Flu Season is On The Way
The Health Authorities in BC have implemented a policy for influenza immunization of all health care workers who come into contact with patients at publicly funded health care facilities in the community, including long-term care facilities. This includes all health care workers including health authority staff, physicians and residents, volunteers, students, and contractors and vendors who come into contact with patients. These individuals are now required to receive an influenza vaccine no later than the first week of December or to wear a surgical/procedure mask during influenza season when in a patient care area (influenza season typically extends from the end of November until the end of March but may vary with seasonal epidemiology).
Dental hygienists who provide care for patients in community settings, public health settings, or residential care facilities are required to comply with this new policy. Students and staff of educational facilities are also encouraged to be immunized against the influenza virus, given their interaction with patients in community and long term care rotations. Program directors should consult with the respective Deans of their institutions regarding implementation strategies.
Dental hygienists who work in private general practice are encouraged to receive the influenza vaccine to assist in the prevention of transmission of the disease, however are not required to follow the Health Authority policy.
The College wishes to emphasize the importance of meticulous infection control and prevention including diligent hand hygiene, proper use of masks and gloves, and refraining from attending work when ill. For more information on the Infection Prevention and Control Guidelines recently published by the CDHBC and CDSBC, please access the document on the Practice Resources page.
Back to Top
Coming Soon: New Log-in Process
In the coming weeks, the College will be introducing an upgrade to the log-in system for the registrant site in order to enhance security. The new system will require all registrants to enter a username and password combination. All registrants must upgrade their account.
Once the new system is in place, the first time registrants visit the site they will be required to provide their current login information (registration number, DOB, email address). Then before they will be able to access their account, they will be prompted to create a unique password for their account; this will be the password to sign in to the registrant profile area of the CDHBC website going forward. As part of this new system, please note that all registrants will only be able to use an email address that they check on a regular basis.
Stay tuned to your email inbox as a message will be coming out within the next few weeks when the new system has been launched which will contain further instructions. All registrants will be encouraged to switch over to the new system before the 2016/17 renewal period opens in January 2016 to ensure a smooth renewal process.
Back to Top
CDHBC Webinar Series
Practice Standards and Clinical Documentation… Are you Hitting the Mark?
Documenting care provided in an accurate and appropriate manner is essential as a healthcare provider, and is one of the College’s required Practice Standards. This webinar highlights critical areas that are often omitted in the client’s treatment record. Sharing these scenarios will help registrants build confidence in implementing the required documentation standards into their practice setting.
The Practice Standards and Clinical Documentation… Are you Hitting the Mark? webinar that was presented live on November 4th, 2014, January 28th, 2015, March 26th, 2015 and June 9th, 2015 is now available on-demand. Registrants are permitted to claim 1 continuing competency (CC) credit for viewing the on-demand webinar. Each registrant viewing the webinar must complete the CDHBC Practice Standards and Clinical Documentation Webinar Form which will act as supporting documentation for the completion of this CC activity.
The College has compiled a selection of frequently asked questions arising from the Practice Standards and Clinical Documentation webinar, which can be accessed here.
Back to Top
Update: Patient Relations
On August 4, 2015, the mandatory 90 day consultation period as required by the Health Professions Act concluded for the proposed bylaw changes to the Patient Relations Program. These changes included a provision that would prevent a dental hygienist from treating a client with whom they have a sexual relationship, including spouses. CDHBC received some feedback from registrants regarding those changes. In addition, CDHBC is aware that both in BC and Ontario, Colleges in the dental related professions are taking another look at the treatment-of-spouses provisions. Also, the BC Health Regulators have formed a working group to address the entire issue of patient relations and client boundaries.
The CDHBC board will review all information in the coming months before taking any further steps in relation to this issue. Therefore, until further notice, the bylaws related to patient relations remain unchanged and it is still permissible for a dental hygienist to treat their spouse or a client with whom they have a sexual relationship.
Back to Top
Root of the Matter: Heart Attack and Stroke
Authored by the CDHBC Dental Hygiene Practice Advisors
In the Spring 2010 issue of Access the College published a Root of the Matter article with information on the timing of dental hygiene treatment for clients following the occurrence of a heart attack or stroke. In response to continued interest in this topic, we are now publishing an updated and expanded version of this article.
To treat or not to treat: What is safe practice following a heart attack or stroke?
In Canada, over 70,000 individuals experience a heart attack each year, which is approximately one every 7 minutes.1 Additionally, more than 50,000 Canadians experience a stroke annually, which is approximately one every 10 minutes.1 Given the prevalence of both of these conditions, there is a strong likelihood that a client may present to their dental hygienist for scheduled treatment within a short time period following a heart attack or stroke. This should promptly raise the question of whether the client is medically stable enough to safely undergo potentially invasive dental hygiene therapy.
For a client who has previously had a stroke, dental hygiene textbooks recommend that elective treatment be avoided within 6 months of the episode;2-4 this is because up to one third of strokes recur within 1 month of the initial event and the risk remains elevated for at least 6 months.3 Textbook recommendations for a client who has previously had a heart attack vary, with some indicating that elective dental treatment should be deferred for a minimum of 30 days following the incident (if the client’s condition is stable and without additional complications)2,3 while others recommend a 6 month deferral.4
Although this information provides a good cautionary window between the incident and potentially stressful oral procedures, there is little evidence to support the recommendations as being appropriate for all clients. Each heart attack or stroke survivor has had a completely unique experience with their own set of complicating factors and healing rates. As such, it may be more appropriate to consider each individual independently, and to obtain and document a medical consult if there are any concerns regarding the client’s medical status and safety in proceeding with dental hygiene treatment.4
In communication to the CDHBC, the American Heart Association (AHA) has indicated there are currently no specific guidelines regarding the length of time required before providing dental hygiene treatment to a client who has had a stroke or heart attack.5,6 For this reason, the AHA recommends that each client be considered on a case-by-case basis when determining fitness for treatment.5 The client’s cardiologist, neurologist or physician (as appropriate for the condition) should be consulted prior to proceeding with dental hygiene treatment in order to determine whether the client is in fact healthy enough to withstand the potential stress and medical impact of these procedures. Preventing medical emergencies and providing safe care may necessitate postponing dental hygiene treatment until the client’s health has stabilized.
As drug therapies for treating and preventing stroke evolve, it remains essential to thoroughly update each client’s medical history and medication list. This includes understanding the complications and dental considerations associated with the medication, prior to providing care. Both stroke and heart attack survivors may receive antiplatelet or anticoagulant therapy which predisposes them to excessive bleeding and therefore physician consultation is also recommended to determine whether the therapy should be altered.2 Appropriate documentation in the client’s chart of any communication with the client’s physician is required.
Lastly, it is important for dental hygienists to remain current with considerations and modifications required when treating someone with cardiovascular concerns, as the perceived stressful nature of a dental hygiene appointment may potentially precipitate a heart attack or stroke while the client is in the chair. Such considerations may include, but are not limited to2,3:
- Measuring and documenting the client’s blood pressure and modifying treatment as required
- Incorporating stress reduction protocols
- Monitoring the client for signs of cardiac complications (ie. chest pain, shortness of breath, dizziness, fatigue)
- Booking short morning appointments
- Ensuring the client’s INR number is within an acceptable range prior to providing care if the client has been placed on anticoagulant therapy (consulting the client’s physician may be required).
- Limiting epinephrine to the cardiac dose of 0.04mg (i.e. 2 carps of 1:100,000epi)
References:
1. Heart and Stroke Foundation. Statistics [Internet]. 2015 Available from: http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3483991/k.34A8/Statistics.htm
2. Darby ML, Walsh M. Dental Hygiene Theory and Practice. 4th ed. St Louis: Saunders; 2015.
3. Little JW, Falace DA, Miller CS, Rhodus NL. Dental Management of the Medically Compromised Patient. 8th ed. St Louis: Mosby; 2013.
4. Malamed SF. Medical Emergencies in the Dental Office. 7th ed. St Louis: Mosby; 2015.
5. American Heart Association. Email from Jessica Swanner (AHA.NSC.General@heart.org) 2015 Aug 4 [cited 2015 Aug 6].
6. American Heart Association. Email from Cherish Hart (cherish.hart@heart.org) 2009 Nov 2 [cited 2015 Aug 6].
Back to Top
Tech Tips
Please be aware that Hotmail has recently changed their security settings. If you have a Hotmail account, please ensure that you have added cdhbc@cdhbc.com to your safe contact list as the College sends important notices via email. Please note this will only ensure that you receive emails sent from the cdhbc@cdhbc.com email address. You will still need to check your junk folders for any emails that have been sent to you directly from a College staff member and add each address to your safe contact list. The College strongly encourages its registrants to use alternate email addresses to reduce the risk of missed emails. It is the registrant's responsibility to ensure that your email host will accept our email notices.
If you are having difficulty logging in to the Registrant site or opening pdfs on our website, please either upgrade your Internet Explorer or use an alternate browser such as Google Chrome or FireFox. The login issue is specifically related to Internet Explorer.
Back to Top
Moving?
It is a bylaw requirement that registrants of the College ensure that their mailing address is always current on the CDHBC register. Incorrect or out-of-date addresses can lead to missed mailings that may include important notices and documents. Address changes can be submitted online at www.cdhbc.com or via email to cdhbc@cdhbc.com and should include the following information.
- Name
- Registration Number
- Old Address
- New Address
- Email
- Telephone
- Effective Date
Back to Top