Practice Resources

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. 

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.

Only those registered dental hygienists who have received International Association of Orofacial Myology (IAOM) certification are considered competent to perform orofacial myology as part of the practice of dental hygiene in Alberta.     

Following successful completion of the IAOM certification process, Alberta RDHs are expected to comply with any code of ethics, policies, procedures, membership, and continuing education requirements set out by the IAOM.

Dental hygienists opening a dental hygiene practice and providing orofacial myology must have completed the certification process and obtained their COM designation.

Despite any orofacial myology training and education, you are limited to the scope of practice for dental hygienists defined by the Health Professions Act, Schedule 5, Section 2.

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.

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.  

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).