Dental Hygiene Regulation: A Comparison - CDHA · PDF fileDental Hygiene Regulation: A...

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March 2013

Dental Hygiene Regulation: A Comparison

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Dental Hygiene Regulation: A Comparison—Table of Contents

Basic Information

Number of Dental Hygienists

Liability and Regulation

Restorative

Competencies

Differences in Provincial Requirements

Agreement on Internal Trade (AIT) Legitimate Objectives

Services

Grads

3-6

7-8

9

10

11-12

13-15

16-18

19-21

22-23

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ProvinceLicensing

Body

Year - Regulation

became mandatory

Year - self-regulation

was achieved

Year - self-

initiation was

achieved

Details pertaining to dentists’ supervision

Legislation online

Pending Regulation Changes

Mandatory CDHA

Membership

Alberta College of Registered Dental Hygienists of Alberta

1990 1960 2006 N/A http://www.qp.alberta.ca/1266.cfm?page=2006_255.cfm&leg_type=Regs&isbncln=0779751108

None Yes

British Columbia College of Dental Hygienists of British Columbia (CDHBC)

1952 1993 1995 Clients must have been examined by a dentist within the previous 365 days for a dental hygienist to provide services (as of July 2012 new category for DH exemption).

Administer local anaesthesia, but may only do so under the supervision of a dentist or other emergency-trained professionals.

www.cdhbc.com/PDF-Files/Tab-6.aspx

No

Manitoba College of Dental Hygienists of Manitoba (CDHM)

1952 2005 2008 Supervision restrictions: dental hygiene services must be provided under the supervision of a dentist, unless a dental hygienist has practised dental hygiene for more than 3000 h and the client does not present with a complex medical condition. However included practices can only be provided in certain settings.

web2.gov.mb.ca/laws/statutes/2005/c05105e.phpand http://web2.gov.mb.ca/bills/39-3/b018e.php

No

Dental Hygiene Regulation: A Comparison—Basic Information

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ProvinceLicensing

Body

Year - Regulation

became mandatory


was achieved

Year - self-

initiation was

achieved


Legislation online


Mandatory CDHA

Membership

New Brunswick New Brunswick College of Dental Hygienists / Ordre des hygienistes dentaires du Nouveau Brunswick

1950s 2009 Still under full supervision – new rules pending (to no supervision), waiting for approval from Minister of Health.

www.gnb.ca/0062/acts/BBA-2009/Chap-10.pdf

• IIncrease in continuing education credits (45 per 3 year cycle/60 for 4 or 75 for 5 years- we will be staggering cycles) -as of January 2013.

• Self initiation course - upon approvla of Rules- only those who wish to self-initiate.

• CPR requirements - as January 2013-Basic CPR once every three years.

• Local Anesthiestics Module -(upon approval of Rules) only those who wish to include this scope.

No

Newfoundland and Labrador

Newfoundland Dental Board is in place until the new DH college forms in response to the 2010 legislation

1969 2010 In progress

www.assembly.nl.ca/business/bills/Bill1017.htm

Pending Yes

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ProvinceLicensing

Body

Year - Regulation

became mandatory


was achieved

Year - self-

initiation was

achieved


Legislation online


Mandatory CDHA

Membership

Northwest Territories

Northwest Territories Professional Licensing, Government of Northwest Territories

1990 Regulated by Government

The scope of practice for a dental hygienists includes the:• performance of dental services

of a preventative and educational nature;

• performance of dental prophylaxes;

• application on teeth of topical flouride or other anticariogenic agents;

• rendering of first aid; and taking and developing x-rays.

www.hlthss.gov.nt.ca/english/services/professional_licensing/dental_hygienists.htm

N/A Yes

Nova Scotia College of Dental Hygienists of Nova Scotia

1973 1990 1990 N/A http://www.qp.alberta.ca/1266.cfm?page=2006_255.cfm&leg_type=Regs&isbncln=0779751108

None Yes

Nunavut Government of Nunavut, Department of Health and Social Services

N/A - regulated by gov’t due to small numbers of DHs

Dental Auxiliaries Act

Dental Mechanics Act

Dental Profession Act

None No

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ProvinceLicensing

Body

Year - Regulation

became mandatory


was achieved

Year - self-

initiation was

achieved


Legislation online


Mandatory CDHA

Membership

Ontario College of Dental Hygienists of Ontario

1951 1994 2007 Since 2007 in Ontario, registrants who have been approved by the College of Dental Hygienists of Ontario can self-initiate their treatment; dental hygienists can now scale and root plane teeth and curettage surrounding tissues without an order from a dentist

www.hprac.org/en/projects/resources/HPRAC-Drug-CDHOsubmission2.pdf

Limited-prescribing, dispensing, compounding and selling of drugs.

No

Prince Edward Island Dental Council of Prince Edward Island

1974 Regulated by government. Under Dental Act

DH must be employed by or practice under contract with: a. an employer that employs or has

established a formal referral or consultation process with a dentist; or

b. a dentist. (If (a) means employed by the provincial government, it does apply, but not for other situations. (b) is the correct answer.

www.gov.pe.ca/law/statutes/pdf/d-06.pdf

None No

Quebec Ordre des hygiénistes dentaires du Québec

1975 1975 N/A Before letting a DH perform an act, a dentist must ensure that the DH possesses sufficient knowledge and training to perform that act. A dentist must ensure the performance and quality of the act performed by a DH before the patient leaves his office.

www.ohdq.com Regulation respecting the legal authorization to practice the profession of dental hygiene outside Quebec that give access to the permit of the Ordre des Hygienistes du Quebec.

No

Saskatchewan Saskatchewan Dental Hygienists Association

1950 1998 2000 DH must be employed by or practise under contract with:a. an employer that employs or has

established a formal referral or consultation process with a dentist; or

b. a dentist.”

www.qp.gov.sk.ca/documents/English/Statutes/Statutes/D4-1.pdf

N/A Yes

Yukon Government of Yukon

1958 Regulated by government

www.gov.yk.ca/legislation/acts/depr.pdf

N/A No

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Dental Hygiene Regulation: A Comparison—Number of Dental Hygienists

Province

Total no. of registered dental hygienists*(represents all individuals who are registered with

the provincial regulating body. This count may include individuals in all registration categories

(including active, inactive))

Total no. of active registered dental hygienists**(represents all registered/licensed individuals who are legally able to work under the title of

the dental hygienist in the province.)

Category of Membership

Registered Restorative dental

hygienists

Exempt from 365 Day Rule

Alberta Male: Female: Total: 2835

Male: Female: Total:2,638

34

British Columbia Male: Female: Total: 3,381

Male: Female: Total: 3,145

Manitoba Male: 28 Female: 739 Total: 767 (715 RDH, 52 Students)

Male: 18 Female: 642 Total: 660

New Brunswick Male: 5 Female: 459 Total: 464


N/A N/A

Newfoundland and Labrador Male: 9 Female:160 Total:169

Unavailable

Northwest Territories Male: 3 Female: 19 Total: 22


Nova Scotia Male: 15 Female: 653 Total: 668

Male: 15 Female:608 Total: unavailable: 623

N/A N/A

Nunavut Male: Female: 5 Total: 5

Unavailable

Ontario Male: 216 Female: 10,909 Total: 11,125

Male: 196 Female: 9,698 Total: 9,894

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Dental Hygiene Regulation: A Comparison—Number of Dental Hygienists

Province

Total no. of registered dental hygienists*(represents all individuals who are registered with

the provincial regulating body. This count may include individuals in all registration categories

(including active, inactive))

Total no. of active registered dental hygienists**(represents all registered/licensed individuals who are legally able to work under the title of

the dental hygienist in the province.)

Category of Membership

Registered Restorative dental

hygienists

Exempt from 365 Day Rule

Prince Edward Island Male: 1 Female: 97 Total: 98


Quebec Male: 117 Female: 5,340 Total: 5,457

Male: 117 Female: 5,333 Total: 5,450

Saskatchewan Male: 11 Female: 539 Total: 550


Yukon Male: 1 Female: 22 Total: 23


Total Male: 406 Female: 18942 Total: 25,564

Male: 366 Female: 17397 Total: 23,526

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Dental Hygiene Regulation: A Comparison—Liability and Regulation

Province Mandatory Professional Liability Coverage Amount ($)

Alberta Yes $1 million per occurrence minimum

British Columbia Yes $1 million per occurrence minimum

Manitoba Yes $1 million per claim /$3 million yearly aggregate

New Brunswick Yes $1 million per occurrence minimum (CDHA liability)

Newfoundland and Labrador Pending regulations

Northwest Territories N/A

Nova Scotia Yes Minimum aggregate of $ 2 million

Nunavut N/A

Ontario Yes $1 million per occurrence with deductable of not more than $10 000.

Prince Edward Island Yes $1 million

Quebec Yes $1 milion

Saskatchewan Yes $1 million per claim /$3 million yearly aggregrate

Yukon N/A

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Dental Hygiene Regulation: A Comparison—Restorative

1. Restorative 2. Temporary Restorative

In conjuction with a dentist In conjunction with a dentist Independent of a Dentist

e.g. Amalgam/composite resin; adapt and cement stainless steel crown, permentent cementation of bridges, veneers, inlays and onlays

e.g. Temporary Crowns, temporary bridges, veneers, inlays and onlays ART (Atraumatic Restorative Treatment)

Province ETPWith additional

educationETP

With additional education

ETPWith additional

education

Alberta x x x

British Columbia x x x

Manitoba x x

New Brunswick x x x

Newfoundland and Labrador x

Northwest Territories x x

Nova Scotia x x x

Nunavut x x

Ontario x x x

Prince Edward Island x n/a n/a

Quebec x x

Saskatchewan x x

Yukon

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Dental Hygiene Regulation: A Comparison—Competencies

Province

Mandatory Continuing Competencies or

Professional Development (PD) Points (pts) or hours (hrs) or credits

Mandatory Clincial Practice Hours

Alberta PD - minimum 45 credits /3 year minimum 600 hrs/3yr

British Columbia PD - 5 year cycle with online testing that determines PD requirements None

Manitoba Program includes self-directed assessment, goal setting, activities and evaluation/reflection. No points/credits required. Two components of the program:• Educational Component: Each RDH will be required to set two goals each year (1 for the first year which is

considered a learning year for everyone), and plan activities that help meet that goal; and• Professional Component: Each RDH will be required to participate in a professional activity (for example a

CDHM or MDHA meeting, being a mentor, volunteering on boards, committees, volunteering at a community program, or providing a presentation/program in a professional or community setting, etc)

Forms will be submitted by each RDH documenting their activities – both educational and professional and will be first due in April 2011, and yearly there after if audited.

600 hours /3yr

New Brunswick Increase to 45 in three years/60 in four years/75 in 5 years as of January 2013- we will be staggering reporting cycle for the next five years.

N/A

Newfoundland and Labrador PD: 30 credits /3 years 2 categories:1. A. Scientific/Clinical (Courses) B. Scientific/Clincial (Hands On)2. Other courses, equivalents or clinical experiences not included in C. 1

N/A

Northwest Territories N/A N/A

Nova Scotia MCC- 45 credits/threeyear cycle : 3 categories N/A

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Dental Hygiene Regulation: A Comparison—Competencies

Province

Mandatory Continuing Competencies or

Professional Development (PD) Points or hours or credits

Mandatory Clincial Practice Hours

Nunavut N/A N/A

Ontario Quality assurance program includes portfolio maintenance N/A

Prince Edward Island 12 hrs / year N/A

Quebec 40 hours for 2 years with a minimum of 10 the first year N/A

Saskatchewan 50 credits /3 year reporting period. Personal Learning Tools completed for each CC activity N/A

Yukon N/A N/A

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Dental Hygiene Regulation: A Comparison—Differences in Provincial Requirements

Province of Destination

British Columbia

Alberta Saskatchewan Manitoba Ontario Quebec NFLD &LNova

ScotiaPEI

New Brunswick

Yukon NT Nunavut

Province of Origin

Alberta • Local anesthesia

x • Local anesthesia

• Language• Restorative• Ortho

British Columbia

x •Hours of practice

•CPR

• Hours of practice


• Language (1)

• Restorative• Ortho (2)


Manitoba • Local anesthesia

• Local anesthesia

x • Language

New Brunswick



• CPR• Local

Anesthesia



• CPR• Local

Anesthesia

• Language• Ortho?• Board Exam

x

Newfoundland & Labrador


• Non- acredited program without clinical


• CPR• Non-

acredited program without clinical





• Non- accedited program without clinical

• Non- accedited program without clinical

• Restorative• Ortho• Language

x • Non- accedited program without clinical



x

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British Columbia

Alberta Saskatchewan Manitoba Ontario QuebecNewfoundland

& Labrador

Nova Scotia

Prince Edward Island

New Brunswick

YukonNorthwest Territories

Nunavut

Province of Origin

Nova Scotia • CE • Hours of practice

• Board exam• Hours of

practice

• Board exam

• Local anestesia

• Language x • Local anesthesia

Nunavut x

Ontario • Local anesthesia



x • Language Require individuals who graduated from non-accredited programs who have not passed the national exam or equivalent to complete exam.

Require individuals who graduated from non-accredited programs who have not passed the national exam or equivalent to complete exam.




• CPR

• Local anestesia


• CPR

• Language• Ortho

x

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British Columbia

Alberta Saskatchewan Manitoba Ontario QuebecNewfoundland

& Labrador

Nova Scotia


New Brunswick

YukonNorthwest Territories

Nunavut

Province of Origin

Quebec* 3 • Local anesthesia

• Langauge

• Language • Language • Hours of practice

• Language

• Language x • Language • Language • Language • Language • Language • Language • Language

Saskatchewan • Hours of practice

• CPR

x • Hours of practice


• Language • Restorative• Ortho

Yukon • Board exam


• Board exam


• Board exam• Non-acredited

program without clinical

• Board exam


• Board exam


• Board exam• Non-

acredited program without clinical

• Board exam


• Board exam


• Board exam


• Board exam


x

1 Not a barrier to intial licensure

2 Not a barrier to intial licensure

3 National Certification Exam (NDHCB) [BC, AB, SK, MB, ON, NL, and PEI] proficiency in English required in some jurisdictions

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Dental Hygiene Regulation: A Comparison—Agreement on Internal Trade (AIT) Legitimate Objectives

Province/Web link ExceptionProvince(s)/

Territory(ies) whose workers are affected

Under which legitimate objective(s) is the measure being

filed

Rationale / Justification:

Material Scope of Practice Difference

Additional Requirement(s):

Duration of the additional

requirement(s):

Albertawww.ait-aci.ca/labour_en/exceptions_ab/Dental%20Hygienists%20-%20Anaesthetic.pdf

Anesthetic Ontario, Quebec, New Brunswick, Prince Edward Island, Newfoundland and Labrador, Yukon, and Northwest Territories

Protection of human health The practice of dental hygiene in Alberta includes the administration of local anaesthesia (dental freezing) by injection. The administration of local anesthesia by injection is not in the scope of practice for dental hygienists in any other Canadian jurisdictions with the exception of British Columbia and Saskatchewan.

Alberta www.ait-aci.ca/labour_en/exceptions_ab/Dental%20Hygienists%20Prescribing.pdf

Prescribing

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Province/web link ExceptionProvince(s)/


Under which legitimate objective(s) is the measure being

filed





requirement(s):

Ontario www.ait-aci.ca/labour_en/exceptions_on/Dental%20Hygienists.pdf

Dental Hygienists Yukon and Nunavut Protection of human health and consumer protection.

Graduation from an accredited Dental Hygiene program and/or successful completion of the national exam or equivalent demonstrates that an individual has the competencies required to perform to the Ontario dental hygiene scope of practice. Applicants from unaccredited programs who have not passed the national exam or equivalent have not demonstrated the integration of their knowledge into independent practice.

Require individuals who graduated from non-accredited programs who have not passed the national exam or equivalent to complete exam.

Indefinite

Newfoundland No application made.

New Brunswick No application made.

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Province/web link ExceptionProvince(s)/


Under which legitimate objective(s)

is the measure being filed





requirement(s):

Nova Scotia NL & Territories who allowed licences without Clinical exam from non-accredited programs

PEI No application made.

Quebec No application made.

Saskatchewan www.ait-aci.ca/labour_en/exceptions_sk/Dental%20Hygienist.pdf

Administration of local anesthesia by injection.

Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Yukon, and Northwest Territories

Protection of human health The practice of dental hygiene in Saskatchewan includes the administration of local anesthesia (dental freezing) by injection. The administration of local anesthesia by injection is not in the scope of practice for dental hygienists in any other Canadian jurisdictions with the exception of British Columbia and Alberta.

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Dental Hygiene Regulation: A Comparison—Services

Residential Care

Entry to Practice x x* Entry to Practice-Supervision until rules approved

x x x x x x x

Additional Education Required x

Dentist Rx required

Dentist must be onsite x Not Permitted

Local anesthesia

Entry to Practice x x x Not permitted until Rules

Not yet permitted

N/A N/A N/A x

Additional Education Required x x x x N/A x

Perform independent of Dentist

Dentist Rx required

Dentist must be onsite x

Administration of nitrous oxide/oxygen conscious sedation

Entry to Practice N/A N/A N/A N/A N/A

Additional Education Required x x N/A N/A N/A x N/A x N/A N/A N/A

Dentist Rx required

Dentist must be onsite

Alberta

British Colu

mbia

Manito

ba

New Brunsw

ick

Newfou

ndland & La

brador

Northwest

Territ

ories

Nunavut

Nova Scot

ia

Ontario

Prince

Edward Isl

and

Quebec

Saskatc

hewan

Yuko

n

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Radiographs

Entry to Practice x x x x x x x x x x

Additional Education Required x N/A

Dentist Rx required x x x


Can prescribe independent of a dentist x

Interpret/diagnose periodontal issues from radiographs

x x *

interpret/diagnose caries from radiographs

interpret

Orthodontic

Entry to Practice x x x x x x x x

Additional Education Required x x x x x

Independent of a dentist

Under the written order of a dentist x x x


Alberta

British Colu

mbia

Manito

ba

New Brunsw

ick

Newfou

ndland & La

brador

Northwest

Territ

ories

Nunavut

Nova Scot

ia

Ontario

Prince

Edward Isl

and

Quebec

Saskatc

hewan

Yuko

n

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Prescribing

Antimicrobial agents x x x Pending N/A x

Antibiotics x N/A Pending N/A

Desenstizing agents x x x Pending N/A x

Anticariogenic agnents x x x Pending N/A x

Lasers

Entry to Practice x

Additional Education Required x x x x x

Independent of a dentist x

Dentist Rx required


Sealants

Apply Independent of dentist x x x x

Apply with a dentist’s Rx x x x x

Alberta

British Colu

mbia

Manito

ba

New Brunsw

ick

Newfou

ndland & La

brador

Northwest

Territ

ories

Nunavut

Nova Scot

ia

Ontario

Prince

Edward Isl

and

Quebec

Saskatc

hewan

Yuko

n

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Alberta*prescribing of schedule 1 drugs used in DH treatment, with a prescriber ID # & CRDHA course - http://www.crdha.ca/LinkClick.aspx?fileticket=wZumKWBsiYU%3d&tabid=56&mid=416

British ColumbiaDental hygienists providing orthodontic and prosthodontic services to their clients will have obtained education in their basic dental hygiene program or through a post-diploma formal education course for the services being provided. Based on client need, this may include placing and removing temporary restorations, including provisional prosthodontic restorations, and performing orthodontic procedures.

Manitoba*Residential care: in order to work in residential care without a dentist

you must be on the Extended Practice Roster (must have worked at least 3000 career hours)Although the educational institutions in Manitoba offer LA as ETP, the registrar does not force registrants from outside provinces to obtain this education.Ortho and restorative: not offered within the dental hygiene education in MB, but can be completed as an additional module.

New BrunswickRegulation changes pending for lasers and sealants.

Nova ScotiaUse of lasers is under review, Nitrous oxide has not been reviewed by the CDHNS as of yet.

NunavutLocal anesthesia: Under very limited conditions

OntarioThe prescribing services may be altered in the new year pending the results of CDHO’s Drug Regulation. * DHs are trained to identify periodontal issues through radiographs and make apprirpatte referrals. Denture relining can be perofrmed under the supervision of a dentist or a dental technologists.

QuebecLocal anesthesia: Requirement for licensureOther: Bleaching and production of bleaching trays

Comments

Fluoride Varnish

Apply Independent of Dentist x x x x x

Apply with a Dentist’s Rx x x x

Myofunctional Therapy

Additional Education required x x

denture reline - chair side

With dentist or denturist supervision N/A N/A x

No supervision required N/A

Alberta

British Colu

mbia

Manito

ba

New Brunsw

ick

Newfou

ndland & La

brador

Northwest

Territ

ories

Nunavut

Nova Scot

ia

Ontario

Prince

Edward Isl

and

Quebec

Saskatc

hewan

Yuko

n

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Dental Hygiene Regulation: A Comparison—Grads

Procedures for grads of non-accredited DH programs (must have the following…)

Procedures for Grads from Accretited DH Programs

ProvinceAccept registrants from

non-accredited programsNDHCB Exam Required Clincal Exam

Must have Exisiting License in Another Province/ Territory

NDHCB Examination Required

Clinical Exam (?)

Alberta Yes Yes Yes - Alberta Clinical Exam No Yes Yes - if applicants qualifications & competencies not deemed substantially equivent to qualifications & competencies required for graduation from the AB approved program - U of A

British Columbia Yes Yes Yes - CDHBC Clinical Exam No Yes No

Manitoba No (Not eligible; must be a grad from an accredited program)

(Not eligible; must be a grad from an accredited program)

(Not eligible; must be a grad from an accredited program)

Yes

New Brunswick Yes Yes Yes (pending) No Yes No

Program must be in the process of accreditation

Newfoundland and Labrador

Yes Yes Yes Yes No


Yes Yes No Yes Yes No

Nova Scotia Yes Yes No No Yes

Nunavut Yes Yes No Yes Yes No

Ontario Yes Yes Yes (non-accredited) Yes Yes No


Yes Yes From another province Yes Yes No

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Dental Hygiene Regulation: A Comparison—Grads

Procedures for grads of non-accredited DH programs (must have the following…)

Procedures for Grads from Accretited DH Programs

ProvinceAccept registrants from

non-accredited programsNDHCB Exam Required Clincal Exam

Must have Exisiting License in Another Province/ Territory

NDHCB Examination Required

Clinical Exam (?)

Quebec No No

Saskatchewan Yes Yes Yes No Yes

Yukon Yes Yes No Yes Yes No

AlbertaIf applicants qualifications & competencies not deemed substantially equivent to qualifications & competencies required for graduation from the AB approved program - U of A

QuebecOnly graduates from accredited programs can register

YukonOne can be licensed as a DH in Yukon by:1) being licensed in another jurisdiction that is party to the Agreement on Internal Trade and supplying a copy of licence and letter of good standing from that jurisdicition 2) certificate of qualification by NDHB – within past 2 years and a) graduate of accredited DH program or b) granduate of non-accredited DH

program – but must provide proof that the program meets the eligibility requirements of NDHB (and we are told NDHB will not provide this)

Notes

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