Under the Health Professions Act and Health Professions Restricted Activity Regulation, dental hygienists in Alberta do not have the restricted activity to prescribe oral sedatives.
To address clients who have been orally sedated, The Alberta College of Dental Hygienists (ACDH) referred to the 2011 Alberta Dental Association and College’s (ADA&C) Standard of Practice: Use of Sedation in Non-Hospital Dental Practice, which stated:
2E2.2 Patients undergoing sedation must be supervised by an appropriately trained dentist and must never be left unattended while sedated.
This previous standard would not allow for an RDH to treat the sedated client without the dentist present in the operatory.
In January 2021, ADA&C released their Standard of Practice for Minimal and Moderate Sedation in Non-Hospital Dental Practice which updated the standards for dentists. This document now states that for patients under oral sedation (12 years and older):
3.3 A regulated member must administer the sedative dose in the dental office, taking into account any pre-arrival medications (e.g., cannabis, alcohol, narcotics, prescriptions, pre-arrival anxiolytics, etc.). The regulated member or a sedation team member must be in continuous attendance and direct observation with the patient to observe level of sedation once the medication is given. A regulated member or a sedation team member must be in continuous attendance until the recovery phase commences.
The interpretation of this new wording suggests that the dentist no longer needs to be directly supervising the client under oral sedation during the intra-operative phase.
As a result of this change in the Sedation Standards, the following question is being asked:
Can a registered dental hygienist provide treatment to clients under sedation if the dentist is not present in the operatory?
ACDH is currently seeking expert and legal advice to assist in developing guidance to answer this question to address client safety and meet the Practice Standards and Code of Ethics of the profession. In the interim, registered dental hygienists are reminded that they must work within their own level of competency and are responsible for their own practice.
For more information, please see the resource below: