As dental professionals, we see patients up to three or four times a year. In retrospect, as per CDHA (Canadian Dental Hygienist Association), Registered Dental Hygienists see a larger population versus other medical professionals. We often work with patients who have complex medical histories, and often present with risk factors that require an interdisciplinary approach.1
Our founding father Dr. Alfred Fones’ initial paradigm for the profession focused on a “new preventative dental care provider who worked outside of the dental office with the intention of motivating people to obtain comprehensive dental care.” Dr. Fones saw dental hygiene as a distinct profession that would be positioned within dental public health, and he believed that dental hygienists should provide education and preventative treatment outside of the dental office. Dr. Fones envisioned dental hygienists working collaboratively with other health and social service workers to provide preventative dental care to the public.2
What is Interprofessional Collaborative Practice (ICP)?
According to the World Health Organization (WHO), Interprofessional Collaborative Practice occurs when multiple health care workers from different professional backgrounds provide comprehensive services by working with patients, their families, caregivers, and communities to deliver the highest quality of care.3 Elements of collaborative practice include responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect. All elements dental hygienists are already familiar with through the College of Dental Hygienists of Ontario (CDHO) Standards of Practice and Code of Ethics.
We play a crucial role within the interprofessional team. It is well established that poor oral health is associated with many different health conditions. As the prevalence of these conditions increases, it is important to understand the role and the value we hold when working within an interprofessional collaborative team.4 As a dental provider, it is also important to recognize our own professional identity while gaining an understanding of other professional’s roles in the healthcare team.
What is our role in the interprofessional paradigm?
As Registered Dental Hygienists we play a significant role in screening patients for certain primary care metrics. For example, hypertension can be easily monitored by dental hygienists. One advantage of having routine patient visits is that we have the opportunity to monitor patients’ blood pressure over an extended period of time. Being able to observe and identify normal, low and high blood pressures allows us to take appropriate measures and communicate with our patient and other members in the interprofessional team.
As disease prevention specialists, we have skills in health promotion, disease prevention, health education, and behavioral motivation that allow us to provide effective tobacco cessation counseling. Since we have a high frequency of interaction with our patients, we’re able to deliver tobacco cessation support with repeated reinforcement, which is essential for all tobacco users. Collaborating between health-care providers is a key to success, and patients may be more open to discussion with a different professional rather than their family physician.
We also provide oral healthcare to a very large population of mental health, chronic pain, diabetic, and COPD patients. These patients take medications that often cause xerostomia, which increases gingival inflammation, and increases caries and periodontal risks. These patients could be better managed when we collaborate as an interprofessional team viewing the disease process from a dental, medical, pharmaceutical, and mental health management standpoint.
As dental professionals, we also know how much diet can affect your mouth. We are in a position where we have tools, such as salivary tests to monitor pH levels, and we have the knowledge in identifying tooth erosion caused by a high carbohydrate or sugar intake. We are also able to identify potential bulimic patients with tooth erosion, not to mention the halitosis caused by vomiting. In these situations, for example, we have the opportunity to refer our patients to a dietician, who can help guide and develop a proper plan for our patients.
Additionally, we have the tools and continuing education opportunities to become Certified Myofunctional Therapists. Orofacial myofunctional disorders can lead to many orthodontic and dental problems and are implicated in sleep-disordered breathing. If left untreated these disorders can negatively impact quality of life. As an RDH trained in Myofunctional Therapy, we are able to work with the muscles of the lips, tongue, cheeks and face, and their related functions such as breathing, sucking, chewing, swallowing and some aspects of speech. In some cases, we are able to collaborate with other healthcare professionals such as doctors, nurses, physical therapists, occupational therapists, and speech pathologists.
To conclude, as Registered Dental Hygienists, we are primary oral health care providers, and we play an integral role within a patient’s circle of care. The collaboration between the dental team and other members of the interprofessional team may increase patient awareness about oral health and its effects on overall systematic health. As such, we have the responsibility to develop and maintain professional relationships with other health care professionals to ensure optimal patient outcomes, safe practices, and mutual respect and trust.5
References
- Tobacco use cessation services and the role of the dental hygienist — a CDHA position paper. Canadian Dental Hygienists Association. Accessed September 28, 2023.
- Nathe , C. (2018, March 1). Fones’ big picture. Registered Dental Hygienists. Accessed May 18, 2024.
- Framework for Action on Interprofessional Education & Collaborative Practice. Geneva: World Health Organization (WHO). 2010. Accessed March 8, 2024.
- Registered Dental Hygienists are Essential Primary Health Care Professionals. CDHA. (2020). Accessed March 16, 2024
- Interprofessional collaboration – CDHO. CDHO . (2016, September). Accessed May 18, 2024
About the Author
Whitney Foster has had the privilege to work in various roles in the dental field. With a passion for oral health and its relationship to overall health, Whitney strives to support and mentor fellow dental hygienists on the subject. In October 2024, Whitney will be offering a professional development course through RDHU that will focus on interprofessional collaboration.
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