Title: An act relating to providers of dental services.

Brief Description: Concerning the licensing of certain dental health care providers.

Sponsors: Senators Thibaudeau, Fairley, Fraser, Poulsen and McAuliffe.

Brief History:

Committee Activity: Health & Long-Term Care: 2/24/05.

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Staff: Stephanie Yurcisin (786-7438)

Background: The Secretary of Health is the disciplinary authority for dental hygienists. The Dental Hygiene Examining Committee serves as an advisory board for the secretary. Some have suggested that it would be better to regulate dental hygienists with a board, rather than the secretary.

The dental hygienists' scope of practice allows them, under the supervision of a licensed dentist, to remove deposits and stains from the surfaces of the teeth, apply topical preventative agents, polish and smooth restorations, perform root planning and soft-tissue curettage, and other dental operations and services delegated to them by a licensed dentist.

Summary of Bill: Licensed dental hygienists who have two years' practical clinical experience with a licensed dentist within the previous five year period may perform all dental operations and services contained within their scope of practice without supervision. However, the hygienist must be under the close supervision of a licensed dentist or physician if the hygienist is administering a local anesthetic or nitrous oxide.

The Board of Dental Hygiene is created. The board consists of six members; five members must be licensed dental hygienists with at least five years of practical experience and one member from the public who has an interest in the rights of consumers of dental services. The board is responsible for developing and administering licensing examinations; reviewing applicant qualifications; adopting rules for carrying out its duties; establishing continuing education program requirements; keep records of the proceedings; and, where appropriate, adopting rules in response to questions put to it concerning the scope of practice of dental hygienists. Several duties of the Secretary relating to the regulation of licensed dental hygienists are transferred to the board. The Dental Hygiene Examining Committee is discontinued.

A licensed dental hygienist may delegate certain functions, as established by the board of dental hygiene, to a dental assistant under their close supervision. The Dental Quality Assurance Commission must adopt rules relating to dental services that may be performed by registered dental assistant. A dental assistant may become registered upon providing the applicable information and fee, provided there are no grounds for denial of the registration.

Appropriation: None.

Fiscal Note: Available.

Committee/Commission/Task Force Created: No.

Effective Date: Ninety days after adjournment of session in which bill is passed.

Testimony For: Dental hygienists are allowed to provide this level of care in other states and by certain insurance companies. The training and clinical practice that dental hygienists perform adequately prepares them to practice unsupervised after an initial period. This would increase access to care by lowering cost and by increasing the number of providers who are able to provide dental services. It would be particularly beneficial in rural areas and for low-income patients and could allow dental care to be provided at "off-peak" hours (evenings and weekends) when it might be easier for patients with children to have appointments.

Testimony Against: There is only one state that allows dental hygienists to practice as expansively as would be allowed under this bill. Dentists are often the gateway to health care, and dentists discover some conditions that require further treatment that a dental hygienist may not be trained to determine.

Who Testified: PRO: Melissa Johnson, Barbara Lynch, Washington State Dental Hygienists Association; Doreen Naughton, Alliance of Dental Hygienist Practitioners; Sharon Golightly, self.
CON: David Michener, Dr. Mark Walker, Dr. Mary Jennings, Washington State Dental Association.