Governmental Affairs Division
The Dental Hygienists’ Association of the State of New York (DHASNY) is the legislative and advocacy voice for thousands of dental hygienists’ in New York. We represent a broad array of dental hygienists – those in private clinical practice as well as those in dental public health; dental and dental hygiene educators, corporate representatives and researchers.
Through an active Governmental Affairs Division, we are working to advance the profession in areas of education, licensure and practice, as well as improve the oral health status of all New Yorkers.
We focus on assuring the dental hygienists’ role in the promotion of oral health as part of overall health and in disease prevention activities and preventive oral health services.
DHASNY, in coordination with its Vice President of Governmental Affairs, Director of Policy and Advocacy, association members and public and private partners, works with NYS policy-makers to shape oral health policy to address ongoing oral health concerns such as ensuring access to preventive oral health care, advocating for funding for dental public health programs and services; ensuring a workforce to meet current and future needs; and eliminating oral health inequities and disparities.
The Governmental Affairs Division monitors emerging policy issues in both health and oral health and works with to assure a strong presence in the New York State policy-making arena.
General Supervision of Dental Hygienists in
New York
Education Law, Article 133, the Dental Hygiene Practice Act states, “[the] practice of dental hygiene…must be done under the supervision of a licensed dentist.” Beyond that statement, the Practice Act is silent on the required level of supervision. Regulations of the State Education Department, however, provide detailed guidance as to the required level of supervision for the practice of dental hygiene.
Personal supervision is clearly the more restrictive of the two levels of supervision and is not an area of confusion for dentists or dental hygienists in New York. The definition of general supervision envisions a level of supervision more flexible than “personal supervision”. New York regulations list the assigned procedures for both general and personal supervision; general supervision is assigned to less invasive procedures. Further, unlike the definition of personal supervision, general supervision does not include a requirement that the dentist be in the dental office or facility nor does it include “personally” before the term “consultation, diagnosis, and evaluation.” The New York State Education Department states that “General supervision does not mandate that the employing dentist be physically present in the office at all times.” And “The relationship between the dentist and the dental hygienist requires that professional judgment be exercised [when determining professional competence in general supervision situations].”
An explanation and interpretation of every Dental Hygiene Practice Act by a U.S. government agency was released in 2004 by The U.S. Department of Health and Human Services (HRSA). HRSA was charged with evaluating the professional practice of dental hygiene based on a detailed examination of individual state laws, statutes, and regulations as they stood in 2001. It should be noted that the professional associations in each state were not involved in assisting in the interpretation of state law. The result of the HRSA report for the practice of dental hygienists in New York finds that in dental offices, long term care facilities/skilled nursing facilities, public or private schools, public health agencies/federally qualified health centers, correctional facilities, and public institutions/mental health facilities general supervision is the required level of supervision, furthermore, the report states that "no requirement for prior exam by a dentist” be performed before the dental hygienist provides services allowed in all of these settings. The HRSA report further analyzed certain dental hygiene services allowed in regulation including prophylaxis, fluoride application, sealant procedures and taking of radiographs. For New York dental hygienists, the HRSA report states that the “physical presence of [the supervising] dentist [is] not required” for prophylaxis and scaling/root planning, fluoride treatment, sealant application, and exposure of x-rays.”
DHASNY is committed to ensuring that dental hygienists provide professional, preventative, safe, and accessible dental hygiene services to all New Yorkers as is the original intent of Education Law, Article 133 and defined by the regulations of the Commissioner of Education. The dentist and dental hygienist should consider their professional obligations as established by New York law which prohibit the performance of professional practice beyond their competence.
Dental Hygiene Diagnosis Position Paper
The dental hygiene diagnosis provides the foundation for the development, implementation, and evaluation of the dental hygiene treatment plan. In order to provide comprehensive quality oral health care, it is the professional obligation of dental hygienists to formulate a dental hygiene diagnosis.
Purpose
The American Dental Hygienists’ Association (ADHA) and the Dental Hygienists’ Association of the State of New York, Inc. (DHASNY) recognizes that the dental hygiene process of care includes assessment, diagnosis, planning, implementation, and evaluation.1 Further, ADHA and DHASNY supports educational curricula that lead to competency in the dental hygiene process of care.2 Therefore, the position of ADHA and DHASNY is that dental hygienists, by virtue of graduation from an accredited dental hygiene program, are educationally prepared to conduct a dental hygiene diagnosis and that the formulation of a dental hygiene diagnosis is the responsibility of the dental hygienist in the delivery of quality oral health care.
Definitions
Diagnosis has been defined as “an analysis of the cause and nature of a problem or situation, or a statement of its solution.” Diagnosis is considered a generic term describing a process used by many professions and should not be considered the domain of any one health profession.
Dental hygiene diagnostic models tend to follow nursing diagnostic models by further focusing on the overall health of the patient/client. Widely recognized dental hygiene experts and textbook authors have formally developed theory, models, and definitions for the dental hygiene diagnosis. Darby and Walsh defined the dental hygiene diagnosis using a human need theory as “the identification of a client’s human need deficit related to dental hygiene care. A professional dental hygiene diagnosis is a clinical diagnosis made by a dental hygienist that identifies an actual or potential human need deficit related to oral health or disease that the dental hygienist is educated and licensed to treat.”3
Wilkins defines the dental hygiene diagnosis as “the identification of an existing or potential oral health problem that a dental hygienist is qualified and licensed to treat.”4
Supporting Evidence
The Accreditation Standards for Dental Hygiene Education Programs as approved by the American Dental Association Commission on Dental Accreditation (ADA CDA) also recognize the dental hygiene process of care which includes the dental hygiene diagnosis in Standard 2-19.5
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Standard 2-19 Excerpt:
Standard 2-19 Graduates must be competent in providing the dental hygiene process of care, which includes: Planning—the establishment of realistic goals and treatment strategies to facilitate optimal oral health
a. dental hygiene diagnosis
b. dental hygiene treatment plan
c. informed consent
d. dental hygiene case presentation.
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The American Dental Education Association (ADEA) Competencies for Entry into the Profession of Dental Hygiene describe the abilities expected of a dental hygienist entering the profession.6 The ADEA competencies include the dental hygiene diagnosis within the patient/client care competencies, which defines dental hygiene diagnosis as “the use of critical decision making skills to reach conclusions about the patient’s/client’s dental hygiene needs based on all available assessment data.”
Conclusion
The formulation of the dental hygiene diagnosis is a vital component of the dental hygiene process of care. Dental hygienists practicing collaboratively with patients/clients and other professional members of interdisciplinary health care teams are prepared to analyze and synthesize patient assessment data as part of the diagnostic process. The dental hygiene diagnosis provides the foundation for the development, implementation, and evaluation of the dental hygiene treatment plan. In order to provide comprehensive quality oral health care, it is the professional obligation of dental hygienists to formulate a dental hygiene diagnosis.
References
1. American Dental Hygienists’ Association: Policy 18-96 Glossary; 1996.
2. American Dental Hygienists’ Association: Policy 16-93 Education; 1993.
3. Darby M, Walsh M. Dental hygiene theory and practice, 2nd ed. St. Louis (MO): Saunders; 2003.
4. Wilkins E. Clinical practice of the dental hygienist, 7th ed. Malvern (PA): Williams & Wilkins; 1994.
5. American Dental Association Commission on Dental Accreditation. Accreditation standards for dental hygiene education programs. Chicago (IL): American Dental Association; 1998.
6. American Dental Education Association. Exhibit 7: competencies for entry into the profession of dental hygiene. J Dent Educ 2004;68(7):745-749.
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New York Hygienists’ Political Action Committee
NY HYPAC
Dear Colleagues:
NY HYPAC is a separate organization from DHASNY and was formed as a political action committee. The objective of the PAC is to raise money that is used to contribute to various legislators’ campaigns, particularly those that are sympathetic to the issues of our profession.
Political action committees are a fact of political life. Those legislators that we support financially are those that we count as “friends of Dental Hygiene” and we look to ensure their viability in the legislature.
You are aware that not only within New York State, but nationwide, Dental Hygiene is being challenged – educational standards, scope of practice issues, access to care issues, protection of our profession and more every day.
In order to maintain and improve the standards of our profession, it is imperative that we are visible within the legislative arena and that means political action and money! We encourage you to get involved with the political scene – both at a state level and at your own local level. Making friends within the political arena is imperative to advancing our agenda. Get involved with local campaigns, stuff envelopes, man telephones, and join your local political clubs. Let people know you are a Registered Dental Hygienist and tell them about our issues.
Aside from involvement, continued support is vital to legislative success. Please take five minutes, complete the application below and become a member of NY HYPAC. Annual dues are $10.00 and the dues amount goes to advancing our agenda. You do not need to be a member of DHASNY (though we certainly encourage and welcome new members!). Join today – a whole lot of $10.00 memberships can add up to the monies we need!!
MEMBERSHIP DUES APPLICATION
Name: _____________________________________________________________
Address: __________________________ City: ______________________________
State: _____ Zip: _______Phone No.___________ Email:______________________
Make checks payable to NY HYPAC and mail to: NY HYPAC
c/o Diana Stewart
49 Park Road
Yulan NY 12792