Title: An act relating to dental professionals.

Brief Description: Regulating certain dental professions.

Sponsors: House Committee on Health Care & Wellness (originally sponsored by Representatives Cody, Hinkle, Green, Bailey, Schual-Berke, Campbell, McCoy, Morrell, Ormsby, Kenney and Moeller).

Brief History: Passed House: 2/21/07, 96-0.

Committee Activity: Health & Long-Term Care: 3/15/07, 3/22/07 [DP-WM].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report: Do pass and be referred to Committee on Ways & Means.Signed by Senators Keiser, Chair; Franklin, Vice Chair; Pflug, Ranking Minority Member; Carrell, Fairley, Kastama, Kohl-Welles and Parlette.

Staff: Edith Rice (786-7444)

Background: Dentists may allow unlicensed individuals to perform certain dental care functions when supervised by a dentist. The Dental Quality Assurance Commission has adopted rules to define the scope of services that these unlicensed personnel may provide and the level of supervision necessary. The services they may provide under the close supervision of a dentist generally include performing oral inspections, providing patient education, conducting certain duties related to impressions, performing coronal polishing, placing temporary fillings, placing topical anesthetics, placing and exposing dental x-ray film, applying sealants, and assisting in the administration of nitrous oxide analgesia or sedation. These unlicensed dental personnel may be trained through on-the-job experience or they may be trained through a dental assistant education program. Nationally, there are approximately 265 dental assisting training programs approved by the American Dental Association's Commission on Dental Accreditation. As of 2004, Washington had the second highest number of dental assistants per dentist in the nation.

Summary of Substitute Bill: Dental assistants are defined as individuals who provide supportive services to dentists under the close supervision of a dentist. "Close supervision" requires that a supervising dentist be present at the treatment facility, while procedures are being performed, and able to respond to an emergency; however, it does not require the supervising dentist to be physically present in the operatory. Dental assistants may perform patient care and laboratory duties as defined by the Dental Quality Assurance Commission (Commission). A dental assistant must demonstrate to a dentist that he or she is capable of competently performing any assigned services. Dental assistants are required to be registered by the Commission. The Commission must issue a registration to any individual who submits an application and pays the appropriate fee.

Expanded function dental auxiliaries are defined as individuals who provide supportive services to dentists under either close or general supervision of a dentist. "General supervision" requires that a supervising dentist have examined and diagnosed the patient; however, it does not require the dentist to be physically present in the treatment facility. In addition to the duties that a dental assistant may perform under close supervision, an expanded function dental auxiliary may perform certain procedures under general supervision, including performing coronal polishing, giving fluoride treatments, applying sealants, placing and exposing x-ray film, and giving patient oral health instruction. In addition, an expanded function dental auxiliary may place and carve direct restorations and take final impressions under close supervision. An expanded function dental auxiliary must demonstrate to a dentist that he or she is capable of competently performing any assigned services. Expanded function dental auxiliaries are required to be licensed by the Commission. The Commission must issue a license to any individual who: (1) submits an application; (2) pays the appropriate fee; (3) completes a dental assisting education program; (4) completes an expanded function dental auxiliary education program; and (5) passes both a written and clinical examination.

A dental hygienist with a limited license who applies for a license to practice as an expanded function dental auxiliary must be considered to have met the requirement to complete a dental assisting education program. A dental hygienist with a full license who applies for a license to practice as an expanded function dental auxiliary must be considered to have met the requirements for a license upon completing training in taking final impressions. Upon obtaining a license to practice as an expanded function dental auxiliary, a dental hygienist may perform the additional duties provided by an expanded function dental auxiliary. Supervising dentists are responsible for maintaining the appropriate level of supervision over dental assistants and expanded function dental auxiliaries and ensuring that those personnel are able to competently perform their tasks.

Two expanded function dental auxiliaries are added to the Commission. By November 15, 2012, the Department of Health, in consultation with the Commission and the Dental Hygiene Examining Committee, must review the effectiveness of the dental assistant and expanded function dental auxiliary professions as related to increasing professional standards, increasing efficiency in dental practices and community clinics, and promoting career ladders in the dental professions. In addition, the review must make any recommendation for adjusting the practices of dental assistants and expanded function dental auxiliaries.

Appropriation: None.

Fiscal Note: Available.

Committee/Commission/Task Force Created: No.

Effective Date: The bill contains several effective dates. Please refer to the bill.

Staff Summary of Public Testimony: PRO: This bill will increase our capacity to treat disease. Our experience with the expanded function dental care has tripled our productivity. Dental assistants appreciate the career ladder aspect. This is not a new health profession; it is done in eight other states. These are a valuable addition to the dental team.

OTHER: It's probably a good idea that dental assistants be registered so that they are subject to the Uniform Disciplinary Act.

Persons Testifying: PRO: Linda Hull, Mary Jennings, DDS, Lynn McDonough, Washington State Dental Association; Joan Martin, South Puget Sound Community College; Sharon Case, Washington Association of Community and Migrant Health Centers.

OTHER: Melissa Johnson, Leona Groesbeck, Washington State Dental Hygienists Association.