2-12</ref>


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 Therapist.<ref>{{cite web|title= Dental Board of Australia - Oral Health Therapist |url=http://www.dentalboard.gov.au/Registration/Oral-Health-Therapist.aspx|accessdate=23 May 2014}}</ref>
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.<ref>{{Cite web |title=Dental Board of Australia - Oral Health Therapist |url=http://www.dentalboard.gov.au/Registration/Oral-Health-Therapist.aspx |access-date=23 May 2014}}</ref>


===Canada===
===Canada===
Dental hygienists in Canada must have completed a diploma program, this can be 19 months to 3 years. All dental hygiene students must pass a NDHCB ([http://www.ndhcb.ca/ NDHCB]) examination after graduation. 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, University of Alberta, University of British Columbia.[http://www.dentistry.dal.ca/programs/BDH/][http://www.dent.ualberta.ca/dentalhygiene.cfm][http://www.dentistry.ubc.ca/Education/Hygiene/default.asp]
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.<ref>{{Cite web|url=https://www.ndhcb.ca/dental-hygiene-practice|title=Dental Hygiene Practice|website=NDHCB}}</ref> 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,<ref>{{Cite web|url=https://www.dal.ca/academics/programs/professional/dentalhygiene.html|title=Dental Hygiene|website=Dalhousie University}}</ref> University of Alberta,<ref>{{Cite web|url=https://www.ualberta.ca/school-of-dentistry/programs-and-admissions/dental-hygiene/index.html|title=Dental Hygiene &#124; School of Dentistry|website=www.ualberta.ca}}</ref> University of British Columbia.<ref>{{Cite web|url=https://www.dentistry.ubc.ca/education/dental-hygiene-degree-program/|title=Dental Hygiene Degree Program &#124; Faculty of Dentistry|website=www.dentistry.ubc.ca}}</ref>


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|date=May 2014}}
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|date=May 2014}}


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.[http://www.crdha.ca/][http://www.cdhbc.com/][http://www.sdha.ca/index.php][http://www.cdhm.info/] 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.
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.[http://www.crdha.ca/ Home][http://www.cdhbc.com/ College of Dental Hygienists of British Columbia /][http://www.sdha.ca/index.php Saskatchewan Dental Hygienists Association][http://www.cdhm.info/ 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 ([http://www.cdho.org/ CDHO]).
In Ontario, dental hygienists are registered with the College of Dental Hygienists of Ontario.<ref>{{Cite web|url=https://www.cdho.org/for-the-public/public-register/about-the-register|title=CDHO - About the Register|website=www.cdho.org}}</ref>
<ref>[http://ledentistemontreal.com/wp-content/uploads/2014/05/Practice-Standards-policies.pdf CDH BC]</ref>
<ref>[http://ledentistemontreal.com/wp-content/uploads/2014/05/Practice-Standards-policies.pdf CDH BC] {{webarchive|url=https://web.archive.org/web/20140518011126/http://ledentistemontreal.com/wp-content/uploads/2014/05/Practice-Standards-policies.pdf |date=2014-05-18 }}</ref>


Dental hygienists in BC, ON, NS and AB are able to open their own private clinics and practice without a dentist on staff.
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===
===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, New Zealand|Burnham]] army base outside [[Christchurch]].<ref name="Coats"/> Hygiene training was briefly offered at the Wellington School for Dental Nurses in 1990 as 2-week a supplement to Dental Therapy students training.<ref name="Coats" /> However, this was quickly discontinued.<ref name="Coats" />
Since 2006,<ref name="Coats"/> [[New Zealand]] Dental Hygienists are trained exclusively at either [[University of Otago]] in [[Dunedin]] (at the country's only [[University of Otago Faculty of Dentistry|Dental School]]), or [[AUT University]] in [[Auckland]].<ref name="CareersNZDHp3">{{cite web | title = Careers NZ: Dental Hygienist: How to enter the job | url = http://www.careers.govt.nz/jobs/health/dental-hygienist/how-to-enter-the-job | date = 25 Jun 2013 | accessdate = 24 Oct 2014 }}</ref> The qualification (Bachelor of Oral Health at Otago, Bachelor of Health Science in Oral Health at AUT) enables graduates to register and practise as both a Dental Hygienist and Dental Therapist.<ref name="Coats"/>


The first independent non-military training began in 1994.<ref name="Coats" /> [[Otago Polytechnic]] began offering a 15-month Certificate in Dental Hygiene in Dunedin.<ref name="Coats" /> In 1998, the programme was modified to be a 2-year Diploma.<ref name="Coats" /> Otago Polytech stopped offering the course in 2000.<ref name="Coats" /> The following year, University of Otago began offering a 2-year Diploma in Dental Hygiene qualification.<ref name="Coats" /> In 2002, the university added a 3-year Bachelor of Health Sciences (endorsed in Dental Hygiene) degree alongside the Diploma.<ref name="Coats" />
Prior to this, Dental Hygienists were first domestically trained in 1974 for use in the [[New Zealand Defence Force]]. The one-year course was taught by the Royal New Zealand Dental Corp at the [[Burnham, New Zealand|Burnham]] army base outside [[Christchurch]].<ref name="Coats"/> Hygiene training was briefly offered at the Wellington School for Dental Nurses in 1990 as 2 week a supplement to Dental Therapy students training.<ref name="Coats"/> However, this was quickly discontinued.<ref name="Coats"/>


From 2006,<ref name="Coats" /> New Zealand dental hygienists and now oral health therapists have been trained at either [[University of Otago]] in [[Dunedin]] (at the country's only [[University of Otago Faculty of Dentistry|Dental School]]) or at [[Auckland University of Technology]].<ref name="CareersNZDHp3">{{Cite web |date=25 Jun 2013 |title=Careers NZ: Dental Hygienist: How to enter the job |url=http://www.careers.govt.nz/jobs/health/dental-hygienist/how-to-enter-the-job |archive-url=https://archive.today/20141023230150/http://www.careers.govt.nz/jobs/health/dental-hygienist/how-to-enter-the-job |archive-date=2014-10-23 |access-date=24 Oct 2014}}</ref> 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.<ref name="Coats" />
The first independent non-military training began in 1994.<ref name="Coats"/> [[Otago Polytechnic]] began offering a 15 month Certificate in Dental Hygiene in Dunedin.<ref name="Coats"/> In 1998, the programme was modified to be a 2 year Diploma.<ref name="Coats"/> Otago Polytech stopped offering the course in 2000.<ref name="Coats"/> The following year, University of Otago began offering a 2 year Diploma in Dental Hygiene qualification.<ref name="Coats"/> In 2002, the university added a 3 year Bachelor of Health Sciences (endorsed in Dental Hygiene) degree alongside the Diploma.<ref name="Coats"/> This course was discontinued in 2007, when the current 3 year Bachelor of Oral Health commenced.<ref name="Coats"/>


In order to practise, all Hygienists must annually register with the Dental Council.<ref name="DCNZannpraccert">{{cite web | title = Dental Council of New Zealand: Apply for an annual practising certificate | url = http://www.dcnz.org.nz/i-practise-in-new-zealand/apply-for-an-annual-practising-certificate/ | date = 2014 | accessdate = 24 Oct 2014 }}</ref> For the 2014-2015 cycle, the cost of this is $669.07.<ref name="DCNZannpraccertDHfees">{{cite web | title = Dental Council of New Zealand: Fees for dental hygienists | url = http://www.dcnz.org.nz/i-practise-in-new-zealand/dental-hygienists/fees-for-dental-hygienists/ | date = 2014 | accessdate = 24 Oct 2014 }}</ref> One Hygienist is represented on the Council for a three-year term.<ref name="DCNZcouncilmembers">{{cite web | title = Dental Council of New Zealand: Council members | url = http://www.dcnz.org.nz/about-the-dental-council/who-we-are/council-members/ | date = 2014 | accessdate = 24 Oct 2014 }}</ref>
In order to practise, dental hygienists and oral health therapists must register and annually recertify with the Dental Council of New Zealand.<ref name="DCNZannpraccert">{{Cite web |date=2014 |title=Dental Council of New Zealand: Apply for an annual practising certificate |url=http://www.dcnz.org.nz/i-practise-in-new-zealand/apply-for-an-annual-practising-certificate/ |access-date=24 Oct 2014}}</ref> One dental hygienist is represented on Council for a 3-year term.<ref name="DCNZcouncilmembers">{{Cite web |date=2014 |title=Dental Council of New Zealand: Council members |url=http://www.dcnz.org.nz/about-the-dental-council/who-we-are/council-members/ |access-date=24 Oct 2014}}</ref>


Dental Hygienists can become members of the New Zealand Dental Hygienists' Association.<ref name="NZDHAaboutus">{{cite web | title = New Zealand Dental Hygienists' Association: About us | url = http://nzdha.co.nz/about-us/ | date = | accessdate = 24 Oct 2014 }}</ref> The association was founded in 1993,<ref name="NZDHAwelcome">{{cite web | title = New Zealand Dental Hygienists' Association: Welcome to NZDHA | url = http://nzdha.co.nz/ | date = | accessdate = 24 Oct 2014 }}</ref> and is affiliated with the International Federation of Dental Hygienists.<ref name="IFDHassocmembers">{{cite web | title = International Federation of Dental Hygienists: Association Members | url = http://www.ifdh.org/members.html | date = 2014 | accessdate = 24 Oct 2014 }}</ref>
The representing body for dental hygienists was the New Zealand Dental Hygienists' Association.<ref name="NZDHAaboutus"/> The association was founded in 1993,<ref name="NZDHAwelcome"/> and is affiliated with the International Federation of Dental Hygienists.<ref name="IFDHassocmembers">{{Cite web |date=2014 |title=International Federation of Dental Hygienists: Association Members |url=http://www.ifdh.org/members.html |access-date=24 Oct 2014}}</ref> 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===
===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).<ref>[http://www.adha.org/careerinfo/dir_education.htm American Dental Hygienists' Association - Education]</ref>


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).<ref>{{Cite web |title=Education & Careers - ADHA - American Dental Hygienists Association |url=http://www.adha.org/careerinfo/dir_education.htm |website=www.adha.org |access-date=2008-11-19 |archive-date=2012-12-27 |archive-url=https://web.archive.org/web/20121227100009/http://www.adha.org/careerinfo/dir_education.htm }}</ref>
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 as well as a clinical board exam.<ref>[http://www.dentalhygienist.org/licensing/ Dental Hygienist License Information]</ref> State requirements vary by state, and are controlled by state dental boards.<ref>[http://new.dentalboards.org American Association of Dental Boards]</ref>

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.<ref>{{Cite web |title=Dental Hygienist License Information |url=http://www.dentalhygienist.org/licensing/ |website=www.dentalhygienist.org}}</ref><ref>{{Cite web |title=Dental Hygienist Education and Training Requirements |url=http://www.ada.org/en/education-careers/careers-in-dentistry/dental-team-careers/dental-hygienist/education-training-requirements-dental-hygienist |website=www.ada.org}}</ref> 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|date=May 2014}}
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|date=May 2014}}


A Bachelor's 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|date=May 2014}}
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|date=May 2014}}


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|date=May 2014}}
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|date=May 2014}}


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.
After completing one of the more than 200 accredited dental hygiene programs in the United States, dental hygienists must be licensed in the state in which they work. Licensure requirements for becoming a Registered Dental Hygienist (RDH) vary from state to state, but most require a two-year degree, a written examination, and a clinical examination. The National Board Dental Hygiene Examination is intended to fulfill the written examination requirements. The clinical examination is typically administered by the state licensing board.


Dental hygienist students perform practical oral examinations free of charge at some institutions which have expressed a shortage in recent years.<ref>{{Cite web |title=Want a Free Teeth Cleaning? School of Dentistry Dental Hygiene Students Need You |url=https://info.umkc.edu/umatters/want-a-free-teeth-cleaning-school-of-dentistry-dental-hygiene-students-need-you/ |website=info.umkc.edu}}</ref>
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]].


==Direct access to care with a dental hygienist==
{{ course assignment | course = Education Program:University of Toronto Mississauga/CCT110: The Rhetoric of Digital and Interactive Media Environments (W14) | term = 2014 Q1 }}
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 ===
==Direct Access to Care with a Dental Hygienist==
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 [[States of India|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.
The dental hygienists in select parts of [[North America]] can provide [[dental 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.


'''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.<ref>{{cite web|title=Dental Hygiene|url=http://www.health.gov.bc.ca/professional-regulation/notice/dental_hygiene.html|accessdate=1 April 2014}}</ref>


===Canada===
''Alberta''

====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.


2006 - Dental hygienists are able to offer their services in many practice settings including independent practice.<ref>{{cite web|title=Dental Hygienists Profession Regulation|url=http://www.qp.alberta.ca/1266.cfm?page=2006_255.cfm&leg_type=Regs&isbncln=0779751108|publisher=Alberta Queen's Printer|accessdate=1 April 2014}}</ref>
2012 - New bylaws offers an exemption from the 365-day rule if hygienists are registered in the Full Registration (365 Day Rule Exempt) class.<ref>{{Cite web |title=Dental Hygiene |url=http://www.health.gov.bc.ca/professional-regulation/notice/dental_hygiene.html |access-date=1 April 2014}}</ref>


====Alberta====
''Manitoba''
2006 - Dental hygienists are able to offer their services in many practice settings including independent practice.<ref>{{Cite web |title=Dental Hygienists Profession Regulation | date=17 September 2012 |url=http://www.qp.alberta.ca/1266.cfm?page=2006_255.cfm&leg_type=Regs&isbncln=0779751108 |access-date=1 April 2014 |publisher=Alberta Queen's Printer}}</ref>


====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.
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.
<ref>{{cite web|title=The Dental Hygienists Act|url=http://web2.gov.mb.ca/laws/statutes/2005/c05105e.php|publisher=Statutory Publications|accessdate=1 April 2014}}</ref>
<ref>{{Cite web |title=The Dental Hygienists Act |url=http://web2.gov.mb.ca/laws/statutes/2005/c05105e.php |access-date=1 April 2014 |publisher=Statutory Publications}}</ref>


''Ontario''
====Ontario====
2007 - Registered dental hygienists in Ontario who have been approved by the College of Dental Hygienists of Ontario can practice independently.<ref>{{Cite web |title=Health Professions Regulatory Advisory Council |url=http://www.hprac.org/en/projects/resources/HPRAC-Drug-CDHOsubmission2.pdf |access-date=1 April 2014 |archive-date=1 December 2021 |archive-url=https://web.archive.org/web/20211201113852/https://www.hprac.org/en/projects/resources/HPRAC-Drug-CDHOsubmission2.pdf |url-status=usurped }}</ref>


===United States===
2007 - Registered dental hygienists in Ontario who have been approved by the College of Dental Hygienists of Ontario can practice independently.<ref>{{cite web|title=Health Professions Regulatory Advisory Council|url=http://www.hprac.org/en/projects/resources/HPRAC-Drug-CDHOsubmission2.pdf|accessdate=1 April 2014}}</ref>

'''United States'''

''California''


====California====
1998 - Registered Dental Hygienist in Alternative Practice (RDHAP): [[RDHAP]]s 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 [[Medical prescription|prescription]] for additional oral treatment from a dentist or physician .<ref>{{cite web|title=RDHAP Application Instructions|url=http://www.dhcc.ca.gov/applicants/becomelicensed_rdhap_appinst.shtml|accessdate=1 April 2014}}</ref>
1998 - Registered dental hygienist in alternative practice (RDHAP): [[RDHAP]]s 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 [[Medical prescription|prescription]] for additional oral treatment from a dentist or physician .<ref>{{Cite web |title=RDHAP Application Instructions |url=http://www.dhcc.ca.gov/applicants/becomelicensed_rdhap_appinst.shtml |access-date=1 April 2014 |archive-date=7 April 2014 |archive-url=https://web.archive.org/web/20140407075742/http://www.dhcc.ca.gov/applicants/becomelicensed_rdhap_appinst.shtml |url-status=dead }}</ref>


''Colorado''
====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]], [[Colorado|CO]].
<ref>{{Cite web |title=Direct Access States |url=https://www.adha.org/resources-docs/7513_Direct_Access_to_Care_from_DH.pdf |access-date=1 April 2014 |publisher=[[American Dental Hygienists' Association|ADHA]]}}</ref>


====Connecticut====
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.
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.<ref>{{Cite web |title=20 Professional and Occupational Licensing, Certification, Title Protection and Registration |url=http://law.justia.com/codes/connecticut/2011/title20/chap379a/Sec20-126l.html |access-date=1 April 2014}}</ref>
<ref>{{cite web|url=https://www.adha.org/resources-docs/7513_Direct_Access_to_Care_from_DH.pdf|title=Direct Access States|publisher=[[American Dental Hygienists' Association|ADHA]]| accessdate=1 April 2014}}</ref>


====Maine====
''Connecticut''
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.
<ref>{{Cite web |title=Public Laws |url=http://www.mainelegislature.org/ros/LOM/lom123rd/123s1/PUBLIC620_ptB.asp |access-date=1 April 2014}}</ref>


====Michigan====
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.<ref>{{cite web|title=20 Professional and Occupational Licensing, Certification, Title Protection and Registration|url=http://law.justia.com/codes/connecticut/2011/title20/chap379a/Sec20-126l.html|accessdate=1 April 2014}}</ref>
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.<ref>{{Cite web |title=Public Health Code Excerpt |url=http://www.legislature.mi.gov/(S(1sfafa45t4gpuc554txfma33))/mileg.aspx?page=GetMCLDocument&objectname=mcl-333-16625 |access-date=1 April 2014}}</ref>


====Washington====
''Maine''
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.<ref>{{Cite web |title=Washington State Legislator |url=http://apps.leg.wa.gov/rcw/default.aspx?cite=18.29.056 |access-date=1 April 2014}}</ref>


==Notable dental hygienists==
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.
<ref>{{cite web|title=Public Laws|url=http://www.mainelegislature.org/ros/LOM/lom123rd/123s1/PUBLIC620_ptB.asp|accessdate=1 April 2014}}</ref>


*[[Janet Gardner]]
''Michigan''
*[[Esther Wilkins]]

*[[Miriam Carey]]
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.<ref>{{cite web|title=Public Health Code Excerpt|url=http://www.legislature.mi.gov/(S(1sfafa45t4gpuc554txfma33))/mileg.aspx?page=GetMCLDocument&objectname=mcl-333-16625|accessdate=1 April 2014}}</ref>

''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. Hygienist must have at least two years of work experience within the last 5 years.<ref>{{cite web|title=Washington State Legislator|url=http://apps.leg.wa.gov/rcw/default.aspx?cite=18.29.056|accessdate=1 April 2014}}</ref>


==See also==
==See also==
{{Portal|Dentistry}}
{{Portal|Medicine}}
* [[Dental Nurse]]
* [[Dental Assistant]]
* [[Dentist]]
* [[Dentist]]
* [[Periodontal Disease]]
* [[Dental therapist]]
* [[Registered Dental Nurse|Dental nurse]]
* [[Dental assistant]]
* [[Periodontal disease]]
* [[Gingivitis]]
* [[Gingivitis]]
* [[Periodontitis]]
* [[Periodontitis]]
Line 352: Line 330:
==Further reading==
==Further reading==
* Mueller-Joseph, L., & Petersen, M. (1995). ''Dental Hygiene Process: Diagnosis and Care Planning''. Albany, NY: Delmar.
* Mueller-Joseph, L., & Petersen, M. (1995). ''Dental Hygiene Process: Diagnosis and Care Planning''. Albany, NY: Delmar.
* Dental Hygienists' Association of Australia Inc. (2014). "What is a Dental Hygienist?" Retrieved from http://www.dhaa.info/information-1/information-brochure/
* Dental Hygienists' Association of Australia Inc. (2014). "What is a Dental Hygienist?" Retrieved from [https://web.archive.org/web/20140517155026/http://www.dhaa.info/information-1/information-brochure/ Information Brochure - DHAA: Dental Hygienists' Association of Australia Inc. Supporting uniformity of Practice & growth of the dental hygienist profession]
* ''Facts about Dental Hygiene''. (2020, February 10). Western Kentucky University. Retrieved February 20, 2024, from https://www.wku.edu/dentalhygiene/facts_dentalhygiene.php


==References==
==References==
{{Reflist}}
{{Refimprove|date=December 2007}}
{{reflist}}


== External links ==
== External links ==
* [http://www.adha.org/careerinfo/dhfacts.htm Important Facts About Dental Hygienists] on [[American Dental Hygienists' Association]]
* [http://www.adha.org/careerinfo/dhfacts.htm Important Facts About Dental Hygienists] {{Webarchive|url=https://web.archive.org/web/20120826151605/http://www.adha.org/careerinfo/dhfacts.htm |date=2012-08-26 }} on [[American Dental Hygienists' Association]]


{{Authority control}}

[[Category:Dental health education]]
[[Category:Dentistry occupations]]
[[Category:Dentistry occupations]]


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Latest revision as of 18:04, 16 November 2024

Dental hygienist
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.

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

[edit]

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:

  • patient screening procedures; such as assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse
  • taking and developing dental radiographs (x-rays)
  • removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth
  • applying preventive materials to the teeth (e.g., sealants and fluorides)
  • teaching patients appropriate oral hygiene strategies to maintain oral health
  • counseling patients about good nutrition and its impact on oral health
  • making impressions of patients' teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs)
  • performing documentation and office management activities[8]

Dental hygienists salary

[edit]

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:

State Hourly mean wage Annual 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:

State Hourly mean wage Annual 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 area Employment (1) Employment per thousand jobs Location quotient (9) Hourly mean wage Annual mean wage (2)
Los Angeles-Long Beach-Anaheim, CA 10,150 1.78 1.21 $50.41 $104,840
New York-Newark-Jersey City, NY-NJ-PA 9,570 1.10 0.75 $44.00 $91,530
Chicago-Naperville-Elgin, IL-IN-WI 6,960 1.64 1.12 $38.24 $79,540
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 4,790 1.80 1.23 $39.90 $83,000
Dallas-Fort Worth-Arlington, TX 4,440 1.24 0.84 $36.37 $75,660

[11] Top paying metropolitan areas for Dental Hygienists:

Metropolitan area Employment (1) Employment per thousand jobs Location quotient (9) Hourly mean wage Annual mean wage (2)
Santa Maria-Santa Barbara, CA 260 1.35 0.92 $60.46 $125,750
San Jose-Sunnyvale-Santa Clara, CA 2,010 1.88 1.28 $58.97 $122,660
San Francisco-Oakland-Hayward, CA 3,270 1.46 0.99 $57.37 $119,320
Anchorage, AK 290 1.81 1.23 $55.90 $116,270
Santa Rosa, CA 460 2.41 1.64 $55.64 $115,730

[11]

Periodontal treatment

[edit]

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

[edit]

Training

[edit]

Australia

[edit]

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

[edit]

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.HomeCollege of Dental Hygienists of British Columbia /Saskatchewan Dental Hygienists AssociationHOME 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

[edit]

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

[edit]

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

[edit]

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

[edit]

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

[edit]

British Columbia

[edit]

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

[edit]

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

Manitoba

[edit]

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

[edit]

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

United States

[edit]

California

[edit]

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

[edit]

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

[edit]

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

[edit]

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

[edit]

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

[edit]

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

[edit]

See also

[edit]

Further reading

[edit]

References

[edit]
  1. ^ Dental Hygienists' Association of Australia Inc. (1999). A professional Body Addressing Training, Uniformity of Practice and Growth of the Dental Hygienist Profession. Retrieved from "Information - DHAA: Dental Hygienists' Association of Australia Inc. Supporting uniformity of Practice & growth of the dental hygienist profession". Archived from the original on 2014-05-18. Retrieved 2014-05-17. Print. Local dental regulations determine the scope of practice of dental hygienists respectively
  2. ^ "Response to the Dental Board of Australia's Preliminary Consultation on the Draft Scope of Practice Registration Standard and Guidelines". Retrieved 24 May 2014.[permanent dead link]
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