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Restricted Activities FAQs

Restricted Activities FAQs

Restricted activities are regulated health services that can only be performed by individuals with specific competencies. Although regulation authorizes regulated members to perform a number of restricted activities, this does not mean that a regulated member is authorized to perform any restricted activity in any situation in any practice setting.

Dental hygienists must always restrict themselves to performing only those restricted activities they are competent to perform and that are appropriate to the registrant's area of practice and the procedure being performed.

The FAQs and answers below plus the Health Professions Restricted Activity Authorization Regulation will assist you in understanding the restricted activities within the practice of dental hygiene care in Alberta.

Health Professions Restricted Activity Authorization Regulation

Most of the restricted activities authorized in the Dental Hygienists Profession Regulation are taught in the basic curriculum of accredited dental hygiene programs and have been a part of the practice of dental hygiene for many years (i.e., probing, scaling, root planing, curettage, ordering, and exposing radiographs). You do not require any special authorization to perform these activities once you have been placed on the CRDHA General register and have been issued a Practice Permit.

Competencies related to the following restricted activities are not inclusive in all dental hygiene educational programs:

  1. Administration of local anesthesia by injection
  2. Prescribing and administering nitrous oxide/oxygen for the purpose of conscious sedation
  3. Restorative procedures of a permanent nature in collaboration with a dentist
  4. Orthodontic procedures specific to preliminary fitting of appliances in collaboration with a dentist
  5. Preliminary fitting of periodontal appliances in collaboration with a dentist
  6. Prescribing Schedule 1 drugs used in dental hygiene practice


You are not authorized to perform the activities listed 1 to 6 above until you complete steps 1 to 3 listed below:

  1. Successfully complete a Council-approved course specific to performance of these activities
  2. Submit an application for authorization to perform the restricted activity, and
  3. Receive written notification from ACDH that you are authorized to perform the activity

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:
Oral Sedation

 

No. You cannot sign a prescription without a prescriber's identification (ID) number.

If you want to be authorized to perform the restricted activity of prescribing you must apply to the ACDH for a prescriber’s identification (ID) number in order to sign prescriptions. ACDH requirements for issuing a prescriber’s ID number are successful completion of a Council-approved pharmacy refresher course.

The refresher course Elements of Prescribing: A Pharmacy Refresher Course for Dental Hygienists, is available online through Continuing Dental Education at the U of A.


ALL Alberta registered dental hygienists with the appropriate competencies can administer drug therapies such as chlorhexidine, Oraqix®, ArestinTM, and Atridox®.

As with any new product dental hygienists may incorporate into their practice, they must ensure they are educated in the appropriate administration techniques and are familiar with the complete product information, including mechanism of action, potential indications and contraindications for use, common side effects, etc. In addition, they must know how to effectively manage adverse reactions to the product. Dental hygienists must make evidence-based decisions regarding when it is appropriate to use a product for a client. Each case is client-specific.

All registered dental hygienists are expected to determine the need for treatment and identify the appropriate sites for treatment following the ADPIE model of assessment, diagnosis, and treatment planning.

Any Schedule 1 drug needs to be prescribed for the client by a health professional authorized to prescribe it. Click the button to learn more about National Drug Schedules.

National Drug Schedules

No.

Dental hygienists without approved advanced training must not provide treatment to a client who is receiving nitrous oxide/oxygen conscious sedation unless an authorized provider remains in the operatory with the unauthorized dental hygienist and the client for the entire duration of the treatment.


Under the Health Professions Act (Alberta) and Dental Hygienists Profession Regulation, registered dental hygienists can perform restorative procedures of a temporary nature as part of their scope of practice. However, they must possess the competencies to perform these procedures safely and effectively. In the case of Atraumatic Restorative Therapy (ART), these competencies include but are not limited to:

  • Understanding caries development and diagnosis
  • Indications and contraindications for ART
  • Client education
  • Risk assessment
  • Clinical competence in performance of the procedure

Because the more comprehensive temporary restorative procedure called ART is recognized as part of the scope of practice of Alberta dental hygienists, interim stabilization therapy (IST) is not a term or procedure recognized in Alberta. ACDH registrants are reminded that the College does not recognize an IST course as equivalent to an ART course. Members who complete an IST course may apply for credit under the ACDH Continuing Competence Program but they will not be deemed to have acquired the competencies to perform ART and will not be authorized to perform IST in Alberta

The ACDH considers the following to be restorative procedures of a temporary nature:

  1. Insertion of zinc oxide eugenol or other medicated cements in primary or permanent teeth when:

1.1.  a dentist is not on-site or readily available to treat the client,

1.2.   there is no evidence of abscess, and

1.3.     the client is experiencing any of the following symptoms as the result of an untreated carious lesion, a fracture of the tooth or loss of a filling:

  • discomfort from gingival or mucosal irritation
  • tooth sensitivity or pain
  • impaired ability to eat

2.  Atraumatic Restorative Treatment (ART) on primary or permanent teeth using glass ionomer or resin based materials when:

2.1.     a dentist is not on-site or readily available to treat the client,

2.2.     there is no evidence of abscess, and

2.3.     the client is experiencing any of the following symptoms as the result of an untreated carious lesion, a fracture of the tooth or loss of a filling:

  • discomfort from gingival or mucosal irritation
  • tooth sensitivity or pain
  • impaired ability to eat

2.4.     the client meets the criteria for ART as part of an early childhood caries prevention program in a community health setting

Dental hygienists placing temporary restorations of any type must ensure that the client is aware of the temporary nature of the restorations and must advise clients or the client’s guardian to obtain further dental care from a dentist.

Dental hygienists are expected to recognize and respond to adverse events, including medical emergencies, using appropriate emergency protocol. An appropriate response to a medical emergency may be to perform a restricted activity that is not authorized for the dental hygiene profession (e.g., administer epinephrine by autoinjector).  

Although the Health Professions Act restricts health professionals from performing unauthorized restricted activities, it still allows an unauthorized person to perform the restricted activity to provide physical comfort or to stabilize a person who is ill, injured or unconscious as a result of an accident or other emergency if there is no authorized person available (HPA s 1.6(2)). This means that if there is no authorized person available (e.g., dentist, paramedic), a dental hygienist may provide this restricted activity despite not being authorized. 

If you are going to respond to a medical emergency by providing a restricted activity, you must ensure you have appropriate training and can safely and competently perform the restricted activity (i.e., know the procedure, be able to identify contraindications, understand if any follow-up is required, etc.). Ensure you are familiar with the emergency protocols in your practice setting.