NEW ZEALAND GAZETTE, No. 200

22 DECEMBER 2011

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 periodontium.
• 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.