WSR 17-01-045 PERMANENT RULES DEPARTMENT OF HEALTH (Dental Quality Assurance Commission) [Filed December 13, 2016, 1:56 p.m., effective January 13, 2017] Effective Date of Rule: Thirty-one days after filing.
Purpose: WAC 246-817-550 and 246-817-560, acts that may be performed by licensed dental hygienists under general and close supervision. The adopted rules add three new tasks to acts under general supervision, includes one task from close supervision under general supervision, and amends local anesthetics under close supervision.
Citation of Existing Rules Affected by this Order: Amending WAC 246-817-550 and 246-817-560.
Adopted under notice filed as WSR 16-19-079 on September 20, 2016.
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, email jennifer.santiago@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Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 1, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 2, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.
Date Adopted: October 28, 2016.
C. Madden
Commission Chairperson
AMENDATORY SECTION (Amending WSR 14-12-057, filed 5/30/14, effective 6/30/14)
WAC 246-817-550 Acts that may be performed by licensed dental hygienists under general supervision.
A dentist may allow a dental hygienist licensed under ((the provisions of)) 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.
(((2))) (3) Patient education in oral hygiene.
(((3))) (4) Take intra-oral and extra-oral radiographs.
(((4))) (5) Apply topical preventive or prophylactic agents.
(((5))) (6) 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) Polish and smooth restorations.
(((6))) (8) Oral prophylaxis and removal of deposits and stains from the surfaces of the teeth.
(((7))) (9) Record health histories.
(((8))) (10) Take and record blood pressure and vital signs.
(((9))) (11) Perform sub-gingival and supra-gingival scaling.
(((10))) (12) Perform root planing.
(((11))) (13) Apply sealants.
(((12))) (14) Apply topical anesthetic agents.
(15) Deliver oral antibiotic prophylaxis as prescribed by a dentist.
(16) 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.
AMENDATORY SECTION (Amending WSR 06-14-018, filed 6/23/06, effective 7/24/06)
WAC 246-817-560 Acts that may be performed by licensed dental hygienists under close supervision.
In addition to the acts ((performed under)) allowed in WAC 246-817-520 and 246-817-550, a dentist may allow a dental hygienist licensed under ((the provisions of)) chapter 18.29 RCW to perform the following acts under the dentist's close supervision:
(1) Perform soft-tissue curettage.
(2) ((Give injections of a local anesthetic.)) Administer local anesthetic agents and adjunctive procedures.
(a) General supervision is allowed if all conditions in WAC 246-817-550 (6)(a) through (d) are met.
(b) Adjunctive procedures include local anesthetic reversal agents and buffered anesthetic.
(3) Place restorations into the cavity prepared by the dentist, and thereafter could carve, contour, and adjust contacts and occlusion of the restoration.
(4) Administer nitrous oxide analgesia.
(5) Place antimicrobials.
|