WSR 19-18-095
PERMANENT RULES
DEPARTMENT OF HEALTH
(Dental Quality Assurance Commission)
[Filed September 4, 2019, 11:24 a.m., effective October 5, 2019]
Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-817-550 Acts that may be performed by licensed dental hygienists under general supervision, the adopted rule amendments update the listing of allowable duties a dentist may delegate to a licensed dental hygienist under general supervision. The dental quality assurance commission (commission) considered a petition for rule making in July 2017 to allow dental hygienists to perform certain tasks under general supervision that are typically completed by dental assistants under close supervision. Close supervision requires the dentist to be physically present in the treatment facility during the performance of a delegated task while general supervision does not.
Citation of Rules Affected by this Order: Amending WAC 246-817-550.
Adopted under notice filed as WSR 19-13-093 on June 18, 2019.
A final cost-benefit analysis is available by contacting Jennifer Santiago, P.O. Box 47852, Olympia, WA 98501, phone 360-236-4893, fax 360-236-2901, TTY 360-833-6388 or 711, email jennifer.santiago@doh.wa.gov, web site www.doh.wa.gov.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 1, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: July 26, 2019.
Julia Richman, D.D.S.
Dental Quality Assurance Commission
AMENDATORY SECTION(Amending WSR 17-01-045, filed 12/13/16, effective 1/13/17)
WAC 246-817-550Acts that may be performed by licensed dental hygienists under general supervision.
A dentist may allow a dental hygienist licensed under chapter
18.29 RCW to perform the following acts under the dentist's general supervision:
(1) Head and neck examination.
(2) Oral inspection and measuring of periodontal pockets, with no diagnosis.
(3) Record health histories.
(4) Take and record blood pressure and vital signs.
(5) Take intraoral and extraoral radiographs.
(6) Take intraoral and extraoral photographs.
(7) Patient education in oral hygiene.
(((4) Take intra-oral and extra-oral radiographs.
(5)))(8) Give preoperative and postoperative instructions.
(9) Oral prophylaxis and removal of deposits and stains from the surfaces of the teeth.
(10) Give fluoride treatments.
(11) Apply topical anesthetic agents.
(12) Deliver oral antibiotic prophylaxis as prescribed by a dentist.
(13) Place and remove the rubber dam.
(14) Apply topical preventive or prophylactic agents.
(((6)))(15) Administer local anesthetic agents and adjunctive procedures if all conditions in (a) through (d) of this subsection are met. Adjunctive procedures include local anesthetic reversal agents and buffered anesthetic.
(a) The patient is at least eighteen years of age;
(b) The patient has been examined by the delegating dentist within the previous twelve months;
(c) There has been no change in the patient's medical history since the last examination. If there has been a change in the patient's medical history within that time, the dental hygienist must consult with the dentist before administering local anesthetics;
(d) The delegating dentist who performed the examination has approved the patient for the administration of local anesthetics by a dental hygienist under general supervision and documented this approval in the patient's record;
(e) If any of the conditions in (a) through (d) of this subsection are not met, then close supervision is required.
(((7)))(16) Perform subgingival and supragingival scaling.
(17) Perform root planing.
(18) Apply sealants.
(19) Polish and smooth restorations.
(((8) Oral prophylaxis and removal of deposits and stains from the surfaces of the teeth.
(9) Record health histories.
(10) Take and record blood pressure and vital signs.
(11) Perform sub-gingival and supra-gingival scaling.
(12) Perform root planing.
(13) Apply sealants.
(14) Apply topical anesthetic agents.
(15) Deliver oral antibiotic prophylaxis as prescribed by a dentist.
(16)))(20) Sterilize equipment and disinfect operatories.
(21) Place retraction cord.
(22) Take impressions, bite registration, or digital scans of the teeth and jaws for:
(a) Diagnostic and opposing models;
(b) Fixed and removable orthodontic appliances, occlusal guards, bleaching trays, and fluoride trays; and
(c) Temporary indirect restorations such as temporary crowns.
(23) Take a facebow transfer for mounting study casts.
(24) Fabricate and deliver bleaching and fluoride trays.
(25) Fabricate, cement, and remove temporary crowns or temporary bridges.
(26) Place a temporary filling such as zinc oxide-eugenol or ZOE after diagnosis and examination by the dentist.
(27) Remove excess cement after the dentist has placed a permanent or temporary inlay, crown, bridge or appliance, or around orthodontic bands.
(28) Pack and medicate extraction areas.
(29) Place periodontal packs.
(30) Remove periodontal packs or sutures.
(31) Select denture shade and mold.
(32) Place and remove orthodontic separators.
(33) Select and fit orthodontic bands, try in fixed or removable orthodontic appliances prior to the dentist cementing or checking the appliance.