The notion of primary health care (PHC) was established in 1978 at the International Conference on Primary Health Care.¹  Primary Health Care is viewed as essential health care that is practical, evidence-based and socially acceptable in terms of methods and technology.¹  In addition, PHC values “universal access to and coverage of health services based on health needs.”¹ Furthermore, PHC encompasses inter-sectoral approach and prevention. ¹ Throughout this process, there is a requirement of individual and community participation. ¹ Ordich further adds on by defining primary-care giver as one that is “the patient’s first point of access to the health-care system.”² As, the patient approaches the primary-care givers, they are obligated to provide health maintenance and illness therapy.  The primary-care giver’s role does not terminate at providing care for the current condition, but rather they should coordinate for the overall health problems of the patients. This is accomplished through directing the patient towards appropriate and agreeable referrals, and community resources. ²

In my own practice, I have found that I have demonstrated primary health care.  Ms. B is a retired librarian who is 64 years old and lives on her own.  During her first visit, she shares her past unpleasant experience at her previous dental offices.  Subsequently, care that I provide for Ms. B requires patience, empathy and a lot of local anesthetic (LA). She experiences a lot of tissue sensitivity and is anxious in a dental clinic setting. After each session I would contact her the next day to provide her with follow-up of her condition after LA. As I referred her out for restorative work to be done, I ensured that she was able to contact and set-up an appointment with a dentist.  It was apparent that as a primary-care giver, the care I provided is in which “closeness to the population and a continuining process of care…”¹. As Ms.B in the completion of phase 1 care wrote (through email to me) “Thank you for everything you have done…I want to keep my teeth and mouth healthy. Whenever I brush with the ‘wringle, wringle, sweep up’ method, I will always remember your smile and your kindness.”

My perception of a dental hygienist as a primary-role care giver are aligned with the literature .^1,2,,4  As dental hygiene competencies include prevention, oral health education, health promotion.³  It was found in literature that dental hygienist are the front line health professionals providing preventative and periodontic services.² Thus, the dental hygiene profession is indeed classified as primary care-givers. Dental hygienist as primary care-giver is responsible for a client is that there is “continuity of care, behavior change, initial therapy, maintenance, and follow-up”. In addition, dental hygienists have a critical task of referral; as this will “affect the periodontal health and utilization of dental services of the underserved.” ². The primary-care hygienist would most efficiently deliver care when they are “educated in health administration, facility management, and health education, as well as advanced dental hygiene skills”.² As the care we provide is client,community-centered,^1,23,4 it is important to establish a trusting clinician-client relationship. ⁴

The Dental hygiene profession provides care that is primary health care. Thus, it is apparent that there is a need for advocacy, and empowerment our profession.¹  Dental hygienist will play a role in bridging disparities present in oral health, increase accessibility and the improvement of overall health.  The World Health Organization reports that principles of disease prevention and health promotion would be key in decreasing risk factors. ⁵

References:

1. Monajem S. Intergration of oral health into primary health care: the role of dental hygienists and the WHO stewardship. Int J Dent Hygiene 2006; 4:47-51.
2. Odrich J. The dental hygienist: a primary care provider. Journal of Public Health Dentistry 1985;45(2): 64-9.
3. Canadian Dental Hygienist Association. Dental hygiene: definition, scope, and practice standards.  [accessed on November 25, 2011] Available at: http://www.cdha.ca/pdfs/Profession/Resources/CDHA_Code_of_Ethics_public.pdf
4. Cbban SJ. A dialectical analysis of an art of dental hygiene practice. Int J Dent Hygiene 2009; 7:217-25.
5. World Health Organization. Global strategy on diet, physical activity and health diet and physical activity: A publich health policy 2003 [Internet]. Geneva: WHO. [updated 2004 Aug 23; cited November 2011]. Available from:  http://www.who.int/dietphysicalactivity/strategy/en