By Madla                                               S.B. No. 114
         77R631 MXM-F                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to delegation of certain acts by dentists.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1. Section 258.001, Occupations Code, is amended to
 1-5     read as follows:
 1-6           Sec. 258.001.  IMPERMISSIBLE DELEGATIONS. A dentist may not
 1-7     delegate:
 1-8                 (1)  an act to an individual who, by board order, is
 1-9     prohibited from performing the act;
1-10                 (2)  any of the following acts to a person not licensed
1-11     as a dentist or dental hygienist:
1-12                       (A)  the removal of calculus, deposits, or
1-13     accretions from the natural and restored surfaces of exposed human
1-14     teeth and restorations in the human mouth;
1-15                       (B)  root planing or the smoothing and polishing
1-16     of roughened root surfaces [or exposed human teeth]; or
1-17                       (C)  any other act the delegation of which is
1-18     prohibited by board rule;
1-19                 (3)  any of the following acts to a person not licensed
1-20     as a dentist:
1-21                       (A)  comprehensive examination or diagnosis and
1-22     treatment planning;
1-23                       (B)  a surgical or cutting procedure on hard or
1-24     soft tissue;
 2-1                       (C)  the prescription of a drug, medication, or
 2-2     work authorization;
 2-3                       (D)  the taking of an impression for a final
 2-4     restoration, appliance, or prosthesis;
 2-5                       (E)  the making of an intraoral occlusal
 2-6     adjustment;
 2-7                       (F)  direct pulp capping, pulpotomy, or any other
 2-8     endodontic procedure;
 2-9                       (G)  the final placement and intraoral adjustment
2-10     of a fixed or removable appliance; or
2-11                       (H)  the placement of any final restoration; or
2-12                 (4)  the authority to an individual to administer a
2-13     local anesthetic agent, inhalation sedative agent, parenteral
2-14     sedative agent, or general anesthetic agent if the individual is
2-15     not licensed as:
2-16                       (A)  a dentist with a permit issued by the board
2-17     for the procedure being performed, if a permit is required;
2-18                       (B)  a certified registered nurse anesthetist
2-19     licensed by the Board of Nurse Examiners, only if the delegating
2-20     dentist holds a permit issued by the board for the procedure being
2-21     performed, if a permit is required; or
2-22                       (C)  a physician anesthesiologist licensed by the
2-23     Texas State Board of Medical Examiners.
2-24           SECTION 2. Section 258.002, Occupations Code, is amended by
2-25     amending Subsection (b) and adding Subsection (c) to read as
2-26     follows:
2-27           (b)  A licensed dentist may delegate, under Subsection (a),
 3-1     the application of a pit and fissure sealant.
 3-2           (c)  The board by rule shall establish guidelines regarding
 3-3     the types of dental acts that may be properly or safely delegated
 3-4     by a dentist, including a determination of which delegated dental
 3-5     acts, if any, require competency testing before a person may
 3-6     perform the act.
 3-7           SECTION 3. Section 265.003, Occupations Code, is amended to
 3-8     read as follows:
 3-9           Sec. 265.003.  PERMITTED DUTIES. (a)  A dental assistant who
3-10     is not professionally licensed may:
3-11                 (1)  be employed by and work in the office of a
3-12     licensed and practicing dentist; and
3-13                 (2)  perform one or more delegated dental acts under
3-14     the direct supervision, direction, and responsibility of the
3-15     dentist, including the application of a pit and fissure sealant.
3-16           (b)  A dental assistant may apply a pit and fissure sealant
3-17     under Subsection (a) only if the assistant:
3-18                 (1)  has at least two years' experience as an
3-19     assistant;
3-20                 (2)  has completed any training required by the board
3-21     for application of a sealant under this section; and
3-22                 (3)  is certified by the board to perform the act.
3-23           SECTION 4. This Act takes effect September 1, 2001.