The Health Practitioners Competence Assurance Act 2003 (the Act) describes a scope of practice as the health service, that a practitioner registered in that scope of practice is permitted to perform, subject to any conditions for the time being imposed by the responsible authority.
The Council publishes a scope of practice as a Notice in the New Zealand Gazette under section 11 of the Act.
Scope of practice for dental hygiene
The practice of dental hygiene is the prevention and non-surgical treatment of periodontal diseases through the provision of oral health assessment, diagnosis, management and treatment of any disease, disorder or condition of the orofacial complex and associated structures in accordance with this scope of practice and a dental hygienist’s approved education, training, experience and competence.
A dental hygienist guides patients’ personal care with the aim of achieving and maintaining oral health as an integral part of general health.
Dental hygiene practice includes:
- obtaining and assessing medical and oral health histories
- examination of oral tissues and recognition of abnormalities
- assessing and provisionally diagnosing disease of periodontal tissues, and appropriate referral
- obtaining informed consent for dental hygiene care plans
- providing oral health education, information, promotion and counselling
- scaling, debridement and prophylaxis of supra and subgingival tooth surfaces
- applying and dispensing non-prescription preventive agents and fissure sealants
- applying prescription preventive agents
- applying and dispensing topical agents for the treatment of tooth surface sensitivity and tooth discolouration
- administering topical local anaesthetic
- administering local anaesthetic using dentoalveolar infiltration and inferior dental nerve block techniques
- taking impressions, recording occlusal relationships and making study models
- taking impressions, constructing and fitting mouthguards and bleaching trays
- taking intra and extra-oral photographs
- performing postoperative procedures such as removal of sutures and placement and removal of periodontal dressings
- recontouring and polishing of restorations
- taking periapical and bitewing radiographs for the purpose of recognising disease of the periodontium
- taking extra-oral radiographs
- assisting the dentist or dental specialist in implementing orthodontic treatment plans through performing the following orthodontic procedures:
- tracing cephalometric radiographs
- supragingival polishing of teeth (as part of oral hygiene, before bonding and after removal of fixed attachments)
- providing oral hygiene instruction and advice on the care and maintenance of orthodontic appliances
- making study models, and fabricating retainers, and undertaking other simple laboratory procedures of an orthodontic nature.
- assisting the dentist or dental specialist in implementing orthodontic treatment plans, as directed by the dentist or dental specialist who is responsible for the patient’s clinical care outcomes and is on-site at the time, through performing the following orthodontic procedures:
- placing separators
- sizing and cementing metal bands including loose bands during treatment
- preparing teeth for bonding fixed attachments and fixed retainers
- indirect bonding of brackets as set up by the dentist or dental specialist
- placing archwires when necessary (as formed by the dentist or dental specialist) and replacing ligatures /closing self-ligating brackets
- trial fitting removable appliances - this does not include activation
- removing archwires after removing elastomeric or wire ligatures, or opening self-ligating brackets
- removing fixed orthodontic attachments and retainers
- removing adhesives after the removal of fixed attachments using burs in slow-speed handpieces where there is minimal potential for the removal of enamel
- fitting of passive removable retainers
- bonding pre-formed fixed retainers.
Practice in this context goes wider than clinical dental hygiene practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of dental hygiene practice which were not included in a practitioner’s training should not be undertaken unless the practitioner has completed appropriate training and practises to the standards required by the Standards Framework for Oral Health Practitioners.
Prescribed qualifications for the dental hygiene scope of practice.