By: Shapiro S.B. No. 455
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.