Position Statements
Community Dental Health Coordinator (CDHC)
vs.
The Advanced Dental Hygiene Practioner
After reviewing the position of the National Dental Association, the American Dental Education Association, and the Academy of General Dentistry, the National Dental Hygienists’ Association proposes the following:
The responsibilities of the Community Dental Health Coordinator can be accomplished by a Public Health Dental Hygienist which allows Registered Dental Hygienist to work in public health settings without supervision of a dentist (PA Senate Bill 455). The NDHA supports and recommends that all States create the PA model in order to meet the needs of underserved populations.
It is the position of the NDHA that the CDHC infringes upon the scope of practice of a dental hygienist; furthermore, the CDHC has no licensure requirement and basic entry level educational requirements and not responsible to anyone except and entity such as a federally Qualified Health Center, a Public Health Facility, or a dentist. If in fact patient care was jeopardized there would be no recourse such as the removal of credentials, fines and charges. It is therefore the position of the National Dental Hygienists’ Association that this new unlicensed provider is a direct threat to the profession and the mid level dental hygiene profession consequently, the NDHA is opposed the creation of the CDHC.
The NDHA remains supportive of the Advanced Dental Hygiene Practitioner as a provider of care as a second pair of hands with the legislature support to be allowed to perform a fuller scope of services such as limited prescriptive authority for fluoride and Medicaid reimbursement. The NDHA believes that this would clearly address the nation’s public oral health needs.
ACCESS TO CARE
The National Dental Hygienists’ Association is an organization for licensed dental hygienists and student dental hygienists who have graduated from or are enrolled in an accredited dental hygiene program. NDHA represents the professional interests of under-represented minority Dental Hygienists in the United States.
Dental hygienists are licensed oral health care professionals responsible for the provision of clinical, educational, research, administrative and therapeutic services to the public. Their services support total health and contribute to optimal oral health.
The National Dental Hygienists’ Associations position on access to dental care is that:
A. Oral health is a very important component of total health.
B. Oral health and total health are inextricably linked.
C. Oral health care is a right and not a privilege.
D. Access to oral health care is a critical issue for African Americans in the U.S.
E. Dental disease is largely preventable through routine periodic dental care.
F. Poverty remains an important determinant of oral health status.
G. Oral disease is unevenly spread throughout the U.S. The following statistics, taken from the American Dental Education Association Minority Trends in Dental Education Data 2000 bare this out:
1. African American children have twice as much untreated tooth decay as White children.
2. The five-year survival rate for African Americans with oral cancer is 32% compared to 54% for Whites.
3. African Americans adults have less than half of the average number of dental visits each year as White adults.
4. The prevalence of periodontal disease among African Americans is higher than among whites.Under-represented minority dental hygienists play a vital role in eliminating oral health disparities and assuring quality oral care for all.
PRECEPTORSHIP
“On the Job Training”
Preceptorship is defined, in the dictionary, as “teacher or instructor”. To the dental hygiene profession it means that a practicing dentist will train a person on-the-job to perform dental hygiene procedures, instead of going through an accredited educational program and taking national and regional examinations to obtain a license to practice.
On the job training is an ineffective method of preparing persons to provide quality oral health care to consumers/patients.
The NDHA believes that inadequate care of unskilled oral health care providers
places the dental hygiene profession in jeopardy and exposes the patient to possible harm injury and death.
FACTS:
A. The bacteria found in the gingiva (gums) are now associated with life threatening conditions such as diabetes, respiratory ailments, heart disease, low weight babies and premature births.
B. The recent actions taken by the ADA House of Delegates indicate that there is a growing effort on their part to increase preceptorship within States in the U.S. The policy making body of the ADA has voted to accept the Alabama Dental Hygiene Preceptorship Program. They have also voted to provide assistance to state dental societies that are trying to change their laws to make preceptorship legal and to urge state dental boards to accept on the job training as adequate preparation for direct dental hygiene care.
C. The state of Kansas has passed a law to allow dental assistants to clean teeth (prophylaxis) above the gum line. The NDHA conside rs this a cosmetic procedure that has no preventive or therapeutic value, or stop the threat of bacteria spreading throughout the body and creating harm, injury and death.
TOBACCO CESSATION
The National Dental Hygienist Association believes that smoking, chewing and dipping tobacco can cause more than bad breath (mal-odor) and stained teeth. Tobacco use can cause cavities, lesions and gum disease. It is the greatest contributor to oral cancer and death.
Conversely, NDHA believes that discontinuance of tobacco use is the greatest preventable contributor to oral and pharyngeal cancer.
The NDHA recognizes and supports the role of dental hygienists in tobacco cessation.
FACTS:
A. The use of tobacco in any form increases the chances of developing oral cancer.2
B. Placing smokeless tobacco or snuff on the oral mucosa for any significant period leads to tissue changes that may be malignant.2
C. More than 90% of cancers affecting the mouth, tongue, lips, throat, larynx and pharynx are attributable to tobacco use.1
D. Tobacco use combined with frequent alcohol consumption increases the risk for oral cancer.
1. U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Rockville MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institute of Health 2000.
www.surgeongeneral.gov/library/oralhealth
2. Wilkins, Esther M. Clinical Practice of the Dental Hygienist. Lea and Febiger, Williams and Wilkins Baltimore. MD.8th edition 2000.
3. CD. Preventing and Controlling Oral and Pharyngeal Cancer- Recommendations from a National Strategic Planning Conference - United States, 1996. MMWR 1998; 47:NoRR-14.
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