In Ontario, dental hygienists face unique legal and professional requirements when incorporating a dental hygiene practice and transferring patient records. These rules are designed to protect patient confidentiality, ensure professional accountability, and maintain high standards of care.
This article provides an overview of some key laws, regulations, and policies that every dental hygienist should understand before incorporating a professional dental hygiene practice or transferring patient records.
1. Professional Regulation and Oversight
Dental hygienists are regulated under the following:
- The College of Dental Hygienists of Ontario (CDHO) policies;
- The Regulated Health Professions Act, 1991 (RHPA) and related regulations; and
- The Dental Hygiene Act, 1991 (DHA) and related regulations.
Violating these statutes or CDHO policies can lead to discipline by the Discipline Committee of the College of Dental Hygienists of Ontario.
2. Operating a Health Professional Corporation
Incorporating a Dental Hygiene Practice
Dental hygienists may practice through a health profession corporation (HPC) if their profession is named in Schedule 1 of the RHPA, known as the Health Professions Procedural Code (HPPC). The regulations that apply to professional corporations under the OBCA also apply to HPCs under the HPPC. Dental hygiene is one such profession listed in that Schedule.
The articles of incorporation of the HPC must clearly state that the corporation will carry on only the practice of dental hygiene and related activities.
Under the RHPA, the name of the HPC must include the surname of one or more shareholders of the corporation who are members of the CDHO. The name of the HPC must also indicate that the corporation will practice dental hygiene.
Dental hygienists must notify the CDHO of the following changes within 10 days:
- Changes to the name, address, or contact information of the HPC;
- Changes to the directors or shareholders of the corporation;
- Changes to the articles of incorporation; and
- Changes to the status of the corporation or dissolution of the corporation.
Certificate of Authorization
Before offering services through a corporation, an HPC must obtain a Certificate of Authorization from the CDHO. The College typically processes applications within about 10 business days.
Shareholders, Directors, and Officers
The OBCA and RHPA require that all issued and outstanding shares of an HPC practicing dental hygiene must be owned solely by CDHO-registered dental hygienists.
Likewise, all directors and officers must be shareholders and therefore dental hygienists themselves registered with the CHDO in the General or Specialty Class,
This ensures that only licensed professionals maintain control over the delivery of care and business decisions.
Unlike dentists and physicians, dental hygienists cannot issue non-voting shares to family members or others.
3. Recordkeeping Responsibilities
Failing to maintain records in accordance with standards of practice constitutes professional misconduct under Ontario Regulation 218/94. Dental hygienists are responsible for ensuring that client records are accurate, complete, and securely maintained, whether in independent or team-based settings.
In multidisciplinary settings, hygienists may work with shared or joint records. However, hygienists remain accountable for ensuring the records meet CDHO expectations.
If the practice’s recordkeeping systems do not meet CDHO expectations, the hygienist should:
- Seek to correct or negotiate improved practices; or
- Maintain separate records, with the employer’s knowledge and consent.
4. Ownership and Goodwill
Patient records represent not only clinical data but also a significant portion of a practice’s goodwill. Ownership can become a contentious issue when a hygienist leaves a practice or when a practice is sold.
Under CDHO guidelines:
- Employers may retain client records, provided they are properly maintained and the dental hygienist can access them when needed; and
- Record ownership and goodwill should be clearly defined in employment or associate agreements from the outset.
The CDHO recommends that hygienists negotiate these terms before entering a work arrangement. Consulting a lawyer before signing or renewing such agreements can prevent future disputes.
5. Transferring Patient Records
When a dental hygienist leaves a practice, client care remains the top priority. The Ontario Personal Health Information Protection Act, 2004 (PHIPA) requires that a Health Information Custodian be designated to manage patient records after the hygienist departs.
Any record transfer must be handled securely and in compliance with privacy laws.
Notifying Clients
Hygienists changing their practice location should:
- Notify clients in writing;
- Provide contact details upon request, unless restricted by contract (see below);
- Identify the Health Information Custodian who will retain the records and how long they will be stored; and
- Explain how clients can access or transfer their records.
Dental hygienists may receive a request for their contact information but have a contractual limitation on providing this information, such as a non-solicitation or non-competition clause in an employment or associate agreement. Having a lawyer review their agreements could help ensure that no contractual requirements are violated.
Example of Client Notice Letter
The CDHO recommends using a courteous, transparent client notification letter—ideally agreed upon by both the departing hygienist and the practice owner. To that end, the CDHO provides the following sample statement that it would approve, subject to any contractual terms:
Dear [Client Name]:
I have enjoyed being your dental hygienist at [name of practice or location]. As a courtesy, I would like to inform you that, as of [date], I am moving my practice. My new address and telephone number will be [phone number]. You may continue to receive your dental hygiene care at [name of practice or location] or transfer your care to my new practice.
As the client, the choice is yours. Your records will be maintained at [specify location] and
may be transferred to the location of your choice upon request.
6. Removal and Retention of Patient Records
When the Hygienist Owns the Records
If a dental hygienist owns the patient records, they may remove them upon leaving a practice.
The dental hygienist remains responsible for retaining and maintaining those records for the period required by CDHO regulations and for providing copies to other practitioners when needed.
When the Hygienist Does Not Own the Records
If another Health Information Custodian owns the patient records, the records may only be removed with the explicit consent of the Health Information Custodian.
Taking or copying records without authorization may breach both privacy law and professional standards.
Where the HIC refuses transfer, the dental hygienist should ensure that:
- The records will be maintained for the required retention period; and
- They will retain access rights to respond to any CDHO inquiry or client request (CDHO Guidelines for Record Transfer).
Dental hygienists should benefit from having a lawyer review their Health Information Custodian Agreements before joining or leaving a practice.
7. Practical Legal Tips for Dental Hygienists
Given these requirements and restrictions, dental hygienists should do the following:
- Define ownership early — clarify in writing who owns the client records and goodwill;
- Consult legal counsel before signing or exiting any employment, associate, or shareholder agreement;
- Comply with PHIPA when transferring or disclosing patient information; and
- Update your CDHO and RHPA compliance if you operate an HPC.
Compliant corporate structures for HPCs and proper patient records management is essential for a dental hygiene practice. By understanding ownership, recordkeeping, and transfer rules under Ontario law, hygienists can:
- Protect their clients’ privacy;
- Maintain compliance with CDHO standards; and
- Safeguard the goodwill and value of their professional practice.
If you are considering incorporating, buying, selling, or leaving a practice, consider speaking with a lawyer experienced in health and business law for regulated professionals.
Thank you to Ephraim Barrera for his contribution to this article. The contents of this article are not to be construed as legal advice. Contact Emerge Law’s lawyers for legal assistance.