S.B. No. 455
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. Subsection (a), Section 258.002, Occupations
Code, is amended to read as follows:
(a) A licensed dentist may delegate to a qualified and
trained dental assistant acting under the dentist's general or
direct supervision any dental act that a reasonable and prudent
dentist would find is within the scope of sound dental judgment to
delegate 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; and
(3) the person to whom the dental act is delegated
holds the appropriate certificate, if a certificate is required to
perform the act.
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;
(D) does not require cutting hard or soft tissue;
and
(E) in the opinion of the treating dentist, may
be performed by a properly trained dental assistant.
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) For purposes of Subsection (a)(2), physical presence
does not require that the supervising dentist be in the treatment
room when the dental assistant performs the service as long as the
dentist is in the dental office.
(c) In this subtitle, a dental assistant is under the
general 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 responsible for supervising the services to be
performed by the dental assistant.
SECTION 4. Section 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:
(1) the direct supervision, direction, and
responsibility of the dentist, including:
(A) the application of a pit and fissure sealant;
(B) coronal polishing, if the dental assistant
holds a certificate under Section 265.006; and
(C) the application of fluoride varnish; or
(2) the general supervision, direction, and
responsibility of the dentist, limited to:
(A) the making of dental x-rays in compliance
with Section 265.005; and
(B) the provision of interim treatment of a minor
emergency dental condition to an existing patient of the treating
dentist.
(a-1) A treating dentist who delegates the provision of
interim treatment of a minor emergency dental condition to a dental
assistant under Subsection (a)(2)(B) shall:
(1) delegate the procedure orally or in writing before
the dental assistant performs the procedure;
(2) retain responsibility for the procedure; and
(3) schedule a follow-up appointment with the patient
within a reasonable time.
(b) A dental assistant who applies [may apply] a pit and
fissure sealant under Subsection (a) may cleanse the occlusal and
smooth surfaces of the teeth immediately before and for the sole
purpose of preparing the tooth area for the placement of the pit and
fissure sealant or orthodontic bonding resin. A procedure
performed by a dental assistant under this subsection may not be
billed as a prophylaxis [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].
SECTION 5. Subsection (b), Section 265.004, 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 relating 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
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 six hours of continuing education
each year in areas covering dental assistant duties.
(b) A dental assistant holding two or more certificates
authorized by this chapter is required to complete 12 hours of
continuing education each year to renew all of the certificates
held by the assistant.
(c) A dental assistant may fulfill continuing education
requirements through board-approved self-study, interactive
computer courses, or lecture courses.
SECTION 8. The following provisions of the Occupations Code
are repealed:
(1) Subsection (b), Section 258.002;
(2) Subsection (d), Section 265.004; and
(3) Subsections (j) and (k), Section 265.005.
SECTION 9. The change in law made by this Act to Subsection
(b), Section 265.004, 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. 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, that
expires on or after the effective date of this Act. A holder of a
certificate issued under that chapter that expires 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.
SECTION 11. This Act takes effect September 1, 2009.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 455 passed the Senate on
April 30, 2009, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 455 passed the House on
May 25, 2009, by the following vote: Yeas 142, Nays 0, one
present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor