Dental Hygiene Regulation: A Comparison March 2013

Dental Hygiene Regulation: A Comparison March 2013 ~ 1 ~

Dental Hygiene Regulation: A Comparison Table of Contents Basic Information Number of Dental Hygienists Liability and Regulation Restorative Competencies Differences in Provincial Requirements Agreement on Internal Trade (AIT) Legitimate Objectives Services Grads 3-6 7-8 9 10 11-12 13-15 16-18 19-21 22-23 ~ 2 ~

Dental Hygiene Regulation: A Comparison Basic Information Province Licensing Body Year - Regulation became mandatory Year - selfregulation was achieved Year - selfinitiation was achieved Details pertaining to dentists supervision Legislation online Pending Regulation Changes Mandatory CDHA Membership Alberta College of Registered Dental Hygienists of Alberta 1990 1960 2006 http://www.qp.alberta.ca/1266. cfm?page=2006_255.cfm&leg_ type=regs&isbncln=0779751108 None Yes British Columbia College of Dental Hygienists of British Columbia (CDHBC) 1952 1993 1995 Clients must have been eamined by a dentist within the previous 365 days for a dental hygienist to provide services (as of July 2012 new category for DH eemption). www.cdhbc.com/pdf-files/ Tab-6.asp No Administer local anaesthesia, but may only do so under the supervision of a dentist or other emergency-trained professionals. Manitoba College of Dental Hygienists of Manitoba (CDHM) 1952 2005 2008 Supervision restrictions: dental hygiene services must be provided under the supervision of a dentist, unless a dental hygienist has practised dental hygiene for more than 3000 h and the client does not present with a comple medical condition. However included s can only be provided in certain settings. web2.gov.mb.ca/laws/ statutes/2005/c05105e.php and http://web2.gov.mb.ca/ bills/39-3/b018e.php No ~ 3 ~

Dental Hygiene Regulation: A Comparison Basic Information Province Licensing Body Year - Regulation became mandatory Year - selfregulation was achieved Year - selfinitiation was achieved Details pertaining to dentists supervision Legislation online Pending Regulation Changes Mandatory CDHA Membership New Brunswick New Brunswick College of Dental Hygienists / Ordre des hygienistes dentaires du Nouveau Brunswick 1950s 2009 Still under full supervision new rules pending (to no supervision), waiting for approval from Minister of Health. www.gnb.ca/0062/acts/bba- 2009/Chap-10.pdf IIncrease in continuing education credits (45 per 3 year cycle/60 for 4 or 75 for 5 years- we will be staggering cycles) -as of January 2013. Self initiation course - upon approvla of Rules- only those who wish to self-initiate. CPR requirements - as January 2013-Basic CPR once every three years. Anesthiestics Module -(upon approval of Rules) only those who wish to include this scope. No Newfoundland and Labrador Newfoundland Dental Board is in place until the new DH college forms in response to the 2010 legislation 1969 2010 In progress www.assembly.nl.ca/business/ bills/bill1017.htm Pending Yes ~ 4 ~

Dental Hygiene Regulation: A Comparison Basic Information Province Licensing Body Year - Regulation became mandatory Year - selfregulation was achieved Year - selfinitiation was achieved Details pertaining to dentists supervision Legislation online Pending Regulation Changes Mandatory CDHA Membership Northwest Territories Northwest Territories Professional Licensing, Government of Northwest Territories 1990 Regulated by Government The scope of for a dental hygienists includes the: performance of dental services of a preventative and educational nature; performance of dental prophylaes; application on teeth of topical flouride or other anticariogenic agents; rendering of first aid; and taking and developing -rays. www.hlthss.gov.nt.ca/english/ services/professional_ licensing/dental_hygienists. htm Yes Nova Scotia College of Dental Hygienists of Nova Scotia 1973 1990 1990 http://www.qp.alberta.ca/1266. cfm?page=2006_255.cfm&leg_ type=regs&isbncln=0779751108 None Yes Nunavut Government of Nunavut, Department of Health and Social Services - regulated by gov t due to small numbers of DHs Dental Auiliaries Act Dental Mechanics Act Dental Profession Act None No ~ 5 ~

Dental Hygiene Regulation: A Comparison Basic Information Province Licensing Body Year - Regulation became mandatory Year - selfregulation was achieved Year - selfinitiation was achieved Details pertaining to dentists supervision Legislation online Pending Regulation Changes Mandatory CDHA Membership Ontario College of Dental Hygienists of Ontario 1951 1994 2007 Since 2007 in Ontario, registrants who have been approved by the College of Dental Hygienists of Ontario can self-initiate their treatment; dental hygienists can now scale and root plane teeth and curettage surrounding tissues an order from a dentist www.hprac.org/en/projects/ resources/hprac-drug- CDHOsubmission2.pdf Limited-prescribing, dispensing, compounding and selling of drugs. No Prince Edward Island Dental Council of Prince Edward Island 1974 Regulated by government. Under Dental Act DH must be employed by or under contract with: a. an employer that employs or has established a formal referral or consultation process with a dentist; or b. a dentist. (If (a) means employed by the provincial government, it does apply, but not for other situations. (b) is the correct answer. www.gov.pe.ca/law/statutes/ pdf/d-06.pdf None No Quebec Ordre des hygiénistes dentaires du Québec 1975 1975 Before letting a DH perform an act, a dentist must ensure that the DH possesses sufficient knowledge and training to perform that act. A dentist must ensure the performance and quality of the act performed by a DH before the patient leaves his office. www.ohdq.com Regulation respecting the legal authorization to the profession of dental hygiene outside Quebec that give access to the permit of the Ordre des Hygienistes du Quebec. No Saskatchewan Saskatchewan Dental Hygienists Association 1950 1998 2000 DH must be employed by or practise under contract with: a. an employer that employs or has established a formal referral or consultation process with a dentist; or b. a dentist. www.qp.gov.sk.ca/documents/ English/Statutes/Statutes/ D4-1.pdf Yes Yukon Government of Yukon 1958 Regulated by government ~ 6 ~ www.gov.yk.ca/legislation/ acts/depr.pdf No

Dental Hygiene Regulation: A Comparison Number of Dental Hygienists Province Total no. of registered dental hygienists* (represents all individuals who are registered with the provincial regulating body. This count may include individuals in all registration categories (including active, inactive)) Total no. of active registered dental hygienists** (represents all registered/licensed individuals who are legally able to work under the title of the dental hygienist in the province.) Category of Membership Registered Restorative dental hygienists Eempt from 365 Day Rule Alberta Male: Female: Total: 2835 Male: Female: Total:2,638 34 British Columbia Male: Female: Total: 3,381 Male: Female: Total: 3,145 Manitoba Male: 28 Female: 739 Total: 767 (715 RDH, 52 Students) Male: 18 Female: 642 Total: 660 New Brunswick Male: 5 Female: 459 Total: 464 Male: 4 Female: 439 Total: 443 Newfoundland and Labrador Male: 9 Female:160 Total:169 Unavailable Northwest Territories Male: 3 Female: 19 Total: 22 Male: 3 Female: 19 Total: 22 Nova Scotia Male: 15 Female: 653 Total: 668 Male: 15 Female:608 Total: unavailable: 623 Nunavut Male: Female: 5 Total: 5 Unavailable Ontario Male: 216 Female: 10,909 Total: 11,125 Male: 196 Female: 9,698 Total: 9,894 ~ 7 ~

Dental Hygiene Regulation: A Comparison Number of Dental Hygienists Province Total no. of registered dental hygienists* (represents all individuals who are registered with the provincial regulating body. This count may include individuals in all registration categories (including active, inactive)) Total no. of active registered dental hygienists** (represents all registered/licensed individuals who are legally able to work under the title of the dental hygienist in the province.) Category of Membership Registered Restorative dental hygienists Eempt from 365 Day Rule Prince Edward Island Male: 1 Female: 97 Total: 98 Quebec Male: 117 Female: 5,340 Total: 5,457 Saskatchewan Male: 11 Female: 539 Total: 550 Yukon Male: 1 Female: 22 Total: 23 Total Male: 406 Female: 18942 Total: 25,564 Male: 1 Female: 97 Total: 98 Male: 117 Female: 5,333 Total: 5,450 Male: 11 Female: 539 Total: 550 Male: 1 Female: 22 Total: 23 Male: 366 Female: 17397 Total: 23,526 ~ 8 ~

Dental Hygiene Regulation: A Comparison Liability and Regulation Province Mandatory Professional Liability Coverage Amount ($) Alberta Yes $1 million per occurrence minimum British Columbia Yes $1 million per occurrence minimum Manitoba Yes $1 million per claim /$3 million yearly aggregate New Brunswick Yes $1 million per occurrence minimum (CDHA liability) Newfoundland and Labrador Northwest Territories Pending regulations Nova Scotia Yes Minimum aggregate of $ 2 million Nunavut Ontario Yes $1 million per occurrence with deductable of not more than $10 000. Prince Edward Island Yes $1 million Quebec Yes $1 milion Saskatchewan Yes $1 million per claim /$3 million yearly aggregrate Yukon ~ 9 ~

Dental Hygiene Regulation: A Comparison Restorative 1. Restorative 2. Temporary Restorative In conjuction with a dentist In conjunction with a dentist Independent of a Dentist e.g. Amalgam/composite resin; adapt and cement stainless steel crown, permentent cementation of bridges, veneers, inlays and onlays e.g. Temporary Crowns, temporary bridges, veneers, inlays and onlays ART (Atraumatic Restorative Treatment) Province ETP With additional education ETP With additional education ETP With additional education Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island n/a n/a Quebec Saskatchewan Yukon ~ 10 ~

Dental Hygiene Regulation: A Comparison Competencies Province Mandatory Continuing Competencies or Professional Development (PD) Points (pts) or hours (hrs) or credits Mandatory Clincial Practice Hours Alberta PD - minimum 45 credits /3 year minimum 600 hrs/3yr British Columbia PD - 5 year cycle with online testing that determines PD requirements None Manitoba Program includes self-directed assessment, goal setting, activities and evaluation/reflection. No points/ credits required. Two components of the : Educational Component: Each RDH will be required to set two goals each year (1 for the first year which is considered a learning year for everyone), and plan activities that help meet that goal; and Professional Component: Each RDH will be required to participate in a professional activity (for eample a CDHM or MDHA meeting, being a mentor, volunteering on boards, committees, volunteering at a community, or providing a presentation/ in a professional or community setting, etc) Forms will be submitted by each RDH documenting their activities both educational and professional and will be first due in April 2011, and yearly there after if audited. 600 hours /3yr New Brunswick Newfoundland and Labrador Increase to 45 in three years/60 in four years/75 in 5 years as of January 2013- we will be staggering reporting cycle for the net five years. PD: 30 credits /3 years 2 categories: 1. A. Scientific/Clinical (Courses) B. Scientific/Clincial (Hands On) 2. Other courses, equivalents or eperiences not included in C. 1 Northwest Territories Nova Scotia MCC- 45 credits/threeyear cycle : 3 categories ~ 11 ~

Dental Hygiene Regulation: A Comparison Competencies Province Mandatory Continuing Competencies or Professional Development (PD) Points or hours or credits Mandatory Clincial Practice Hours Nunavut Ontario Quality assurance includes portfolio maintenance Prince Edward Island 12 hrs / year Quebec 40 hours for 2 years with a minimum of 10 the first year Saskatchewan 50 credits /3 year reporting period. Personal Learning Tools completed for each CC activity Yukon ~ 12 ~

Dental Hygiene Regulation: A Comparison Differences in Provincial Requirements Province of Destination Province of Origin British Columbia Alberta Saskatchewan Manitoba Ontario Quebec NFLD &L Nova Scotia PEI New Brunswick Yukon NT Nunavut Alberta Language Restorative Ortho British Columbia CPR Language (1) Restorative Ortho (2) Manitoba Language New Brunswick CPR Anesthesia CPR Anesthesia Language Ortho? Board Eam Newfoundland & Labrador CPR Nonaccedited Nonaccedited Restorative Ortho Language Nonaccedited Northwest Territories ~ 13 ~

Dental Hygiene Regulation: A Comparison Differences in Provincial Requirements Province of Destination Province of Origin British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Newfoundland & Labrador Nova Scotia Prince Edward Island New Brunswick Yukon Northwest Territories Nunavut Nova Scotia CE Board eam Board eam anestesia Language Nunavut Ontario Language Require individuals who graduated from nonaccredited s who have not passed the national eam or equivalent to complete eam. Require individuals who graduated from nonaccredited s who have not passed the national eam or equivalent to complete eam. Prince Edward Island CPR anestesia CPR Language Ortho ~ 14 ~

Dental Hygiene Regulation: A Comparison Differences in Provincial Requirements Province of Destination Province of Origin British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Newfoundland & Labrador Nova Scotia Prince Edward Island New Brunswick Yukon Northwest Territories Nunavut Quebec* 3 Langauge Language Language Language Language Language Language Language Language Language Language Language Saskatchewan CPR Language Restorative Ortho Yukon Board eam Board eam Board eam Non-acredited Board eam Board eam Board eam Board eam Board eam Board eam Board eam 1 Not a barrier to intial licensure 2 Not a barrier to intial licensure 3 National Certification Eam (NDHCB) [BC, AB, SK, MB, ON, NL, and PEI] proficiency in English required in some jurisdictions ~ 15 ~

Dental Hygiene Regulation: A Comparison Agreement on Internal Trade (AIT) Legitimate Objectives Province/Web link Eception Province(s)/ Territory(ies) whose workers are affected Under which legitimate objective(s) is the measure being filed Rationale / Justification: Material Scope of Practice Difference Additional Requirement(s): Duration of the additional requirement(s): Alberta www.ait-aci.ca/labour_en/ eceptions_ab/dental%20 Hygienists%20-%20 Anaesthetic.pdf Anesthetic Ontario, Quebec, New Brunswick, Prince Edward Island, Newfoundland and Labrador, Yukon, and Northwest Territories Protection of human health The of dental hygiene in Alberta includes the administration of local anaesthesia (dental freezing) by injection. The administration of local by injection is not in the scope of for dental hygienists in any other Canadian jurisdictions with the eception of British Columbia and Saskatchewan. Alberta www.ait-aci.ca/labour_en/ eceptions_ab/dental%20 Hygienists%20Prescribing.pdf Prescribing ~ 16 ~

Dental Hygiene Regulation: A Comparison Agreement on Internal Trade (AIT) Legitimate Objectives Province/web link Eception Province(s)/ Territory(ies) whose workers are affected Under which legitimate objective(s) is the measure being filed Rationale / Justification: Material Scope of Practice Difference Additional Requirement(s): Duration of the additional requirement(s): Ontario www.ait-aci.ca/labour_en/ eceptions_on/dental%20 Hygienists.pdf Dental Hygienists Yukon and Nunavut Protection of human health and consumer protection. Graduation from an accredited Dental Hygiene and/ or successful completion of the national eam or equivalent demonstrates that an individual has the competencies required to perform to the Ontario dental hygiene scope of. Applicants from unaccredited s who have not passed the national eam or equivalent have not demonstrated the integration of their knowledge into independent. Require individuals who graduated from non-accredited s who have not passed the national eam or equivalent to complete eam. Indefinite Newfoundland No application made. New Brunswick No application made. ~ 17 ~

Dental Hygiene Regulation: A Comparison Agreement on Internal Trade (AIT) Legitimate Objectives Province/web link Eception Province(s)/ Territory(ies) whose workers are affected Under which legitimate objective(s) is the measure being filed Rationale / Justification: Material Scope of Practice Difference Additional Requirement(s): Duration of the additional requirement(s): Nova Scotia NL & Territories who allowed licences Clinical eam from non-accredited s PEI No application made. Quebec No application made. Saskatchewan www.ait-aci.ca/labour_en/ eceptions_sk/dental%20 Hygienist.pdf Administration of local by injection. Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Yukon, and Northwest Territories Protection of human health The of dental hygiene in Saskatchewan includes the administration of local (dental freezing) by injection. The administration of local by injection is not in the scope of for dental hygienists in any other Canadian jurisdictions with the eception of British Columbia and Alberta. ~ 18 ~

Dental Hygiene Regulation: A Comparison Services Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Residential Care Entry to Practice * Entry to Practice- Additional Education Required Dentist R required Supervision until rules approved Dentist must be onsite Not Permitted Local Entry to Practice Not Not yet permitted permitted Additional Education Required until Rules Perform independent of Dentist Dentist R required Dentist must be onsite Administration of nitrous oide/oygen conscious sedation Entry to Practice Additional Education Required Dentist R required Dentist must be onsite ~ 19 ~

Dental Hygiene Regulation: A Comparison Services Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Radiographs Entry to Practice Additional Education Required Dentist R required Dentist must be onsite Can prescribe independent of a dentist Interpret/ diagnose periodontal issues from radiographs interpret/ diagnose caries from radiographs * interpret Orthodontic Entry to Practice Additional Education Required Independent of a dentist Under the written order of a dentist Dentist must be onsite ~ 20 ~

Dental Hygiene Regulation: A Comparison Services Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Prescribing Antimicrobial agents Pending Antibiotics Pending Desenstizing agents Pending Anticariogenic agnents Pending Lasers Entry to Practice Additional Education Required Independent of a dentist Dentist R required Dentist must be onsite Sealants Apply Independent of dentist Apply with a dentist s R ~ 21 ~

Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Fluoride Varnish Apply Independent of Dentist Apply with a Dentist s R Myofunctional Therapy Additional Education required denture reline - chair side With dentist or denturist supervision No supervision required Alberta *prescribing of schedule 1 drugs used in DH treatment, with a prescriber ID # & CRDHA course - http://www.crdha.ca/linkclick.asp?fileticket=wzumkwbsiyu%3d &tabid=56&mid=416 British Columbia Dental hygienists providing orthodontic and prosthodontic services to their clients will have obtained education in their basic dental hygiene or through a post-diploma formal education course for the services being provided. Based on client need, this may include placing and removing temporary restorations, including provisional prosthodontic restorations, and performing orthodontic procedures. Manitoba *Residential care: in order to work in residential care a dentist Comments you must be on the Etended Practice Roster (must have worked at least 3000 career hours) Although the educational institutions in Manitoba offer LA as ETP, the registrar does not force registrants from outside provinces to obtain this education. Ortho and restorative: not offered within the dental hygiene education in MB, but can be completed as an additional module. New Brunswick Regulation changes pending for lasers and sealants. Nova Scotia Use of lasers is under review, Nitrous oide has not been reviewed by the CDHNS as of yet. ~ 22 ~ Nunavut Local : Under very limited conditions Ontario The prescribing services may be altered in the new year pending the results of CDHO s Drug Regulation. * DHs are trained to identify periodontal issues through radiographs and make apprirpatte referrals. Denture relining can be perofrmed under the supervision of a dentist or a dental technologists. Quebec Local : Requirement for licensure Other: Bleaching and production of bleaching trays

Dental Hygiene Regulation: A Comparison Grads Procedures for grads of non-accredited DH s (must have the following ) Procedures for Grads from Accretited DH Programs Province Accept registrants from non-accredited s NDHCB Eam Required Clincal Eam Must have Eisiting License in Another Province/ Territory NDHCB Eamination Required Clinical Eam (?) Alberta Yes Yes Yes - Alberta Clinical Eam No Yes Yes - if applicants qualifications & competencies not deemed substantially equivent to qualifications & competencies required for graduation from the AB approved - U of A British Columbia Yes Yes Yes - CDHBC Clinical Eam No Yes No Manitoba No (Not eligible; must be a grad from an accredited ) (Not eligible; must be a grad from an accredited ) (Not eligible; must be a grad from an accredited ) Yes New Brunswick Yes Yes Yes (pending) No Yes No Program must be in the process of accreditation Newfoundland and Labrador Northwest Territories Yes Yes Yes Yes No Yes Yes No Yes Yes No Nova Scotia Yes Yes No No Yes Nunavut Yes Yes No Yes Yes No Ontario Yes Yes Yes (non-accredited) Yes Yes No Prince Edward Island Yes Yes From another province Yes Yes No ~ 23 ~

Dental Hygiene Regulation: A Comparison Grads Procedures for grads of non-accredited DH s (must have the following ) Procedures for Grads from Accretited DH Programs Province Accept registrants from non-accredited s NDHCB Eam Required Clincal Eam Must have Eisiting License in Another Province/ Territory NDHCB Eamination Required Clinical Eam (?) Quebec No No Saskatchewan Yes Yes Yes No Yes Yukon Yes Yes No Yes Yes No Notes Alberta If applicants qualifications & competencies not deemed substantially equivent to qualifications & competencies required for graduation from the AB approved - U of A Quebec Only graduates from accredited s can register Yukon One can be licensed as a DH in Yukon by: 1) being licensed in another jurisdiction that is party to the Agreement on Internal Trade and supplying a copy of licence and letter of good standing from that jurisdicition 2) certificate of qualification by NDHB within past 2 years and a) graduate of accredited DH or b) granduate of non-accredited DH but must provide proof that the meets the eligibility requirements of NDHB (and we are told NDHB will not provide this) ~ 24 ~