Dental Hygienist Complaints, Investigations and Discipline in Ontario

When the CDHO Contacts You

This page is for Registered Dental Hygienists whose practice, conduct or capacity is being looked at by their College. Complaints come from clients and their families. Concerns also arrive as mandatory reports from employers or other professionals, which can lead to a Registrar’s investigation. Hygienists who own an independent practice can face questions about billing and business practices as well as clinical care.

Illustrative example, not an actual CDHO letter

“The College has received a complaint from a client about scaling performed at your clinic and the information provided before treatment. Please provide the client’s complete record, including the health history and consent documentation, along with any response you wish to make.”

Who Investigates and Who Decides

Regulator: The College of Dental Hygienists of Ontario, established, under the Dental Hygiene Act, 1991. Its complaint, investigation and discipline procedures come from the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991 (“the Code”), which applies to every regulated health profession in Ontario.
Who investigates: College investigators. In a Registrar’s investigation you must co-operate fully (Code, s. 76(3.1)).
Who decides at the investigation stage: A panel of the Inquiries, Complaints and Reports Committee (ICRC) (Code, s. 26).
Who holds hearings: The CDHO Discipline Committee. Panels include at least three members, including public members and a Registered Dental Hygienist. Hearings follow the Code, the Statutory Powers Procedure Act and the Committee’s Rules of Procedure.

Rules specific to dental hygiene

Hygienists may scale teeth and root plane on their own initiative only if none of the contraindications set out in the regulations are present, and must stop if a contraindication arises; otherwise the procedure must be ordered by a dentist. Orthodontic and restorative procedures always require a dentist’s order. Breaching these requirements is professional misconduct under the Act itself (Dental Hygiene Act, 1991, s. 5).

Key timelines in the Code

The Registrar must notify you within 14 days of receiving a complaint or report (Code, s. 25(6)).
You may make written submissions to the Inquiries, Complaints and Reports Committee within 30 days of receiving that notice. The committee can shorten that time if it believes, on reasonable and probable grounds, that your conduct exposes or is likely to expose clients to harm or injury (Code, s. 25.2).
Complaints are expected to be disposed of within 150 days. If that is missed, the Registrar must give the complainant a new expected date no more than 60 days later (Code, s. 28).
With both your and the complainant’s consent, the Registrar can refer a complaint to alternative dispute resolution, but not if it involves an allegation of sexual abuse or has already been referred to discipline (Code, s. 25.1).

Common Issues in Dental Hygienist Investigations

Self-initiation and contraindications

Scaling or root planing when a regulatory contraindication was present, or without an updated health history, or performing orthodontic or restorative procedures without a dentist’s order (Dental Hygiene Act, 1991, s. 5).

Records and documentation

Missing health histories, assessments or treatment notes, and records that do not support what was billed. CDHO publishes a Clinical Information Practice Standard and guidance on record keeping.

Consent

Treating without informed consent, or not explaining options, risks and fees. CDHO’s Informed Consent guidance applies.

Infection prevention and control

Concerns raised by public health or clients about sterilization, reprocessing and office practices. CDHO publishes IPAC guidelines.

Boundaries and business practices

Boundary violations and sexual abuse allegations, which carry mandatory penalties (Code, s. 51(5)), and billing or insurance concerns in independent practice. See CDHO’s Code of Ethics and its guidance on boundaries.

What Can Happen Next

Complaint or Registrar’s investigation

After considering the investigation and your submissions, a panel of the Inquiries, Complaints and Reports Committee (ICRC) may take no further action; give advice or recommendations; require a specified continuing education or remediation program (SCERP); require you to appear to be cautioned; refer specified allegations of professional misconduct or incompetence to the Discipline Committee; or refer you for incapacity proceedings (Code, s. 26). Matters are also sometimes resolved through an undertaking, such as an agreement to restrict or monitor your practice. If the panel considers a complaint frivolous, vexatious, made in bad faith, moot or an abuse of process, it must give notice and allow 30 days for written submissions before declining to act (s. 26(4)–(5)).
Interim order

If the committee believes your conduct exposes or is likely to expose clients to harm or injury, it can suspend your certificate or impose terms, conditions or limitations while the matter continues (Code, s. 25.4(1)). You must normally receive notice and at least 14 days to make written submissions first, unless the risk is urgent (s. 25.4(6)–(7)). The order lasts until it is varied or the matter is finally resolved (s. 25.4(4)).
Discipline hearing

A panel of the Discipline Committee hears evidence and decides whether professional misconduct or incompetence is proven (Code, ss. 51, 52). If misconduct is found, it may revoke or suspend your certificate, impose terms, conditions and limitations, order a reprimand, or order a fine of up to $35,000 (s. 51(2)). Findings of sexual abuse carry mandatory orders, including revocation for the conduct listed in s. 51(5). The panel can also order you to pay all or part of the College’s legal, investigation and hearing costs.
Review or appeal

HPARB review: you or the complainant may ask the Health Professions Appeal and Review Board to review an ICRC decision on a complaint, except a referral to discipline or for incapacity proceedings (Code, s. 29(2)). The request must be made within 30 days after receiving the notice of the right to request a review that comes with the decision (s. 29(3)), and HPARB cannot extend that time by more than 60 days (s. 29(4)).

Divisional Court: discipline and fitness to practise decisions can be appealed on questions of law, fact or both (Code, s. 70). Orders based on incompetence, incapacity or certain sexual abuse findings, and orders in matters where an interim order was in place, take effect immediately despite an appeal (ss. 25.4(5), 71, 71.1).

Checklist: Responding to a CDHO Complaint

Documents to gather

The College’s letter and the date you received it
The client record: health history and updates, periodontal charting, treatment notes and radiographs
Consent documentation and any written treatment plan
Any dentist’s order for the procedure, if one was required
Fee schedules, invoices and insurance claims
Sterilization and IPAC logs, if infection control is raised
Your employment or contractor agreement, if you work in someone else’s clinic

Details to check in the notice

Complaint or Registrar’s investigation?
Your submission deadline, and whether it has been shortened
Which clients, dates and procedures are identified
Whether an interim order is being considered

Rules and resources to consult

Health Professions Procedural Code, ss. 25–29, 51–52, 70–71 and 75–76
Dental Hygiene Act, 1991, ss. 4–5, and the regulations on contraindications
CDHO Dental Hygiene Standards of Practice, Code of Ethics, and its consent, record-keeping, IPAC and boundaries guidance
CDHO Rules of Procedure of the Discipline Committee
Your professional liability insurer

Frequently Asked Questions

The dentist I work with told me to do it. Does that protect me?

A dentist’s order is required for orthodontic and restorative procedures and can authorize scaling, but you remain responsible for your own practice and record keeping. The College looks at what you did and documented, not only at who directed the work.

What is the difference between a complaint and a report?

A complaint is filed by someone, usually a patient or family member, who becomes a party and receives the decision. A report is information the Registrar acts on by appointing investigators (Code, s. 75), for example after a mandatory report from an employer or another professional. The same committee decides both, but HPARB review rights under s. 29 are tied to complaints.

Can I keep practising during the investigation?

Usually, yes. Your certificate is unaffected unless the committee makes an interim order (Code, s. 25.4) or you agree to an undertaking that limits your practice.

Will this appear on the public register?

The Code requires the public register to note cautions, SCERPs, acknowledgements and undertakings, and allegations referred to discipline (s. 23(2)). College by-laws can add more. Check what will be posted before agreeing to any resolution.

Sources

Statutory references are to the provisions listed below, as consolidated on e-Laws when this page was prepared.

Regulated Health Professions Act, 1991, S.O. 1991, c. 18, Schedule 2 (Health Professions Procedural Code), ss. 23, 25–29, 51–52, 70–71, 75–76, 85.5 — e-Laws consolidation period beginning January 1, 2026; checked November 10, 2026.
Dental Hygiene Act, 1991, S.O. 1991, c. 22, ss. 4–6 — e-Laws consolidation period beginning January 1, 2026; checked November 10, 2026.
CDHO, “Discipline” — Checked November 10, 2026.
CDHO, “File a Complaint” — Checked November 10, 2026.
CDHO, “Standards & Resources” — Document titles checked November 10, 2026.
Health Professions Appeal and Review Board (role; Consolidated Rules of Practice and Procedure in effect May 4, 2026) — Checked November 10, 2026.