Virginia Regulatory Town Hall
Department of Health Professions
Board of Dentistry
Regulations Governing the Practice of Dental Hygiene [18 VAC 60 ‑ 25]
Action Continuing education for practice by remote supervision
Stage Fast-Track
Comment Period Ended on 9/5/2018
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8/10/18  6:45 pm
Commenter: Nicholas Ilchyshyn, DDS

CE for practice by remote supervision

The 2 hour CE requirement for hygienists practicing under remote supervision guidelines is inadequate primarily due to the deficiencies in certain undergraduate training programs. Even 4 year programs offering BS and RDH degrees manifest shortcomings in: 1.understanding the concept of therapeutic endpoints in periodontal disease management, 2. communicating basic prevention concepts (understanding that one-size does not fit all), 3. critical acknowledgement as to one's limits in "hygiene therapy", which in essence should be periodontal therapy, 4. Understanding the concept of the hygienist as a co-therapist versus a substitute for a trained specialist with post graduate certification and qualifications. According to §54,1-2722F "A dental hygienist ...may continue to treat a patient for 90 days. After such 90-day period, the supervising dentist,...shall either conduct an examination of the patient or refer the patient...". However, under 18VAC60-25-60 "A licensed dentist assumes ultimate responsibility for determining with the patient or his representative the specific treatment the patient will receive...". So how does one reconcile the conflict that the dentist assumes the "ultimate responsibility" but without the requirement to assess the patient prior to delivery of treatment in the remote supervision scenario?! I would not want to place myself in that position. This perspective comes from one who has practiced for over 40 years, has served as an adjunct clinical instructor in dental hygiene programs, and serves in free clinics where remote supervision applies. To summarize, CE for remote supervision is indeed indicated and necessary, but it would need to be within a meaningful context of comprehensive education supplanting the current educational shortcomings. Two hours does not satisfy that need.





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