Thoughts on the profession “then and now” from Shirley Bassett BCDHA Vice-President 1988-1990, President 1991-1992

S.Bassett1. What was different about dental hygiene (techniques, practice etc.) during the decade or so during which you were President?

Quite a bit has changed for the better since I was BCDHA President. A few notable examples below.

In the early 1980’s gloves, masks and eyewear were not standard practice in dental offices. However as awareness of HIV/AIDS grew, public concern for possible transmission of the disease through dental procedures led to the development of infection control guidelines with gloves, masks, and eyewear becoming the standard when treating all patients.

The BCDHA also worked really hard during the late 1980’s to raise awareness of both the skills of the dental hygienist and the plight of individuals living in long term care that were unable to manage their own personal oral care. At that time training programs for long term care staff had no obligation to include instruction oral health and oral care.  As a result health care workers often had very little knowledge about the need for good oral care or the skills to provide it. BCDHA sent a written brief and made a public presentation to the 1990 Royal Commission on Health Care & Costs that was established by the government. Most of the recommendations that BCDHA made to the Commission were fulfilled. These included the development of policies and procedures to support the oral health care of long term care residents, and inclusion of oral care in the health care assistant curriculum. (As well as self-regulation and degree education for dental hygienists.)

Today licensed long term care facilities must have policies and procedures in place to support their residents’ oral health, including an examination by a dentist or dental hygienist. Students enrolled in health care assistant training (HCA) programs now receive instruction in oral care. At Camosun for example, the dental hygiene students enjoy the opportunity to participate in this instruction during a practical session with the health care assistant students. In return they receive instruction from the HCA students in how to transfer clients.  All of this work not only helped to empower other health care workers in the area of oral care, it also created job opportunities for dental hygienists in long term care facilities.

Dental hygiene was not recommended for designation as a self-regulated profession until 1993. My colleagues and I worked really hard to present the very clear evidence that dental hygiene is an independent profession, just like nursing or physiotherapy. We were fortunate that dental hygiene aligned well with new direction the government wanted to take, shifting from treatment to prevention and health promotion.  Introduction of the Health Professions Act (HPA) by the government, at that time provided a perfect means to achieve self-regulation.  It would have been extremely difficult to achieve a separate Dental Hygienists Act.  Now all health care professions fall under the HPA (including the dentists).

We were able to work with the BC Government and Ministry of Health at time when the climate was right to ensure that our profession could be more independent.

During my time as BCDHA President, I was very driven by my own views that people need to be able to access preventive care, and they shouldn’t have to suffer the costly consequences of dental disease due to lack of education or access to care.  Dental hygienists are an incredibly sensible group of skilled people who spend a great deal of our professional lives on prevention with great benefits to the health and quality of lives of our clients.

2. What do you wish had changed between then and now that has not?

There are several things that I would like to have seen change over the last 20-30 years. I think we’re making great strides in improving the profession, but there is more to do.

First, the 365 rule.  Those of us involved during the self-regulation period never thought we’d be stuck with this rule almost 20 years later. The 365 component of the legislation came out of the blue and was tacked on, at the last minute to the self-regulation piece we’d been working to get through.  We knew we could walk away and not accept what was being offered, but we felt that the ability to self-regulate was the critical piece. To be honest, we also felt that 365 was such ridiculous legislation that it would be no problem to get it off the books.  We have seen this has not been so easy!  I would love to see this 365 rule go away as it is an impediment to access to care, and it does nothing to ensure patient safety.

The second thing I really notice is that dental hygiene is still on the fringes of health care. Consider for example when a patient is admitted to hospital.  Not only do they see the “standard” group of health care providers, they have access to nutritionists, physiotherapists, occupational therapists, social workers etc. But rarely do they have access to a dental hygienist. To me this speaks to a continued lack of understanding about the role of oral health and its contribution to overall health.  Until oral health is seen as an essential part of the “sickness care system”, we remain on the fringe.  I do think things are changing, just slowly. For example, I was heartened to hear that at a one of our local hospitals cardiac care patients are being given information about dental hygiene care.  What I want the new generation of dental hygienists to hear is that there are jobs out there for us, you just have to know which doors to knock on.  Hospitals, pediatrician offices, long term care facilities, community health clinics, and diabetes associations are just a few of a long list of “doors” that need “knocking on”. The public needs the support of dental hygienists.  Let’s keep pushing to make that happen.  Don’t be daunted by the fact that change takes time (even 10 years is not that long in the grand scheme of things).

As a profession we’re quite a disparate group in terms of where we work.  Not many of us have large dental hygienist work groups that might provide inspiration and support for tackling change.  That is why BCDHA is so important.  It is our common bond and our strength lies in unity.  Keep plugging away and rely on BCDHA and new communication mediums to unite our voices so we can continue to make a difference.