Definition of Committee
the Dental Hygiene Committee of California (DHCC)
Definition of Dental Board
the Dental Board of California
Direct supervision
A set of procedures where The dentist must physically be present in treatment facility
General supervision
Procedures where the dentist does NOT need to be physically present in treatment facility
Oral prophylaxis
Preventative and therapeutic dental procedures that include
-- bacterial debridements with complete removal of supra and sub calculus, soft deposits, plaque and stains. And to smooth out tooth surfaces
What is the purpose of the prophylaxis
To create an environment for a patient to maintain healthy hard and soft tissues
Can an RDH perform
the same functions of an rda?
Yes
What does the practice of an rdh include
Dental hygiene assessment and development, planning and implementation of a dental hygiene plan.
It also includes oral hygiene education, counseling and health screenings
Dental hygiene does NOT include what
---Diagnosing or comprehensive treatment plans
---Placing, moving, condensing, carving, removing of permanent restorations
---surgery, or cutting on hard and soft tissue , removing teeth and cutting and suturing
--- prescribing meds
---administering local
What can an rdh do under direct supervision?
---Soft-tissue curettage
---Administration of local anesthesia
---Administration of nitrous oxide and oxygen, whether administered in tandem or alone.
What can an rdh do under general supervision
--- preventative and therapeutic interventions including : oral prophylaxis, scaling and root planing
---application of topical, therapeutic and subgingival agents used for the control of caries and periodontal disease.
---the taking of impressions for bl
What can an rdh do without any supervision
-Educational services
-Oral health training programs
-Oral health screenings
*rdh must refer any screened patients with abnormalities to a dentist to receive a comprehensive exam, diagnosis and a treatment plan
In a government public health program an rdh may provide without supervision the following:
-oral prophylaxis,srp.
-Fluoride application
-Pit and fissure sealants
* the rdh may submit insurance claims for the services provided under the public health programs.
No person shall be allowed to practice as a dental hygenist except for what Exceptions
---a student in a dental/dental hygiene school performing the curriculum.
---a dental assistant acting under the rules of the dental board may perform the following:
*taking impressions
*applying fluorides
*applying non-areosol and non caustic topical age
What is the timeframe required to notify the board if there are any name changes or address/email changes (1934)
The board must be notified within 30 days for all living address and email address changes
The board must be notified within 10 days of a name change
When does a license expire (1935)
12 midnight On the last day of the birth month of the applicant on the second year of a 2 year term
License is good for 2 years must renew prior to that day
Can you renew an expired license? (1936)
Yes, it must be renewed within 5 years of expiring by filing an application for renewal and paying accrued renewal and delinquency fees.
For what reasons may a license be revoked, suspended, or put on probations (1949)
Gross negligence,
Incompetence
Unprofessional conduct
Repeated acts of negligence
Receiving a license by mistake
Why may a licensee get their license revoked, suspended, reprimanded, or put on probation. (1950)
--If they have committed a crime that is substantially related to the licensees qualifications, functions or duties
When would the dhcc revoke, suspend, reprimand, or probate the license (1950)
*When the time to appeal has lapsed
*When the judgment for conviction has been affirmed on appeal
*When an order granting probation is made suspending the imposition of sentence, allowing a person to withdraw guilty plea and enter a plea of not guilty, or
When would the committee undertake proceedings under this section? (1950)
upon receipt of a certified copy of the record of conviction. A plea or verdict of guilty or a conviction following a plea of nolo contendere made to a charge of a felony or of any misdemeanor related to the licensee's qualifications, functions, or duties
Define Unprofessional conduct
See law 1950.5
When a licensee is placed on probation what could be the terms of probation (1951)
Requirement to receive additional training -or-
Requirement to pass an exam ( the exam can be written, oral, clinical , or practical. Or all) -or both-
If the probation is because of physical or mental issues, there may be an examination required by physi
It is unprofessional conduct in relation to controlled substances to do what (1952)
---Obtain or possess a controlled substance
---Use of a controlled substance, dangerous drug or alcoholic beverage to an extent or manner dangerous to himself, any person, or public.
---be convicted of a charge that is federal or state regarding a control
If a rdh performs a service on a patient what must they do to identify themselves (1953)
Name signature or identification number with initials must be written next to the services performed. All entries must be dated. (repeated violation is considered unprofessional conduct)
Is it illegal to establish ones self as being able to perform services that is beyond their scope of practice. (1954)
No but is considered unprofessional. This includes using a device or instrument in a manner that is different from standard practices of dental hygiene.
The exception is when conducting research.
It is against the law to provide care that discourages health. (1956)
True
It is unprofessional conduct to provide hygiene care that discourages necessary treatment, or permits clearly excessive, incompetent, unnecessary, or grossly negligent treatment
What could the punishment be for a misdemeanor crime (1958)
Not less than 10 days in a county jail, and not more than 1 year
Or by a fine that is not less than 100.00 or more than 1,500.00 or both fine and imprisonment
What are the ways that an rdh can be convicted of a misdemeanor (1958)
-- assumes the title of rdh without having the right to do so
--engages in rdh practice without displaying their license
--fails to furnish names and addresses of all employees in office within 10 days of demand
-- is under the influence of alcohol or con
If a person willfully, under circumstances that cause risk of bodily harm, serious physical or mental harm or death, practices, attempts to practice or advertises to practice may be convicted and sentenced to what? (1961)
Up to 1 year in jail
Who is accepted in the diversion program? (1966.1)
A- a licensee not under investigation may self refer
B- a licensee under investigation may request to participate in the diversion program by contacting the committee - may need to be evaluated for eligiblity and could still be disciplined.
*Unless ordere
Does participation in the diversion program mean that the committee cannot investigate or take disciplinary actions against the licensee? (1966.1)
No. They can still investigate or continue to investigate, or take disciplinary action or continuing to take disciplinary action against, any licensee for any unprofessional conduct committed before, during, or after participation in the program.
What if the reason for investigation is self-administration of any controlled substance, drugs, or alcohol, or the illegal possession, prescription, or procurement of any controlled substance or drug for self-administration that doesn't involve actual, di
The committee will close the investigation without further action if the licensee is accepted into a diversion program and successfully completes the program.
- The investigation shall be reopened and disciplinary action imposed, if warranted, by the comm
What happens if a participant withdraws or is terminated from the diversion program? (1966.1)
- If the licensee presents a threat to the public's health and safety, the committee will use the diversion treatment records in the criminal proceedings
- They are subject to disciplinary action by the committee for acts committed before, during, and aft
If a person is admitted into a diversion program what are their responsibilities and what could happen if they do not comply (1966.4)
They need to pay for all costs of the program ( unless the committee waives the fees) If they do not abide by the rules they may be terminated from the program
In regards to the subversion of licensing examinations what could the crime be and what can you NOT do (123)
The crime is a misdemeanor.
You can not
--remove materials from exam
--unauthorized reproduction of any exam materials
-- paying or using any paid examination takers to recreate portions of the test
--buying, selling, distributing any portion of a current
Other than misdemeanor penalties, and other associated penalties, what would a person found guilty of section 123 be liable for?
the actual damages sustained by the agency administering the examination not to exceed $10,000 and the costs of litigation.
In regards to enjoining violations (123.5)
Whenever any person has engaged, or is about to engage, in any acts or practices with constitute, or will constitute, a violation of section 123, the superior court for that county may issue an injunction, or other appropriate order, restraining such cond
When can a board deny, revoke, suspend, or restrict a license? (496)
when an applicant has violated Section 123 pertaining to subversion of licensing examinations.
A mandated reporter is defined as? (11165.7 a.)
a dental hygienist (21)
Are employers required to provide training for mandated reporters? (11165.7 c.)
No. They are strongly encouraged to though. They are required to provide employees who are mandated reporters with the statement required pursuant to subdivision (a) of Section 11166.5
Do you still have to report abuse if you haven't received training? (11165.7 e.)
Yes. The absence of training shall not excuse a mandated reporter from the duties imposed by this article.
What is the protocol for reporting abuse, reasonably suspected abuse or neglect of a child? (11166 a.)
They shall make an initial report by phone to the agency immediately or as soon as possible, and shall send, fax, or email a written followup report within 36 hours of incident.
What is reasonable suspicion? (11166 a.1)
it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing on their training and experience, to suspect child abuse or neglect.
---It doesn't require certainty or a
What if a mandated reporter fails to report abuse? (11166 c.)
They are guilty of a misdemeanor punishable by up to 6 months in county jail or by a fine of $1,000 or by both imprisonment and fine.
What if two people, who are required to report, have knowledge of suspected abuse? (11166 h.)
They will mutually agree who will make a single report. If that person fails to make the report, the other person should then make the report.
Is reporting the information to an employer the same as a mandated report? (11166 i.3)
No. You must report directly to the specified agency.
Health practioner according to 15610.37
is a dental hygienist
Who is a mandated reporter for elder abuse? (15630)
Any person who has assumed full or intermittent responsibility for the care or custody of an elder or dependent adult including a health practitioner (dental hygienist)
What is elder abuse?
physical abuse, abandonment, abduction, isolation, financial abuse, or neglect.
When and how should a mandated report be made of suspected elder abuse?
It should be reported immediately or as soon as possible by phone or through a confidential Internet reporting tool. If reported by phone, a written report must be sent within two working days.
See long-term care abuse for exceptions
What if the abuse happened in a long-term care facility?
If the suspected abuse results in serious bodily injury a phone report must be made immediately, and no later than 2 hours after.
If it doesn't result in serious injury, a phone report must be made within 24 hours and a written report must be made within
What if you fail to report or inhibit a report of elder abuse?
It is a misdemeanor and is punishable by max of 6 months in jail and $1,000
If the patient dies from that abuse or incurs great bodily harm, it shall be punished by max of 1 year in jail and $5,000
Or both fine and imprisonment
What are the requirements of continuing education (1017)
Dentists 50 hr
Rdh- 25 hrs
Rdh ap- 35 hours
2 units need to be infection control
2 units need to be for California Dental Practice Act
4 units max. of Basic Life Support
Can CEs be taken online or at home? (1017 h.&i.)
Yes but these materials (non-live instruction) cannot exceed 50% of the licensee's total required units.
Live interactive courses can be taken online and can be counted to make up the other 50%
How long do you have to keep CE certificates? (1017 n.)
3 renewal periods (6 years). You will need to forward these to the board upon an audit.
6 core principles of ethical dental care
1. Nonmaleficence
2. Veracity
3. Autonomy
4. Beneficence
5. Confidentiality
6. Justice
Nonmaleficence
Do no harm
Veracity
Our obligation to tell the truth
Autonomy
Pt's right to informed consent prior to treatment with full disclosure of relevant information to make an informed decision about treatment.
Beneficence
Do good - promote the well being of individuals and the public by engaging in health promotion/disease prevention activities
Confidentiality
Respect the confidentiality of client information and relationships. Do not share without pt. consent or legal need.
Justice
Fair and equal rights to quality and affordable oral healthcare
Compassion
Caring and the ability to identify with the patient's overall well-being. Acts of kindness and sympathy.
Competence
The competent dentist is able to diagnose and treat the patient's oral health needs and to refer when it is in the patient's best interest. It involves a commitment to continual learning and self-assessment.
Professionalism
Self-governance is the hallmark of a profession. All members must support and promote the profession in its service to the public. (Oral health initiatives for society)
Tolerance
Tolerance to diversity requires dentists to recognize cultural and ethnic differences and how they may affect patient choices and treatment
Informed Consent
A dentist has an obligation to obtain informed consent of the patient prior to treatment or the use of identifiable artifacts (photos, x-rays, study models). This includes:
Explanation of proposed treatment, reasonable alternatives, and the risk of not pe
Integrity
Requires the dentist to behave with honor and decency. He affirms core values and recognizes when words, actions or intentions are in conflict with one's values and conscience.
Standard Precautions
a group of infection prevention practices that apply to all patients, regardless of suspected or confirmed infection status, in any setting in which healthcare is delivered.
These include: hand hygiene, use of gloves, gown, mask, eye protection, or face s
Critical items
confer a high risk for infection if they are contaminated with any microorganism.
These include: all instruments, devices, and other items used to penetrate soft tissue or bone.
Semi-critical items
are instruments, devices and other items that are not used to penetrate soft tissue or bone, but contact oral mucous membranes, non-intact skin or other potentially infectious materials (OPIM)
Non-critical items
are instruments, devices, equipment, and surfaces that come in contact with soil, debris, saliva, blood, OPIM and intact skin, but not oral mucous membranes
Low-level disinfection
is the least effective disinfection process. It kills some bacteria, some viruses and fungi, but doesn't kill bacterial spores or mycobacterium tuberculosis var bovis (TB), a lab test organism used to classify the strength of disinfection chemicals.
Intermediate-level disinfection
kills TB indicating that many human pathogens are also killed. This process does not necessarily kill spores
High-level disinfection
kills some, not not necessarily all bacterial spores. This process kills TB, bacteria, fungi, and viruses.
Germicide
a chemical agent that can be used to disinfect items and surfaces based on the level of contamination
Sterilization
a validated process used to render a product free of all forms of viable microorganisms.
Cleaning
is the removal of visible soil (e.g., organic and inorganic material) debris and OPIM from objects and surfaces and shall be accomplished manually or mechanically using water with detergents or enzymatic products
Personal Protective Equipment (PPE)
specialized clothing or equipment worn or used for protection against a hazard. PPE items may include, but are not limited to, gloves, masks, respiratory devices, protective eyewear and protective attire which are intended to prevent exposure to blood, bo
Other Potentially Infectious Materials (OPIM)
means any of the following:
A. Human body fluids such as saliva in dental procedures and any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids.
B.
Dental Healthcare Personnel (DHCP)
are all paid and non-paid personnel in the dental healthcare setting who might be occupationally exposed to infections materials, including body substances and contaminated supplies, equipment, environmental surfaces, water, or air.
All DHCP shall comply with infection control precautions and enforce the following minimum precautions to protect patients and DHCP and to minimize transmission of pathogens in health care settings as mandated by California division of OSHA
1. Standard precautions shall be practiced in the care of all patients
2. A written protocol shall be developed, maintained, and periodically updated for proper instrument procession, operatory cleanliness, and management of injuries. the protocol shall b
What PPE should be worn?
- Surgical masks in combination with either chin length plastic face shield or protective eyewear whenever there is potential for aerosol spray, splashing or spattering.
- Chemical-resistant utility gloves and appropriate PPE shall be worn when handling h
What do you do with PPE after each patient?
Masks must be changed and disposed.
Face shields and eyewear should be cleaned, disinfected, or disposed.
Hand hygiene protocols
All DHCP must wash hands with soap and water at the start and end of each workday. They will wash contaminated or visibly soiled hands with soap and water and put on new gloves before treating patient.
If hands aren't visibly soiled or contaminated an alc
When should medical exam gloves be worn?
whenever there is contact with:
mucous membranes
blood
OPIM
during all:
pre-clinical
clinical
post-clinical
lab procedures
When should gloves be discarded?
when torn or punctured
upon completion of treatment
before leaving operatories
What type of glove should be worn to process contaminated instruments and sharps?
heavy-duty utility gloves
What is the protocol for needle recapping and disposal?
Needles shall be recapped only by using the scoop technique or a protective device. Needles and other sharps should be placed into sharps disposal containers as close as possible to the point of use.
*needles should never be bent or broken for disposal.
Sterilization Protocols
Cleaning must precede any disinfection or sterilization process.
Critical and Semi-Critical instruments and items shall be discarded or pre-cleaned, packaged or wrapped and sterilized after each use. If item is heat sensitive, it shall, at minimum, be pro
How often should you test sterilization devices?
at least once weekly with a biological indicator. Results should be documented and maintained for 12 months.
How should you clean non-critical items in operatory?
Items that are unable to be disinfected should be protected with an impervious barrier that would be changed after each patient and when visibly soiled.
All other surfaces should be disinfected with a hospital grade low to intermediate germicide after eac
What should be done daily with water/air lines?
They should be flushed for 2 minutes at beginning of the day before attaching handpieces or other devices. The lines and devices should be flushed between patients for at least 20 seconds.