A dental hygienist working under the appropriate supervision of a licensed dentist shall perform the following tasks:

1. (1) Assessment, which must include:

   1. (a) Documentation of patient history.

      1. (i) Recording current and past dental oral health care; and

      2. (ii) Collection of health history data including the patient's:

         1. (A) Current and past health status;
         2. (B) Pharmacologic considerations;
         3. (C) Additional considerations;
         4. (D) Record vital signs and compare with previous readings; and
         5. (E) Consultation with appropriate health care provider(s) as indicated.

   2. (b) A comprehensive clinical evaluation:

      1. (i) An inspection of the head and neck and oral cavity including an oral cancer screening, evaluation of trauma and a temporomandibular joint (TMJ) assessment;
      2. (ii) Evaluation for further diagnostics including radiographs;

      3. (iii) Comprehensive periodontal evaluation that includes the documentation of:

         1. (A) Full mouth periodontal charting:

            1. (I) Probing depths;
            2. (II) Bleeding points;
            3. (III) Suppuration;
            4. (IV) Mucogingival relationship and defects;
            5. (V) Recession;
            6. (VI) Attachment level or loss.
         2. (B) Presence, degree and distribution of plaque and calculus;
         3. (C) Gingival health and disease;
         4. (D) Bone height and bone loss;
         5. (E) Mobility and fremitus;
         6. (F) Presence, location and extent of furcation involvement; and

         7. (G) A comprehensive hard tissue evaluation that includes the charting conditions and oral habits to include:

            1. (I) Demineralization;
            2. (II) Caries;
            3. (III) Defects;
            4. (IV) Sealants;
            5. (V) Existing restorations and potential needs;
            6. (VI) Anomalies;
            7. (VII) Occlusion;
            8. (VIII) Fixed and removable prostheses; and
            9. (IX) Missing teeth.
   3. (c) Risk assessments.

2. (2) A dental hygiene analysis of assessment findings. The dental hygienist shall:

   1. (a) Analyze and interpret all assessment data to evaluate clinical findings and formulate the dental hygiene care plan;
   2. (b) Determine patient needs that can be improved through the delivery of dental hygiene care; and
   3. (c) Incorporate the dental hygiene care plan into the overall dental treatment plan.

3. (3) Dental hygiene care planning. The dental hygienist shall:

   1. (a) Identify, prioritize and sequence dental hygiene intervention;
   2. (b) Coordinate resources to facilitate comprehensive quality care;
   3. (c) Collaborate with the dentist and other health and dental care providers and community-based oral health programs;
   4. (d) Present and document dental hygiene care plan to patient;
   5. (e) Explain treatment rationale, risks, benefits, anticipated outcomes, treatment alternatives, and prognosis; and
   6. (f) Obtain and document informed consent or informed refusal.

4. (4) Care plan implementation. The dental hygienist shall:

   1. (a) Review and implement the dental hygiene care plan with the patient or caregiver;
   2. (b) Modify the plan as necessary and obtain consent;
   3. (c) Communicate with patient or caregiver appropriate for age, language, culture and learning style; and
   4. (d) Confirm the plan for continuing care.

5. (5) Dental hygiene evaluation. The dental hygienist shall:

   1. (a) Use measurable assessment criteria to evaluate the outcomes of dental hygiene care;
   2. (b) Communicate to the patient, dentists and other health/dental care providers the outcomes of dental hygiene care; and
   3. (c) Collaborate to determine the need for additional diagnostics, treatment, referral education and continuing care based on treatment outcomes and self-care behaviors.

[Statutory Authority: RCW 18.29.210, 43.70.280, and chapter 18.29 RCW. WSR 18-21-141, § 246-815-160, filed 10/19/18, effective 11/19/18. Statutory Authority: RCW 18.29.130, 18.29.076 and 18.130.050. WSR 92-02-018 (Order 224), § 246-815-160, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. WSR 91-02-049 (Order 121), recodified as § 246-815-160, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.29.076 and 18.130.050(12). WSR 89-16-096 (Order PM 858), § 308-25-170, filed 8/2/89, effective 9/2/89.]