Dental Hygiene in Community Settings: Collaborative Dental Hygiene Practice
Today’s dental hygienist is no longer limited to providing care in a traditional dental setting. This toolkit provides guidance regarding collaborative dental hygiene practice and how you can become part of a "community dental team".
Toolkit: Collaborative Dental Hygiene Practice (CDHP) in Community Settings
Collaborative Dental Hygiene Practice: Making a Difference in Oral Health Care in a Twin Cities Homeless Shelter (audio file 2:33)
Click Minnesota Community Care, St. Paul (formerly West Side Community Health Services)
Lynn Anderson, RDH
Collaborative Dental Hygiene Practice: Providing Oral Health Services for People in a Twin Cities Day Center (audio file 2:46)
Click Sharing and Caring Hands Dental Clinic, Minneapolis
Melissa Cozart, RDH
Minnesota Oral Health Coalition Infomars
Click HERE to access the Infomar video
Click HERE to access the Infomar slides (pdf)
June 23, 20202 (51:14)
Click HERE to access the Infomar video
June 2, 2020 (1:00)
Presentation on January 17, 2020
- To define and give an understanding of what it means to be a non-profit
- Review the types of non-profits
- Give an overview of the steps to gaining non-profit status
- Answer the question: "Do I really need to start a non-profit organization to meet my goals?"
Collaborative Agreement Template and Tutorial
How to navigate the voice-over PowerPoint tutorial: (17 minutes)
* The video auto-advances.
Statutes (Laws), Rules and Regulations
Click HERE to find Minnesota Statutes 150A.10, subd. 1a (law) that authorizes Collaborative Dental Hygiene Practice in Community Settings and describes the community settings in which collaborative practice dental hygienists may provide care.
Click HERE to find Minnesota Administrative Rules 3100.8700 that lists/describes dental hygiene scope of practice/procedures that may be provided by a collaborative practice dental hygienist under general supervision and as outlined in a written collaborative agreement.
Click HERE for: Understanding the complexity of employment law and worker rights
Coffee Talk Videos: How to Get Started (earn CE credit)
Dental Hygienists and Dentists: learn how YOU can:
*Expand the number of dental hygienists who provide more people with access to preventive and therapeutic services and help in finding a dental home.
*Create a collaborative agreement between a licensed dental hygienist and dentist authorizing provision of dental hygiene services in settings such as schools, Head Start centers, long term care settings, mobile dental units, etc. as specified by law and when a dentist need not be on site.
* Obtain 2 no-cost 'fundamental' continuing dental education credits*
- View all five Coffee Talk videos (50 minutes, total)
- Print out the objectives/presenter biographies page
- Print out and answer the questions related to each video (45 minutes, total). Answer key is
provided with each set of questions.
Note: A printout of the objectives and completed questions will serve as documentation for your professional portfolio. Continuing Dental Education (CE) credit has been approved by the Minnesota Board of Dentistry.
Closed Captioning (CC) is available within each video.
Objectives/Presenter Biographies for CE Credit HERE
Collaborative Dental Hygiene Practice: A Professional Option (CDHP)
Collaborative dental hygiene practice in community settings results in more people with access to preventive and therapeutic services and in finding a dental home.
April 16, 2020
Creating a Dentist-Dental Hygienist Collaborative Relationship
Tell me about the Let's Smile story, and how you found your collaborative dentist.
I was a sub at a dental practice in my hometown, covering for a hygienist who was on medical leave. Being in that position provided a wonderful opportunity to develop a professional relationship with the dentist owner. I noticed that he participates in Give Kids a Smile (GKAS) and sponsors local children’s park and rec teams. In 2013, I approached him with the idea of becoming a collaborative dentist for me. I explained my plan to provide dental hygiene services to low income children and adolescents through non-traditional practice based in school-based clinics. He was hesitant at first since he had not heard of this concept. I provided him with information found on the Normandale Community College “21st Century Dental Team” website regarding Collaborative Dental Hygiene Practice in Community Settings. These are fantastic resources!
The dentist was under the impression that he would have to take all the referrals of the children seen by Let’s Smile. He was a current provider for Delta Dental Civic Smiles, Medicaid/Medical Assistance (MA) and UCare, however, the number of patients in his office on MA is limited and only to existing patients. I found three local offices that would accept Let’s Smile’s MA patients and assured him that I would only use his office as a referral source for GKAS.
What were some of the more difficult things you had to figure out when first practicing as a Collaborative Practice Dental Hygienist?
One thing we worked on was how referrals would work, because the dental practice couldn't handle all of them. To solve for this, I needed to find offices that I could refer to.
How did you accomplish that?
I called around and found other dental offices in the area that would accept MA and referrals. I send most of my referrals to a dental office in a neighboring city. We have a really special relationship and model that makes it a win-win-win for everybody! Let’s Smile contracts with one of their collaborative hygienists for each school-based dental clinic day. Then, we refer the patients to that dental practice (as well as 2 other locations) for follow up care. Dental therapists in the dental practice see the kids for follow up care when needed. This makes for continuation of care and an ongoing relationship to a dental home. This model is how we make our program sustainable.
You mentioned you have had 2 collaborative dentists, right?
Yes, after three years my collaborative dentist had some growing concerns over liability issues and chose to no longer participate as Let’s Smile’s collaborative dentist.
I then researched dentists that were active in my community. I became aware of another dentist who also participates in GKAS and sponsors local sports teams. He was and still is on the board of the Children’s Remedial Fund. He was and still is an active member of the Minnesota Dental Association. When I approached asked him to be my collaborative dentist, he already had knowledge of how a collaborative agreement works. He very graciously said yes! He wanted to use this model to reach and impact underserved families. He is a current provider for MA and had limited his practice to patients of record. I reassured him that Let’s Smile had a strong referral arrangement already with a dental practice which helped with his decision to participate. He attends the Let’s Smile board meetings, offers me advice, and is a true advocate for oral health care.
Do you have any other tips for hygienists looking to partner with a dentist in a collaborative agreement?
Begin by researching the dentists in your area. How involved are they in the community? What are they doing for the kids (or the populations that you serve)? Do they volunteer? Look for dentists that want to make a difference, and brainstorm together about how it can be done.
What would you say to dental hygienists hesitant about asking a dentist to form a collaborative agreement?
I would just say get curious about why you are hesitant. Perhaps, you don't fully understand the power you could have together! Collaborative Dental Hygiene Practice has the potential to make a HUGE impact in your community and the communities around you. In the end, the worst thing that can happen is that they say no. Then, just continue to ask around until you hear YES! Believe me, there ARE dentists out there who want to support new and non-traditional ways of delivering care-- especially during these trying times.
Holly Jorgenson, RDH
Let's Smile, Inc.
Advisory Committee/Advocates For Collaborative Dental Hygiene Practice
Stakeholder groups include representatives from the Minnesota Board of Dentistry, Minnesota Dental Assistants Association, Minnesota Dental Hygienists' Association, Minnesota Dental Association, Minnesota Department of Health, Minnesota Department of Human Services, Minnesota Oral Health Coalition, Normandale Community College Dental Hygiene Faculty, Delta Dental of Minnesota Foundation, Hennepin County Medical Center, Apple Tree Dental, Children's Dental Services, Park Dental, Herzing University, and the University of Minnesota School of Dentistry.
Becoming a "21st Century" Dental Team Member
Normandale Community College, as a result of HRSA and Delta Dental of Minnesota Foundation funding, hosted an event on August 3, 2017 intended to move thinking about provision of oral health care in an interprofessional direction. Speakers described their vision and experiences in development of a "Minnesota 21st Century Dental Team" to improve access to care and reduce health disparities.
School-Based Oral Health Programs
Click HERE for the Summit I Agenda
School-Based Dental Sealant Programs: Recommendations (2017)- Children's Dental Health Project. The national Sealant Workgroup's (SWG) report and recommendations for states and school sealant programs. Click HERE
School-Based Dental Sealant Programs Ohio Safety Net Dental Clinics modules describing the history, operations, and underlying principles of dental sealant programs. Click HERE
Long-Term Care; Elderly; Dementia/Alzheimer's Disease
April 6, 2021
Delta Dental and Ecumen Awakenings presents: Oral Care Series:
Click HERE to access education videos focusing on oral care for people living with dementia.
- Introduction (1:05)
- Oral changes and risks (5:24)
- Basic oral care for people living with Alzheimer's disease (3:11)
- Providing care for an independent person (2:52)
- Providing care for a dependent person (2:43)
- Techniques and atmosphere (2:02)
Teaching Oral Health Care for Older Adults
In a significant expansion of the NLN's signature Advancing Care Excellence for Seniors (ACE.S) program, four new teaching strategies in the critical area of oral health have been added to an array of free resources for nurse faculty. Created in partnership with the Oral Health Nursing Education and Practice (OHNEP) program at the Rory Meyers College of Nursing at New York University, they include:
- Importance of Oral-Systemic Health in Older Adults
- Oral Health for the Older Adult Living in the Community
- Developing Inter-professional Education and Practice in Oral Health
- Performing Oral Health Assessments
Click HERE for National League for Nursing teaching strategies
Growing Old With a Smile: Oral Care for Older Adults in Long-Term Care
Click HERE to access the video series (Minnesota Dental Association site)
This video series and workbook helps long-term care facilities improve the quality of oral care provided to residents and to assist in compliance with federal and state nursing home regulations. Developed by the Minnesota Department of Health and University of Minnesota School of Dentistry.
Special Care Dentistry
CE Opportunity (online; no cost)
One segment titled Therapeutic Oral Care Considerations for Adults with Intellectual and Developmental Disabilities is presented by Apple Tree Dental dentists Lyubov Slashcheva, DDS, MS, FABSCD and Christine Foulkes, DDS.
- A broad overview of individuals who present with special needs
- Risk reduction strategies to improve safety
- Tips for staff training and skills and communication
Listen to each episode and complete the short CE quiz at the end of each to earn .25 CE credits per episode.
- Click HERE to access the Colgate Oral Health Network Dental Podcast Series
or guidance. Free continuing education credits offered. Click HERE
(3rd ed.) provides information to health professionals to assist them in planning, developing, and implementing efforts to ensure that children and adolescents with special health care needs receive optimal oral health care. Click HERE
Click HERE for Gender identity and the role of the dental hygienist
Suzanne Hubbard, RDH; in RDH magazine. January 7, 2020
Suzanne Hubbard, RDH, has several patients who are undergoing gender transitions. She has been respectful of their choices and has learned much about the process. How does the process affect oral health?
Early Childhood; Head Start; Early Head Start
What is Head Start and how can a collaborative practice dental hygienist become involved?
Head Start programs prepare America’s most vulnerable young children to succeed in school and in life beyond school. To achieve this, Head Start programs deliver services to children age birth to 5 and their families in core areas of early learning, health, and family well-being.
Explore this tip sheet to find out about the Dental Hygienist Liaison (DHL) project. Learn about the purpose, scope, and role of DHLs.
Under the DHL project, DHLs promote oral health in Head Start programs. One dental hygienist from each state volunteers to help promote oral health for pregnant women and children enrolled in Head Start.
https://eclkc.ohs.acf.hhs.gov/sites/default/files/pdf/dhl-project-handout.pdfFind examples of the types of activities DHLs engage in to improve the oral health of pregnant women and children enrolled in Head Start.
Contact Minnesota's Dental Hygienist Liaison (DHL):
Cathy Jo Gunvalson email@example.com
Click HERE to access the guidance document titled
Understanding the Dental Periodicity Schedule and Oral Exam: A Guide for Head Start Staff
COVID-19 Infection Control Protocols and Procedures Webinar
On March 20, 2020, the American Dental Association (ADA) teamed up with leading infection control experts from the Organization for Safety, Asepsis, and Prevention (OSAP) to provide the dental community with practical guidance and education as we navigate the challenges COVID-19 is presenting to our profession.
The complete webinar is available to watch and earn 1 free CE credit. Included also are short clips from the discussion for quick answers to your questions. Click HERE
To address these issues, stakeholders in academia and public health worked together to identify some of these challenges and to provide strategies and suggestions for implementing CDC recommendations.
OSAP Infection Control for Dental Programs Using Mobile Vans and Portable Dental Equipment: toolkit; factsheets; site assessments; checklists. Uploaded 1-16-21
Helpdesk: Contact us with questions about Collaborative Dental Hygiene Practice
Help Desk FAQ
Q: As a Collaborative Agreement RDH how often do we need to take a Medical Emergencies Continuing Ed [course]?
A: The continuing education cycle for all dental hygienists follows a two-year license renewal timeframe, no matter the type of oral health setting/program in which the DH practices.
(a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter may be employed or retained by a health care facility, program, or nonprofit organization to perform the dental hygiene services listed in Minnesota Rules, part , subpart 1, without the patient first being examined by a licensed dentist if the dental hygienist:
Q: What strategies can you suggest when seeking a collaborative dentist? My long-standing dentist stepped down.
A: Refer to the dropdown menu titled Collaborative Dental Hygiene Practice: A Professional Option (see black sidebar on left side of this page) to learn of a dental hygienist's experience when seeking a new collaborative dentist.
Q: What are the benefits (tangible and intangible) to a dentist in signing on as a collaborative practice dentist?
A: In addition to increasing access to dental care, entering into a collaborative agreement provides an opportunity to innovate with other dental professionals in order to create a more sustainable dental delivery system. With collaborative dental hygiene practice models, dental professionals can meet patients where they're at - whether it's in a school, a nursing home, a memory care facility, hospital, etc. As a result, more people will get the care they need. CDHP allows a dentist and dental team to provide services to the community and extend the reach of their work. The tangible benefits to entering into a collaborative agreement will vary depending on organizational structure, but could include increased revenue for the dental practice if it is structured that way. The intangible benefits may include increased job satisfaction, brand awareness, and customer/patient loyalty. Dental practices that engage in CDHP with their existing staff could also see intangible benefits in increased employee morale and retention. Utilizing collaborative practice provides a unique opportunity for dental teams to come together with a common purpose and passion to create innovative paths inside dentistry.
Q: What is the liability to the dentist in signing on as a collaborative practice dentist?
A: The following response was transcribed from this website's video Coffee Talk 3: Unravelling the Challenges: Part II; time stamp 4:15... https://tinyurl.com/vyrjkg4
Liability for Services Provided by the Collaborative Practice Dental Hygienist:
"Another thing that comes up often on the business side of collaborative dental hygiene practice is the issue of liability. The law doesn’t speak directly to this. There is nothing in the language that states who is liable for the patient outcomes. But as with any clinical situation, we assume that it’s both the dentist who’s collaborating with the dental hygienist, as well as the dental hygienist who is responsible for patient outcomes.
[In Minnesota], there really is no mandate for a dentist or a dental hygienist to carry liability insurance. And often dental hygienists are covered under their employer's plans. But we highly recommend that a dental hygienist carry their own liability insurance, even if they are covered under their employer. There are good reasons for that."
Q: Is a collaborative practice dental hygienists' work limited to a certain target population?
A: The opportunity for dental hygienists to provide care in community settings was developed in 2001 with the intention to serve uninsured and underinsured Minnesotans, in particular those persons enrolled in Minnesota Health Care Programs, who experience(d) barriers/difficulty in accessing oral health care services.
Q: As a collaborative practice dental hygienist, I have a written agreement with a dentist who will be away from work for a period of time. If a collaborating dentist is, for example, on maternity or medical leave, can I continue as usual with services in the schools or do I need to find a different dentist to sign a collaborative agreement?
A: If the collaborative dentist is willing to remain in the relationship and communicate with you during their leave, there doesn’t seem to be a reason why they couldn't continue as the collaborative dentist with your program. Consider meeting with the dentist before they go on leave to discuss that they will be available by phone for questions/collaboration if needed during this time. Immediately following the discussion, you may want to add a note to your collaborative agreement document describing what you and the dentist talked about. To plan in advance if a chart review or urgent answer is needed during the extended leave, the dentist may consider naming a colleague for this purpose, although not required by MN Statute 150A.10.
Q: Am I required by the Board of Dentistry to register my collaborative agreement?
A: Response to this question can be found on the above-mentioned document Collaborative Dental Hygiene Practice FAQs.