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Standards for Patient Scheduling

Are there laws governing how many patients a dental hygienist can treat per day and whether he or she should be provided with a daily patient schedule?

QUESTION: Are there laws governing how many patients a dental hygienist can treat per day and whether he or she should be provided with a daily patient schedule?

ANSWER: There are no laws governing how many patients a dental hygienist can treat per day, nor do any laws dictate whether a daily patient schedule should be provided. In your case, the concern is whether you are able to provide the minimum standard of care because you have such limited time or you are not able to adequately prepare for each patient. Most state dental boards have provisions regarding standards of care for the practice of dentistry and dental hygiene. Licensees must practice at or above the standard of care. If dentists or dental hygienists fail to meet the standard of care, they can be held liable and their license will be in jeopardy. The standard of care, however, can be subjective. One helpful resource is the American Dental Hygienists’ Association’s Standards for Clinical Dental Hygiene Practice.1 These standards should be used in concert with the laws and rules in your particular state that guide dental hygiene practice.

Per the Standards for Clinical Dental Hygiene Practice, the dental hygienist is required to: complete or update a health history; complete a clinical assessment, including a head and neck examination; perform an oral cancer screening; update radiographs when necessary; provide a periodontal assessment and hard-tissue evaluation; conduct a risk assessment; provide oral hygiene education; create a dental hygiene diagnosis; deliver the appropriate care; and evaluate and document the care provided. Enough time must be allotted to follow these standards or dental hygienists may fall below the standard of care dictated by law. Many variables should be considered when determining the amount of time allotted per patient, such as the planned procedure, patient age, and whether an assistant is used, to name a few. Not being provided a schedule for the day may inhibit a dental hygienist’s ability to adequately prepare for the patient. Clinicians need to be aware of their daily schedule so they can review patient records and plan accordingly.

An example of falling below the standard of care is when a dental hygienist does not have enough time to conduct periodontal charting or if there is not enough time for a complete and thorough prophylaxis. If a dental hygienist feels he or she does not have adequate time to comply with the Standards for Clinical Dental Hygiene Practice and meet the standard of care outlined in their dental practice act, a conversation needs to happen between the employee and employer that focuses on the quality of patient care and potential liability. If the situation does not improve, other employment opportunities should be investigated. Dental hygienists should never agree to provide treatment below the standard of care or practice in a manner that would jeopardize patient care or their dental hygiene license.

References

  1. American Dental Hygienists’ Association. Standards for Clinical Dental Hygiene Practice. Available at: adha.org/resources-docs/2016-Revised-Standardsfor- Clinical-Dental-Hygiene-Practice.pdf. Accessed May 18, 2017.
The Ask the Expert column features answers to your most pressing clinical questions provided by Dimensions of Dental Hygiene’s online panel of key opinion leaders, including: Jacqueline J. Freudenthal, RDH, MHE, on anesthesia; Nancy K. Mann, RDH, MSEd, on cultural competency; Claudia Turcotte, CDA, RDH, MSDH, MSOSH, on ergonomics; Van B. Haywood, DMD, and Erin S. Boyleston, RDH, MS, on esthetic dentistry; Michele Carr, RDH, MA, and Rachel Kearney, RDH, MS, on ethics and risk management; Durinda Mattana, RDH, MS, on fluoride use; Kandis V. Garland, RDH, MS, on infection control; Mary Kaye Scaramucci, RDH, MS, on instrument sharpening; Stacy A. Matsuda, RDH, BS, MS, on instrumentation; Karen Davis, RDH, BSDH, on insurance coding; Cynthia Stegeman, EdD, RDH, RD, LD, CDE, on nutrition; Olga A.C. Ibsen, RDH, MS, on oral pathology; Jessica Y. Lee, DDS, MPH, PhD, on pediatric dentistry; Bryan J. Frantz, DMD, MS, and Timothy J. Hempton, DDS, on periodontal therapy; Ann Eshenaur Spolarich, RDH, PhD, on pharmacology; and Caren M. Barnes, RDH, MS, on polishing. Log on to dimensionsofdentalhygiene.com/asktheexpert to submit your question.

From Dimensions of Dental HygieneJune 2017;15(6):54. 

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