1. A partner for school based care Deborah Bailey Astroth, RDH, BS, Chair, Council on Regulation and Practice Colorado Dental Hygienists’ Association

3. Definitions Direct Access Dental Hygiene Practitioner: A proprietary business state where the dental hygienist retains ownership or control of a practice of dental hygiene through direct agreement with each client/patient in accordance with the statutory authority of this state. Colorado Dental Hygienists’ Association Policy Manual 3-02

4. Supervised Dental Hygiene Direct Supervision: Nitrous Oxide Administration Indirect Supervision: Administration of Local Anesthesia

5. What constitutes unsupervised dental hygiene? Patient histories Extra- and Intra-oral inspection Dental and periodontal charting X-rays Patient education Dental hygiene diagnosis and treatment planning Impressions and study casts Scales teeth with hand, ultrasonic or other devices, including root planing and gingival curettage Polishes natural and restored tooth surfaces Provides fluorides, sealants, and antimicrobial agents for the prevention treatment of oral disease Administers topical and local anesthesia May be the proprietor of a practice, and purchase equipment

6. Why a partner for school based care? Dental Hygiene Services: Education – nutritional counseling oral health care(brushing, flossing, rinsing) systemic & oral health relationship Prevention – oral health care fluorides sealants athletic mouthguards Treatment – assessment, radiographs, study casts dental hygiene diagnosis, anesthesia, prophylaxis, antimicrobials, referral

7. What a dental hygienist cannot provide Dental Services: Restorative procedures Surgical procedures Orthodontic procedures Prescriptive authority

8. Why a partner for school based care? A dental hygienist MAY be a proprietor A dental hygienist CAN provide educational, preventive and therapeutic services The dental hygienist CAN assist with referral into the dental care delivery system There ARE dental hygienists in counties where there are no dentists available who would like to pursue school-based care partnerships

9. CDHA Member Survey 2012 Are you interested in acquiring your own equipment to become a Direct Access Dental Hygienist? TotalCentral Region Northeast Region Southern Region Western Region Yes 36%38%42%25%44% N0 64%63%58%75%56%

10. School-based practice TotalCentral Region Northeast Region Southern Region Western Region % Very Interested/ Interested 76% 78%75%72% Neutral10% 5%17%14% % Somewhat Interested/ Not at all interested 14%13%19%8%14%

11. Prevent the need for costly restorative and surgical procedures Partner with Direct Access Dental Hygienists

12. Changes on the horizon Legislation is being introduced in January, 2013 for an oral health mid-level provider that would be able to perform limited restorative and surgical procedures, and would have prescriptive authority. The Dental Practice Law is scheduled for Sunset Review in 2014. The Colorado Dental Association and the Colorado Dental Hygienists’ Association are meeting to discuss possibly changes to be introduced.

13. Questions? Contact information Deborah Bailey Astroth, RDH, BS Dbastroth@aol.com 303-748-4713

15. Definitions “Premises” means within the same building, dental office, or treatment facility and within close proximity to respond in a timely manner to an emergency or the need for assistance. Dental Practice Law, 12-35-103 (10) (b)

16. Definitions Supervised Dental Hygiene: “Indirect supervision” means the supervision of those tasks or procedures that do not require the presence of the dentist in the office or on the premises at the time such tasks or procedures are being performed, but do require that the tasks be performed with the prior knowledge and consent of the dentist. Dental Practice law, 12-35-103, (10) (a)

17. Definitions “Dental hygiene diagnosis” means the identification of an existing oral health problem that a dental hygienist is qualified and licensed to treat within the scope of dental hygiene practice. The dental hygiene diagnosis focuses on behavioral risks and physical conditions that are related to oral health. A dentist shall confirm any dental hygiene diagnosis that requires treatment that is outside the scope of dental hygiene practice pursuant to sections 12-35-124, 12-35-125, and 12-35-128. Dental Practice Law, 12-35-103 (4.5)

18. Unsupervised Dental Hygiene Unsupervised Dental Hygiene: Not defined in the Dental Practice Law definitions, however, is defined in 12-35-124.What constitutes practicing unsupervised dental hygiene.

19. Definitions “Dental hygiene” means the delivery of preventive, educational, and clinical services supporting total health for the control of oral disease and the promotion or oral health provided by a dental hygienist within the scope of his or her education, training and experience and in accordance with applicable law. Dental Practice Law, 12-35-103, (4)