SENATE BILL REPORT

SHB 1271

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Background: Denturists are licensed by the Department of Health (DOH) and may: make, place, construct, alter, reproduce, or repair a denture; take impressions and furnish or supply a denture directly to a person; advise the use of a denture; and maintain a facility for the same.

In 2012, DOH conducted a sunrise review to determine whether the scope of practice of denturists should be broadened to include making, placing, constructing, altering, reproducing, or repairing all non-orthodontic removable oral devices; and teeth whitening using bleaching solutions of 20 percent or less. DOH concluded that denturists should be allowed to fabricate and fit mouth guards for teeth grinding (bruxism) or sports mouth guards if: adequate training standards are set in law; a dentist examines the patient prior to the fitting or fabrication of a bruxism device to ensure that there is no temporomandibular disorder; a patient fitted with a mouth guard for bruxism must visit a dentist for followup; and a patient fitted with a mouth guard for bruxism is encouraged in writing to have regular dental checkups to identify any adverse effects of bruxism or from the device.

DOH also concluded that: denturists should be allowed to provide teeth-whitening trays and over-the-counter solutions for the patient's use at home if the patient is encouraged in writing to have regular dental checkups; and denturists should be allowed to take impressions and order removable cosmetic appliances regardless of whether the patient is missing teeth. DOH was opposed to any other non-orthodontic removable oral devices because they may lead to denturists treating obstructive sleep apnea.

Summary of Bill: Denturists may make, place, construct, alter, reproduce, or repair certain non-orthodontic removal oral devices, excluding devices to treat obstructive sleep apnea or temporomandibular joint dysfunction, when accompanied by written encouragement to have regular dental checkups with a licensed dentist. These permitted devices are bruxism devices; sports mouth guards; removable cosmetic appliances, regardless of whether the patient is missing teeth; and snoring devices, only after a physician has ruled out snoring associated with sleep breathing disorders, including obstructive sleep apnea. Denturists may also provide teeth-whitening services, including fabricating whitening trays, providing whitening solutions determined to be safe for public use, and providing required follow-up care and instructions for use of the trays and solutions at home. Before providing any of these services, a denturist must provide documentation of education and training in providing such services, to be determined by rules adopted by the Board of Denturists.

Staff Summary of Public Testimony: PRO: All stakeholders agree with this scope-of-practice bill that mirrors the recommendations of the DOH sunrise review. This bill is responding to patient requests who want to receive these services from a denturist. The denturists have the facilities to make these non-orthodontic removable devices and they can make them cost effectively. Denturist-made devices will fit better than equivalent over the counter devices. This is similar to practice in Oregon. Patients will be given instruction and follow-up.