Dental hygienist – a Primary Care Provider.

One would start to think, what is a primary care provider? And why is dental hygienist a primary care provider?

Primary care – “is a service at the entrance to the healthcare system. It addresses diagnosis, ongoing treatment and the management of health conditions as well as health promotion, disease and injury prevention. Primary care coordinates the care of patients and integrates their care with the rest of the health system by enabling access to other healthcare providers and services.” ^1-2

Dental hygienist: A Primary Care Provider. 

A dental hygienist serves the society as a highly trained Clinician, Educator, Advocate, Administrator, and Researcher with specialized focus on oral disease prevention and health promotion. All of these roles of a dental hygienist aim to achieve an improved oral health and quality of life for individuals in the society.³

Dental hygienist are regarded as primary care providers for the following reasons:

1. Dental hygienists are often the first point-of-access for individuals seeking oral care. It is evident that individuals see a dental hygienist once to twice a year, generally more often than the physician.⁴ Dental hygienists provide initial care in a dental office setting more often than physicians.⁵ A review reveals that dental hygienists are the only healthcare professionals and members of the oral health teams whose primary function continues to be the prevention of oral diseases and promotion of wellness.⁵

2. As a clinical therapist, dental hygienists adopt the dental hygiene process of care, ADPIE, to provide preventive, therapeutic, and educational services.⁶ ADPIE is defined as follows:
   1. Assessing signs, symptoms, and risk factors related to oral diseases with specialization in periodontal health.
   2. Making Diagnosis that identifies an actual or potential condition, need and oral disease based on all available assessment data.
   3. Planning treatments, strategies, and setting goals to facilitate optimal oral health.
   4. Implementing the planned interventions, including non-surgical periodontal therapy, caries management, oral health education, smoking cessation, nutritional counseling, sealants, and making referrals.
   5. Evaluating the outcomes of implemented interventions.

3. The UBC Dental Hygiene Graduate Competencies states the essential knowledge, skills, and attitudes that UBC graduates possess. These competencies educate and train a dental hygienist to be a biologically oriented, technically competent, and socially sensitive practitioner who adheres to the highest standards of professional conduct and ethics and can function effectively as a member of the health care delivery system. These competencies identify and organize the knowledge and skills UBC graduates must acquire to become competent and caring dental practitioners who treat clients with a holistic approach.

The Fourteen competencies include Professionalism, Communication, Collaboration, Coordination, Leadership, Critical thinking, Research use, Scientific investigation, Oral disease prevention, Clinical therapy, Health promotion, Oral health education, Advocacy, and Policy use.⁷

Health promotion, oral health education, oral disease prevention, clinical therapy, advocacy, and policy use are professional services provided by dental hygienists to improve and protect the oral and general health status and quality of life of the public, including improving the access to dental hygiene services.^7-8

Critical thinking, research use, and scientific investigation are abilities that allow dental hygienists to provide effective and safe practice by applying up-to-date and scientifically sound research to make autonomous judgments and decisions.^7-8

Communication, collaboration, coordination, leadership, and professionalism are the core competencies dental hygienists must possess in order to work interactively with clients and other professionals in a variety of practice environments.^7-8

References:

1. Canadian medical Association. Strengthening the foundation: the role of the physician in primary health care in Canada. Ottawa, CMA, 1994.

2. Canadian Patient Safety Institute and BC Patient Safety & Quality Council. Patient Safety in Primary Care. [Internet]. 2010 [cited 25 November 2015]. Available from: https://bcpsqc.ca/documents/2015/08/Primary_Care_2010_english_FINAL.pdf

3. Cdha.ca. Entry-To-Practice Competencies and Standards for Canadian Dental Hygienists [Internet]. 2010 [cited 25 November 2015]. Available from: http://www.cdha.ca/cdha/The_Profession_folder/Resources_folder/Entry-To-Practice_Competencies_and_Standards_for_Canadian_Dental_Hygienists_folder/CDHA/The

4. Brondani MA, Chang SM. Are we ready for HIV screening in dental clinics? J Can Dent Assoc. 2014;80:e58.

5. Monajem S. Integration of oral health into primary health care: the role of dental hygienists and the WHO stewardship. Int J Dent Hyg. 2006;4(1):47-51

6. Darby ML, Walsh MM. Dental hygiene: theory and practice. 3rd ed. St. Louis, Mo: Saunders/Elsevier; 2010.

7. University of British Columbia. UBC Dental Hygiene Degree Program Competencies Document Version 1.3 [Internet]. 2011 [cited 25 November 2015]. Available from: https://secure.dentistry.ubc.ca/intranet/academicprograms/hygiene/DentalHygieneCompetenciesDocument.pdf

8. Cdha.ca. Canadian Competencies for Baccalaureate Dental Hygiene Programs, 2015 [Internet]. 2015 [cited 29 November 2015]. Available from: http://www.cdha.ca/cdha/The_Profession_folder/Resources_folder/Reports_folder/CDHA/The_Profession/Resources/Reports.aspx?hkey=235bb4c0-7d52-4d1f-b42a-8b04e365c2e2