Advanced Dental Hygiene Practitioner: An Emerging Midlevel Provider

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Advanced Dental Hygiene Practitioner An
Emerging Midlevel Provider

• Christine Nathe, RDH, MS
• Professor and Graduate Program Director

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Advanced Dental Hygiene Practitioner (ADHP)

• Vision Statement
• Extending primary oral healthcare to all.

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Advanced Dental Hygiene Practitioner (ADHP)

• Mission Statement
• To improve the underserved publics health, the
  ADHP provides access to early interventions,
  quality preventive oral healthcare and referrals
  to dentists and other healthcare providers.

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Background

• Oral Health in the United States
• Oral Health Disparities
• The Oral Health Workforce
• Effectiveness of Non-Dentist Providers
• The Community
• ADHP

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ADHP Specific Points

• Increase the effectiveness and efficiency of the
  dental workforce
• Potentially reduce the cost of dental services by
  providing primary oral healthcare within the
  scope of ADHP
• Extend primary dental care to disadvantaged and
  remote populations outside of the traditional
  private practice setting.

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ADHP Specific Points

• Expand the capacity of community-based health
  personnel and facilities to meet the oral care
  needs.
• Collaborate with dentists and other healthcare
  providers.

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Educational Framework

• Advanced dental hygiene practice must be grounded
  in science and guided by research evidence, sound
  theories, best practices and professional ethics.
• The ADHPs masters degree curriculum allows for
  the acquisition of competencies that build upon
  the fundamental knowledge and skills achieved at
  the BSDH level.

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Educational Domains

• Provision of Primary Oral Healthcare
• Healthcare Policy and Advocacy
• Management of Oral Care Delivery
• Translational Research
• Professionalism

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Domain I Primary Oral Healthcare

• Health Promotion and Disease Prevention
• Provision of Primary Care

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Domain I Primary Oral Healthcare

• Provide restorative services that treat
  infection, relieve pain, promote function and
  oral health
• Preparation of cavities and restoration of
  primary and permanent teeth using direct
  placement of appropriate dental materials.
• Placement of pre-formed crowns.
• Pulp capping in primary and permanent teeth.
• Pulpotomies on primary teeth.
• Referral

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Domain I Primary Oral Healthcare

• Perform extractions of primary teeth and
  uncomplicated extractions of permanent teeth.

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Domain I Primary Oral Healthcare

• Place and remove sutures.
• Provide simple repairs and adjustments for
  patients with removable prosthetic appliances.

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Domain I Primary Oral Healthcare

• Prescribe pharmacologic agents for prevention,
  control of infection and pain management
  utilizing established protocols or in
  consultation with a dentist or physician.

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Domain I Primary Oral Healthcare

• Case Management
• Multidisciplinary Collaboration

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Domain II Healthcare Policy and Advocacy

• Healthcare Policy
• Advocacy

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Domain III Management of Oral Healthcare
Delivery

• Practice Management
• Quality Assurance
• Fiscal Management

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Domain IV Translational Research

• Evidence-based Practice
• Clinical Scholarship

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Domain V Professionalism

• Ethics and Professional Behavior
• Lifelong Learning

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Public Health Settings

• Acute and long-term care facilities
• Age-related development centers
• Ambulatory care clinics
• Alternative living situations
• City and county clinics
• Community health centers
• Correctional facilities

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Public Health Settings Continued

• Day care facilities
• Dental and medical practices
• Federally Qualifed Heathl Centers
• Head Start
• Home healthcare agencies
• Hospitals
• Mobile dental clinics

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Public Health Settings Continued

• Ob-gyn practices
• Pediatric practices
• Rural health clinics
• School and afterschool programs
• School-based clinics
• Women, Infants and Children (WIC)
• US PHS/IHS

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Timeline

• 2004 ADHA adopts policy to pursue the
  establishment of the ADHP
• ADHA establishes curriculum task force to work on
  educational framework.

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Timeline

• 2005 ADHA seeks funding to pilot test the ADHP
• Congress approves language encouraging the Health
  Resources and Services Administration to explore
  development of an ADHP as part of the report
  (Public Law 109-409)
• ADHA convenes an advisory committee comprised of
  14 national organizations dedicated to increasing
  access to oral health care services to provide
  input on the ADHP Concept

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Timeline

• 2007 ADHA president testifies before the House
  Appropriations Subcommittee on Labor, Health and
  Human Services about funding for oral health
  programs, including ADHP.
• 2008 ADHA educational competencies were
  finalized in March. (www.adha.org)
• 2009 Metropolitan State University in St. Paul
  Minnesota has approved the first ADHP Masters
  program and is slated to begin instructing
  students in early 2009.

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Summary

• ADHP Vision
• Mission
• Educational Preparation
• Competences