MPP Reception

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MPP Reception Tuesday, March 30, 2004
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Dental Hygiene Act, 1991 Section 4 In the
course of engaging in the practice of dental
hygiene, a member is authorized, subject to the
terms, conditions and limitations imposed on his
or her certificate of registration, to perform
the following 1. Scaling teeth and root planing
including curetting surrounding tissue. 2.
Orthodontic and restorative procedures. Section
5 (1) A member shall not perform a procedure
under the authority of section 4 unless the
procedure is ordered by a member of the Royal
College of Dental Surgeons of Ontario. (2) In
addition to the grounds set out in subsection
51(1) of the Health Professions Procedural Code,
a panel of Discipline Committee shall find that a
member has committed an act of professional
misconduct if the member contravenes subsection
(1).
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Excerpts of Letter from the Ministry of Health to
the Royal College of Dental Surgeons, et al it
has been the Ministrys expectation that under
general orders, dental hygienists would be free
to practice many components of their scope of
practice much more autonomously than in the past.
This would include aspects of practice in both
institutional and community settings. It is
the Ministry of Healths wish that the two
professionssee that all other issues related to
orders, delegation, or assigning intra-oral
duties are addressed in a way that is acceptable
to the professions, to the Ministry, and meets
the test of serving the public interest, as
opposed to any professional self-interests.
Alan Burrows, Director Professional
Relations Branch Ministry of
Health November 30, 1993
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HPRAC Recommendations HPRAC recommends that the
Dental Hygiene Act be amended to allow dental
hygienists to perform their authorized acts of
scaling teeth and root planing including
(incidental) curetting of surrounding tissue
without an order In HPRACs view, an
appropriate starting place to develop an
exemption regulation would be the CDHOs proposed
amendment to the Dental Hygiene Act, 1992, and
the RCDSO protocol. Accordingly, the RHPA
exemption regulation might take the following
form as an amalgam of proposed amendment and the
protocol regulation 1. A member of the College
of Dental Hygienists of Ontario, is exempt
from subsection 27(1) of the Act, for purposes
of carrying on self-initiation of scaling teeth,
root planing including incidental curretage of
surrounding tissues Health Professions
Regulatory Advisory Council (HPRAC) Report to
the Minister of Health Dental Hygiene
Referral, May 1996
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I am really sorry that the (dental hygiene
order) file was the one we didnt complete. We
were ready to do it, we just ran out of
time. Steve Gilchrist, Co-chair Red
Tape Commission October, 2003
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We have expressed disappointment with the
Tory governments failure to act upon
recommendations that have been received from
HPRAC regarding dental hygienists. In
government, we are committed to acting on the
HPRAC recommendations. Dalton
McGuinty Leader of the Ontario Liberal
Party September 29, 2003
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Organizations Supporting Implementation of HPRAC
Recommendations Ontario Coalition for Senior
Citizens College of Denturists of
Ontario Organizations (OCSCO) Concerned Friends
of Ontario Citizens Ontario Association of
Social in Long-Term Care Facilities Workers Reg
istered Practical Nurses Association Ontario
Association of Public Health of Ontario
(RPNAO) Dentistry Retired Teachers of
Ontario ALS Society of Ontario Haldimand-Norfol
k Womens Services Denturist Association of
Ontario CHC Lanark County Ontario
Physiotherapy Association Good Shepard
Centres Association of Ontario
Midwives Trillium Court Seniors
Community Ontario Association of Medical
Radiation Technologists
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Organizations Supporting Implementation of HPRAC
Recommendations Ontario Association of
Non-Profit Homes Ontario Opticians
Association and Services for Seniors Ontario
Society of Chiropodists John Noble Home
(Brantford) Ontario Speech Language
Association and many individuals.
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John has had three home visits for scaling in
this past year, and I feel he is getting safe and
professional care in a completely stress free
setting. Both dentist and hygienist were careful
about providing this service quietly, in case the
Royal College of Dental Surgeons should step in
and force the dentist to rescind the order. It
seems incredible to me that this should be
necessary, knowing first hand the need for this
type of care, and being aware of the extensive
training and professionalism of dental
hygienists. the fact that there must be
an order for scaling will surely impede others
from receiving professional oral hygiene care in
their homes. Sheila E.
Land Concerned Caregiver December 16,
2002
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I practice in three small towns in Northwestern
Ontario. We employ two hygienists. Occasionally
the hygienists will work without the dentist
present. Further restrictions with respect to
orders will result in decreased service or
interruption in services in areas of the province
where basic dental needs are very
high. Dr. Matthew Walkiewicz,
DDS February 22, 2002
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Letter to the Premier, March 5, 2004 Dear
Premier   For several years, I have been
following the twists and turns of the so-called
"order" issue as it applies to dental hygienists
in Ontario. To refresh your memory, the Dental
Hygiene Act, 1991 as currently drafted requires a
dental hygienist to obtain an order from a
dentist before the dental hygienist may perform
the authorized act of "scaling, root planing and
curetage". Laypersons understand this as teeth
cleaning.   As a dentist, I can tell you that
such orders are being used by my profession to
ensure that dental hygienists can only be
employed by dentists and that oral hygiene care
can only be provided in conventional dental
practices, for fees set by and paid to dentists.
Orders advance the economic interests of
dentists. They are not necessary to protect the
public. I believe that the Health Professions
Regulatory Advisory Council (HPRAC) came to this
conclusion in 1996.   My personal experience is
relevant here. In 1995 I had a very severe
stroke and was in a coma for an extended period
of time. My oral care was neglected and I
contracted pneumonia. Fortunately, I was young
and healthy prior to my stroke and my body was
able to fight off the bacteria. However,
pneumonia would never have occurred if I had been
able to obtain the services of a dental
hygienist.   My elderly mother had a similar
experience. After an accident at home she was
confined to Sunnybrook Hospital. Prior to her
confinement she had excellent oral hygiene.
Subsequent to her accident, her oral condition
deteriorated because we could not secure the
services of a dentist and no dental hygienist
could provide the care necessary without a
dentist's order. We were very concerned that she
would lose her teeth due to an advancing
periodontal condition or, even worse still,
contract life-threatening pneumonia because of
the spread of bacteria from her gums to her
lungs. This phenomenon has been documented by
Dr. Hardy Lineback of the University of Toronto
and I commend his research to your
attention.   Regrettably, my mother's experience
is all too common for residents of long-term care
facilities and the homebound for whom the order
requirement deprives them of access to necessary
oral hygiene care.   I am writing to urge you to
implement the HPRAC recommendations without
further delay. It is a simple and zero-cost
answer to a serious and growing problem. I know
that dentistry will mount considerable opposition
in order to protect its commercial interests, but
that should not deter you. Dr. Howard
Rocket, DDS March 5, 2004