Competencies for the New Dental Hygiene Graduate
University of Michigan

Introduction

Competencies for the New Dental Hygiene Graduate define and organize the skills, understanding, and professional values of an individual ready for beginning dental hygiene (DH) practice in a variety of settings. These competencies take into consideration that the DH program at the University of Michigan is unique in that it is structured to confer the baccalaureate degree to all students at the completion of the dental hygiene curriculum. Graduates are prepared not only for the traditional DH duties as clinician and health educator but also for roles as consumer advocate, change agent, researcher, and health care manager/administrator.

By defining the competencies of the new graduate, the DH program will have a basis with which to

1. review, redefine, and restructure the DH curriculum;
2. review and improve student evaluation processes and promotion criteria; and
3. establish and apply measures to assess the effectiveness of the DH program.

What Are Competencies?

Competencies describe the skills, understanding, and professional values of an individual ready for beginning dental hygiene practice. They are stated in terms of what a student must be able to do to be considered competent by the profession after the completion of the DH curriculum. As used in this document, the term “competency” does not imply marginal performance; it implies performance at a clinically acceptable level.

How are They Organized?

The competencies are organized into three domains: Professionalism, Patient Care, and Health Promotion and Disease Prevention. Within each domain there are four or five major competencies that are specifically defined by supporting competencies. Each supporting competency has foundation knowledge, skills, and attitudes that are not defined in this document but are found in individual courses.

1. Professionalism

   The profession of dentistry is changing rapidly and continuously. The competent new dental hygienist must not only provide skilled dental hygiene care based on contemporary knowledge and therapeutics, but must also be able to discern and manage ethical issues and problems in dental practice, exercise critical thinking and sound clinical judgment and communicate with other professionals.

   1. Ethics – The new dental hygiene graduate must be able to discern and manage the ethical issues of dental hygiene practice in a rapidly changing environment. Specifically, the new dental hygiene graduate must be able to:
      1. Articulate ethical principles relevant to the profession of dental hygiene and practice with personal and professional integrity.
      2. Provide humane and compassionate care for all patients while serving them and the community without discrimination.
      3. Maintain honesty and confidentiality in relationships with patients, colleagues and other health professionals.
      4. Comply with state and federal laws governing the practice of dentistry and dental hygiene.
      5. Provide treatment options that are sensitive to the patient’s goals and values, compatible with contemporary therapeutics and congruent with a patient-centered comprehensive oral care philosophy.
      6. Take appropriate action against an incompetent, unethical, or chemically/psychologically impaired colleague.
   2. Information Management and Critical Thinking – The new dental hygiene graduate must be able to acquire and synthesize information in a critical, scientific and effective manner. Specifically, the new dental hygiene graduate must be able to:
      1. Assume responsibility for lifelong learning and critical thinking in maintaining competency.
      2. Draw upon biomedical science and clinical knowledge to exercise sound clinical judgment and to manage problems of oral health care.
      3. Critically analyze published clinical and basic science research and integrate this information to the practice of dental hygiene.
      4. Demonstrate the ability to communicate professional knowledge verbally and in writing; using the principles of scientific writing where appropriate.
      5. Evaluate the safety and efficacy of oral health care products and treatments.
      6. Use current technology to organize information for retrieval, storage, and application.
      7. Apply the knowledge gained from current technology to the dental hygiene process of care and in management decisions.
   3. Professional Identity – The new dental hygiene graduate must be concerned with the knowledge, skills and values of the profession. Specifically, the new dental hygiene graduate must be able to:
      1. Advance the profession through leadership, service activities, and affiliation with professional organizations.
      2. Promote the expansion of and contribute to the knowledge base of dental hygiene.
      3. Assume the role of the profession (clinician, educator, researcher, change agent, consumer advocate, administrator) as defined by the ADHA.
      4. Promote the value of the dental hygiene profession to the public and other organizations.
      5. Accept responsibility and accountability for the evaluation of his/her own dental hygiene interventions.
   4. Management and Employment Practices – The new dental hygiene graduate will be able to support the dental team concept for providing the highest quality of care for all patients. Specifically, the new dental hygiene graduate must be able to:
      1. Utilize effective marketing strategies to promote dental and dental hygiene services.
      2. Identify the economic considerations required for a profitable practice including production, collection, and office overhead.
      3. Demonstrate effective leadership and motivational skills using communication and conflict resolution techniques.
      4. Utilize principles of office management relating to personnel issues including recruitment, retention, training, and evaluation.
      5. Establish standards for quality assurance of dental hygiene care.
   
   
2. Patient Care

   The dental hygienist is a licensed preventive oral health professional who provides education and clinical services for the support of optimal health. The new dental hygiene graduate must possess a thorough foundation in the biomedical, clinical and behavioral sciences and be able to apply those principles in diagnosis, risk assessment, treatment and evaluation.

   1. Patient Centered Care – Dental hygiene care should be provided in a manner and environment that focuses on the patient’s needs, interest, and well-being. Specifically, the new dental hygiene graduate must be able to:
      1. Establish and maintain effective and confidential rapport with patients using appropriate interpersonal skills.
      2. Identify the patient’s attitudinal, emotional, and psychological factors that enhance or impede the delivery of oral health care.
      3. Recognize the dental hygiene care needs of all patients, including those who are elderly, culturally diverse, disadvantaged, and physically challenged.
      4. Maintain accurate patient treatment records suitable for legal and scientific purposes.
   2. Assessment – The new dental hygiene graduate will be able to perform an examination that collects biological, psychological, and social information needed to evaluate the medical and oral conditions for patients of all ages. This includes the ability to recognize, organize, and manage behavioral factors which affect oral health and to use that information to implement strategies that facilitate the provision of oral health care. Specifically, the new dental hygiene graduate must be able to:
      1. Obtain, review, and update a reliable and valid medical, psychological, and dental history.
      2. Identify medical conditions that require special precautions or considerations and be prepared to handle an emergency should one occur during dental hygiene treatment.
      3. Perform an extraoral and intraoral examination including the assessment of vital signs and be able to record these findings.
      4. Recognize clinical manifestations of systemic diseases.
      5. Assess the periodontium and identify conditions that compromise the patient’s oral health.
      6. Determine the need for referral to an appropriate health professional.
      7. Identify the need for radiographs and when required, be able to radiographically distinguish normal from abnormal findings.
      8. Identify conditions and diseases that affect dietary intake and food selection, and recognize risks and benefits of alternative food patterns.
      9. Recognize the need for supplemental diagnostic tests and interpret the results.
   3. Dental Hygiene Diagnosis -- The new dental hygiene graduate will be able to analyze and interpret data to formulate a dental hygiene diagnosis related to and congruent with the diagnosis of the dentist and other health professionals. Specifically, the new dental hygiene graduate must be able to:
      1. Use both subjective and objective data to determine factors that impact on an individual’s oral health.
      2. Explain to the patient and significant others, as appropriate, the rationale, nature and prognosis of the dental hygiene care plan.
      3. Recognize the conditions of health, disease and disease mechanisms and apply this knowledge to clinical practice.
   4. Planning – The new dental hygiene graduate must be able to discuss the condition of the oral cavity by identifying actual and potential problems, etiologic and contributing factors and to recommend alternative available treatments. Specifically, the new dental hygiene graduate must be able to:
      1. Establish an individualized, comprehensive, properly sequenced treatment plan based on all relevant diagnostic data and develop alternative treatment plans as appropriate to achieve patient compliance.
      2. Establish planned educational services using appropriate interpersonal skills and educational strategies to promote optimal health.
      3. Identify the health needs of individuals and assist them in the development of appropriate and individualized self-care regimens.
      4. Encourage patients to assume responsibility for their health and promote adherence to self-care regimens.
      5. Provide appropriate oral hygiene aids according to patient’s attitudes, capabilities and intraoral needs.
      6. Establish a planned sequence of educational and clinical services based on the dental hygiene diagnosis using the evidence-based approach.
      Implementation – The new dental hygiene graduate must be able to provide care for patients of all ages that emphasizes prevention of oral disease and supports the maintenance of existing oral health through therapeutic procedures. Specifically, the new dental hygiene graduate must be able to:
      1. Provide care for patients of all ages that emphasizes prevention of oral diseases and supports the maintenance of existing health.
      2. Utilize accepted infection control procedures.
      3. Obtain diagnostic quality radiographs when appropriate.
      4. Apply basic and advanced techniques of dental hygiene instrumentation to remove deposits without trauma to hard and soft tissues.
      5. Control pain and anxiety during treatment through the use of accepted clinical techniques and appropriate behavioral management strategies.
      6. Select and administer appropriate chemotherapeutic agents and provide pre-and post-treatment instructions.
      7. Provide adjunct dental hygiene services that are legally appropriate.
      8. Proved oral health education to assist patients in assuming responsibility for their oral health.
      1. Evaluation – The dental hygiene graduate must be able to evaluate the effectiveness of planned clinical and education services and modify as appropriate. Specifically, the new dental hygiene graduate must be able to:
         1. Evaluate the effectiveness of the patient’s self care and the dental hygiene treatment in attaining or maintaining oral health care.
         2. Determine the patient’s satisfaction with the dental hygiene care received and the oral health status achieved.
         3. Determine the clinical outcomes of dental hygiene interventions.
         4. Develop a recall program that meets the patient’s needs and is appropriate to the specific practice setting.
   
   
3. Health Promotion and Disease Prevention

   The dental hygienist serves the community in both practice and public health settings. Public health is concerned with promoting health and preventing disease through organized community efforts, using an interdisciplinary approach. In the practice setting, the dental hygienist plays an active role in the promotion of optimal oral health and its relationship to general health. The dental hygienist, therefore, should be competent in the performance and delivery of oral health promotion and disease prevention services in the public health, private practice and alternative settings.

   1. Community Involvement – The new dental hygiene graduate must be able to interact with others to promote activities that protect, restore and improve oral health. Specifically, the new dental hygiene graduate must be able to:
      1. Identify services that promote oral health and prevent oral disease and related conditions.
      2. Respond to personal, patient or community requests for information about contemporary dental problems.
      3. Provide dental hygiene services in a variety of settings including hospitals, clinics, offices, hospices, extended care facilities, HMOs, community programs, institutions and schools.
      4. Assess, plan, implement and evaluate community based oral disease prevention strategies that aim to improve the oral health of the public.
   2. Self-Care Instruction – The dental hygiene graduate must be able to provide planned educational services using appropriate interpersonal communication skills and educational strategies to promote optimal health. Specifically, the dental hygiene graduate must:
      1. Promote preventive health behaviors by personally maintaining optimal oral and general health.
      2. Incorporate a wellness philosophy that promotes healthy lifestyles for staff and patients into the practice of dental hygiene and/or the workplace.
      3. Identify the health needs of individuals and assist them in the development of appropriate and individualized self-care plans.
      4. Encourage patients to assume responsibility for their health and promote adherence to self-care plans.
   3. Infection Control – The new dental hygiene graduate will routinely use universal precautions and comply with regulations regarding infection control, hazard communications, and medical waste disposal in order to protect patients, employees, and the community.