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 SCDHA President's Message ...

Having 2020 Vision
 

This may seem like a silly question to ask now, but what were you doing when the ball dropped at midnight on December 31 as we “welcomed” the New Year 2020?  I can remember so many people using “2020” and its relationship to sight or visual acuity as a metaphor for seeing clearly; “the year 2020 will be the year we see clearly into the next decade” … oh, if we only knew what was coming!!!  
 

I think most don’t stop long enough to look ahead with clarity – I suspect there are quite a few of us whose “vision” had become dull and out-of-focus from the day in and day out grind, and most of us are (or were) complacent in our day-to-day work/life/school activities.  In some regard, I think it could be said we took a lot for granted. But then something got our attention: SARS-CoV-2.  
 

Regardless of where you are in your dental hygiene career – all have been affected, to some extent, by the COVID-19 pandemic.  In March, practicing dental hygienists experienced temporary unemployment and, for some, forced retirement or job loss.  Graduating dental hygiene students were scrambling to complete educational and clinical requirements while schools were closing down around them, and licensing examinations were cancelled and rescheduled ultimately postponing new grads from licensure attainment. Our vision was clouded by fear, which was at an all-time high, and conflicting leadership distracted our focus.  In May, when dentistry in Ohio re-opened, we emerged to confusing, and somewhat contradicting reports for practicing safely; new infection control regulations, strategies for patient management and scheduling, navigating office flow to maintain social distancing best practices, and PPE requirements were implemented to keep both clinician and public safe during dental health care. Although we tried to "see clearly," the ever evolving pandemic only allowed for a focus on the "here and now.”   
 

Vision, I have come to realize, is less about perfection – we can’t always all have “20/20 vision;” it is more about movement (correction can be applied to help us “see more clearly” along the way). Philosophically speaking, vision is grounded in purpose.  It requires us to ask “why do we exist?” and once we have a good understanding of our purpose – a clearer vision will follow.  In order to move forward, we must remind ourselves that our purpose is unchanged: “…to improve the oral health of the public, to advance the art and science of dental hygiene, and to promote high standards of quality care.” and “… to render a full measure of service to each patient entrusted to [our] care, and to uphold the highest standards of professional competence and the personal conduct in the interests of the dental hygiene profession and the public it serves.” (Excerpts from the Dental Hygiene Oath). Movement forward also requires us to look at our past mistakes in order to correct them and effectively move forward. This is not an easy task – but we can be more efficient together.  
 

The Pandemic has “opened our eyes” to day-to-day indifference and requires that we elevate our infection control standards and vigilance in patient care and treatment planning.  We must remain focused on standards of care in a changing environment; we can no longer be complacent in our daily work/life/school activities.  And now – more than ever, your voice matters during these unprecedented times! Dental hygiene practice is experiencing real change and it’s an important time to become involved, to stay up-to-date, and be part of the conversations taking place that are shaping our future profession.  

 

So – what vision do you see?  Do you want to join the conversation and have a voice that is part of the change?  Your membership counts!  If you are a member – great; now get involved!  If you are not, I urge you to join ADHA as a means to secure your future vision as a dental hygienist AND collectively we can continue to be an influence in oral and dental health policy and decision making. To learn more about becoming a member or renewing your ADHA membership, visit our membership page or ADHA.

 
 
Jamie Krob, DHEd, MPH, RDH 
SCDHA President 2020-2021

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From the State Dental Board of Ohio

The Board recently amended OAC rule 4715-8-01(B) to require dentists and dental hygienists to obtain a minimum of two (2) hours of continuing education per biennium pertaining to the prescribing of opioids for acute, subacute, and chronic pain. This requirement applies to the 2020-2021 and 2022-2023 biennium only. 

 

You may be wondering why RDHs would be included in this mandate.  Although RDHs are not licensed to actually prescribe, they are definitely responsible for assessing/updating patient medical history and clinical assessments, including recognizing acute, subacute, and chronic pain and patterns/potential for addiction.  RDHs are included in patient treatment planning concerning pain management (e.g. local anesthetic).  Ultimately, RDHs are directly involved with patient safety and education, so the importance of this educational requirement cannot be overstated. 

Licensees should ensure they meet this continuing education requirement during each biennium. You may view OAC rule 4715-8-01(B) here: 

http://codes.ohio.gov/oac/4715-8 

 

If you would like more information regarding other continuing education requirements, please visit the “Education & Renewal” tab of our website here: 

https://www.dental.ohio.gov/Education-Renewal/Continuing-Education 

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Ohio and the Opioid Epidemic:
How Dental Hygienists Play a Role 

Unintentional drug overdose continues to be the leading cause of injury-related death in Ohio, ahead of motor vehicle traffic crashes – a trend which began in 2007. 

 

According to a new report released by the Ohio Department of Health (ODH), Ohio’s opioid epidemic has continued to evolve with stronger drugs driving an increase in unintentional overdose deaths. The ODH report shows a sharp rise in overdose deaths involving the opioid fentanyl, the emergence of more deadly fentanyl-related drugs like carfentanil, and indications that cocaine is now being used with fentanyl and other opiates. The report also contains some promising news – the fewest prescription opioid overdose deaths since 2009.  This is promising overall, how does dentistry fit into this perspective? 

 

"The latest numbers from the NIH show 1 in 8 high schoolers report using prescription opioid painkillers recreationally. The majority of these kids get their pills from friends and family, which is hardly surprising considering a 2016 study found nearly 100 million prescribed painkillers go unused after wisdom tooth extractions" (as reported in "Dentists: On the front line of the opioid epidemic").

 

Dental pain is real – and dental professionals are faced with the professional dilemma of striving for patients’ optimal oral health, while elevating their dental pain, on a daily basis.  So it is even more imperative that dental health professionals become better educated themselves on how to educate their patients about early detection and early intervention of dental/oral disease as well as how to best manage pain.  Education is key – for both the dental health processional -- and the patient. 

 

Call to Action

So how can we, as dental hygienists, be proactive and help lead the call to action within our offices?  We must position ourselves through self-education and gain awareness of the resources available to us and our patient populations. We should educate ourselves on reducing our patients’ exposure to opioids, on what is being done to limit the opioid supply, and how to help those already struggling with addiction.  The American Dental Education Association (see full article below) suggested implementing this strategy as a start: 

  • Educating ourselves about pain management, addiction, and prescribing practices
  • Screening patients to identify their risk for substance misuse.
  • Consulting prescription monitoring programs (PMPs) to identify patients who may be “doctor shopping.”
  • Developing relationships with addiction treatment providers to facilitate referrals

 

 I have provided several resources below to help you get started.  

Jamillee L. Krob, DHEd, MPH, RDH

SCDHA  President

 

Resources
 

“The Opioid Crisis” (Bilich, 2017) published in Dimensions of Dental Hygiene

http://www.dimensionsofdentalhygiene.com/2017/04_April/Features/The_Opioid_Crisis.aspx 
 

"A Dental Response to the Opioid Epidemic” from the American Dental Education Association
https://adeachartingprogress.wordpress.com/2017/11/15/a-dental-response-to-the-opioid-epidemic/ 

 

Governor's Cabinet Opiate Action Team
http://fightingopiateabuse.ohio.gov/ 

 

Action Guide to Address Opioid Abuse  http://mha.ohio.gov/Portals/0/assets/Initiatives/GCOAT/GCOAT-Health-Resource-Toolkit.pdf 

 

From the OSDB 

(orignially published in Ohio State Dental Board’s electronic newsletter, e-Bulletin)


ACUTE PAIN PRESCRIBING RULES

As one of the responses to the opioid epidemic facing Ohio, the Board adopted the following rules related to opioid prescribing on August 31, 2017 along with other healthcare related licensing boards.  It is important for prescribers to not only be aware of these rules but also to understand their practical application.  The Board’s Chair of the Dental Opioid Strategy Team, Dr. Kumar Subramanian, has worked closely with other clinicians on developing an appropriate strategy for addressing overprescribing. 

4715-6-01 Standards and procedures for review of "Ohio Automated Rx Reporting System" (OARRS).

4715-6-02 Prescribing opioid analgesics for acute pain.

 

The link below will take you to the Morphine Equivalent Dose calculator that is convenient to use.  This calculator is housed in the OARRS portal.

https://www.ohiopmp.gov/MED_Calculator.aspx

 

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Permissible Practices Documentation for Dental Hygienists

Please be advised that the Ohio State Dental Board (OSDB) requires every dental hygienist to provide and maintain specific documentation in each office or facility in which they are employed. The documentation does NOT need to be filed with the OSDB, but must be maintained at each place of employment in their employee file. Please click here for the Permissible Practices Documentation for Dental Hygienists.

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SCDHA Newsletter

Members of SCDHA receive a newsletter twice a year as a direct benefit of membership. For more information about the SCDHA Newsletter or how to join the mailing list, contact the editor at: scdhacereg@aol.com

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