Scope of practice competencies for dental hygienists

A competent dental hygienist is one who applies knowledge, skills, attitudes, communication, and judgement to the delivery of appropriate oral health care in accordance with the scope of practice within which they are registered.

 Understanding current scientific knowledge

A competent dental hygienist understands current biological, physical, cultural, social, and psychological factors involved in dental and oral disease, and in attaining and maintaining oral health.

Measuring understanding

The dental hygienist:

  • demonstrates an understanding of biological, physical, cultural, social, and psychological factors in dental hygiene
  • uses these factors to inform best practice
  • communicates this knowledge to patients and the wider community
  • demonstrates familiarity with, and implements, oral health maintenance programmes.

Obtaining patient information

A competent dental hygienist obtains, by interview and examination, patient information relevant to oral health care, and records this information logically, legibly, and securely.

Measuring patient information

Records show:

  • an adequate medical history
  • an adequate dental history
  • adequate charting, demonstrating that all dental tissues and associated structures have been examined closely
  • appropriate radiographs of adequate diagnostic quality
  • compliance with the Dental Council Patient information and Records Practice Standard
  • a logical and legible format
  • that the dental hygienist has ensured patients confidentiality is maintained.

 Analysing information and planning an oral health care programme

A competent dental hygienist assesses client or patient information to identify oral health problems. The dental hygienist then formulates an evidence-based treatment plan that addresses:

  • the aetiology of dental and oral disease
  • the attainment or maintenance of oral health
  • priority of management
  • patient options
  • anticipated outcomes
  • the duration of treatment.

Measuring analysis and planning

The dental hygienist demonstrates and records:

  • an adequate, evidence-based, prioritised dental hygiene treatment plan
  • easily understood options
  • instructions given for prevention
  • recall arrangements made
  • advice sought from other practitioners.

 Providing oral health care

A competent dental hygienist clearly communicates the details of an oral health care plan to patients to obtain informed consent. Where necessary, a competent  dental hygienist carries out agreed procedures and manages any complications.

Measuring clinical competence in  radiography

The dental hygienist demonstrates clinical competence in:

  • relating patients’ needs with relevant structures in view
  • providing adequate film quality, correctly mounted
  • practising satisfactory radiation safety
  • recording accurate reports
  • taking a view ideal for diagnosis.

Measuring clinical competence in  clinical records

The  dental hygienist demonstrates clinical competence in:

  • ensuring extra and intra oral photographs are adequately and correctly labelled
  • models that are adequately and correctly trimmed.

Measuring clinical competence in periodontal management

The dental hygienist demonstrates clinical competence in:

  • detecting and removing plaque and calculus from supra and subgingival tooth surfaces
  • correcting predisposing factors
  • giving and recording appropriate self-care instructions
  • having in place a recall regime
  • providing adequate management of acute periodontal infections
  • the placement and removal of periodontal dressing
  • the removal of sutures
  • appropriate referral. 

Measuring clinical competence in preventative care

The dental hygienist demonstrates clinical competence in providing:

  • fissure sealants
  • the construction and fitting of mouthguards
  • recontouring and polishing of restorations
  • application of  non prescriptive preventive agents
  • supervised application of prescriptive preventive agents
  • topical agents for treatment of tooth sensitivity and tooth discolouration.

Measuring clinical competence in use of local anaesthetics

The dental hygienist demonstrates clinical competence in:

  • undertaking supervised administration of local anaesthetic
  • using correct solutions and technique
  • achieving adequate anaesthesia
  • understanding and appropriately managing complications.

Measuring clinical competence in orthodontics

The dental hygienist demonstrates clinical competence in:

  • the correct placement of appliances
  • appropriate removal of composite and cement
  • replacement of O rings and loose bands
  • de-bonding and de-banding.

Measuring clinical competence in oral health promotion

The dental hygienist demonstrates clinical competence in:

  • providing ‘one on one’ counsel and advice to encourage sound attitudes and practices
  • demonstrating a commitment to oral health promotion
  • communicating importance of issues such as diet, smoking, etc on oral health.

 Knowing when to refer

A competent dental hygienist refers for advice or treatment where diagnosis and treatment planning indicates that the patient requires a level of knowledge or skills greater than those of the dental practitioner.

Measuring clinical competence in referrals

The dental hygienist demonstrates clinical competence in:

  • making appropriate referrals
  • obtaining advice from other health professionals where necessary
  • having in place a written agreement with a dentist(s) for clinical guidance.
  • completing relevant documentation.

 Assessing the effectiveness of oral health strategies

A competent dental hygienist objectively assesses both short-term and long-term outcomes of oral health strategies.

Measuring competence in assessing effectiveness

The dental hygienist demonstrates competence in:

  • understanding the prognosis for treatment strategies offered to individuals
  • communicating this knowledge to patients.

 Communicating effectively

A competent dental hygienist communicates effectively with and educates patients, other health workers, and the public on oral health matters.

Measuring competence in communications

With patients, the dental hygienist demonstrates:

  • good rapport
  • empathy
  • adequate history-taking technique
  • explanation of findings, treatment options and likely outcomes in easily understood language to ensure informed consent
  • confirmation of the patients understanding of the information provided
  • English language skills equivalent to 7.5 on the Academic Skills Category of the International English Language Testing System with no less than 7 in each of the four bands.

With other health professionals, the dental hygienist:

  • refers where necessary
  • seeks advice where necessary
  • contributes dental hygiene input to overall health treatment planning.

With the general public, the dental hygienist:

  • promotes oral health
  • communicates the importance of factors such as diet and smoking on oral health.

 Understanding scientific methodology

The competent dental hygienist undertakes research and/or analyses relevant scientific literature, and applies findings to the delivery of appropriate oral health care.

Measuring competence in applying recent knowledge to practice

The dental hygienist demonstrates understanding of current issues including:

  • recent developments in dental hygiene
  • the evidential base of dental hygiene practice of new materials and treatment techniques based on research.

Maintaining competence

The competent dental hygienist maintains competence by monitoring the outcomes of oral health care delivery, and undertaking continuing personal professional development.

Measuring maintaining competence

The dental hygienist reviews their own professional practice including:

  • identifying the hygienists skills and knowledge to be developed
  • identifying the learning needs for personal professional development
  • implementing an active professional development programme
  • discussing professional issues with colleagues.

The dental hygienist demonstrates:

  • compliance with Dental Council practice standard
  • compliance with Dental Council minimum recertification requirements.

 Understanding and complying with legal requirements

The competent dental hygienist understands and complies with the ethical responsibilities and legislative requirements for the safe and competent practice of dental hygiene in New Zealand.

Measuring legal understanding and compliance

The dental hygienist demonstrates familiarity with, and complies with, relevant legislation and professional standards including:

  • Health Practitioners Competence Assurance Act 2003
  • Health and Disabilities Services Consumer Rights
  • Radiation Protection Act
  • Medicines and Misuse of Drugs legislation
  • Privacy Act and the Health Information Privacy Code
  • Restrictive trade practices legislation
  • Fair Trading Act
  • Occupational safety and health legislation
  • Children, Young Persons and their Families Act — specifically the protection of children.
  • Employment legislation, if appropriate
  • Dental Council prescribed scopes of practice
  • Dental Council Standards Framework for Oral Health Practitioners
  • Joint Dental Council practice standards.