Follow-up consultation outcome on proposed working relationship requirements, and dental hygiene practising conditions

The Dental Council issued a follow-up consultation on the proposed changes to the working relationship requirements for oral health practitioners with dentists, and the practising conditions for dental hygiene activities.

Following consideration of the submission responses, the Council has agreed to proceed with the proposals as consulted. The details and basis for the decisions are contained in the consultation outcome.

In summary, the changes are:

Changes to existing professional relationships

Effective 1 August 2021:

  • A mandated professional relationship with a dentist or dental specialist is no longer required for dental therapy, dental hygiene, and orthodontic auxiliary practice; and no signed agreement is needed.
  • A mandated consultative professional relationship is no longer required for oral health therapy practice.
  • The professional relationship practice standards for dental therapy, dental hygiene and orthodontic auxiliary practice will be rescinded, and the existing guidance document for the consultative professional relationship for oral health therapy will be removed.
  • The practice standards for the working relationship in dental technology and clinical dental technology will be removed.
  • There will be no references to professional relationships in the scopes of practice, with a new gazette notice issued to effect the proposed changes to the scopes of practice. The Council will soon publish updated scopes of practice in the New Zealand Gazette, that will come into effect on 1 August 2021.
Dental hygiene scope of practice changes

Effective 1 August 2021, for dental hygiene:

  • Direct clinical supervision for administration of local anaesthetic and prescription preventive agents is no longer required.
  • Clinical guidance for the remaining dental hygiene activities (excluding the defined orthodontic procedures) is no longer required.
  • The scope of practice will reflect the above, and the following updated wording: obtaining and assessing medical and oral health histories.
  • Dental hygienists will need to have a standing order with a dentist/dental specialist in place to enable access to prescription medicines, such as local anaesthetic and adrenaline. Guidance on establishing standing orders is available on the Ministry of Health’s website.
  • An updated medical emergencies practice standard will be published with a requirement for dental hygienists to have access to adrenaline (1:1000) for use in the management of an anaphylactic event.  The Council consulted on a one year lead-time for the medical emergencies practice standard to come into effect for dental hygienists. However, in the interest of patient safety the Council decided to align this implementation date to when the dental hygiene scope changes come into effect. Hygienists already have the capability to manage anaphylaxis already exists through their resuscitation training.

The changes will come into effect on 1 August 2021. This will give practitioners time to make sure they understand the changes and how this may impact on their practice, and to ensure they meet the other obligations (e.g., establishing a standing order, having adrenaline available).

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