WAC 246-815-160. Standards of dental hygiene practice

A dental hygienist working under the appropriate supervision of a licensed dentist shall perform the following tasks: (1) Assessment, which must include: (a) Documentation of patient history. (i) Recording current and past dental oral health care; and (ii) Collection of health history data including the patient's: (A) Current and past health status; (B) Pharmacologic considerations; (C) Additional considerations; (D) Record vital signs and compare with previous readings; and (E) Consultation with appropriate health care provider(s) as indicated. (b) A comprehensive clinical evaluation: (i) An inspection of the head and neck and oral cavity including an oral cancer screening, evaluation of trauma and a temporomandibular joint (TMJ) assessment; (ii) Evaluation for further diagnostics including radiographs; (iii) Comprehensive periodontal evaluation that includes the documentation of: (A) Full mouth periodontal charting: (I) Probing depths; (II) Bleeding points; (III) Suppuration; (IV) Mucogingival relationship and defects; (V) Recession; (VI) Attachment level or loss. (B) Presence, degree and distribution of plaque and calculus; (C) Gingival health and disease; (D) Bone height and bone loss; (E) Mobility and fremitus; (F) Presence, location and extent of furcation involvement; and (G) A comprehensive hard tissue evaluation that includes the charting conditions and oral habits to include: (I) Demineralization; (II) Caries; (III) Defects; (IV) Sealants; (V) Existing restorations and potential needs; (VI) Anomalies; (VII) Occlusion; (VIII) Fixed and removable prostheses; and (IX) Missing teeth. (c) Risk assessments. (2) A dental hygiene analysis of assessment findings. The dental hygienist shall: (a) Analyze and interpret all assessment data to evaluate clinical findings and formulate the dental hygiene care plan; (b) Determine patient needs that can be improved through the delivery of dental hygiene care; and (c) Incorporate the dental hygiene care plan into the overall dental treatment plan. (3) Dental hygiene care planning. The dental hygienist shall: (a) Identify, prioritize and sequence dental hygiene intervention; (b) Coordinate resources to facilitate comprehensive quality care; (c) Collaborate with the dentist and other health and dental care providers and community-based oral health programs; (d) Present and document dental hygiene care plan to patient; (e) Explain treatment rationale, risks, benefits, anticipated outcomes, treatment alternatives, and prognosis; and (f) Obtain and document informed consent or informed refusal. (4) Care plan implementation. The dental hygienist shall: (a) Review and implement the dental hygiene care plan with the patient or caregiver; (b) Modify the plan as necessary and obtain consent; (c) Communicate with patient or caregiver appropriate for age, language, culture and learning style; and (d) Confirm the plan for continuing care. (5) Dental hygiene evaluation. The dental hygienist shall: (a) Use measurable assessment criteria to evaluate the outcomes of dental hygiene care; (b) Communicate to the patient, dentists and other health/dental care providers the outcomes of dental hygiene care; and (c) Collaborate to determine the need for additional diagnostics, treatment, referral education and continuing care based on treatment outcomes and self-care behaviors.