By: Hopson H.B. No. 3670

A BILL TO BE ENTITLED

AN ACT

relating to the regulation of the practice of dental assistants, including the delegation of certain dental acts.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 258.002, Occupations Code, is amended by amending Subsection (b) and adding Subsection (d) to read as follows:

(b) A licensed dentist may delegate to a qualified and trained dental assistant acting under the dentist's general supervision any dental act designated by this chapter for delegation under general supervision if:

(1) in the opinion of the delegating dentist, the act:

(A) can be properly and safely performed by the person to whom the dental act is delegated; and

(B) is performed in a customary manner and is not in violation of this subtitle or any other statute; and

(2) the person to whom the dental act is delegated does not represent to the public that the person is authorized to practice dentistry [, under Subsection (a), the application of a pit and fissure sealant to a dental assistant if the dentist is a Medicaid provider or the dentist practices in an area determined to be underserved by the Texas Department of Health. Cleansing of the occlusal and smooth surfaces of the teeth by a dental assistant is allowed immediately prior to and for the sole purpose of preparing the tooth area for the placement of pit and fissure sealants or orthodontic bonding resin, and shall not be billed as a prophylaxis].

(d) If a dental assistant is required to hold a certificate under this subtitle to perform a dental act, the dental assistant must hold the certificate before the act is delegated.

SECTION 2. Chapter 265, Occupations Code, is amended by adding Section 265.0001 to read as follows:

Sec. 265.0001. DEFINITIONS. In this chapter:

(1) "Coronal polishing" means the removal of plaque and extrinsic stain from exposed natural and restored tooth surfaces using an appropriate rotary instrument with rubber cup or brush and polishing agent, including the use of a toothbrush.

(2) "Interim treatment of a minor emergency dental condition" means treatment of a condition that:

(A) arises unexpectedly;

(B) causes pain or discomfort to the patient;

(C) is considered reversible; and

(D) does not require cutting hard or soft tissue.

SECTION 3. Section 265.002, Occupations Code, is amended to read as follows:

Sec. 265.002. SUPERVISION, DIRECTION, AND RESPONSIBILITY. (a) In this subtitle, a dental assistant is under the direct supervision, direction, and responsibility of a dentist if the dentist:

(1) employs the dental assistant or is in charge of the dental assistant; and

(2) is physically present in the dental office when the dental assistant performs a delegated dental act.

(b) In this subtitle, a dental assistant is under the general supervision of a dentist if the dentist is responsible for monitoring the services to be performed by the dental assistant. The dentist is not required to be physically present in the dental office when the dental assistant performs a delegated dental act under general supervision.

SECTION 4. Sections 265.003, Occupations Code, is amended to read as follows:

Sec. 265.003. PERMITTED DUTIES. (a) A dental assistant who is not professionally licensed may:

(1) be employed by and work in the office of a licensed and practicing dentist; and

(2) perform one or more delegated dental acts under the direct supervision, direction, and responsibility of the dentist, including:

(A) [the] application of a pit and fissure sealant, if the dental assistant is certified to apply a pit and fissure sealant under Section 265.004;

(B) coronal polishing, if the dental assistant is certified to perform coronal polishing under Section 265.006; and

(C) application of fluoride varnish.

(b) A dental assistant who is not professionally licensed may:

(1) be employed by and work in the office of a licensed and practicing dentist; and

(2) perform the following delegated dental acts under the general supervision, direction, and responsibility of the dentist:

(A) making dental x-rays in compliance with Section 265.005; or

(B) providing interim treatment of a minor emergency dental condition to an existing patient of the treating dentist, if the treating dentist delegates the procedure orally or in writing before the dental assistant performs the procedure [may apply a pit and fissure sealant under Subsection (a) only if:

(1) the assistant is certified to apply a pit and fissure sealant under Section 265.004; and

(2) the dentist described by Subsection (a):

(A) is a Medicaid provider; or

(B) practices in an area determined to be underserved by the Texas Department of Health].

(c) The dental acts permitted under this section are not considered to be the practice of dental hygiene as described by Section 262.002.

SECTION 5. Section 265.004(b), Occupations Code, is amended to read as follows:

(b) To qualify for a certificate, an applicant must:

(1) have at least two years' experience as a dental assistant; and

(2) have successfully completed a minimum of eight [16] hours of clinical and didactic education in pit and fissure sealants taken through an accredited dental hygiene program or a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board.

SECTION 6. Chapter 265, Occupations Code, is amended by adding Section 265.006 to read as follows:

Sec. 265.006. CORONAL POLISHING CERTIFICATE. (a) The board shall issue a coronal polishing certificate to a dental assistant who qualifies under this section.

(b) To qualify for a coronal polishing certificate, an applicant must have at least two years' experience as a dental assistant and:

(1) have successfully completed at least eight hours of clinical and didactic education in coronal polishing taken through a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board that includes courses on:

(A) oral anatomy and tooth morphology relating to retention of plaque and stain;

(B) indications, contraindications, and complications of coronal polishing;

(C) principles of coronal polishing including armamentarium, operator and patient positioning, technique and polishing agents;

(D) infection control procedures;

(E) polishing coronal surfaces of teeth; and

(F) jurisprudence related to coronal polishing; or

(2) present proof to the board that the assistant has:

(A) graduated from a dental assisting program accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the board that includes specific didactic course work and clinical training in coronal polishing; or

(B) received certification of completion of the requirements specified by the Dental Assisting National Board and approved by the board.

SECTION 7. Chapter 265, Occupations Code, is amended by adding Section 265.007 to read as follows:

Sec. 265.007. CONTINUING EDUCATION FOR CERTIFICATE HOLDERS. (a) To renew a certificate issued under this chapter, a dental assistant must complete at least six hours, but not more than 12 hours, of continuing education each year in areas covering dental assistant duties. A dental assistant holding more than one certificate authorized by this chapter is not required to complete more than the minimum required hours for one certificate.

(b) A dental assistant may fulfill continuing education requirements through board-approved self-study, interactive computer courses, or lecture courses.

SECTION 8. The following sections of the Occupations Code are repealed:

(1) Section 265.004(d); and

(2) Sections 265.005(j) and (k).

SECTION 9. The change in law made by this Act to Section 265.004(b), Occupations Code, applies only to an application for a pit and fissure sealant certificate under that section that is filed on or after the effective date of this Act. An application filed before that date is governed by the law in effect on the date the application was filed, and the former law is continued in effect for that purpose.

SECTION 10. (a) The change in law made by this Act by the enactment of Section 265.007, Occupations Code, applies to a certificate issued under Chapter 265, Occupations Code, on or after the effective date of this Act. A holder of a certificate issued under that chapter before the effective date of this Act may renew that certificate by complying with the law in effect at the time the certificate was issued, and the former law is continued in effect for that purpose.

(b) The State Board of Dental Examiners shall adopt rules under Section 265.007, Occupations Code, as added by this Act, not later than January 1, 2010.

SECTION 11. This Act takes effect September 1, 2009.