SENATE BILL REPORT

HB 1330

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: Dental hygienists must be licensed by the Department of Health (DOH) and may perform dental services only under the supervision of a licensed dentist. Licensed dental hygienists 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 perform other operations and services delegated to them by a dentist. Dental hygienists may be employed by hospitals, boards of education of public or private schools, county boards, boards of health, public or charitable institutions, or in dental offices, but they must be supervised by a licensed dentist in these facilities.

Dental hygienists who are licensed and have two years' practical clinical experience with a licensed dentist may be employed or retained by, or work under a lease agreement with, health care facilities and senior centers to perform dental hygiene services without dental supervision; however, if performing services in a senior center, the dental hygienist must enter into a written practice plan providing off-site supervision by a dentist. These dental hygienists may only remove deposits and stains from the surfaces of the teeth, apply a topical preventive or prophylactic agent, polish and smooth restorations, and perform root planing and soft-tissue curettage.

Dental assistants must be registered with the Dental Quality Assurance Commission (DQAC) and may perform duties authorized by DQAC after a supervising dentist personally diagnoses the condition to be treated, personally authorizes the procedures to be performed, and is continuously onsite in the treatment facility during the procedure.

Summary of Bill: Dental hygienists may apply topical anesthetic agents to a patient after a supervising dentist examines and diagnoses the patient and provides instruction to the dental hygienist. This may be performed if the supervising dentist is not physically present in the treatment facility. In addition to the procedures currently authorized, dental hygienists may also apply topical anesthetic agents when employed or retained by, or working under a lease agreement with a health care facility or senior center.

Dental hygienists with two years of practical clinical experience may perform tasks established by DQAC in rule on patients who are homebound – incapable of traveling due to age or disability. Services may be performed after a supervising dentist examines and diagnoses the patient and provides instruction to the dental hygienist. Services may be performed if the supervising dentist is not physically present in the treatment facility. Before performing services on a homebound patient, the dental hygienist must: obtain information from the patient's primary health care provider about health conditions of the patient that are relevant to the provision of preventative dental care, which must be reviewed with the supervising dentist before providing care; discuss the appropriateness of care with the supervising dentist; and obtain written consent from the supervising dentist.

Dental assistants may apply topical anesthetic agents to a patient after a supervising dentist personally diagnoses the condition to be treated, personally authorizes the use of the topical anesthetic agent, and is continuously onsite in the treatment facility during the procedure.

Staff Summary of Public Testimony: PRO: This bill addresses access of care for people who are homebound and are unable to travel to receive necessary treatment. This bill corrects an outdated DOH interpretative statement relating to topical anesthesia. Both the Washington State Dental Hygienists Association and the Washington State Dental Association support this bill which implements essential updates to the practice of dental hygienists and dental assistants. This bill correctly reflects the current standard of practice for dental hygienists and dental assistants. This supports the collaborative work between dental hygienists and dentists. It is essential that homebound practice be added.