CALIFORNIA RDHAP DENTISTRY LAW
AND ETHICS
CERTIFICATION ASSESSMENT
Q&A
2024
1. You are a registered dental hygienist in alternative practice (RDHAP) and
you have been hired by a nursing home to provide oral care services to the
residents. You notice that one of the residents, Mrs. Jones, has severe
periodontal disease and needs scaling and root planing. However, the
nursing home does not have a dentist on staff and Mrs. Jones has not seen a
dentist in years. What is the most ethical and legal course of action for you to
take?
a) Perform scaling and root planing on Mrs. Jones without a dentist's
supervision or referral.
b) Refer Mrs. Jones to a dentist and wait for his or her authorization before
performing scaling and root planing.
c) Inform the nursing home administrator of Mrs. Jones' condition and
request that they arrange for a dentist to examine her.
d) Decline to provide any oral care services to Mrs. Jones until she sees a
dentist.
*Answer: b) Refer Mrs. Jones to a dentist and wait for his or her
authorization before performing scaling and root planing.*
*Rationale: According to the Dental Practice Act of California, RDHAPs can
only perform scaling and root planing under the general supervision of a
dentist, which means that the dentist has authorized the procedure but does
not need to be physically present. Performing scaling and root planing
without a dentist's supervision or referral would be unethical and illegal, as
it would violate the scope of practice and endanger the patient's health.
Informing the nursing home administrator or declining to provide any oral
,care services would not be sufficient, as it would not ensure that Mrs. Jones
receives the necessary treatment in a timely manner.*
2. You are an RDHAP and you have been contracted by a school district to
provide preventive oral health services to low-income children. You are
working in a mobile dental unit that visits different schools every week. One
day, you encounter a child who has a large carious lesion on his maxillary
central incisor that is causing him pain and discomfort. The child tells you
that his parents do not have dental insurance and cannot afford to take him
to a dentist. What is the most ethical and legal course of action for you to
take?
a) Apply fluoride varnish on the child's tooth and advise him to brush and
floss regularly.
b) Place a temporary filling on the child's tooth and give him some
analgesics for pain relief.
c) Refer the child to a dentist who provides free or low-cost care and follow
up with him until he receives treatment.
d) Report the child's parents to the child protective services for neglecting
his dental health.
*Answer: c) Refer the child to a dentist who provides free or low-cost care
and follow up with him until he receives treatment.*
*Rationale: According to the American Dental Hygienists' Association
(ADHA) Code of Ethics, RDHAPs have a duty to promote access to care for
all people and to collaborate with other health professionals to meet the oral
health needs of the public. Applying fluoride varnish or placing a temporary
filling would not address the underlying cause of the child's pain and
infection, which could lead to serious complications if left untreated.
Reporting the child's parents would not be appropriate, as it would not help
the child get the care he needs and could harm his relationship with his
family. Referring the child to a dentist who provides free or low-cost care
and following up with him until he receives treatment would be the most
ethical and legal course of action, as it would ensure that the child gets the
best possible care within his means.*
3. You are an RDHAP and you have been hired by a dental office to provide
oral hygiene instruction and prophylaxis to their patients. You work under
the direct supervision of Dr. Smith, who is the owner and sole dentist of the
office. Dr. Smith has instructed you to use an ultrasonic scaler on all patients,
regardless of their medical history or oral condition. You know that
ultrasonic scaling is contraindicated for some patients, such as those with
,cardiac pacemakers, infectious diseases, or hypersensitivity. What is the
most ethical and legal course of action for you to take?
a) Follow Dr. Smith's instructions and use an ultrasonic scaler on all
patients, as he is your employer and supervisor.
b) Refuse to use an ultrasonic scaler on any patient, as it is not within your
scope of practice as an RDHAP.
c) Use your professional judgment and discretion to decide whether to use
an ultrasonic scaler or not on each patient, based on their individual needs
and preferences.
d) Report Dr. Smith to the dental board for violating the standard of care
and endangering the patients' health.
*Answer: c) Use your professional judgment and discretion to decide
whether to use an ultrasonic scaler or not on each patient, based on their
individual needs and preferences.*
*Rationale: According to the Dental Practice Act of California, RDHAPs can
perform ultrasonic scaling under the direct supervision of a dentist, which
means that the dentist is physically present and personally diagnoses and
authorizes the procedure. However, RDHAPs also have a duty to exercise
their professional judgment and discretion in providing oral health care
services, as stated in the ADHA Code of Ethics. Following Dr. Smith's
instructions blindly and using an ultrasonic scaler on all patients would be
unethical and illegal, as it would disregard the patients' individual needs
and preferences and potentially harm their health. Refusing to use an
ultrasonic scaler on any patient would also be unethical and illegal, as it
would limit the patients' access to care and deprive them of the benefits of
ultrasonic scaling when indicated. Reporting Dr. Smith to the dental board
would not be appropriate, as it would not resolve the issue at hand and
could damage the working relationship. Using your professional judgment
and discretion to decide whether to use an ultrasonic scaler or not on each
patient, based on their individual needs and preferences, would be the most
ethical and legal course of action, as it would respect the patients' autonomy
and well-being and comply with the scope of practice and standard of care.*
1. A patient has requested to access their dental records. Which of the
following statements best describes the ethical and legal obligations of a
dental hygienist in this situation?
a) The dental hygienist has the ethical duty to provide access to the patient's
dental records, but the patient must pay a fee for photocopies.
, b) The dental hygienist has the legal obligation to provide access to the
patient's dental records within a reasonable timeframe and at no additional
cost.
c) The dental hygienist can deny access to the patient's dental records if they
believe it may cause harm to the patient.
d) The dental hygienist can refuse access to the patient's dental records
unless a valid court order is provided.
Answer: b) The dental hygienist has the legal obligation to provide access to
the patient's dental records within a reasonable timeframe and at no
additional cost.
Rationale: Patients have the right to access their dental records under the
Health Insurance Portability and Accountability Act (HIPAA). Dental
hygienists are legally obliged to provide access to the patient's dental records
within a reasonable timeframe and without charging any additional fees.
2. Which of the following actions represents an ethical breach by a dental
hygienist?
a) Exchanging personal gifts with patients during the holiday season.
b) Accepting a dinner invitation from a patient to build a stronger rapport.
c) Discussing a patient's oral health condition in an open waiting room.
d) Providing evidence-based dental hygiene education to patients.
Answer: c) Discussing a patient's oral health condition in an open waiting
room.
Rationale: Confidentiality is an essential ethical principle in dentistry.
Discussing a patient's oral health condition in a public setting violates the
patient's right to privacy and breaches ethical standards.
3. A dental hygienist suspects that a child is being physically abused based
on visible injuries. What is the dental hygienist's ethical and legal
responsibility in this situation?
a) The dental hygienist is obligated to report suspicions of child abuse to
local authorities.
b) The dental hygienist can choose whether or not to report suspicions of
child abuse.
AND ETHICS
CERTIFICATION ASSESSMENT
Q&A
2024
1. You are a registered dental hygienist in alternative practice (RDHAP) and
you have been hired by a nursing home to provide oral care services to the
residents. You notice that one of the residents, Mrs. Jones, has severe
periodontal disease and needs scaling and root planing. However, the
nursing home does not have a dentist on staff and Mrs. Jones has not seen a
dentist in years. What is the most ethical and legal course of action for you to
take?
a) Perform scaling and root planing on Mrs. Jones without a dentist's
supervision or referral.
b) Refer Mrs. Jones to a dentist and wait for his or her authorization before
performing scaling and root planing.
c) Inform the nursing home administrator of Mrs. Jones' condition and
request that they arrange for a dentist to examine her.
d) Decline to provide any oral care services to Mrs. Jones until she sees a
dentist.
*Answer: b) Refer Mrs. Jones to a dentist and wait for his or her
authorization before performing scaling and root planing.*
*Rationale: According to the Dental Practice Act of California, RDHAPs can
only perform scaling and root planing under the general supervision of a
dentist, which means that the dentist has authorized the procedure but does
not need to be physically present. Performing scaling and root planing
without a dentist's supervision or referral would be unethical and illegal, as
it would violate the scope of practice and endanger the patient's health.
Informing the nursing home administrator or declining to provide any oral
,care services would not be sufficient, as it would not ensure that Mrs. Jones
receives the necessary treatment in a timely manner.*
2. You are an RDHAP and you have been contracted by a school district to
provide preventive oral health services to low-income children. You are
working in a mobile dental unit that visits different schools every week. One
day, you encounter a child who has a large carious lesion on his maxillary
central incisor that is causing him pain and discomfort. The child tells you
that his parents do not have dental insurance and cannot afford to take him
to a dentist. What is the most ethical and legal course of action for you to
take?
a) Apply fluoride varnish on the child's tooth and advise him to brush and
floss regularly.
b) Place a temporary filling on the child's tooth and give him some
analgesics for pain relief.
c) Refer the child to a dentist who provides free or low-cost care and follow
up with him until he receives treatment.
d) Report the child's parents to the child protective services for neglecting
his dental health.
*Answer: c) Refer the child to a dentist who provides free or low-cost care
and follow up with him until he receives treatment.*
*Rationale: According to the American Dental Hygienists' Association
(ADHA) Code of Ethics, RDHAPs have a duty to promote access to care for
all people and to collaborate with other health professionals to meet the oral
health needs of the public. Applying fluoride varnish or placing a temporary
filling would not address the underlying cause of the child's pain and
infection, which could lead to serious complications if left untreated.
Reporting the child's parents would not be appropriate, as it would not help
the child get the care he needs and could harm his relationship with his
family. Referring the child to a dentist who provides free or low-cost care
and following up with him until he receives treatment would be the most
ethical and legal course of action, as it would ensure that the child gets the
best possible care within his means.*
3. You are an RDHAP and you have been hired by a dental office to provide
oral hygiene instruction and prophylaxis to their patients. You work under
the direct supervision of Dr. Smith, who is the owner and sole dentist of the
office. Dr. Smith has instructed you to use an ultrasonic scaler on all patients,
regardless of their medical history or oral condition. You know that
ultrasonic scaling is contraindicated for some patients, such as those with
,cardiac pacemakers, infectious diseases, or hypersensitivity. What is the
most ethical and legal course of action for you to take?
a) Follow Dr. Smith's instructions and use an ultrasonic scaler on all
patients, as he is your employer and supervisor.
b) Refuse to use an ultrasonic scaler on any patient, as it is not within your
scope of practice as an RDHAP.
c) Use your professional judgment and discretion to decide whether to use
an ultrasonic scaler or not on each patient, based on their individual needs
and preferences.
d) Report Dr. Smith to the dental board for violating the standard of care
and endangering the patients' health.
*Answer: c) Use your professional judgment and discretion to decide
whether to use an ultrasonic scaler or not on each patient, based on their
individual needs and preferences.*
*Rationale: According to the Dental Practice Act of California, RDHAPs can
perform ultrasonic scaling under the direct supervision of a dentist, which
means that the dentist is physically present and personally diagnoses and
authorizes the procedure. However, RDHAPs also have a duty to exercise
their professional judgment and discretion in providing oral health care
services, as stated in the ADHA Code of Ethics. Following Dr. Smith's
instructions blindly and using an ultrasonic scaler on all patients would be
unethical and illegal, as it would disregard the patients' individual needs
and preferences and potentially harm their health. Refusing to use an
ultrasonic scaler on any patient would also be unethical and illegal, as it
would limit the patients' access to care and deprive them of the benefits of
ultrasonic scaling when indicated. Reporting Dr. Smith to the dental board
would not be appropriate, as it would not resolve the issue at hand and
could damage the working relationship. Using your professional judgment
and discretion to decide whether to use an ultrasonic scaler or not on each
patient, based on their individual needs and preferences, would be the most
ethical and legal course of action, as it would respect the patients' autonomy
and well-being and comply with the scope of practice and standard of care.*
1. A patient has requested to access their dental records. Which of the
following statements best describes the ethical and legal obligations of a
dental hygienist in this situation?
a) The dental hygienist has the ethical duty to provide access to the patient's
dental records, but the patient must pay a fee for photocopies.
, b) The dental hygienist has the legal obligation to provide access to the
patient's dental records within a reasonable timeframe and at no additional
cost.
c) The dental hygienist can deny access to the patient's dental records if they
believe it may cause harm to the patient.
d) The dental hygienist can refuse access to the patient's dental records
unless a valid court order is provided.
Answer: b) The dental hygienist has the legal obligation to provide access to
the patient's dental records within a reasonable timeframe and at no
additional cost.
Rationale: Patients have the right to access their dental records under the
Health Insurance Portability and Accountability Act (HIPAA). Dental
hygienists are legally obliged to provide access to the patient's dental records
within a reasonable timeframe and without charging any additional fees.
2. Which of the following actions represents an ethical breach by a dental
hygienist?
a) Exchanging personal gifts with patients during the holiday season.
b) Accepting a dinner invitation from a patient to build a stronger rapport.
c) Discussing a patient's oral health condition in an open waiting room.
d) Providing evidence-based dental hygiene education to patients.
Answer: c) Discussing a patient's oral health condition in an open waiting
room.
Rationale: Confidentiality is an essential ethical principle in dentistry.
Discussing a patient's oral health condition in a public setting violates the
patient's right to privacy and breaches ethical standards.
3. A dental hygienist suspects that a child is being physically abused based
on visible injuries. What is the dental hygienist's ethical and legal
responsibility in this situation?
a) The dental hygienist is obligated to report suspicions of child abuse to
local authorities.
b) The dental hygienist can choose whether or not to report suspicions of
child abuse.
