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A BILL TO BE ENTITLED
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AN ACT
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relating to the administration of a local anesthetic agent by a |
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dental hygienist. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 258.001, Occupations Code, is amended to |
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read as follows: |
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Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not |
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delegate: |
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(1) an act to an individual who, by board order, is |
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prohibited from performing the act; |
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(2) any of the following acts to a person not licensed |
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as a dentist or dental hygienist: |
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(A) the removal of calculus, deposits, or |
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accretions from the natural and restored surfaces of exposed human |
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teeth and restorations in the human mouth; |
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(B) root planing or the smoothing and polishing |
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of roughened root surfaces or exposed human teeth; or |
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(C) any other act the delegation of which is |
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prohibited by board rule; |
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(3) any of the following acts to a person not licensed |
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as a dentist: |
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(A) comprehensive examination or diagnosis and |
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treatment planning; |
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(B) a surgical or cutting procedure on hard or |
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soft tissue; |
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(C) the prescription of a drug, medication, or |
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work authorization; |
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(D) the taking of an impression for a final |
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restoration, appliance, or prosthesis; |
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(E) the making of an intraoral occlusal |
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adjustment; |
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(F) direct pulp capping, pulpotomy, or any other |
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endodontic procedure; |
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(G) the final placement and intraoral adjustment |
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of a fixed or removable appliance; or |
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(H) the placement of any final restoration; [or] |
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(4) the authority to an individual to administer a |
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local anesthetic agent, inhalation sedative agent, parenteral |
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sedative agent, or general anesthetic agent, including as a |
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teledentistry dental service as that term is defined by Section |
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111.001, if the individual is not licensed as: |
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(A) a dentist with a permit issued by the board |
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for the procedure being performed, if a permit is required; |
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(B) a certified registered nurse anesthetist |
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licensed by the Texas Board of Nursing, only if the delegating |
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dentist holds a permit issued by the board for the procedure being |
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performed, if a permit is required; or |
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(C) a physician anesthesiologist licensed by the |
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Texas Medical Board; or |
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(5) the authority to a dental hygienist to administer |
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a local anesthetic agent unless: |
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(A) the dental hygienist: |
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(i) administers the local anesthetic agent |
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by infiltration for purposes of a procedure the dental hygienist is |
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authorized to perform; |
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(ii) has passed a board-approved |
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certification examination relating to the administration of a local |
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anesthetic agent; |
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(iii) either: |
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(a) has completed a board-approved |
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course of study designed to train dental hygienists to administer a |
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local anesthetic agent by infiltration that consists of at least 40 |
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hours of didactic education and 30 hours of clinical education; or |
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(b) during the preceding year, was |
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authorized to administer a local anesthetic agent by: |
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(1) a branch of the United States |
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armed forces; or |
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(2) another state with clinical |
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and didactic education requirements substantially equivalent to |
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the requirements of a course approved by the board under |
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Sub-subparagraph (a); and |
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(iv) complies with any applicable rules |
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adopted by the board establishing minimum standards for the |
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administration of a local anesthetic agent; |
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(B) the delegating dentist is physically present |
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in the facility where the procedure is occurring and is |
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continuously aware of the patient's physical status and well-being; |
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and |
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(C) the patient to whom the local anesthetic |
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agent is administered is: |
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(i) at least 18 years of age; and |
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(ii) not sedated, or is sedated using only |
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nitrous oxide-oxygen inhalation. |
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SECTION 2. Section 262.002(a), Occupations Code, is amended |
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to read as follows: |
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(a) A person practices dental hygiene if the person: |
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(1) removes accumulated matter, tartar, deposits, |
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accretions, or stains, other than mottled enamel stains, from the |
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natural and restored surface of exposed human teeth and |
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restorations in the human mouth; |
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(2) smoothes roughened root surfaces; |
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(3) polishes exposed human teeth, restorations in the |
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human mouth, or roughened root surfaces; |
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(4) topically applies drugs to the surface tissues of |
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the human mouth or the exposed surface of human teeth; |
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(5) makes dental x-rays; [and] |
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(6) administers a local anesthetic agent under the |
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authorization and supervision of a dentist in compliance with |
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Section 258.001(5); and |
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(7) performs any other service, task, or procedure |
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prescribed by board rule. |
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SECTION 3. (a) Not later than January 1, 2024, the State |
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Board of Dental Examiners shall: |
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(1) prescribe by rule the requirements for a course to |
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train dental hygienists to administer a local anesthetic agent |
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consistent with Section 258.001, Occupations Code, as amended by |
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this Act; |
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(2) develop a procedure for the approval of courses |
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described by Subdivision (1) of this subsection; and |
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(3) adopt rules to administer Sections 258.001 and |
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262.002, Occupations Code, as amended by this Act, including rules |
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to establish the minimum standards for the administration of a |
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local anesthetic agent by a dental hygienist consistent with those |
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sections. |
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(b) A rule adopted under Subsection (a)(1) of this section |
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must require that a course be offered in a classroom setting at an |
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educational institution accredited by the Commission on Dental |
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Accreditation of the American Dental Association. |
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SECTION 4. This Act takes effect September 1, 2023. |