Dental hygienists are valued to be an advocate, educator, researcher, administrator, and clinician. Through these multiple and diverse roles, the profession strives to support clients in their oral and overall healthcare needs. (1) Oral health is an influential factor to overall health and has been found to be a risk factor for many systemic diseases. For example, links between oral health and uncontrolled diabetes have significant impacts on overall health including fungal infections, dry mouth, and increased risk of periodontal disease. (2) Additionally, oral bacteria have the ability to travel through the bloodstream and reach vital organs such as the heart. This can cause inflammation and can cause endocarditis and many heart conditions. (3) It is therefore essential that a dental hygienist identifies individual restraining factors that may inhibit adequate oral health and wellbeing. Through identification, an evidence-based plan can be made in collaboration with the client and other healthcare professionals to improve oral and overall health. The overall goal of a primary healthcare provider is to work holistically within the scope of practice of dental hygiene and facilitate access to other aspects of care, including coordination and collaboration with specialists. (4)
Identification of disease and health concerns as well as collaboration with healthcare professions occurs at each dental appointment. A dental hygienist routinely sees clients for dental hygiene services and manages clients within their scope of practice. Conversely, recognizing abnormalities beyond their scope of practice and referrals to other healthcare professionals may be necessary. (5) A clinician considers the whole person including the spiritual, physical, emotional, and mental factors that allow for the possible diagnosis of conditions that would not be recognized sooner. (6) Referrals can be sent to specialists and other healthcare providers to ensure the clients’ health is being addressed appropriately and maintained. For these reasons, it is evident that a dental hygienist functions as a primary healthcare provider.
Primary healthcare can be seen outside of the private dental setting. Dental hygienists who are 365-day exempt have the opportunity to care for special care populations including; long-term care senior homes, immigrants/ refugees, low socioeconomic status, the incarcerated, special needs children, complex systemic conditions, and the homeless. It is difficult for these populations to receive care due to barriers specific to a population. (7) For example, the HIV community is known to experience stigma or discrimination. (8) For seniors in care homes, it may be a lack of transportation. Those with sensory impairment it may be the feeling of being judged, and for the incarcerated may be a lack of ability to find access to healthcare services once released. It is important the dental hygienists evolve outside of their traditional roles, as the population is aging, and more conditions are creating a higher demand for primary healthcare providers in special care populations.
With the developing population comes a development for dental hygienists to evolve their scope of practice and continually make changes that fit the needs of society. That change begins with the dental hygienist as a primary health care provider. It is essential that hygienists take their scope of practice, roles, responsibilities, competencies, and dedication to the profession in order to advocate for public needs at a local, national, and international level. Awareness of oral health is awareness of overall health and well-being. Working with other healthcare providers creates a holistic ability to prevent disease and treat current disease effectively and efficiently. The competencies of dental hygiene include professionalism, communication, coordination, leadership, and collaboration, research use, health promotion, policy use, scientific investigation, clinical therapy, oral disease prevention, oral health education, and advocacy. (9) These abilities provide dental hygienist guidelines in the ability to provide comprehensive, safe, and systematic evidence-based care to clients. Ethics, values, skills, literature, and knowledge are integrated to allow professionals to perform health promotion and disease prevention. All competencies are essential into the investigation of care to each client as all are different, requiring complex case investigation and using evidence/ literature to support decision making in care.
- College of Dental Hygienists of British Columbia. Scope of practice statement. 2019. CDHBC. [cited Mar 20, 2019]. Available from: http://www.cdhbc.com/Practice-Resources/Scope-of-Practice-Statement.aspx
- American Diabetes Association. Diabetes and oral health problems. 2018. ADA. [cited Mar 20 2019]. Available from: http://www.diabetes.org/living-with-diabetes/treatment-and-care/oral-health-and-hygiene/diabetes-and-oral-health.html
- Najafipour H, Mohammadi TM, Rahim F, Haghdoost AA, Shadkam M, Afshari M. Association of oral health and cardiovascular disease risk factors “results from a community based study on 5900 adult subjects”. ISRN Cardiol. 2013(782126): 1-6. 78212.
- The Canadian Dental Hygienists Association. Dental hygienists: primary oral health care providers. 2006. CDHA. [cited Mar 20 2019]. Available from: https://www.cdha.ca/cdha/The_Profession/Policy_Advocacy/Tagged_Content/SubGov_oral_presentation.aspx
- College of Dental Hygienists of British Columbia. Duty to provide care. 2014. CDHBC. [cited Mar 20 2019]. Available from: http://www.cdhbc.com/Practice-Resources/Interpretation-Guidelines/Duty-to-Provide-Care.aspx
- University of California. Dimensions of wellness. 2019. [cited Mar 20 2019]. Available from: https://wellness.ucr.edu/seven_dimensions.html
- The Canadian Dental Hygienists Association. Access angst: a CDHA position paper on access to oral health services. 2003. CDHA. [cited Mar 20 2019]. Available from: https://www.cdha.ca/pdfs/Profession/Resources/position_paper_access_angst.pdf
- Patel N, Furin J, Willenberg D, Chirouze NJ, Vernon L. HIV-related stigma in the dental setting: a qualitative study. Spec Care Dentist. Jan 2015; 35(1): 22-8.
- The Canadian Dental Hygienists Association. Canadian competencies for baccalaureate dental hygiene programs. 2015. CDHA. [cited Mar 20 2019]. Available from: https://files.cdha.ca/profession/CCBDHP_report.pdf