Performance Expectations

The dental hygienist must… 

1. Utilize prescription and non-prescription drugs and natural health products appropriately within their practice of dental hygiene, competencies, practice setting, and in compliance with legislation. 

The dental hygienist who administers, recommends, prescribes, sells, or provides a prescription or non-prescription drug must… 

2. Adhere to current applicable provincial and federal legislation, standards, ethical principles, guidelines, and policies. 
3. Complete appropriate patient assessments, including medical and medication history. 
4. Identify and use evidence-informed best practice guidelines and resources regarding drug therapies used in the practice of dental hygiene. This includes but is not limited to: 
1. Knowledge of the drug; 
2. Possible drug interactions; 
3. Contraindications; and  
4. Risks and benefits of the expected treatment outcomes. 
5. Apply critical thinking to ensure that the drug therapy is appropriate and aligns with the patient’s oral health goals.  
6. Support the patient’s informed choices and obtain informed consent in accordance with the College’s Informed Consent Standard of Practice. This also includes discussing the following with the patient: 
1. The rationale for the selection of a particular drug; and 
2. Implications of using drug therapy. 
7. Maintain complete and accurate records of drugs administered, recommended, prescribed, sold, or provided. This includes but is not limited to: 
1. Accessing, utilizing, and contributing to the patient record and complete medication history; 
2. Documenting the administration of drugs in accordance with applicable legislation, standards, and guidelines; and 
3. Documenting drugs recommended, prescribed, sold, or provided. 
8. Acquire, store, and dispose of drugs in a manner that: 
1. Adheres to provincial and federal legislation and guidelines;  
2. Protects the integrity, quality, and safety of drugs;  
3. Minimizes the possibility of errors; and 
4. Ensures that drugs are secured against theft, loss, or diversion. 
9. Participate in a quality assurance program that provides for preventing, reporting, investigating, and evaluating drug errors. This includes but is not limited to: 
1. Taking appropriate action if: 
   i. A drug error or adverse drug event is discovered; or 
   ii. There is a reasonable suspicion that a drug error has occurred or will occur;
2. Documenting and reporting all drug incidents, drug errors, or adverse drug events within 24 hours of discovery; 
3. Contributing to monitoring and improving processes to minimize risk; and 
4. Participating in the Canada Vigilance Program, Health Canada’s post-market surveillance program for reported adverse drug reactions. 

The dental hygienist who administers a prescription or non-prescription drug must… 

10. Prepare and administer the drug in a manner that ensures accuracy and safety. This includes but is not limited to: 
1. Using knowledge of drug incidents and errors and taking steps to prevent them; 
2. Identifying the need for, and participating in, activities that create safe drug systems and practices; and 
3. Safeguarding drugs and not leaving drugs unattended. 
11. Ensure the patient record contains:  
1. The date and time the drug was administered; 
2. The route of administration; 
3. The name, strength, dose, and dosage form of the drug;  
4. The reason for administering the drug and the patient’s response; and 
5. Identification of the dental hygienist who administered the drug.  

The dental hygienist who recommends a non-prescription drug for a patient must… 

12. Consider appropriate information about the patient's condition to make a professional judgment on whether to: 
1. Recommend a non-prescription drug;  
2. Recommend another treatment or no treatment; or  
3. Refer the patient to another appropriate health professional. 
13. Provide the patient with relevant information to enable the patient to receive the intended benefit of the drug therapy. This includes but is not limited to: 
1. Rationale for the selection of a particular drug; 
2. Implications of using drug therapy; 
3. Risks and benefits of drug therapy; 
4. Possible side effects and when to report; and 
5. Administration instructions, and possible drug or food interactions, if applicable. 
14. Record the recommendation of non-prescription drugs in the patient record, including: 
1. The date the drug was recommended; 
2. Reason for recommending the drug; 
3. Identification of the dental hygienist who recommended the drug; and 
4. Details of the name, strength, dose, and dosage form of the drug, if provided to the patient. 

The dental hygienist who provides or sells a drug must… 

15. Store all drugs for provision or sale in a location and manner that does not allow patients to self-select the drugs. 
16. Provide the patient with sufficient information to enable the patient to receive the intended benefit of the drug therapy. This includes but is not limited to: 
1. Rationale for the selection of a particular drug; 
2. Implications of using drug therapy; 
3. Risks and benefits of drug therapy; 
4. Possible side effects and when to report; and 
5. Administration instructions, and possible drug or food interactions, if applicable. 
17. Hand the drug directly to the patient. If the drug is being released to a patient’s agent, the dental hygienist must: 
1. Confirm that the person is authorized to act as an agent for the patient; 
2. Provide the agent with the adequate information described above, if the dental hygienist is satisfied that it is in the patient’s best interest to do so; and 
3. Where possible, communicate verbally with the patient. 
18. Ensure drugs provided or sold are in appropriate containers by: 
1. Providing or selling drugs in the manufacturer’s original package or container unless it is not reasonably possible to do so; and 
2. Using a child-resistant package unless it is not appropriate for the patient, not suitable for the drug, or not readily available.  
19. If the drug is removed from the manufacturer’s package, ensure that:  
1. The drug is in an appropriate package, having regard for the nature of the drug, including sensitivity to light, humidity, and temperature.  
2. For non-prescription drugs, the package or container has a label that is clear, legible, and includes the following: 
1. A description of the drug in English including the generic name, strength, and manufacturer of the drug, or the brand name and manufacturer for a combination drug product; 
2. The quantity of drug in the package; 
3. A lot number for the drug; 
4. The expiry date for the drug; 
5. Directions for use. 
3. For Schedule 1 drugs, the package or container has a label that is clear, legible, and includes the following: 
1. The name of the patient for whom the drug is provided; 
2. The name, address, and telephone number of the dental hygienist who provided the drug; 
3. The name of the prescriber of the drug; 
4. A description of the drug in English including the generic name, strength, and manufacturer of the drug, or the brand name and manufacturer for a combination drug product; 
5. Instructions for the use of the drug;  
6. The date the drug was provided;  
7. The quantity of the drug provided; and 
8. The expiry date for the drug.  
20. Ensure the accuracy of the drug being provided.   
21. Record the sale or provision of the drug in the patient record. This includes: 
1. The date the drug was provided; 
2. The name, strength, and dosage form of the drug; 
3. The drug identification number (DIN) of the drug; 
4. The quantity of the drug provided;  
5. Reason for sale or provision of the drug; and 
6. Identification of the dental hygienists who provided the drug.  
22. Only provide or sell compounded drugs when it is not reasonably possible for the patient to obtain the drug from a pharmacy. 

Patient Expectations

The patient can expect the dental hygienist to safely, competently, and appropriately incorporate drugs into the patient’s care.