Competencies for the Dental Hygienist

Introduction

Competencies for the Dental Hygienist identifies and organizes the knowledge and skills the graduate must acquire to become a critcally thinking, competent practitioner in the delivery of dental hygiene services in clinical and alternative practice settings. The document also reflects an evidence-based curriculum that is patient driven, competency based, and criterion referenced.

These competencies serve to define the core content of the curriculum. The document provides a method of stating graduate knowledge and skills after completing the dental hygiene program, thus, establishing a basis for the content of all courses. The competencies set standards for identifying relevant content and provides guidance in making decisions related to pedagogy and course sequencing.

The document also sets forth individual measurable competencies which a student must demonstrate to qualify for graduation and entry into the profession. These competencies assess the degree to which a student can provide the defined standard of dental hygiene care to patients. 

Competencies for the Dental Hygienist should be viewed as dynamic standards which must be responsive to the professional environment. It is recognized that this educational plan will require regular review for continual improvement.

Competency as an Educational Concept

This document has been organized using the concept of "competencies". The term competent is described as the repeated demonstration of the student’s independent performance of a skill to a defined standard as measured against relevant, valid and reliable criteria.

Organization

Domains

The organization of this document is structured to list competencies from the general to the more specific. The model depicts six domains centered around the patient: Professionalism and Ethics, Disease Prevention and Health Promotion, Examination and Assessment, Dental Hygiene Diagnosis, Planning and Implementation. These represent broad categories of the dental hygiene care process. The concept of domains is intended to encourage an interdisciplinary structure and process in the dental hygiene curriculum.

Encompassing all aspects of dental hygiene care is Professionalism and Ethics. This domain includes self evaluation, ethics, values, skills and knowledge integral to all aspects of the dental hygiene profession. Health Promotion and Disease Prevention competencies focus on disease prevention and evaluation measures to ensure effective health care delivery. These domains thread throughout the entire dental hygiene care process and are strategically placed as outer circles in the Competency Model.

The domain of Examination and Assessment involves the systematic collection and integration of data on the general and oral health status of the patient. Dental Hygiene Diagnosis refers to an analysis of the patient’s general and oral health status, congruent with the diagnoses of dentists and other health professionals, to assess its relationship to oral health status and dental hygiene care. The domain of Planning addresses strategies including goals, priorities, dental hygiene procedures and patient interaction to facilitate optimal oral health. Implementation includes the provision of treatment and education to assist the patient in achieving oral health goals.

Major Competencies

Within each domain, "Major Competencies" are involved. A Major Competency is defined as the ability to perform or provide a particular, complex service or task. The complexity of the service suggests that multiple and more specific abilities are required to support the performance of any Major Competency.

Supporting Competencies

The more specific abilities are considered subdivisions of the "Major Competency" and are termed "Supporting Competencies". The acquisition and demonstration of a "Major Competency" requires a level of mastery of all Supporting Competencies related to that particular service or task. While less complex than a Major Competency, a Supporting Competency also requires foundational knowledge.

Foundational Knowledge

Foundational knowledge is the product of didactic and laboratory instruction which imparts the information and experience that are prerequisite for satisfactory mastery of Supporting Competencies.

The biomedical, dental, behavioral, and clinical sciences all provide instruction at the foundational level. The Competency Model depicts these sciences as the foundation matrix for the entire dental hygiene care process. This education ensures an understanding of basic biological principles for student analysis and synthesis of the interrelationships of the body systems when making decisions regarding oral health services within the context of total body health. These sciences provide the student with knowledge of oral health and disease as a basis for assuming responsibility for assessing, analyzing, planning, implementing and evaluating dental hygiene care. Didactic, small group discussion, seminar, and laboratory instruction provide information and psychomotor experiences that enable students to acquire and demonstrate competence in the clinical setting.

Professionalism And Ethics

1. The Graduate Demonstrates Interpersonal Communication Skills to Function Successfully in a Multicultural Work Environment with Diverse Populations:

The graduate...
1a. Demonstrates cultural sensitivity.
1b. Provides humane and compassionate care to all patients.

2. The Graduate Makes Professional Decisions Affecting the Practice of Dental Hygiene that Satisfy Legal, Societal and Ethical Principles:

The graduate...
2a. Practices within the context of legal obligations.
2b. Practices within the context of professional obligations and jurisdictional Code of Ethics.
2c. Demonstrates personal/professional responsibility to the welfare of society through service activities.
2d. Participates in professional organizations at the local, state, and/or national level.

3. The Graduate Performs Routine Self Evaluation and Takes Corrective Action to Address Perceived Deficiencies:

The graduate...
3a. Routinely evaluates personal well being.
3b. Routinely evaluates professional skills, knowledge, and outcomes of clinical practice.
3c. Plans and implements corrective measures to address personal and professional deficiencies of self.

4. The Graduate Critically Evaluates the Validity and Relevance of Emerging Information, Products, and Treatment Modalities to the Practice of Dental Hygiene:

The graduate...
4a. Uses current information systems to access medical/dental databases/information.
4b. Critically evaluates research, sales and continuing education presentations, and journal articles and determines their value in dental hygiene practice.
4c. Plans for professional development including utilization of continuing education resources.

5. The Graduate Applies Business and Practice Management Skills:

The graduate...
5a. Identifies career options.
5b. Develops effective communication skills.
5c. Demonstrates effective time management skills.
5d. Assesses patient satisfaction and responds appropriately.
5e. Apply Quality Assurance mechanisms to ensure continuous commitment to accepted standards of care.

Disease Prevention and Health Promotion

6. The Graduate Promotes Health Maintenance and Disease Prevention:

The graduate...
6a. Educates patients concerning their risk factors and assists in developing self-care regimens.
6b. Utilizes the principles of learning and instruction in patient education.
6c. Supports patient wellness and quality of life.
6d. Evaluates the outcomes of dental hygiene care and determines an individualized maintenance schedule, or additional treatment needs or referral to the appropriate health care provider.
6e. Applies the dental hygiene care process (assessment, planning, implementation and evaluation) to community oral health education.

7. The Graduate Applies the Principles of Infection Control and Environmental Safety:

The graduate...
7a. Establishes and maintains an environment that protects against transmission of disease.
7b. Implements protocols that establish and maintain an environment which protects against environmental hazards.
7c. Utilizes ergonomic principles to promote health and comfort of self, staff, and patients.

Examination and Assessment

8. The Graduate Obtains, Records, Updates and Organizes Accurate and Complete Medical/Dental Histories Including Pertinent Psychological and Socioeconomic Information:

The graduate...
8a. Establishes a patient dialogue to obtain demographic, medical, family and dental histories, psychological and socioeconomic information relevant to dental hygiene care; and patient expectations and goals for dental hygiene care.
8b. Establishes a patient dialogue to obtain and record the chief complaint of the patient and the history of the present illness.
8c. Establishes and maintains the patient record as an accurate and consistent legal document of patient encounters.
8d. Identifies and records patient’s medication(s), potential effect(s) on dental and systemic health, and impact on dental treatment.
8e. Initiates necessary medical and/or dental consultation or referral in legal media to clarify questions related to the patient’s dental and systemic health.

9. The Graduate Performs, Records and Organizes a Physical Assessment Appropriate for Dental Care:

The graduate...
9a. With the cooperation of the patient, performs and records an appropriate physical examination not limited to the head and neck.
9b. Performs and records the findings of intraoral examinations including but not limited to dental charting, periodontal examination and indices.
9c. Identifies the need and/or performs and records results of other diagnostic procedures and tests.
9d. Identifies the signs and manages the symptoms of medical emergencies.
9e. Identifies the signs of physical, psychological, and verbal abuse.
9f. Performs risk assessments.

Dental Hygiene Diagnosis

10. The Graduate Determines Differential, Provisional or Definitive Dental Hygiene Diagnoses Related to and Congruent with the Diagnosis of the Dentist and Other Health Professionals:

The graduate...
10a. Interprets and correlates examination and assessment findings.
10b. Determines unmet needs of the patient based on analysis of assessment findings.

Planning

11. The Graduate Develops Alternative Dental Hygiene Care Plans which are Sequenced to Address Patient Needs, Consistent with Assessment and Diagnoses:

The graduate...
11a. Determines priorities and establishes oral health goals with the patient and/or family and/or guardian as an active participant.
11b. Plans treatments that reflect the impact of behavioral, social and cultural differences in the provision of dental health care.
11c. Develops dental hygiene care plans that reflect the impact of systemic disease and its management on the provision of dental care.
11d. Develops dental hygiene care plans consistent with and supportive of the patient’s overall dental treatment plan.
11e. Establishes a planned sequence of educational and clinical services that include health promotion, and therapeutic and maintenance care.
11f. Communicates the plan for dental hygiene care to interdisciplinary health team members to determine its congruence with the overall plan for oral health care.

12. The Graduate Establishes with the Patient a Mutually Acceptable Dental Hygiene Care Plan:

The graduate...
12a. Presents findings and/or diagnoses to the patient.
12b. Explains dental hygiene care plan options to patients using understandable and professional terminology.
12c. Responds to patient’s questions and concerns.
12d. Agrees on and records the final dental hygiene care plan.
12e. Obtains written informed consent.

Implementation

13. The Graduate Monitors and Provides for Patient Comfort Associated with Dental Hygiene Care:

The graduate...
13a. Utilizes psychological and/or behavioral techniques to assure patient comfort.
13b. Utilizes accepted clinical techniques to provide for control of pain and anxiety.
13c. Temporarily manages medical emergencies and maintains basic life support.

14. The Graduate Delivers and/or Manages The Planned Dental Hygiene Evidence-Based Treatment and Education in Sequence and in Accordance with Accepted Standards of Care:

The graduate...
14a. Delivers and/or manages dental hygiene treatment considering the impact of behavioral, social, and cultural manifestations contributing to difficulty.
14b. Delivers and/or manages periodontal therapy utilizing basic and advanced principles of instrumentation.
14c. Recognizes the need to modify dental hygiene care based on changing patient needs and/or evaluation of achievement of established care plan goals.
14d. Delivers and/or manages oral health maintenance care.
14e. Provides adjunct dental hygiene services.
14f. Identifies the need for chemotherapeutic agents, selects and administers them as appropriate and provides pre- and post-treatment instructions.