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I work for a corporate dental company. At my office located in a rural area, the dentist moved on and there hasn’t been a provider the past 3 months. They are looking for another dentist but haven’t had any luck and have indicated it may be another 6 months before we have a provider. I have been still doing prophys/SRP’s/perio maint on patient’s of record, but I am concerned about the legality of it. Is it appropriate to be completing treatment on these patients without having periodic exams within so many years? I realize in different states there are different laws/rules regarding this. I live in Oregon, which is a great state to be a hygienist in :), but I can’t seem to find any information on this subject. Also at another office I work in for the same company, I have had some pushing from my office manager to see patient’s who have never had an exam/been seen at our office before for their “cleaning”, and then the comprehensive exam is scheduled a couple of weeks later due to limited openings on the Doctor’s side of the schedule. I don’t feel that this is right on an ethical level, not to mention having the radiographs to determine the proper dental hygiene diagnosis, but my manager doesn’t seem to care. Any advice or links to specific laws would be greatly appreciated!!

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As far as patients of record who have been seen and diagnosed by the dentist, there isn’t anything in Oregon’s Dental Practice Act which specifies how long a hygienist can treat them without having a doctor exam. This is because it is up to the doctor to determine the frequency of need for exams. I’m licensed in Oregon too and I reached out to the Board of Dentistry for clarification because I couldn’t find any thing in the Practice Act either. 🙂
As far as treating new patients who have not had a doctor exam (let alone not have radiographs, etc.), I think it’s safe to say that is beyond a hygienists scope of practice, as we are under indirect supervision of a dentist. Regardless of what your manager says, it’s not their license on the line. It sounds to me that they are most likely more interested in production numbers than following the law, protecting your license, and being ethical in regards to proper patient care.
For further help on this, I would recommend reaching out to the Oregon Board of Dentistry. They make the rules and enforce them, so they are the ones to point you to specific laws. Teresa Haynes at the Board has always been a great help to me. Her email is: Teresa.Haynes@state.or.us
Stick to your ethics and what you know is lawful!

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