What is An RDHAP? An RDHAP is a Registered Dental Hygienist in Alternative Practice. An RDHAP has specialized training and an additional license that allows them to have their own independent business and work in settings other than a dental office and without the supervision of a dentist.
Why was the RDHAP created? The California Legislature created the RDHAP to deliver quality preventive dental hygiene services to those who donít have easy access to a traditional dental office. The legislature authorized a Health Manpower Pilot Project to review the work of dental hygienists practicing independently and determined the care they provide is equal to that received in a traditional dental office.
Where can the RDHAP provide services? In areas where there is a dearth of dentists, the RDHAP can open an office. Their services can always be provided in schools, institutions, residence and skilled nursing facilities and private homes of homebound persons.
How can RDHAPs be of value to residential facilities? The RDHAP can be a link between residential home administration and staff, families and community dental providers, and, they can be a conduit between the dentist and the consumer.
They can provide: Oral evaluations Oral care plan Customized direct care staff in-service training for providing resident oral care In-residence and bed-side dental hygiene care which may include:
Oral Prophylaxis (cleaning of debris, bacteria and deposits above the gumline)
Non-surgical periodontal therapies (scaling and root planing below the gumline which may require topical anesthetic)
Therapies for dry mouth
Denture and partial cleaning
Strategies for prevention of cavities and gum disease
How does the RDHAP get paid? RDHAPs are independent providers who bill insurance companies and responsible parties for services provided to private pay or Medi-Cal insured residents.Non-covered dental hygiene services to residents of SNFís qualify for Share of Cost.Fees for in-service presentations will vary.
Why utilize an RDHAP? Prevention is the key to avoiding extensive dental treatment and the toll it takes on the resident and skilled nursing facility staff.Staff and families will appreciate the one-on-one care and time given to each resident by the RDHAP.
What can I expect during a typical mobile dental hygiene appointment?
In my experience I have found that the special need patient has different needs. In a traditional dental office setting, patients are given the same amount of time per appointment no matter what their needs. With this kind of restrictive schedule, often times, the offices do what they can so we can to stay on time. Every appointment I make is scheduled to allow adequate time to treat the patient, talk with caregiver and give them all the special care they need. I will work with the patient, the caregiver and the family to develop individual daily care plans to promote oral health and possibly reduce painful and costly dental emergencies. A typical appointment is 1 hour to 2 hours. It may be longer if the patient needs more time or it may be shorter depending on the patients tolerance level.
-Review and update the medical/health history. -Review with patient any concerns they may currently be having with their teeth -Do an intra/extra oral cancer screening -Take any intra-oral camera pictures to document any findings -Do periodontal evaluation ie: measure and record pocket depths, evaluate tissue health, determine if patient needs a simple prophylaxis (cleaning) or non-surgical periodontal therapy (deep cleaning) and evaluate patient's level of comfort. (Do they need topical anesthetic to make them more comfortable?) -Do a general assessment of restorations to determine if patient may need a referral to a general dentist or specialist. -Remove and clean any removable appliances -Provide treatment with hand scale and/or Sonic cleaning -Apply Sodium Fluoride to all tooth surfaces to strengthen enamel, prevent decay and reduce any tooth sensitivity. -Discuss daily oral care with patient and develop a plan to make effective daily care more achievable. Review with caregiver or family. -Distribute dental aides specific to the patients needs. -Make available copy of the Treatment forms for Nursing or family records. -Schedule for their next dental hygiene appointment.
How much does this service cost?
My fees are similar to those in a traditional dental office. The appointment with travel fee is under $200. If there is any dental insurance involved, I can help billing. With exception, Medi-cal/ Denti-cal when pt is ICF or SNF, I will bill for the patient.
All fees will be due and payable to Special Access Dental at the time of service. We accept cash, or checks.
Please call at any time if you have questions regarding how dental insurance works or about my billing practices.
At Special Access Dental, sterilization is my priority. I take cleanliness seriously and want to make sure you leave healthier than when you came. I make sure I meet or exceed Occupational Safety and Health Administration (OSHA) and the Center for Disease Control (CDC) guidelines.Special Access Dental will meet or exceed all guidelines of professional organizations and government regulations.
Before I began as an RDHAP, I carefully planned a sterilization area that I could ensure cleanliness and sterilization is an everyday reality. Everything that goes into your mouth goes through one of two basic processes with no exceptions. Disposable instruments (suction straws, prophy angles, etc.) are thrown away. Everything else goes through an elaborate process to ensure sterilization:
The instruments are first scrubbed with soap and water, then they are put into a device called an ultrasonic bath which contains disinfectant.
The ultrasonic bath creates extremely aggressive agitation.
After the ultrasonic bath, instruments are rinsed with water again, then dried, and run through a dry heat sterilization, which completely sterilizes the instruments.
Sterilization of non-disposable plastic instruments by immersion in hospital grade sterilizing fluid for 15 hours. (exceeding the methods used in hospitals for surgical instrument).
Some of the techniques routinely used include:
The extensive use of disposable supplies, used once and discarded.
Any surfaces that were touched are sprayed or wiped with ADA-approved disinfectants.
All surfaces, such as the dental chair, portable, and dental light have been cleaned and decontaminated after each client.
I use gloves, gowns, masks, eye protection, and barrier covers for each procedure.
Periodic Monitoring and testing of sterilization and disinfection systems is part of my routine. This includes microbial spore testing of sterilizing equipment, constant monitoring of sterilization temperatures and times, replacing disinfecting solutions.
Every patient had their own set of heat sterilized instruments
All surfaces and equipment are cleaned and disinfected between patients.