MPP Reception Tuesday, March 30, 2004
Dental Hygiene Act, 1991 Section 4 “ In the course of engaging in the practice of dental hygiene, a member is authorized, ...
Excerpts of Letter from the Ministry of Health to the Royal College of Dental Surgeons, et al “… it has been the Ministry’...
HPRAC Recommendations “ HPRAC recommends that the  Dental Hygiene Act  be amended to allow dental hygienists to perform th...
“ I am really sorry that the (dental hygiene order) file was  the one we didn’t complete. We were ready to do it, we just ...
“ We have expressed disappointment with the Tory government’s failure to act upon recommendations that have been received ...
Organizations Supporting Implementation of  HPRAC Recommendations Ontario Coalition for Senior Citizens’ College of Dentur...
Organizations Supporting Implementation of  HPRAC Recommendations Ontario Association of Non-Profit Homes Ontario Optician...
“ John has had three home visits for scaling in this past year, and I feel he is getting safe and professional care in a c...
“ I practice in three small towns in Northwestern Ontario. We employ two hygienists. Occasionally the hygienists will work...
Letter to the Premier, March 5, 2004 Dear Premier:   For several years, I have been following the twists and turns of the ...
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MPP Reception Tuesday, March 30, 2004

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MPP Reception Tuesday, March 30, 2004

  1. 1. MPP Reception Tuesday, March 30, 2004
  2. 2. Dental Hygiene Act, 1991 Section 4 “ In the course of engaging in the practice of dental hygiene, a member is authorized, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following: 1. Scaling teeth and root planing including curetting surrounding tissue. 2. Orthodontic and restorative procedures.” Section 5 “ (1) A member shall not perform a procedure under the authority of section 4 unless the procedure is ordered by a member of the Royal College of Dental Surgeons of Ontario. (2) In addition to the grounds set out in subsection 51(1) of the Health Professions Procedural Code, a panel of Discipline Committee shall find that a member has committed an act of professional misconduct if the member contravenes subsection (1).”
  3. 3. Excerpts of Letter from the Ministry of Health to the Royal College of Dental Surgeons, et al “… it has been the Ministry’s expectation that under general orders, dental hygienists would be free to practice many components of their scope of practice much more autonomously than in the past. This would include aspects of practice in both institutional and community settings.” “ It is the Ministry of Health’s wish that the two professions…see that all other issues related to “orders”, “delegation”, or “assigning” intra-oral duties are addressed in a way that is acceptable to the professions, to the Ministry, and meets the test of serving the public interest, as opposed to any professional self-interests.” Alan Burrows, Director Professional Relations Branch Ministry of Health November 30, 1993
  4. 4. HPRAC Recommendations “ HPRAC recommends that the Dental Hygiene Act be amended to allow dental hygienists to perform their authorized acts of scaling teeth and root planing including (incidental) curetting of surrounding tissue without an order …” “ In HPRAC’s view, an appropriate starting place to develop an exemption regulation would be the CDHO’s proposed amendment to the Dental Hygiene Act, 1992, and the RCDSO protocol.” “ Accordingly, the RHPA exemption regulation might take the following form as an amalgam of proposed amendment and the protocol regulation: 1. A member of the College of Dental Hygienists of Ontario, is exempt from subsection 27(1) of the Act, for purposes of carrying on self-initiation of scaling teeth, root planing including incidental curretage of surrounding tissues…” Health Professions Regulatory Advisory Council (HPRAC) Report to the Minister of Health “ Dental Hygiene Referral”, May 1996
  5. 5. “ I am really sorry that the (dental hygiene order) file was the one we didn’t complete. We were ready to do it, we just ran out of time.” Steve Gilchrist, Co-chair Red Tape Commission October, 2003
  6. 6. “ We have expressed disappointment with the Tory government’s failure to act upon recommendations that have been received from HPRAC regarding dental hygienists. In government, we are committed to acting on the HPRAC recommendations.” Dalton McGuinty Leader of the Ontario Liberal Party September 29, 2003
  7. 7. Organizations Supporting Implementation of HPRAC Recommendations Ontario Coalition for Senior Citizens’ College of Denturists of Ontario Organizations (OCSCO) Concerned Friends of Ontario Citizens Ontario Association of Social in Long-Term Care Facilities Workers Registered Practical Nurses Association Ontario Association of Public Health of Ontario (RPNAO) Dentistry Retired Teachers of Ontario ALS Society of Ontario Haldimand-Norfolk Women’s Services Denturist Association of Ontario CHC Lanark County Ontario Physiotherapy Association Good Shepard Centres Association of Ontario Midwives Trillium Court Seniors Community Ontario Association of Medical Radiation Technologists
  8. 8. Organizations Supporting Implementation of HPRAC Recommendations Ontario Association of Non-Profit Homes Ontario Opticians Association and Services for Seniors Ontario Society of Chiropodists John Noble Home (Brantford) Ontario Speech Language Association … and many individuals.
  9. 9. “ John has had three home visits for scaling in this past year, and I feel he is getting safe and professional care in a completely stress free setting. Both dentist and hygienist were careful about providing this service quietly, in case the Royal College of Dental Surgeons should step in and force the dentist to rescind the order. It seems incredible to me that this should be necessary, knowing first hand the need for this type of care, and being aware of the extensive training and professionalism of dental hygienists.” “… the fact that there must be an order for scaling will surely impede others from receiving professional oral hygiene care in their homes.” Sheila E. Land Concerned Caregiver December 16, 2002
  10. 10. “ I practice in three small towns in Northwestern Ontario. We employ two hygienists. Occasionally the hygienists will work without the dentist present. Further restrictions with respect to orders will result in decreased service or interruption in services in areas of the province where basic dental needs are very high. Dr. Matthew Walkiewicz, DDS February 22, 2002
  11. 11. Letter to the Premier, March 5, 2004 Dear Premier:   For several years, I have been following the twists and turns of the so-called "order" issue as it applies to dental hygienists in Ontario. To refresh your memory, the Dental Hygiene Act, 1991 as currently drafted requires a dental hygienist to obtain an order from a dentist before the dental hygienist may perform the authorized act of "scaling, root planing and curetage". Laypersons understand this as teeth cleaning.   As a dentist, I can tell you that such orders are being used by my profession to ensure that dental hygienists can only be employed by dentists and that oral hygiene care can only be provided in conventional dental practices, for fees set by and paid to dentists. Orders advance the economic interests of dentists. They are not necessary to protect the public. I believe that the Health Professions Regulatory Advisory Council (HPRAC) came to this conclusion in 1996.   My personal experience is relevant here. In 1995 I had a very severe stroke and was in a coma for an extended period of time. My oral care was neglected and I contracted pneumonia. Fortunately, I was young and healthy prior to my stroke and my body was able to fight off the bacteria. However, pneumonia would never have occurred if I had been able to obtain the services of a dental hygienist.   My elderly mother had a similar experience. After an accident at home she was confined to Sunnybrook Hospital. Prior to her confinement she had excellent oral hygiene. Subsequent to her accident, her oral condition deteriorated because we could not secure the services of a dentist and no dental hygienist could provide the care necessary without a dentist's order. We were very concerned that she would lose her teeth due to an advancing periodontal condition or, even worse still, contract life-threatening pneumonia because of the spread of bacteria from her gums to her lungs. This phenomenon has been documented by Dr. Hardy Lineback of the University of Toronto and I commend his research to your attention.   Regrettably, my mother's experience is all too common for residents of long-term care facilities and the homebound for whom the order requirement deprives them of access to necessary oral hygiene care.   I am writing to urge you to implement the HPRAC recommendations without further delay. It is a simple and zero-cost answer to a serious and growing problem. I know that dentistry will mount considerable opposition in order to protect its commercial interests, but that should not deter you. Dr. Howard Rocket, DDS March 5, 2004

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