The dental hygienist provides direct patient care and receives guidance from higher-level or supervisory staff members for only the most complex patients and requires only general supervision from a dentist. Dental Hygienists perform a wide variety of interventions which contribute to the overall oral health of Veterans. The work requires a professional knowledge of the field of dental hygiene and the biomedical sciences that relate to dentistry. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. Dental hygienists must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). Education. Associate Degree or higher in an accredited dental hygiene program. This program must be accredited by the American Dental Association's Commission on Dental Accreditation (CODA). Licensure. Applicants must be currently licensed to practice as a dental hygienist with a full, current, and unrestricted license in a State, Territory, or Commonwealth of the United States, or the District of Columbia. Certification. Public Law 97-35 requires that persons who administer radiologic procedures meet the credentialing standards in 42 CFR Part 75. Essentially, they must have successfully completed an educational program that meets or exceeds the standards described in that regulation, and is accredited by an organization recognized by the Department of Education, and be certified as radiographers in their field. Accredited dental hygiene programs contain curriculum addressing radiologic procedures which will meet the requirement for certification as dental radiographers. Exception. Non-certified applicants, who otherwise meet the eligibility requirements for licensure, may be given a temporary appointment as a graduate dental hygienist under the authority of 38 U.S.C. § 7405(c)(2)(B) for a period not to exceed 2 years. Failure to obtain certification during this time period may result in termination of employment. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grandfathering Provision. All individuals employed in VHA in this occupational series or in another occupational series performing the duties as described in the qualification standard on the effective date of the qualification standard are considered to have met all qualification requirements for the grade held including positive education and licensure/trademark/registration/certification. For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply: (1) Employees may be reassigned, promoted up to and including the full performance (journey) level or changed to lower grade within the occupation, 4 but may not be promoted beyond the journeyman level or placed in supervisory or managerial positions. (2) Employees in an occupation that requires a licensure/certification only at higher grade levels must meet the licensure/certification requirement before they can be promoted to those higher grade levels. (3) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis until they fully meet the basic requirements of the standard. (4) Employees who are converted to title 38 hybrid status under this provision and subsequently leave the occupation lose protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation. (5) Employees initially grandfathered into this occupation, who subsequently obtain additional education and/or licensure/certification that meet all the basic requirements of this qualification standard must maintain the required credentials as a condition of employment in the occupation. Grade Determinations: GS-9 Dental Hygienist (Full Performance Level) Experience. At least 1 year of experience at the next lower grade level that demonstrates the clinical competencies described at that level. Assignment. Employees at this level serve as developmental level 3 dental hygienists with the ability to perform direct patient care under the general supervision of the dentist. It is expected that they receive guidance from higher-level or supervisory staff members for only the most complex patients. Assignments at this level include, but are not limited to: patient assessments (e.g. risk assessments, oral health assessments), prevention recommendations, prophylaxis, periodontal treatment for mild to moderate disease (e.g. scaling and root planing, full mouth debridement), Periodontal Screening and Recording (PSR) radiograph/image capture, fluoride treatment application, topical anesthesia administration and management of stable medically compromised patients (including risk factors). Demonstrated Knowledge, Skills, and Abilities. In addition to meeting the KSAs for the GS-8 level, the candidate must demonstrate the following KSAs: Knowledge of hygiene procedures to explain the process and indication, complications and expected treatment outcomes for each. Knowledge of proper usage of dental radiography equipment, radiation safety, assessment of proper image capture and interpretation of films. Knowledge to select appropriate available fluoride products and indications/limitations for safe and proper application. Skill in detecting plaque and calculus, dental abnormalities/pathologies, assessing inflammation and providing safe instrumentation for each procedure. Skill in educating patients and caregivers on periodontal disease, wellness, health maintenance, oral hygiene practices, parafunctional habits, and effects of illness, addictions, medications and tobacco on the oral cavity. Ability to assess the patient's medical, dental, anxiety/phobias, medications and comorbidities to administer safe patient care. Ability to assess the impact of patient's medical and dental condition on maintaining oral health, recognize age-related changes in individual patients, adapt patient environment, and maximize patient's physical comfort. References: VA HANDBOOK 5005/73, PART II, APPENDIX G37, DENTAL HYGIENIST QUALIFICATION STANDARD GS-682 Physical Requirements: Long periods of standing, walking, sitting, and bending are required. Pushing dental equipment and carts are necessary in order to deliver items to the operatory or procedure site. It is necessary to climb onto lifts in order to retrieve or store supplies, or to help the dentist carry out a surgical or dental procedure. Lifting of patients from gurneys or wheelchairs into the dental chair is required in order to position them for radiographs or dental examination and treatment. ["Assignments include but are not limited to: patient medical assessment (e.g. medical/dental history, social history, vital signs, full periodontal assessment and charting), disease and treatment management recommendations, denture care, scaling and root planning, radiographs/image interpretation, patient education (e.g. post-procedure, tobacco cessation, caries and perio-disease prevention), behavior management, management of stable medically compromised patients (including risk factors), instrument sharpening, inter-service communication. The dental hygienist complies with guidelines andpolicies set forth by the Dental Service, the VA San Diego Healthcare System, VHA policy, and VA statutes and policy. Functions or Scope of Practice: The duties and responsibilities of a Dental Hygienist include, but are not limited to the following: Set-Up 1.Obtains and prepares equipment, hand pieces, instruments, and accessories according to the procedure being performed. 2.Sets up operatory for planned dental procedure. 3.Handles and cares for dental items in accordance with the Reusable Medical Equipment (RME) Standard Operating Procedure (SOP) and Infection Control guidelines. Hygienist duties: Handles and pre-cleans critical and semi-critical dental equipment, handpieces, instruments and accessories in accordance with RME SOPs and Infection Control guidelines. Handles instruments safely, accurately, and efficiently. Provides routine oral prophylactic care to include application of fluoride solutions Provides gross debridement, deep scaling, and curettage and root planning procedures Cleans dental prostheses, fixed, and removable Manages dental recall system, referring patients to the doctor for additional care. Applies desensitizing and sealant materials as needed. Makes impressions for fluoride carrier trays. Accomplishes all procedures within infection control protocols Administers local anesthetic agents Performs patient assessments/clinical evaluations Provides prophylaxis in complex restorative cases, scaling and root planning Performs adjunctive treatment Provides patient education appropriate to the veteran's needs and oral condition Prepares and provides individual and group oral health care instruction to inpatients, outpatients, and caregivers Assists patients in scheduling appointments. Manages behavior and stable medically compromised patients. Maintains patient confidentiality according to HIPAA with written and verbal information. Assists more than one dentist when required by the clinic. Charts findings, treatment plans, and treatment provided in patient records Radiography: Performs the full range of dental radiography with both analog and digital systems. Takes radiographs of inpatients and outpatients according to prescription, including periapical, bitewing, occlusal, panoramic, cephalometric, facial series, mandibular series, and temporomandibular joint tomographs. Correctly positions the patient and the film/sensor to achieve proper radiographic angles and diagnostic quality. Protects the patient from unwanted radiation exposure by correctly utilizing a variety of lead shields. For analog systems develops, fixes, washes, dries and mounts radiographs using both manual and automatic processors. Maintains and cleans all developing equipment. Prepares solutions, cleans manual and automatic tanks. For digital systems, registers patients for and stores images in digital form. Maintains x-ray area, operatory, and monitors levels of all supplies and orders supplies when stock is low. Imaging requests are accomplished within the desired time frame. Work Schedule: Full-time Monday - Friday, 7:00am to 3:30pm Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: No Authorized Permanent Change of Station (PCS): Not Authorized"]

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