A partner for school based care
Deborah Bailey Astroth, RDH, BS, Chair,
Council on Regulation and Practice
Colorado Dental Hygienists’ Association
Definitions
 Direct Access Dental Hygiene Practitioner: A
proprietary business state where the dental hygienist
retains ownership or control of a practice of dental
hygiene through direct agreement with each
client/patient in accordance with the statutory
authority of this state.
Colorado Dental Hygienists’ Association Policy Manual 3-02
Supervised Dental Hygiene
Direct Supervision: Nitrous Oxide Administration
Indirect Supervision: Administration of Local
Anesthesia
What constitutes unsupervised
dental hygiene?
 Patient histories
 Extra- and Intra-oral inspection
 Dental and periodontal charting
 X-rays
 Patient education
 Dental hygiene diagnosis and treatment planning
 Impressions and study casts
 Scales teeth with hand, ultrasonic or other devices, including root




planing and gingival curettage
Polishes natural and restored tooth surfaces
Provides fluorides, sealants, and antimicrobial agents for the
prevention treatment of oral disease
Administers topical and local anesthesia
May be the proprietor of a practice, and purchase equipment
Why a partner for school based care?
 Dental Hygiene Services:
Education – nutritional counseling
oral health care(brushing, flossing, rinsing)
systemic & oral health relationship
Prevention – oral health care
fluorides
sealants
athletic mouthguards
Treatment – assessment, radiographs, study casts
dental hygiene diagnosis, anesthesia,
prophylaxis, antimicrobials, referral
What a dental hygienist
cannot provide
 Dental Services:
Restorative procedures
Surgical procedures
Orthodontic procedures
Prescriptive authority
Why a partner for school based care?
 A dental hygienist MAY be a proprietor
 A dental hygienist CAN provide educational, preventive
and therapeutic services
 The dental hygienist CAN assist with referral into the
dental care delivery system
 There ARE dental hygienists in counties where there are no
dentists available who would like to pursue school-based
care partnerships
CDHA Member Survey 2012
Are you interested in acquiring your own equipment to
become a Direct Access Dental Hygienist?
Total
Central
Region
Northeast
Region
Southern
Region
Western
Region
Yes
36%
38%
42%
25%
44%
N0
64%
63%
58%
75%
56%
School-based practice
Total
Central
Region
Northeast
Region
Southern
Region
Western
Region
% Very
Interested/
Interested
76%
76%
78%
75%
72%
Neutral
10%
10%
5%
17%
14%
%
Somewhat
Interested/
Not at all
interested
14%
13%
19%
8%
14%
Prevent the need for costly
restorative and surgical procedures
Partner with
Direct Access
Dental Hygienists
Changes on the horizon
 Legislation is being introduced in January, 2013 for an
oral health mid-level provider that would be able to
perform limited restorative and surgical procedures,
and would have prescriptive authority.
 The Dental Practice Law is scheduled for Sunset
Review in 2014. The Colorado Dental Association and
the Colorado Dental Hygienists’ Association are
meeting to discuss possibly changes to be introduced.
Questions?
Contact information
Deborah Bailey Astroth, RDH, BS
Dbastroth@aol.com
303-748-4713
Definitions
 “Premises” means within the same building, dental
office, or treatment facility and within close proximity
to respond in a timely manner to an emergency or the
need for assistance.
Dental Practice Law, 12-35-103 (10) (b)
Definitions
 Supervised Dental Hygiene:
“Indirect supervision” means the supervision of those
tasks or procedures that do not require the presence
of the dentist in the office or on the premises at the
time such tasks or procedures are being performed,
but do require that the tasks be performed with the
prior knowledge and consent of the dentist.
Dental Practice law, 12-35-103, (10) (a)
Definitions
 “Dental hygiene diagnosis” means the identification of
an existing oral health problem that a dental hygienist
is qualified and licensed to treat within the scope of
dental hygiene practice. The dental hygiene diagnosis
focuses on behavioral risks and physical conditions
that are related to oral health. A dentist shall confirm
any dental hygiene diagnosis that requires treatment
that is outside the scope of dental hygiene practice
pursuant to sections 12-35-124, 12-35-125, and 12-35-128.
Dental Practice Law, 12-35-103 (4.5)
Unsupervised Dental Hygiene
 Unsupervised Dental Hygiene:
Not defined in the Dental Practice Law definitions,
however , is defined in
12-35-124.What constitutes practicing unsupervised
dental hygiene.
Definitions
 “Dental hygiene” means the delivery of preventive,
educational, and clinical services supporting total
health for the control of oral disease and the
promotion or oral health provided by a dental
hygienist within the scope of his or her education,
training and experience and in accordance with
applicable law.
Dental Practice Law, 12-35-103, (4)