Ministry of Health Amendments to Oral Health Regulations in Force
February 26, 2020
On February 24, the Ministry of Health announced that the amended oral health regulations for dental hygienists, dental technicians, denturists and dentists were deposited with the registrar of regulations and are now in force. Read the Ministerial Order >>
This is a high-level description of the changes to the regulations. We intend to communicate with the other oral health colleges about the implications of the changes and will provide additional guidance in the near future.
Regulations define scopes of practice
Regulations are created by the government for each health profession governed under the Health Professions Act (HPA). Each regulation contains a scope of practice statement that describes what the profession does and how it does it, and a list of activities that outlines what members of that profession are authorized to do.
The amended regulations are in keeping with the Minister's desire to improve access to oral health services and to promote inter-professional, collaborative, team-based care and are intended to:
- align the regulations to the HPA model (characterized by two elements: shared scope of practice statements and restricted activities)
- standardize terms shared between the regulations
- clarify that unregulated persons cannot perform the restricted activities that fall under these professions (unless authorized) and ensure that colleges have the necessary authority to act when unregulated individuals provide these services
To build understanding among all members of dental team about how the changes affect each profession, below is a summary of key changes for dental hygienists, dental technicians, denturists and dentists.
Please note that regulations are hosted on the BC government's BC Laws website (see links below). As of February 26, the amendments described below are not reflected on the BC Laws website but will be shortly.
- 365 day rule has been removed, meaning that a dental exam is not required for dental hygiene care
- Dental hygienists may make a dental hygiene diagnosis identifying gingivitis or periodontitis as the cause of the signs or symptoms of an individual
- Dental hygienists who have the proper certification may administer local anaesthetic without a dentist on site
There is enhanced clarity related to prescription drugs (prescription* from a health care professional must be documented in the chart before a registrant can administer a Schedule 1 drug). Dental hygienists working with a dentist in a traditional office setting have always been allowed to provide local anaesthetic. Existing office protocols for this would still apply under the amended regulation
Dental hygienists may initiate intra-oral radiographs for the purpose of dental hygiene care
- Dental hygienists may reduce a complete dislocation of the temporomandibular joint (TMJ) using manual therapy, should it occur during the course of dental hygiene care
- Dental technicians may, on receipt of a written request from a denturist:
- make or alter a complete denture and provide the denture to the denturist who requested it
- make or alter a partial denture or overdenture and provide the denture to the denturist who requested it, if the request is accompanied by a prescription*
- Dental technicians may take impressions only for the purpose of making or altering a mouthguard designed or offered for temporary protection against injury during sporting activities*
- Denturists may make minor adjustments to a partial denture or overdenture, without a prescription*, if it does not change the original design of the prosthesis or with consent from the prescribing dentist
- Denturists are not required to refer a patient back to the prescribing dentist for an examination after he/she has been fitted with an overdenture or partial denture
- Denturists, authorized by a prescription, may dispense a partial denture that is supported by implants and natural teeth
- Denturists may reduce a complete dislocation of the temporomandibular joint (TMJ) using manual therapy is included in the regulation, should it occur during treatment
- Denturists may perform tooth whitening
- The requirement for a denturist to provide a prescribed service within 90 days after the prescription is issued (or 365 days with the approval of a dentist) has been removed
- Denturists may interpret radiographs
- Denturists may provide sport mouthguards
- Changes to the dentists regulation were limited to the standardization of terms shared between the regulations, and do not impact the scope of practice for dentists
*Where additional clarity is needed, the colleges will work collaboratively to develop guidance for registrants. For example, the definition of “prescription" has been changed in the denturists and dental technicians regulation, and CDSBC is working collaboratively with the College of Denturists of BC (CDBC) and the College of Dental Technicians of BC (CDTBC) to develop interpretive guidelines around this new definition.
No changes for certified dental assistants and dental therapists
The services that dental therapists are authorized to provide are contained in Schedule D1 of the CDSBC bylaws (PDF, page 115).
The services that CDAs are authorized to provide are contained in Part 8 of the CDSBC Bylaws. For more information, see the interpretive document A Guide to CDA Services (PDF).
Questions
We are preparing additional communications to provide guidance to registrants on these amended regulations. In the meantime, any questions can be submitted to registrarsoffice@cdsbc.org. Please include “regulations" in the subject line.
