H.B. No. 3824
AN ACT
relating to the administration of a local anesthetic agent by a
dental hygienist.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 258.001, Occupations Code, is amended to
read as follows:
Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not
delegate:
(1) an act to an individual who, by board order, is
prohibited from performing the act;
(2) any of the following acts to a person not licensed
as a dentist or dental hygienist:
(A) the removal of calculus, deposits, or
accretions from the natural and restored surfaces of exposed human
teeth and restorations in the human mouth;
(B) root planing or the smoothing and polishing
of roughened root surfaces or exposed human teeth; or
(C) any other act the delegation of which is
prohibited by board rule;
(3) any of the following acts to a person not licensed
as a dentist:
(A) comprehensive examination or diagnosis and
treatment planning;
(B) a surgical or cutting procedure on hard or
soft tissue;
(C) the prescription of a drug, medication, or
work authorization;
(D) the taking of an impression for a final
restoration, appliance, or prosthesis;
(E) the making of an intraoral occlusal
adjustment;
(F) direct pulp capping, pulpotomy, or any other
endodontic procedure;
(G) the final placement and intraoral adjustment
of a fixed or removable appliance; or
(H) the placement of any final restoration; [or]
(4) the authority to an individual to administer a
local anesthetic agent, inhalation sedative agent, parenteral
sedative agent, or general anesthetic agent, including as a
teledentistry dental service as that term is defined by Section
111.001, if the individual is not licensed as:
(A) a dentist with a permit issued by the board
for the procedure being performed, if a permit is required;
(B) a certified registered nurse anesthetist
licensed by the Texas Board of Nursing, only if the delegating
dentist holds a permit issued by the board for the procedure being
performed, if a permit is required; or
(C) a physician anesthesiologist licensed by the
Texas Medical Board; or
(5) the authority to a dental hygienist to administer
a local anesthetic agent unless:
(A) the dental hygienist:
(i) administers the local anesthetic agent
by infiltration for purposes of a procedure the dental hygienist is
authorized to perform;
(ii) has passed a board-approved
certification examination relating to the administration of a local
anesthetic agent;
(iii) either:
(a) has completed a board-approved
course of study designed to train dental hygienists to administer a
local anesthetic agent by infiltration; or
(b) during the preceding year, was
authorized to administer a local anesthetic agent by:
(1) a branch of the United States
armed forces; or
(2) another state with clinical
and didactic education requirements substantially equivalent to
the requirements of a course approved by the board under
Sub-subparagraph (a); and
(iv) complies with any applicable rules
adopted by the board establishing minimum standards for the
administration of a local anesthetic agent;
(B) the delegating dentist is physically present
in the facility where the procedure is occurring and is
continuously aware of the patient's physical status and well-being;
and
(C) the patient to whom the local anesthetic
agent is administered is:
(i) at least 18 years of age; and
(ii) not sedated, or is sedated using only
nitrous oxide-oxygen inhalation.
SECTION 2. Section 262.002(a), Occupations Code, is amended
to read as follows:
(a) A person practices dental hygiene if the person:
(1) removes accumulated matter, tartar, deposits,
accretions, or stains, other than mottled enamel stains, from the
natural and restored surface of exposed human teeth and
restorations in the human mouth;
(2) smoothes roughened root surfaces;
(3) polishes exposed human teeth, restorations in the
human mouth, or roughened root surfaces;
(4) topically applies drugs to the surface tissues of
the human mouth or the exposed surface of human teeth;
(5) makes dental x-rays; [and]
(6) administers a local anesthetic agent under the
authorization and supervision of a dentist in compliance with
Section 258.001(5); and
(7) performs any other service, task, or procedure
prescribed by board rule.
SECTION 3. (a) Not later than January 1, 2024, the State
Board of Dental Examiners shall:
(1) prescribe by rule the requirements for a course to
train dental hygienists to administer a local anesthetic agent
consistent with Section 258.001, Occupations Code, as amended by
this Act;
(2) develop a procedure for the approval of courses
described by Subdivision (1) of this subsection; and
(3) adopt rules to administer Sections 258.001 and
262.002, Occupations Code, as amended by this Act, including rules
to establish the minimum standards for the administration of a
local anesthetic agent by a dental hygienist consistent with those
sections.
(b) A rule adopted under Subsection (a)(1) of this section
must require that a course be offered in a classroom setting at an
educational institution accredited by the Commission on Dental
Accreditation of the American Dental Association.
SECTION 4. This Act takes effect September 1, 2023.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 3824 was passed by the House on May
12, 2023, by the following vote: Yeas 133, Nays 7, 2 present, not
voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 3824 was passed by the Senate on May
24, 2023, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor