Washington State House of Representatives Office of Program Research | BILL ANALYSIS |
Health Care & Wellness Committee |
HB 1935
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. |
Brief Description: Concerning dental assistants, expanded function dental auxiliaries, and dental hygienists.
Sponsors: Representatives Caldier, Cody and Pollet.
Brief Summary of Bill |
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Hearing Date: 2/13/19
Staff: Kim Weidenaar (786-7120).
Background:
Dental Personnel in Washington.
Washington has a variety of credentialed providers who provide assistance to licensed dentists:
dental assistants;
dental anesthesia assistants;
dental hygienists; and
expanded function dental auxiliaries.
Dental Assistants.
Dental assistants must register with the Dental Quality Assurance Commission (DQAC) and may perform patient care and laboratory duties as authorized by the DQAC in rule. Dental assistants may apply topical anesthetic agents under close supervision of a supervising dentist. Dental assistants may not perform:
scaling procedures;
oral prophylaxis, except coronal polishing;
administration of general or local anesthetic;
removal of, or addition to, the hard or soft tissue of the oral cavity;
diagnosis of, or prescription for, the treatment of disease, pain, deformity, deficiency, injury, or physical condition of the teeth, jaw, or adjacent structures; or
the taking of impressions of the teeth or jaw for purpose of fabricating any intra-oral restoration, appliance, or prosthesis.
Expanded function dental auxiliaries.
In order to be licensed, an expanded function dental auxiliary must complete a dental assistant education program and an expanded function dental auxiliary education program approved by the DQAC and pass an examination. Expanded function dental auxiliaries may perform the duties of a dental assistant and may also perform coronal polishing, give fluoride treatments, apply sealants, place dental x-ray film and expose and develop the films, give the patient oral health instruction, place and carve direct restorations, and take final impressions.
Dental Hygienists.
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 other operations and services delegated to them by a dentist. In order to be licensed, dental hygienists must complete an educational program, pass an examination, and fulfill continuing education requirements.
A person may be granted a limited dental hygienist license if he or she:
is licensed in another state or Canadian province that allows a substantially similar scope of practice;
has actively practiced for at least 560 hours in the preceding 24 months;
has graduated from an accredited dental hygiene school;
has completed the dental hygiene national board examination;
provides information pertaining to the conditions and criteria in the Uniform Disciplinary Act;
demonstrates knowledge of Washington law pertaining to the practice of dental hygiene; and
meets AIDS education requirements.
A holder of an initial limited dental hygienist license may perform the following procedures:
oral inspection and the measuring of periodontal pockets;
patient education in oral hygiene;
taking intra-oral and extra-oral radiographs;
applying topical preventive or prophylactic agents;
polishing and smoothing restorations;
oral prophylaxis and removing 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; and
performing root planing.
An initial limited dental hygienist license expires after 18 months and may be renewed only if the applicant passes a dental hygiene patient evaluation/prophylaxis examination, passes a local anesthesia examination, and demonstrates didactic and clinical competency in the administration of nitrous oxide analgesia. In addition to the procedures authorized for initial licensees, a holder of a renewed limited dental hygienist license may:
give injections of local anesthetic;
perform soft tissue curettage; and
administer nitrous oxide/analgesia.
If the holder of a limited licensee can show substantively equivalent licensing standards, he or she may be issued a temporary endorsement to administer local anesthesia or perform restorative procedures.
Dental Anesthesia Assistants.
Dental anesthesia assistants perform duties related to dental anesthesia under the supervision of an oral and maxillofacial surgeon or dental anesthesiologist. In order to be certified, a dental anesthesia assistant must complete a training course, complete a course in basic life support and cardiac pulmonary resuscitation, and provide the permit of the oral and maxillofacial surgeon or dental anesthesiologist where the dental anesthesia assistant will be performing his or her services.
Summary of Bill:
Dental assistants.
Dental assistant means a person registered by the Washington state Dental Quality Assurance Commission (DQAC) to provide supportive services to a licensed dentist to the extent provided in the chapter and under the specified supervision of a dentist, rather than under the close supervision of a dentist.
In addition to the application of topical anesthetic agents, a dental assistant is permitted to do the following under the close supervision of a supervising dentist as the dentist may allow:
perform dental prophylaxis with supragingival scaling;
perform periodontal probing; and
perform gross debridement with an ultrasonic device.
In order to provide these services a dental assistant must complete a one-time training approved by the DQAC.
A dental assistant may disinfect operatories and sterilize equipment under the general supervision of a supervising dentist as the dentist may allow.
Prohibitions on dental assistants performing scaling procedures and oral prophylaxis, except coronal polishing, are removed.
Expanded Function Dental Auxiliary.
An expanded function dental auxiliary may disinfect operatories and sterilize equipment under the general supervision of a supervising dentist as the dentist may allow.
Dental hygienists.
A person may be granted a limited dental hygienist license if he or she:
is licensed in another state or Canadian province that allows a substantially similar scope of practice;
has graduated from an accredited dental hygiene school;
has completed the dental hygiene national board examination;
provides information pertaining to the conditions and criteria in the Uniform Disciplinary Act;
demonstrates knowledge of Washington law pertaining to the practice of dental hygiene; and
meets AIDS education requirements.
An initial limited license may be renewed as either a renewed anesthetic limited license or a renewed hygiene only limited license.
A. Renewed Anesthetic Limited License
An initial limited license is renewable as a renewed anesthetic limited license upon demonstrating:
passage of a dental hygiene patient evaluation/prophylaxis examination;
passage of a local anesthesia examination; and
didactic and clinical competency in the administration of nitrous oxide analgesia
A person practicing with a renewed anesthetic limited license may perform the following procedures:
oral inspection and the measuring of periodontal pockets;
patient education in oral hygiene;
taking intra-oral and extra-oral radiographs;
applying topical preventive or prophylactic agents;
polishing and smoothing restorations;
oral prophylaxis and removing 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;
performing root planning;
give injections of local anesthetic;
perform soft tissue curettage; and
administer nitrous oxide and oxygen analgesia.
A person practicing with a renewed anesthetic limited license may not place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, and adjust contacts and occlusion of the restoration.
B. Renewed Hygiene Only Limited License
An initial limited license is renewable as a renewed hygiene only limited license upon demonstrating successful passage of a dental hygiene patient evaluation/prophylaxis examination
A person practicing with a renewed hygiene only limited license may perform the following procedures:
oral inspection and the measuring of periodontal pockets;
patient education in oral hygiene;
taking intra-oral and extra-oral radiographs;
applying topical preventive or prophylactic agents;
polishing and smoothing restorations;
oral prophylaxis and removing 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; and
performing root planing.
A person practicing with a renewed hygiene only limited license may not:
place restorations into the cavity prepared by a licensed dentist and afterwards carve, contour, or adjust contacts and occlusion of the restoration;
given injections of local anesthetic;
perform soft tissue curettage; or
administer nitrous oxide or oxygen analgesia.
Appropriation: None.
Fiscal Note: Not requested.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.