WSR 09-08-119



(Dental Quality Assurance Commission)

[ Filed April 1, 2009, 8:43 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 08-21-158.

Title of Rule and Other Identifying Information: WAC 246-817-510 Definitions for WAC 246-817-501 through 246-817-570, adding definition of volunteer dental assistant providing services in a charitable dental clinic.

Hearing Location(s): Department of Health, 310 Israel Road S.E., Room 152/152 [153], Tumwater, WA 98501, on June 5, 2009, at 8:00 a.m.

Date of Intended Adoption: June 5, 2009.

Submit Written Comments to: Jennifer Santiago, P.O. Box 47867, Olympia, WA 98504-7867, web site, fax (360) 236-2901, by May 29, 2009.

Assistance for Persons with Disabilities: Contact Jennifer Santiago by May 29, 2009, TTY (800) 833-6388 or 711.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule will provide a definition of volunteer dental assistant providing services in a charitable dental clinic. The proposed rule will define a volunteer dental assistant who is exempt from registration requirements.

Reasons Supporting Proposal: HB 3088 (chapter 150, Laws of 2008) creates an exemption from dental assistant registration for volunteer dental assistants providing services under supervision of a licensed dentist in a charitable dental clinic. A definition of volunteer dental assistant was necessary to clearly distinguish who would meet this definition.

Statutory Authority for Adoption: RCW 18.32.0365, 18.260.120, and 18.260.110.

Statute Being Implemented: RCW 18.260.110.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Dental quality assurance commission, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Jennifer Santiago, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4893.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rule would not impose more than minor costs on businesses in an industry.

A cost-benefit analysis is not required under RCW 34.05.328. The agency did not complete a cost benefit analysis under RCW 34.05.328. RCW 34.05.328 (5)(b)(v) exempts rules the content of which is explicitly and specifically dictated by statute.

March 31, 2009

Jennifer Santiago

Program Manager

Dental Quality

Assurance Commission


AMENDATORY SECTION(Amending WSR 08-14-010, filed 6/19/08, effective 7/1/08)

WAC 246-817-510   Definitions for WAC 246-817-501 through 246-817-570.   (1) "Close supervision" means that a licensed dentist whose patient is being treated has personally diagnosed the condition to be treated and has personally authorized the procedures to be performed. A dentist shall be physically present in the treatment facility while the procedures are performed. Close supervision does not require a dentist to be physically present in the operatory; however, an attending dentist must be in the treatment facility and be capable of responding immediately in the event of an emergency.

(2) "Coronal polishing" means a procedure limited to the removal of plaque and stain from exposed tooth surfaces, utilizing an appropriate instrument and polishing agent.

This procedure shall not be intended or interpreted as an oral prophylaxis as defined in WAC 246-817-510 a procedure specifically reserved to performance by a licensed dentist or dental hygienist. Coronal polishing may, however, be performed by dental assistants under close supervision as a portion of the oral prophylaxis. In all instances, however, a licensed dentist shall determine that the teeth need to be polished and are free of calculus or other extraneous material prior to performance of coronal polishing by a dental assistant.

(3) "Debridement at the periodontal surgical site" means curettage or root planing after reflection of a flap by the supervising dentist. This does not include cutting of osseous tissues.

(4) "Elevating soft tissues" is defined as part of a surgical procedure involving the use of the periosteal elevator to raise flaps of soft tissues. Elevating soft tissue is not a separate and distinct procedure in and of itself.

(5) "General supervision" means supervision of dental procedures based on examination and diagnosis of the patient and subsequent instructions given by a licensed dentist but not requiring the physical presence of the supervising dentist in the treatment facility during the performance of those procedures.

(6) "Incising" is defined as part of the surgical procedure of which the end result is removal of oral tissue. Incising, or the making of an incision, is not a separate and distinct procedure in and of itself.

(7) "Luxation" is defined as an integral part of the surgical procedure of which the end result is extraction of a tooth. Luxation is not a distinct procedure in and of itself. It is the dislocation or displacement of a tooth or of the temporomandibular articulation.

(8) "Oral prophylaxis" means the preventive dental procedure of scaling and polishing which includes complete removal of calculus, soft deposits, plaque, stains and the smoothing of unattached tooth surfaces. The objective of this treatment shall be creation of an environment in which hard and soft tissues can be maintained in good health by the patient.

(9) "Periodontal soft tissue curettage" means the closed removal of tissue lining the periodontal pocket, not involving the reflection of a flap.

(10) "Root planing" means the process of instrumentation by which the unattached surfaces of the root are made smooth by the removal of calculus or deposits.

(11) "Supportive services" means services that are related to clinical functions in direct relationship to treating a patient.

(12) "Suturing" is defined as the readaption of soft tissue by use of stitches as a phase of an oral surgery procedure. Suturing is not a separate and distinct procedure in and of itself.

(13) "Treatment facility" means a dental office or connecting suite of offices, dental clinic, room or area with equipment to provide dental treatment, or the immediately adjacent rooms or areas. A treatment facility does not extend to any other area of a building in which the treatment facility is located.

(14) "Noncredentialed person" means a person who is not a dentist licensed under chapter 18.32 RCW; dental hygienist licensed under chapter 18.29 RCW; expanded function dental auxiliary licensed under chapter 18.260 RCW; or a dental assistant registered under chapter 18.260 RCW.

(15) "Volunteer dental assistant" means an individual who, without compensation, provides the supportive services set forth in WAC 246-817-520 in a charitable dental clinic.

[Statutory Authority: RCW 18.260.120 and 18.32.0365. 08-14-010, 246-817-510, filed 6/19/08, effective 7/1/08. Statutory Authority: RCW 18.32.035. 95-21-041, 246-817-510, filed 10/10/95, effective 11/10/95.]

Washington State Code Reviser's Office