The Dental Hygienists’ Association of Australia Inc. through supportive leadership, advocacy, education and mentoring seeks to provide a network to encourage and empower dental hygienists to develop lifelong learning through professional development…Continue Reading
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DHAA Inc. Submission AWPA updating advice on SOL - 22/11/2013
Read the latest DHAA Submission: Australian Workforce and Productivity Agency (AWPA) updating advice on the Australian Government’s Skilled Occupation List (SOL) in the members area.
21st November 2013
Dental Hygienists’ Association says CPD is a wasted opportunity unless accompanied by translational research
The Dental Hygienists’ Association of Australia (DHAA) Inc. has called for professional associations, educators and policy-makers to collaborate in ‘translational research’ to ensure evidenced-based research knowledge gained through continuing professional development (CPD) results in changed clinical practice.
At present, it can take 15 years for this conversion to occur. Professor Ian Chubb reported in 2012 that, ‘it takes 6.3 years for evidence to reach reviews, papers and textbooks. On average it then takes an additional 9.3 years to implement evidence from reviews, papers and textbooks into clinical practice’.1
The DHAA Inc. recognises the value of CPD, currently being reviewed by the Dental Board, in ensuring awareness of new science or ‘declarative knowledge’.2 However, CPD alone will not improve patient outcomes; a practitioner’s cognitive processes must change in order for this new knowledge to become adopted evidenced-based practice, with the ability to impact positively on patient health outcomes.3 This requires investment in translation research and enhanced collaboration between oral health professional associations, educational and research institutions, industry and policy makers.
Translational research refers to the implementation of new knowledge, effective use of treatments, interventions and guidelines designed for populations actuated by health care providers.4 Translation research is conducted in community and clinical care settings such as private and public dental clinics.5
Speaking at the DHAA Inc.’s National Symposium in Perth this week, National President, Hellen Checker, encouraged a new mindset towards CPD. “Rather than viewing CPD as an obligation of registration, health professionals and associations should collaborate to enhance its value by implementing the knowledge gained. We need to address organisational inertia, infrastructure and resource constraints.6 If we place a high value on implementing evidenced based practice, we are more likely to see positive, measurable improvements in patient health outcomes – DHAA Inc.’s ultimate goal.”
Patricia Chan, DHAA Inc. National Administrator, 0433 480 860 or President@dhaa.asn.au
1 Can Australia Afford to Fund Translational Research? Professor Ian Chubb’s keynote address to the Bio-Melbourne Network on 3rd April 2012.
2 Titler, M. 2007, ‘Translating research into practice: Models for changing clinician behaviour,’ The American Journal of Nursing, 107, 6, 26-33
4 Woolf, S. 2008, ‘The meaning of translational research and why it matters,’ JAMA: the journal of the American Medical Association, 299, 2, 211-213
Take 5 minutes and complete the oral health survey being conducted by HWA: click here to complete the survey
Understanding your Scope of Practice
The DHAA Inc. will update members on the Scope of Practice review consultation when finalized. However it is essentially your responsibility to recognize your individual and institutional Scope of Practice.
Scope of practice can be easily identified by three categories.
If requirements for practicing a profession satisfy all three requirements then it is within that person’s scope of practice:
1. Education and training — Is the person academically educated, trained and competent to perform a specific service or clinical duty by an ADC accredited and DBA approved course? Does the person possess an approved qualification?
2. Governing bodies — Does the National Law and the Standards, Codes and Guidelines of the Dental Board of Australia that govern the profession allow the person to perform the duty in question?
There are also State based legislations that also determine Scope of Practice. These include, but not limited to laws pertaining to the use of controlled substances such as local anesthesia, whitening and radiography.
These laws are established under state and territory drugs and poisons legislation, radiology legislation and the requirements of the Australian Competition and Consumer Commission (ACCC) and the Therapeutic Goods Administration (TGA).
Drugs and poisons Legislation sets out the regulatory mechanisms relevant to a dental practitioners’ capacity to possess, prescribe/supply and administer medications in Australia.
3. Institution —Does the institution allow a person or their profession to do the item in question?
Essential Links to understand your Scope of Practice: (Please also review your competed Curriculum)
Reminder from Dental Board of Australia
The National Board reminds all dental practitioners to be aware of and comply with ALL relevant regulatory requirements not just those that the National Board develops. This includes, but is not limited to, those established under state and territory drugs and poisons legislation, radiology legislation and the requirements of the Australian Competition and Consumer Commission (ACCC) and the Therapeutic Goods Administration (TGA).
Tooth whitening/bleaching. The DBA have published an interim policy that states:
Teeth whitening/bleaching, is an irreversible procedure on the human teeth and any tooth whitening/bleaching products containing more than 6% concentration of the active whitening/bleaching agent, should only be used by a registered dental practitioner with education, training and competence in teeth whitening/bleaching. It is the ACCC’s position that dentists cannot supply patients’ take-home teeth whiteners above 6%. We advise practitioners to review the ACCC’s bulletin published on their website. This bulletin provides information for consumers about hydrogen peroxide and carbamide peroxide in DIY teeth whitening products for use at home including hazards associated with their use. It also assists suppliers of these cosmetic goods to ensure products they supply are safe and comply with the law.
National Law objectives are:
“to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.”
“It is relevant to note that the National Law provides for the protection of the public through the protection of titles …Section 117 of the National Law prohibits a person from knowingly or recklessly taking or using any title that could be reasonably understood to induce a belief that the person is registered in a health profession or a division of a health profession in which the person is not registered. “
“Section 116 of the National Law prohibits a person who is not a registered health practitioner from knowingly or recklessly taking or using a title that, having regard to the circumstances, indicates or could be reasonably understood to indicate the person is a registered health practitioner, or authorised or qualified to practise in a health profession”
DHAA Inc. advises all members the use of RDH is not permitted under National Law and is not acceptable to the Dental Board of Australia.
20th September 2014
Hope for Scope
The Comprehensive Primary Health Care Model Changes to the scope of practice should reflect the alignment of dental hygiene and oral health therapy services with the Comprehensive Primary Health Care Model, which emphasizes working within multi-disciplinary teams and multi- sectorial collaborations. Endorsing dental hygiene services in this way will remove one of the most significant barriers to direct public access to preventive oral health services, which would in turn help to reverse the decline in public oral health. These are key reforms identified by Health Workforce Australia, which recognizes that the public needs access to preventive dental services in community settings.
The scope of practice standard to facilitate delivery of primary health care is the first step in the paradigm
shift necessary for economically responsible dental service delivery and workforce training and utilization. The Comprehensive Primary Health Care Model is highly adaptable to
community settings and congruent with the scope of practice requirement for supportive structured professional relationships to expedite the cross referral process.
The standard and guidelines need to vigorously emphasize a preventive model with direct access to primary preventive dental providers such as dental hygienists and oral health therapists working in unsupervised community settings. Denying this, or giving only lukewarm support as an add-on to restorative services, is to deny long-suffering population groups the right to oral health.
Dental hygienists, dental therapists and oral health therapists are autonomous professionals who work collaboratively when required as part of the professional dental team. It needs to be made clear, both to dental practitioners and the public, that dental hygienists, dental therapists and oral health therapists are extensively trained professionals, properly qualified and registered and possessing the expertise needed to perform their roles
Many countries around the world recognize the value of preventive dental care and place a high community value on preventive dental services. Many encourage direct access, meaning citizens may see a dental hygienist without first having to see a dentist. In Ontario, Canada, Bill 171 was introduced in 2007 which allows the public to access the dental services of registered dental hygienists. Other counties with similar legislation the United Kingdom, Netherlands, New Zealand and Scandinavian countries including Sweden and Norway and many states in America, where dental hygienists have recently celebrated the centenary of their profession. The recent recommendations from the Australian parliament are in keeping with international, evidence- based trends
Dental Board of Australia’s meeting held on 30 August 2013 is now available on the Board’s website by clicking here
The Dental Hygienists Association of Australia Inc.
To Members of the Public
Dear valued community member,
Thank you for visiting the website of the DHAA Inc., which represents registered dental hygienists and oral health therapists.
A recent Australian parliamentary inquiry has made recommendations to improve access to dental services. These recommendations are fully supported by our members but have caused some one-sided, negative press, which did not include any attempt to balance its claims by inviting our comments. We hope this letter explains the very sensible recommendations of the parliamentary inquiry and reassures you that our services are of the highest standard.
The first relevant recommendation of the Inquiry into Adult Dental Services is that dental hygienists and oral health therapists should be given provider numbers, so that our patients can claim Medicare or health insurance rebates, and that it should be possible for patients to make appointments directly with us rather than going through a dentist. This would allow people to access and claim for dental hygiene services, just as they do for physiotherapy, podiatry, optometry, speech therapy and any number of other services.
The second recommendation is that dental hygienists and oral health therapists should be able to practice without the direct supervision of a dentist. In reality, this already happens and has done for many years. ‘Supervision’ is currently interpreted very loosely, meaning the ‘supervising dentist’ may be working in a dental practice in one suburb, whilst the dental hygienist is carrying out preventive dental services in community settings such as aged care homes. The Inquiry has responded to existing practice by recommending that dental hygienists should be enabled to carry out these vital primary preventive dental services in many community locations without a dentist present but that close ties should exist between members of the dental team.
This means we would refer patients in need of more extensive treatment to a dentist but would be able to fulfill our own role to the full extent of our training. This role includes assessment (taking of radiographs, periodontal charting, and dental examination), formulation of a treatment plan, management of clients, evaluation of responses to treatment and adjusting the treatment plan as necessary. Wider roles include advocacy, oral health promotion, research, teaching and dietary counselling. Dental hygienists already have the capacity and qualifications to fulfill these roles.
We are already senior members of the dental team. The closest comparisons to our profession would be nurse practitioners or senior midwives, who work as part of broader multi-disciplinary teams but are trained and trusted to practice within their areas of expertise.
Dental hygienists and oral health therapists are extensively trained dental professionals, who specialise in preventing dental disease. Our training includes health sciences, human biology, anatomy and physiology, microbiology, pathology, oral medicine, dental medicine, pharmacology, dental materials, periodontics, risk factors, etiology of disease, cariology, orthodontics, paediatric dentistry, geriatric dentistry, special needs dentistry, oral health promotion and education, dental public health, preventive dentistry, community dentistry, minimal intervention, dental radiography, temporary restorations, local anaesthesia and clinical practice, including examinations, diagnosis and treatment planning and delivery within scope of practice.
The extra two years of training undertaken by dentists equip them to undertake more complex restorative procedures, which dental hygienists do not do. But, as regards preventive dental care, we believe our skills are more than equal to those of a dentist.
DHAA Inc. believes we need a paradigm shift to a preventive model of care, with dental hygienists providing outreach services in community settings in order to promote oral health and prevent costly and painful dental disease. We need to combat the existing ‘drill and fill’ mentality by utilising dental hygienists and oral health therapists in the primary prevention and treatment phase. This empowers the patient through education, oral health instruction and practice, diet and exercise recommendations and preventive care for dental diseases. Ultimately, people become advocates for their own oral and general health.
Many countries around the world recognise the value of preventive dental care and place a high community value on preventive dental services. Many encourage direct access, meaning citizens may see a dental hygienist without first having to see a dentist. In Ontaria, Canada, Bill 171 was introduced in 2007 which allows the public to access the dental services of registered dental hygienists. Other counties with similar legislation include England, Scotland and Wales, the Netherlands, Scandinavian countries including Sweden, and many states in America, where dental hygienists have recently celebrated the centenary of their profession. The recent recommendations from the Australian parliament are in keeping with international, evidence- based trends.
The DHAA Inc. wishes to thank you for your continuous trust and support for primary care oral health professionals. We have provided the public with the highest standard of quality preventive care for more than 40 years in Australia. The DHAA Inc. has an impeccable public safety record, treating patients in environments without a dentist present. Our members have the highest regard for public safety and work within our scope of practice (meaning we only perform procedures for which we have formal Dental Board Approved training).
The existing legislation frustrates our efforts to provide preventive, community based dental care. There is a high level of unmet need and the existing system creates artificial bottlenecks by requiring patients to see a dentist firsrt. It is difficult for people to access our services in community settings (not everyone can easily get to a dental clinic), and it is frustrating to many people that they cannot easily claim rebates for our services, when they are used to doing so for almost every other type of health care. We are pleased that there are proposals to change these restrictions so that we can improve access to safe, high quality, preventive dental treatment for all Australian citizens.