Registered Dental Hygienists in Alternative Practice

Hygiene Services Authorized by Medical or Dental Prescription

Policy Statement

“The California Dental Association will promote and support an increase in the availability of providers who participate in and deliver oral health care to California’s underserved and special needs populations.   .  .  .  .  The development of new or the expansion of existing traditional and non-traditional allied training programs designed to meet the need for increased allied dental personnel will be encouraged and supported by CDA.”
--Access to Care position paper, 2002

Background

Effective January 1, 1998, this new category of dental auxiliary licensure was established by the Legislature which the Dental Board’s Committee on Dental Auxiliaries (COMDA) examines and licenses.

Generally, applicants for RDHAP licensure are required to:

  1. Hold a current Registered Dental Hygienist license;
  2. Have been engaged in clinical practice as a dental hygienist for a minimum of 2,000 hours during the immediately preceding 36 months (which can be in California or another state);
  3. Possess a bachelor's degree or its equivalent;
  4. Complete 150 hours of an approved educational program; and
  5. Pass a written examination prescribed by the Dental Board.

On August 9, 2002, the Dental Board approved the first RDHAP educational program, offered by West Los Angeles College.  On January 30, 2004, the Board approved the application of the University of the Pacific’s School of Dentistry to offer RDHAP training.  That program started offering distance learning courses in Fall 2004.

Summary of RDHAP Scope of Practice

Once licensed, an RDHAP may practice as:

  1. An employee of a dentist;
  2. An employee of another registered dental hygienist in alternative practice;
  3. As an independent contractor;
  4. As a sole proprietor of an alternative dental hygiene practice;
  5. As an employee of a primary care clinic or specialty clinic that is licensed pursuant to Section 1204 of the Health and Safety Code;
  6. As an employee of a primary care clinic that is licensed pursuant to Section 1204 of the Health and Safety Code;
  7. As an employee of a clinic owned or operated by a public hospital or health system; or,
  8. As an employee of a clinic owned and operated by a hospital that maintains the primary contract with a county government to fill the county's role under Section 17000 of the Welfare and Institutions Code.

RDHAPs may perform the duties established by Dental Board regulation in the following settings:

  1. Residences of the homebound.
  2. Schools.
  3. Residential facilities and other institutions.
  4. Dental health professional shortage areas, as certified by the Office of Statewide Health Planning and Development in accordance with existing office guidelines.

An RDHAP may provide allowable services to a patient without a prescription for no more than 18 months. After 18 months the RDHAP must obtain a written verification that the patient has been examined by a dentist or physician and surgeon before providing additional services. The verification shall include a prescription for the continuation of dental hygiene services. The prescription shall remain valid for no more than two years.  

Prior to the establishment of an independent practice, an RDHAP must provide to the board documentation of an existing relationship with at least one dentist for referral, consultation, and emergency services. The dentist's license must be current, active and not under discipline by the board.  Any changes must be reported to the Board in writing, within 30 days following such change.

Resources

California Business and Professions Code Section 1775 

California Code of Regulations Sections 1090 and 1090.1

UOP Education Program in Oral Health for People With Special Needs

 

Updated June 2009