HOUSE BILL REPORT

HB 1330

As Passed Legislature

Title: An act relating to allowing dental hygienists and dental assistants to provide certain services under the supervision of a dentist.

Brief Description: Allowing dental hygienists and dental assistants to provide certain services under the supervision of a dentist.

Sponsors: Representatives Moeller, Harris, Green, Cody, Tharinger, Pettigrew, Appleton, Springer, Roberts, Kagi, Pollet, Moscoso and Morrell.

Brief History:

Committee Activity:

Health Care & Wellness: 2/5/13, 2/8/13 [DP].

Floor Activity:

Passed House: 3/5/13, 95-0.

Passed Senate: 4/16/13, 47-0.

Passed Legislature.

Majority Report: Do pass. Signed by 16 members: Representatives Cody, Chair; Jinkins, Vice Chair; Schmick, Ranking Minority Member; Hope, Assistant Ranking Minority Member; Angel, Clibborn, Green, Harris, Manweller, Moeller, Morrell, Riccelli, Ross, Short, Tharinger and Van De Wege.

Staff: Jim Morishima (786-7191).

Background:

I. Dental Hygienists.

A dental hygienist may remove deposits and stains from the surfaces of teeth, apply topical preventive or prophylactic agents, polish and smooth restorations, perform root planing and soft tissue curettage, and other operations and services delegated to them by a dentist. Generally speaking, dental hygienists must be supervised by a licensed dentist. In order to be licensed, dental hygienists must complete an educational program, pass an examination, and fulfill continuing education requirements.

A. General Supervision.

Under rules adopted by the Dental Quality Assurance Commission, a dental hygienist may perform certain services under the general supervision (the supervisor need not be present in the treatment facility) of a dentist. The services a dental hygienist may perform under general supervision include:

• oral inspection and measuring of periodontal pockets with no diagnosis;

• patient education in oral hygiene;

• intraoral and extraoral radiographs;

• the application of topical preventive or prophylactic agents;

• polishing and smoothing restorations;

• oral prophylaxis and removal of deposits and stains from the surfaces of teeth;

• recording health histories;

• taking and recording blood pressure and vital signs;

• performing subgingival and supragingival scaling;

• root planing; and

• applying sealants.

B. Dental Hygiene in a Health Care Facility or Senior Center.

A dental hygienist with two years of practical clinical experience within the last five years may provide dental hygiene operations and services without the supervision of a dentist when employed or retained by, or under a lease agreement with, a health care facility or a senior center. Such a hygienist may only remove deposits and stains from the surfaces of teeth, apply topical preventative or prophylactic agents, polish and smooth restorations, and perform root planning and soft-tissue curettage. The dental hygienist must enter into a practice agreement with a dentist who agrees to provide off-site supervision of the dental services provided.

II. Dental Assistants.

A dental assistant is authorized to perform patient care and laboratory duties as authorized by the Dental Quality Assurance Council (DQAC) in rule. All services provided by a dental assistant must be under the close supervision of a dentist. Dental assistants must register with the DQAC.

Summary of Bill:

I. Dental Hygienists.

A. General Supervision.

A dental hygienist may apply topical anesthetic agents under the general supervision of a dentist.

A dental hygienist with two years of practical clinical experience in the preceding five years may perform delegated acts for a homebound patient (a patient incapable of travel due to age or disability) under the general supervision of a dentist if the patient has first been examined by the supervising dentist. Before performing any acts on a homebound patient, the dental hygienist must obtain information from the patient's primary care provider about any of the patient's relevant health conditions, review and discuss any changes in the patient's health condition with the supervising dentist, and discuss appropriateness of care with the supervising dentist. The acts the dental hygienist may perform on a homebound patient include:

• oral inspection and measuring of periodontal pockets with no diagnosis;

• patient education in oral hygiene;

• intraoral and extraoral radiographs;

• the application of topical preventive or prophylactic agents;

• polishing and smoothing restorations;

• oral prophylaxis and removal of deposits and stains from the surfaces of teeth;

• recording health histories;

• taking and recording blood pressure and vital signs;

• performing subgingival and supragingival scaling;

• root planing; and

• applying sealants.

B. Dental Hygiene in a Health Care Facility or Senior Center.

The services a dental hygienist may provide in a health care facility or senior center are expanded to include the application of topical anesthetic.

II. Dental Assistants.

A dental assistant may apply topical anesthetics under the close supervision of a dentist.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony:

(In support) This bill will allow dental hygienists and dental assistants to administer topical anesthetics, which are already available over-the-counter, under the supervision of a dentist. The bill also allows dental hygienists to perform services on homebound patients, which will help preserve access to dental care for this vulnerable population.

(Opposed) None.

Persons Testifying: Representative Moeller, prime sponsor; Vhari Rust-Clark, Washington State Dental Hygiene Association; and Bracken Killpack, Washington State Dental Association.

Persons Signed In To Testify But Not Testifying: None.