Public Health Dental Hygienist (PHDH) Toolkit
Legislative Overview
Office of Oral Health
Massachusetts Department of Public Health

Requirements of the Public Health Dental Hygienist (PHDH)

•	According to Chapter 530 of the Acts of 2008, a Public Health Dental Hygienist (PHDH) must:
•	Be a registered dental hygienist with a valid license to practice in the Commonwealth;
•	Have three years of full-time or an equivalent 4500 hours of clinical experience; 
•	Have the appropriate training pursuant to 234 CMR 5.07(2); and 
•	Work in a public health setting pursuant to a written collaborative agreement with a local or state government agency or institution or with a licensed dentist who holds a valid license.

Training for the PHDH

•	Prior to practicing as a public health dental hygienist pursuant to 234 CMR 2.03 and 5.08, a dental hygienist shall successfully complete a minimum of ten (10) hours of continuing education as follows:
•	A minimum of six (6) hours of hands-on experience in a public health  setting; 
•	A minimum of (4) hours of Continuing Education (CE) covering each of the following areas:
•	CDC Guidelines for Infection Control 
•	Risk Management for practice in a public health setting; and
•	Management of medical emergencies.
•	The public health dental hygienist shall permanently retain documentation demonstrating compliance with 234 CMR 5.07(2) (a) and 234 CMR 5.08  

Approved Public Health Settings

•	A Public Health Setting is defined in the legislation … “to include, but not be limited to”:
•	Residences of the homebound;
•	Schools;
•	Head Start programs;
•	Nursing homes and long-term care facilities; 
•	Clinics; 
•	Community health centers; and 
•	Hospitals and medical facilities; 
•	Prison;
•	Residential treatment facilities
•	Federal, state or local public health programs;
•	Mobile dental facilities;  
•	Portable dental programs; and
•	Other facilities or programs deemed appropriate by the Department of Public Health

PHDH Practice 234 CMR 5.07(1)

•	A PHDH may provide dental hygiene services including placement of sealants without first having a dentist examine the patient either pursuant to a written collaborative agreement or under the general supervision of a licensed dentist 
•	A dental hygienist or public health dental hygienist may not perform acts or services which require diagnosis and treatment planning for non-dental hygiene services, surgical or cutting procedures on hard or soft tissue, and/or the prescription of medications, unless specifically authorized herein. 

Picture- Dental office… dentist, dental assistant, and a patient (patient is being treated)

234 CMR 5.08- Collaborative Agreement

•	A PHDH must… 
•	“enter into a written collaborative agreement with a dentist who holds a valid license issued pursuant to M. G. L. c. 112, § 45 or with the appropriate local or state government agency or institution which provides for a dentist licensed pursuant to M.G.L. c. 112, § 45 to be available to provide the appropriate level of communication and consultation with the dental hygienist to ensure patient health and safety.”
•	Go to the Documents and Resources Page for a sample collaborative agreement

234 CMR 5.08 (7-8)- Documentation to the Office of Oral Health

•	Each PHDH must report specific data to the Massachusetts Department of Public Health’s Office of Oral Health
•	Each PHDH shall maintain the following data to be reported to the Massachusetts Department of Public Health’s Office of Oral Health on forms and in accordance with procedures established by that office:
•	The dates of each session with name and address of the site where public health dental hygiene services were provided; and
•	The number of patients served and the type(s) and quantity(ies) of each service provided.
•	Go to the PHDH Toolkit main page for detailed information
Questions?

•	Contact the Department of Public Health Office of Oral Health with specific questions regarding public health settings at oral.health@state.ma.us
•	Contact the Board of Registration in Dentistry with specific questions regarding PHDH qualifications, regulations, and scope of service
•	Massachusetts Board of Registration in Dentistry Webpage
•	Board of Registration in Dentistry 239 Causeway Street, Suite 200 Boston, MA  02114 Phone: 1-800-414-0168 or 617-973-0971 Fax: 617-973-0982 
•	dentistry.admin@state.ma.us

What’s Next?

•	The next PowerPoint presentation in this toolkit will review procedures, equipment and supplies to inform a dental hygienist  working in public health settings