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Legislation and Regulation governing Oral Hygiene Practice in South Africa

The practice of Oral Hygiene has been governed by legislation since 1969, even before oral hygiene education commenced. Currently, the policy of the Health Professions Council of South Africa (HPCSA) states that courses in oral hygiene must be conducted at a dental faculty or a department of dentistry at a university and that matriculation exemption is a requirement for entry to the course. The scope of practice was initially enacted in 1974 by the Minister of Health and Welfare in the Medical, Dental and Supplementary Health Service Professions Act and extended in 2000 to include extended functions.

Oral hygienists are legally required to be registered annually by payment of a fee to the HPCSA. The oral hygiene profession is regulated by the Professional Board for Dental Therapy and Oral Hygiene under the Health Professions Council of South Africa (HPCSA). The chairman of the Professional Board for Dental Therapy and Oral Hygiene has voting rights in the Council on matters concerning oral hygiene. At present the initial law, which requires oral hygienists to practice under the direct supervision of dentists is in effect.However, Oral Hygienists that comply with the requirements for registration of independent practice may register to do so according to the CONDITIONS TO REGISTER IN THE CATEGORY INDEPENDENT PRACTICE (REGULATIONS NO R.800 OF 17 OCTOBER 2013) .

Regulations Defining the Scope of the Profession of Oral Hygiene

In these regulations the "Act" means the Health Professions Act, 1974 (Act 56 of 1974), and any expression to which a meaning has been assigned in the Act shall bear that meaning, and unless the context otherwise dictates:
"board" means the Professional Board for Dental Therapy and Oral Hygiene established in terms of section 15 (1) of the Act;
"oral hygiene" means the profession of a person registered as a oral hygienist in terms of the Act;
"oral hygienist" means a person registered as such in terms of the Act;
"independent practice" means practicing independently and autonomously as in private practice and/or in the employ of a third party where the oral hygienist functions as an independent health care practitioner within the scope of the profession of the oral hygienist;

Scope of the profession of oral hygiene

The following acts are hereby specified as acts which shall, for the purposes of the application of the Act, be deemed to be acts pertaining to the profession of oral hygiene:

1. Develop, implement and evaluate oral health promotion programmes;

2. Patient care:

a. Assessment:

i. assess a patient by means of an interview and an oral clinical examination, which includes patient histories, oral hygiene practices, dietary and tobacco use, vital signs, extra-oral and intra-oral examination;

ii. perform analogue and digital radiography and take clinical photographs;

iii. take impressions, cast, trim and polish study casts;

iv. refer to appropriate dental practitioner any conditions or presenting features outside the scope of practice of the oral hygienist;

b. Diagnosis and treatment plan:

i. make a differential diagnosis

ii. make a dental hygiene diagnosis and develop an appropriate treatment plan within the scope of the profession of the oral hygienist;

iii. consult with dental therapists, dentists and dental specialists as appropriate;

c. Education and preventive care:

i. advise and educate patients about oral self care practices, including mechanical and chemotherapeutic plaque control, nutritional counselling and tobacco cessation;

ii. advise patients about the dietary supplements, such as vitamins, fluoride tablets, mouth rinses and other anti-microbial agents;

iii. apply topical agents such as caries-preventive agents, remineralising agents, tooth-desensitising agents, topical anaesthetics and plaque-controlling agents;

iv. apply pit and fissure sealants;

v. perform scaling of teeth, scaling of implants and polishing of teeth;

vi. make study casts to produce protective vacuum formed mouth guards;

d. Therapeutic care:

i. apply minimally invasive procedures such as atraumatic restorative techniques (ART);

ii. apply minimally invasive procedures such as sealant restorations;

iii. treat dentine hypersensitivity and cervical abrasion lesions with glass ionomer cement or appropriate materials;

iv. polish and recontour overhanging restorations;

v. perform root debridement;

vi. apply local anaesthesia;

e. Cosmetic care:
apply vital tooth bleaching (whitening) techniques and procedures;

3. assist dental therapists, dentists, dental specialists in the performance of basic and advanced clinical procedures;

4. manage a medical emergency within the scope of the profession of oral hygiene;

5. perform the following supportive clinical procedures as prescribed by dentists and dental specialists:

a. Periodontics:

i. take cytological smears;

ii. apply and remove periodontal packs;

iii. remove surgical sutures;

iv. splinting mobile teeth

b. Conservative Dentistry and Prosthodontics:

i. place temporary restorations as an emergency measure;

ii. perform temporary cementing of inlays, crowns and bridges;

iii. place soft linings in dentures as tissue conditioners;

iv. place and remove rubber dam and matrix bands;

c. Orthodontics:

i. perform cephalometric tracings;

ii. relieve trauma caused by intra-and extra-oral appliances, such as the cutting of distal ends of arch wires;

iii. take impressions, cast and trim study and primary work models;

iv. place pre-activated orthodontic appliances, remove orthodontic attachments and bands (place and remove elastics and ligature wires, place and activate arch wires);

v. re-cement orthodontic retainers.

Oral Hygiene Education and Academic Tradition in South Africa

The duration of all programs is three years, at the end of which a Degree in Oral Hygiene is issued. There is an academic entry requirement to be admitted into programs, which constitutes 12 years of schooling and a matriculation.

After graduation from an accredited program, oral hygienists are registered with the Professional Board for Dental Therapy and Oral Hygiene. Since 2000 the Minister of Health has approved extended functions into the scope of oral hygiene practice. Previously qualified practicing oral hygienists will be permitted to perform these functions after attending upgrading coursework. Upon successful completion a certificate of competency will be issued for registration purpose. OHASA has achieved that continuing professional development should become compulsory in 2004.

Today, the oral hygiene student body includes representatives of all ethnicities residing in South Africa. All universities offer general financial assistance to students if necessary and on merit.

Educational Programs in Oral Hygiene are offered at:

Education & Training Institution Contact Details

University of the Western Cape Ms N Gordon
Tel (+27) 21 3704400
E-mail ngordon@uwc.ac.za
University of Pretoria Ms R du Bruyn
Tel (+27) 12 3192645
E-mail Rene.DuBruyn@up.ac.za
University of Witwatersrand Mrs Tshakane Daveyrose Ralephenya
Tel (+27) 11 488 4892
E-mail Tshakane.Ralephenya@wits.ac.za
University of KwaZulu Natal Dr Shenuka Singh
Tel (+27) 31 242 6214
Fax (+27) 31 260 8069
Cel (+27) 73 841 7384
E-mail singhshen@ukzn.ac.za
Sefako Makgatho Health Sciences University Ms Gabonege Sedibe
Tel (+27) 12 521 4938
E-mail gabonege.sedibe@smu.ac.za

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