Affiliated Practice Relationship; An Opportunity for Dental Hygienists and Dentists

An Affiliate Practice Relationship must:

• Be between a licensed Arizona dental hygienist and licensed Arizona dentist • Be in writing and submitted to the Board of Dental Examiners within 30 days after the effective date of the agreement • Have identified procedures and standing orders that the dental hygienist must follow
Scope: Subject to the terms of the written affiliated practice agreement, the hygienist may perform the following procedures: ? Prophylaxis ? Record clinical findings ? Scaling ? Compile case histories ? Closed subgingival curettage ? Periodontal examination ? Expose and process dental radiographs ? Apply topical fluoride ? Examine the oral cavity and surrounding structures ? Place dental sealants The dental hygienist may NOT provide the following procedures: ? Root planing ? Administration of local anesthetics and nitrous oxide ? Placing of periodontal sutures Settings: Dental hygienist may perform procedures in contract with a public health agency or institution, a public or private school authority or government sponsored program that provides dental services. The dental hygienist may perform dental hygiene procedures in affiliate practice settings on persons who are: ? Enrolled in a federal, state, county or local health care program ? Participating in the national school meal program ? From a family with a household income that is less than 200% of the federal poverty guidelines Referrals & Follow up Care: • Patients must be seen by a licensed dentist within 12 months of initial treatment by the dental hygienist or the dental hygienist cannot provide further treatment • Patients must be informed when further dental hygiene services may not be received until the patient is seen by a licensed dentist • Affiliated dentist can make necessary referrals to other dentists • Patients over the age of 64 must be seen by a licensed dentist after treatment by the dental hygienist or the dental hygienist cannot provide further treatment • If a patient presents with a complex medical history or medication regimen, the dental hygienist is required to consult with the affiliated dentist prior to any treatment Dental Hygienists are eligible to enter into an affiliated practice relationship if they: • Hold an active Arizona license and current CPR certification • Have held a dental hygiene license for at least 5 years Affiliated Practice Relationship: An Opportunity for Dental Hygienists and Dentists Revised 8/21/10 Content compiled from BODEX by Michelle Panico & Lynnette Martin • Were actively engaged in dental hygiene practice for at least 2,000 hours in the five years immediately preceding the affiliated practice relationship • Maintain an appropriate level of contact, communication and consultation with the affiliated dentist • Complete 12 hours of continuing education in the following areas to be included in the already required 54 hours: 4 hours in medical emergencies and 8 hours in two of the following: pediatric or other special health care needs, preventive dentistry or public health community-based dentistry • Advise the patient that care is provided by a licensed dental hygienist and does not take the place of a diagnosis or treatment plan by a dentist • Limit services to those duties within the terms of the affiliated practice relationship Dentists: • Must be licensed in the state of Arizona • Must be available to provide an appropriate level of contact, communication and consultation with the affiliated dental hygienist • Adopt standing orders applicable to the dental hygiene procedures • Arrange a substitute dentist to cover when the AP dentist is unavailable for contact, communication, or consultation • Provide timely referral of patients referred by the affiliated dental hygienist to a licensed dentist for examination and treatment planning with a dentist who is geographically available to the patient For more information go to: www.azdentalboard.us