Pursuant to section 11 of the Health Practitioners Competence Assurance Act 2003, this notice is issued by the Dental Council.
The following replaces the scope of practice for the "Scope of Dental Hygiene Practice" in the notice published in the
New Zealand Gazette, 17 March 2011, No. 32, page 872*.
Dental Hygiene
Scope of Dental Hygiene Practice
The scope of practice for dental hygiene is set out in the documented "Detailed Scope of Practice for Dental Hygiene Practice" produced and published from time to time by the Dental Council.
Dental hygiene practice is a subset of the practice of dentistry, and is commensurate with a dental hygienist’s approved education, training and competence.
A dental hygienist’s major role is in the provision of oral health education and the prevention of oral disease to promote healthy oral behaviours. A dental hygienist’s primary task is in prevention and non-surgical treatment of periodontal diseases. A dental hygienist guides patients’ personal care to maintain sound oral tissues as an integral part of their general health.
Dental hygienists practise in a team situation with clinical guidance provided by a practising dentist or dental specialist1, though some aspects of the scope of practice are provided under direct clinical supervision2.
Detailed Scope of Practice for Dental Hygiene Practice
The Dental Council defines the practice of dentistry as the maintenance of health through the assessment, diagnosis, management, treatment and prevention of any disease, disorder or condition of the orofacial complex and associated structures.
Dental hygiene practice is a subset of the practice of dentistry, and is commensurate with a dental hygienist’s approved education, training and competence.
A dental hygienist’s major role is in the provision of oral health education and the prevention of oral disease to promote healthy oral behaviours. A dental hygienist’s primary task is in prevention and non-surgical treatment of periodontal diseases. A dental hygienist guides patients’ personal care to maintain sound oral tissues as an integral part of their general health. Dental hygienists practise in a team situation with clinical guidance provided by a practising dentist or dental specialist, though some aspects of the scope of practice are provided under direct clinical supervision.
Dental hygiene practice includes teaching, research and management given that such roles influence clinical practice and public safety.
Dental hygiene practice involves the following aspects:
Provided under clinical guidance:
- Obtaining and reassessing medical and dental health histories.
- Examination of oral tissues and recognition of abnormalities.
- Assessing and provisionally diagnosing disease of periodontal tissues, and appropriate referral.
- Obtaining informed consent for dental hygiene care plans.
- Providing oral health education, information, promotion and counselling.
- Scaling, debridement and prophylaxis of supra and subgingival tooth surfaces.
- Applying and dispensing non-prescription preventive agents and fissure sealants.
- Applying and dispensing topical agents for the treatment of tooth surface sensitivity and tooth discolouration.
- Administering topical local anaesthetic.
- Taking impressions, recording occlusal relationships and making study models.
- Taking impressions, constructing and fitting mouthguards and bleaching trays.
- Taking intra and extra-oral photographs.
- Performing postoperative procedures such as removal of sutures and placement and removal of periodontal dressings.
- Recontouring and polishing of restorations.
- Taking periapical and bitewing radiographs for the purpose of recognising disease of the periodontium3.
- Taking extra-oral radiographs.
- Assisting the dentist or dental specialist in implementing orthodontic treatment plans, prepared by the dentist or dental specialist responsible for the patient’s clinical care outcomes, through performing the following orthodontic procedures:
- Tracing cephalometric radiographs.
- Supragingival polishing of teeth (as part of oral hygiene, before bonding and after removal of fixed attachments).
- Providing oral hygiene instruction and advice on the care and maintenance of orthodontic appliances.
- Making study models, and fabricating retainers, and undertaking other simple laboratory procedures of an orthodontic nature.
Provided under the direct clinical supervision of a dentist or dental specialist:
- Applying prescription preventive agents.
- Administering local anaesthetic using dentoalveolar infiltration and inferior dental nerve block techniques.
- Assisting the dentist or dental specialist in implementing orthodontic treatment plans, prepared by the dentist or dental specialist responsible for the patient’s clinical care outcomes, through performing the following orthodontic procedures:
- Placing separators.
- Sizing of metal bands and their cementation including loose bands during treatment.
- Preparation of teeth for the bonding of fixed attachments and fixed retainers.
- Indirect bonding of brackets as set up by the dentist or dental specialist.
- Placing archwires as formed by the dentist or dental specialist when necessary and replacing ligatures/closing self ligating brackets.
- Removing archwires after removing elastomeric or wire ligatures, or opening self ligating brackets.
- Removing fixed orthodontic attachments and retainers.
- Removing adhesives after the removal of fixed attachments using burs in slow speed handpieces where there is minimal potential for the removal of enamel.
- Trial fitting of removable appliances. This does not include activation.
- Fitting of passive removable retainers.
- Bonding preformed fixed retainers.
Key to Annotations
1Clinical guidance means the professional support and assistance provided to a dental hygienist by a practising dentist or dental specialist as part of the provision of overall integrated care to the patient group. Dental hygienists and dentists or dental specialists normally work from the same premises providing a team approach. Clinical guidance may be provided at a distance but appropriate access must be available to ensure that the dentist or dental specialist is able to provide guidance and advice, when required, and maintain general oversight of the clinical care outcomes of the patient group. Dental hygienists are responsible and accountable for their own clinical practice within their scope of practice but the dentist or dental specialist is responsible and accountable for the clinical guidance provided. Further detail on the working relationship between dental hygienists and dentists will be set out in the relevant Dental Council Code of Practice.
2Direct clinical supervision means the clinical supervision provided to a dental hygienist by a practising dentist or dental specialist when the dentist is present on the premises at the time the dental hygiene work is carried out.
3Section 15 of the Radiation Protection Act 1965 requires non-licensed persons who take x-rays to do so under the supervision or instructions of a person who holds a licence under that Act.
*New Zealand Gazette, 17 March 2011, No. 32, page 872