1678-S.E AMS KING S2994.1
ESHB 1678 - S AMD 423
By Senator King
NOT ADOPTED 04/11/2023
On page 3, beginning on line 7, after "(8)" strike all material through "patient" on line 9 and insert ""General supervision" means that a supervising dentist has examined and diagnosed the patient and provided subsequent instructions to be performed by the dental therapist, but does not require that the dentist be physically present in the treatment facility"
Beginning on page 4, line 27, strike all of section 6 and insert the following:
"NEW SECTION.  Sec. 6. (1) Excluding the practice of dental therapy in tribal settings and subject to the limitations in this section, a licensed dental therapist may provide the following services and procedures under the general supervision of a licensed dentist as provided under section 7 of this act and to the extent the supervising dentist authorizes the service or procedure to be provided by the dental therapist:
(a) Oral health instruction and disease prevention education, including nutritional counseling and dietary analysis;
(b) Comprehensive charting of the oral cavity;
(c) Making radiographs;
(d) Mechanical polishing;
(e) Prophylaxis;
(f) Periodontal scaling and root planing;
(g) Application of topical preventative or prophylactic agents, including fluoride and pit and fissure sealants;
(h) Pulp vitality testing;
(i) Application of desensitizing medication or resin;
(j) Fabrication of athletic mouth guards;
(k) Placement of temporary restorations;
(l) Fabrication of soft occlusal guards;
(m) Tissue conditioning and soft reline;
(n) Atraumatic restorative therapy;
(o) Dressing changes;
(p) Administration of local anesthetic;
(q) Administration of nitrous oxide;
(r) The placement and removal of space maintainers;
(s) Placement of temporary crowns;
(t) Suture removal;
(u) Brush biopsies; and
(v) Minor adjustments and repairs on removable prostheses.
(2) Excluding the practice of dental therapy in tribal settings and subject to the limitations in this section, a licensed dental therapist may provide the following services and procedures under the close supervision of a licensed dentist as provided under section 7 of this act and to the extent the supervising dentist authorizes the service or procedure to be provided by the dental therapist:
(a) Interim restorative therapy;
(b) Emergency palliative treatment of dental pain limited to the procedures listed in this section;
(c) Cavity preparation;
(d) Restoration of primary and permanent teeth;
(e) Preparation and placement of preformed crowns for patients 18 years of age or older;
(f) Indirect and direct pulp capping on primary and permanent teeth;
(g) Stabilization of reimplanted teeth;
(h) Extractions of primary teeth;
(i) Recementing of permanent crowns;
(j) Oral evaluation and assessment of dental disease and the formulation of an individualized treatment plan. When possible, a dental therapist must collaborate with the supervising dentist to formulate a patient's individualized treatment plan;
(k) Identification of oral and systemic conditions requiring evaluation and treatment by a dentist, physician, or other health care provider, and management of referrals;
(l) Nonsurgical extractions of erupted permanent teeth under limited conditions; and
(m) The dispensation and oral administration of drugs pursuant to subsection (3) of this section.
(3)(a) A dental therapist may dispense and orally administer the following drugs within the parameters of the practice plan contract established in section 7 of this act: Nonnarcotic analgesics, anti-inflammatories, preventive agents, and antibiotics.
(b) The authority to dispense and orally administer drugs extends only to the drugs identified in this subsection and may be further limited by the practice plan contract.
(c) The authority to dispense includes the authority to dispense sample drugs within the categories established in this subsection if the dispensing is permitted under the practice plan contract.
(d) A dental therapist may not dispense or administer narcotic drugs as defined in chapter 69.50 RCW.
(e) A dental therapist does not have the authority to prescribe drugs.
(4) A licensed dental therapist may supervise expanded function dental auxiliaries, dental assistants, and dental hygienists. However, a dental therapist may supervise no more than a total of three expanded function dental auxiliaries, dental assistants, and dental hygienists at any one time in any one practice setting. A dental therapist may not supervise an expanded function dental auxiliary, dental assistant, or dental hygienist with respect to tasks that the dental therapist is not authorized to perform.
(5) A dental therapist may only provide services and procedures in which they have been educated.
(6) A dental therapist may not provide any service or procedure that is not both authorized by this section and been authorized by the supervising dentist via inclusion in the dental therapist's practice plan contract."
On page 6, line 35, after "under" strike "off-site" and insert "general"
Beginning on page 6, line 37, after "(a)" strike all of material through "(b)" on page 7, line 1
Reletter the remaining subsections consecutively and correct any internal references accordingly.
EFFECT: Clarifies that the practice of dental therapy in tribal settings is excluded from the provisions in section 6.
Categorizes procedures that may only be performed under the general supervision of a licensed dentist and procedures that may only be performed under the close supervision of a licensed dentist.
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