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Occupational Health and Safety Resources

Under the Health Professions Act, prescription of dental radiographs (x-rays) falls within the allowed scope of practice for a dental hygienist. Furthermore, dental hygienists may own and operate ionizing and non-ionizing radiation equipment, including dental x-ray equipment and certain lasers.

Changes to the Occupational Health and Safety Act (OHS Act)  and revised regulations took effect on December 1, 2021. The Radiation Protection Act and its regulations were incorporated into the OHS Act and OHS Code. This means these health and safety laws are in one place rather than multiple statutes.

Click the links to read more about the changes to the OHS laws and access more radiation health and safety resources  from the Alberta Government. 

OHS Act

OHS Law Changes

Radiation Health & Safety Resources

Safety Code 30 was updated on June 30, 2022. This new document replace the 1999 version and provides specific guidance to the dentist, dental hygienist, dental assistant, and other support personnel concerned with safety procedures and equipment performance.

Safety Code 30

Under the Occupational Health and Safety Act (OHS) and Code, Part 35, Section 527 states that a person must not recap waste needles. Further, Section 525.2(2) states an employer must provide and ensure that any medical sharp is a safety-engineered syringe (SES) medical sharp.

For oral healthcare practitioners, this legislates the use of an SES for local anesthetic injection.

An acceptance, allowing for recapping of used dental needles, was granted by OHS, subject to several terms and conditions and general requirements. For dental hygienists who have evaluated the safety of SES and deemed recapping of waste needles to be safer, or as safe, and preferred over use of an SES, please make note of the following:

  • The work procedures in a document, Policy Protocol Sharps, Syringes & Safety Engineered Syringes (SES) dated May 2018, MUST be followed by all dental and dental hygiene offices wishing to recap needles under the acceptance.
  • All other requirements of the OHS Code must continue to be met.
  • A copy of a signed acceptance letter must be posted at each dental or dental hygiene office and/or communicated to all affected workers. 

The College collaborated with 11 other Alberta regulated health professions to develop resources for healthcare professionals who may have been exposed to, or are at risk of exposure to blood and body fluids (BBFE).

Click the button to access the BBFE Resources for Healthcare Professionals.

This provides resources including:

  • An interactive algorithm to determine next steps if you have had an exposure to BBFE
  • An online module for prevention in the workplace
  • Posters for display in the workplace

BBFE Resources for HCPs 

Laser Use

Yes. Dental hygienists who have completed the appropriate theoretical and clinical education may use lasers for dental hygiene procedures. Laser bleaching and laser periodontal therapy competencies can be obtained through a dental hygiene undergraduate program or a formal continuing education opportunity. Laser periodontal therapy courses must include hands-on clinical experiences using the laser on live, human clients.

  1. The theoretical component should be a minimum of 7 hours in length and cover all aspects of laser therapy. If the introductory theory component is online, there must be an in-person review of the theory prior to proceeding to the hands-on component. (We recommend at least 2 hrs for this review.) This will allow the instructors to ensure that the participants have a good strong understanding of the theory and the mechanics of the laser itself. 
  2. The hands-on clinical component should be at least one full day (7-8 hours). However, if you, the provider, do not feel adequately prepared to safely provide the laser therapy after the first day of a clinical course, you will need to obtain further clinical education until you feel competent to safely and effectively provide this service. The time needed to become competent will vary from dental hygienist to dental hygienist, but a full day of clinical experiences is the minimum. 

The instructor of the hands-on component must be a registered member of their respective regulatory college in Alberta — either as a General Member or a Courtesy Member. For example, if a dental hygienist is teaching this section of the course and they are not a regulated member with ACDH, they must contact the College and apply for courtesy registration prior to delivering the course. Dental hygienists must make evidence-based decisions regarding implementation of new techniques, technology or research before incorporating them into practice.

Dental hygienists must restrict their use of lasers to bleaching, treatment of herpes labialis, and periodontal therapy. Dental hygienists are not authorized to provide laser therapy for treatment of TMJ disorders. While dental hygienists are able to identify potential TMJ concerns, they must refer the client to an appropriate health care provider (e.g., a dentist who specializes in treating TMJ disorders) for treatment. Dental hygiene practice does not include use of lasers for alternative therapies such as hair removal.

Orofacial Myology

Dental hygienists demonstrate competence in orofacial myology by completing the steps in the International Association of Orofacial Myology (IAOM) Certified Orofacial Myologist (COM) designation process (see How to become an IAOM Certified Orofacial Myologist (COM®) - IAOM). The process involves completing an introductory course in orofacial myology and working through case studies in practice.

The College does not restrict dental hygienists from completing case studies while working through the IAOM certification process if they:

  • Self-assess their individual competency and only work within it (Professional Accountability Standard of Practice, Performance Expectation 9);
  • Obtain informed consent to provide treatment, including informing the patient that they are working to obtain certification and have not yet been examined for competency (Clinical Therapy Standard of Practice, Performance Expectation 1); and
  • Refer the patient if their needs for assessment, diagnosis, or treatment are best addressed in collaboration with or by another health professional (i.e., physician, dentist, certified orofacial myologist).

Dental hygienists may only provide orofacial myology services if they are (1) pursuing their COM designation by working on their case studies with a mentor after completing the introductory course, or (2) COM certified.” 

Despite any orofacial myology training and education, dental hygienists are limited to the scope of practice for dental hygienists as defined by the Health Professions Act, Schedule 5, Section 3. The Health Professions Act allows dental hygienists to assess, diagnose, and treat oral health conditions through the provision of therapeutic, educational, and preventive dental hygiene procedures and strategies to promote wellness and provide restricted activities authorized by the regulations. This limits dental hygienists from assessing, diagnosing, or treating conditions that are not oral health conditions, such as sleep disorders (e.g., obstructive, sleep apnea) or breathing disorders (e.g., asthma). 

Dental Hygiene Practices

Dental x-ray equipment, including digital radiography systems, and any Class 3B or Class 4 lasers  must be installed, registered, and inspected in accordance with Alberta’s Radiation Protection Act and Regulation. Registration and inspection must be completed prior to use of the equipment. Please contact the ACDH office for further details. Failure to be in possession of a valid registration certificate prior to operation of radiation equipment is a contravention of the Radiation Protection Act. The penalty for this offence is a maximum fine of $15,000 and/or six months imprisonment. Operation of unregistered radiation equipment would also be considered unprofessional conduct under the HPA. You must have a written Quality Assurance Program in place that is consistent with the legislation and Safety Code 30. This includes policies and procedures that:

  • Ensure the dental X-ray equipment produces quality radiograms reliably with minimal doses to clients and staff
  • Test the radiography equipment for quality control

Safety Code 30

Supervision or Direction

No. The HPA does not require supervision of dental hygiene practitioners, other than students performing restricted activities. Unlike legislation in other provinces, the HPA does not require an order to provide services and does not require a dentist to examine a client prior to dental hygiene treatment.

The authorization for dental hygienists to provide direction to regulated dental assistants is contained in the Health Professions Restricted Activity Authorization Regulation.

Dental hygienists may provide direction for a dental assistant to perform the following restricted activities:

  • to apply any form of ionizing radiation in medical radiography.
  • to cut a body tissue or to perform surgical or other invasive procedures on body tissue in or below the surface of teeth, for the purpose of performing dental probing, including periodontal screening and recording.
  • to cut a body tissue or perform surgical or other invasive procedures on body tissue in or below the surface of teeth, for the purpose of scaling teeth.

A dental assistant’s practice permit will indicate if they are authorized to scale teeth under the direction of a dentist or dental hygienist.

The Health Professions Restricted Activity Authorization Regulation sets specific criteria for the performance of scaling teeth by dental assistants. As a result, authorized dental assistants may only perform scaling when the client has been recently assessed by a dentist or dental hygienist. The dental hygienist providing direction must perform an assessment to establish that the client meets all of the following criteria:

  • Healthy gingival and periodontal tissues or plaque associated gingivitis;
  • Pockets of 4mm or less; and
  • No overt or radiographic signs of alveolar bone loss.

If you do not feel comfortable or qualified to provide direction, you are not required to do so. Any regulated health professional authorized to supervise or direct a member of another regulated health profession may decline to do so for a number of reasons. You should give careful consideration to the following questions before making your decision. If you cannot answer yes to any of the following questions, you must not consent to give direction.

  1. Are you qualified (competent) and authorized to perform the restricted activity yourself and is it appropriate to your practice?
  2. Do you have sufficient practice experience in the restricted activity to be directing another provider?
  3. Does your assessment of the client lead you to believe that it is appropriate to direct someone else to provide the service?
  4. Has the provider who is asking for direction completed any advanced training that may be required by their college?
  5. Are you confident that the provider you will be directing has the level of competence required to perform the procedure?

Yes. There are other things that would prevent you from providing direction. If you have conditions on your own practice permit that prevent you from performing, supervising, or directing a restricted activity, you cannot provide direction to another health care provider.

Secondly, a dental hygienist may only provide direction to members of other regulated health professions in the provision of restricted activities if the restricted activity is authorized for both professions. As an example, you may be authorized to administer nitrous oxide/oxygen conscious sedation but you cannot direct a registered dental assistant to administer nitrous oxide/oxygen conscious sedation because the Health Professions Restricted Activity Authorization Regulation does not authorize dental assistants to perform that restricted activity.

Neuromodulators and Dermal Fillers

No. Dental hygienists are unable to provide neuromodulators (e.g., Botox) or dermal fillers in their dental hygiene practice for cosmetic purposes. The legislation in Alberta restricts dental hygienists to assessing, diagnosing and treating only oral health conditions. Other health professionals may be able to provide neuromodulators or dermal fillers based on the restricted activities they are authorized to perform. 

TMJ disorders are multifactorial, complex and may mimic other orofacial pain conditions. It is appropriate for dental hygienists to assess for these conditions, but dental hygienists are not the appropriate health professional to diagnose or treat TMJ disorders. Clients can be referred to an appropriately trained health professional.  

Service Codes

The lists of service codes define the service and provide explanations for the use of each code, including how long a unit of time is and what is included within the code.

Typically, an office will bill under one of these two systems:

  • Canadian Dental Association’s Uniform System of Codes and List of Services where the Alberta Dental Association establishes a fee guide for the use of these service codes;

OR

  • Canadian Dental Hygienists Association’s National List of Service Codes.

If you have questions about whether a code is appropriate for the service you are providing, you should contact the administrator of the service codes (e.g., CDA, ADA, or CDHA).