First Substitute S.B. 124

Senator Michael G. Waddoups proposes the following substitute bill:

1 DENTAL HYGIENIST LICENSING ACT
2 AMENDMENTS
3 2007 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Michael G. Waddoups
6 House Sponsor: ____________
7
8 LONG TITLE
9 General Description:
10 This bill modifies provisions of the Dental Hygienist Licensing Act by expanding the
11 definition of the practice of dental hygiene, defining public health supervision as related
12 to the "practice of dental hygiene," and allowing a dental hygienist to practice dental
13 hygiene health care under general supervision or under public health supervision in
14 specific health care facilities.
15 Highlighted Provisions:
16 This bill:
17 . expands the definition of the practice of dental hygiene to include administering and
18 prescribing topical medicaments related to and appropriate in the practice of dental
19 hygiene and specifies procedures a dental hygienist may perform under the public
20 health supervision of a dentist;
21 . defines "public health supervision" to mean practicing dental hygiene according to a
22 protocol established with a consulting dentist; and
23 . allows a dental hygienist to practice dental hygiene in specific health care facilities
24 under general supervision or public health supervision, with certain qualifications.
25 Monies Appropriated in this Bill:

26 None
27 Other Special Clauses:
28 None
29 Utah Code Sections Affected:
30 AMENDS:
31 58-69-102, as enacted by Chapter 116, Laws of Utah 1996
32 58-69-801, as enacted by Chapter 116, Laws of Utah 1996
33
34 Be it enacted by the Legislature of the state of Utah:
35 Section 1. Section 58-69-102 is amended to read:
36 58-69-102. Definitions.
37 In addition to the definitions in Section 58-1-102 , as used in this chapter:
38 (1) "Board" means the Dentist and Dental Hygienist Licensing Board created in
39 Section 58-69-201 .
40 (2) "Dental assistant" means an unlicensed individual who engages in, directly or
41 indirectly, supervised acts and duties as defined by division rule made in collaboration with the
42 board.
43 (3) "Direct supervision" means the supervising dentist is present and available for
44 face-to-face communication with the person being supervised when and where professional
45 services are being provided.
46 (4) "General supervision" means that the supervising dentist is available for
47 consultation regarding work the supervising dentist has authorized, without regard as to
48 whether the supervising dentist is located on the same premises as the person being supervised.
49 (5) "Indirect supervision" means that the supervising dentist is present within the
50 facility in which the person being supervised is providing services and is available to provide
51 immediate face-to-face communication with the person being supervised.
52 (6) "Practice of dentistry" means the following, regarding humans:
53 (a) to offer, undertake, or represent that a person will undertake by any means or
54 method to:
55 (i) examine, evaluate, diagnose, treat, operate, or prescribe therapy for any disease,
56 pain, injury, deficiency, deformity, or any other condition of the human teeth, alveolar process,

57 gums, jaws, or adjacent hard and soft tissues and structures in the maxillofacial region;
58 (ii) take an appropriate history and physical consistent with the level of professional
59 service to be provided and the available resources in the facility in which the service is to be
60 provided;
61 (iii) take impressions or registrations;
62 (iv) supply artificial teeth as substitutes for natural teeth;
63 (v) remove deposits, accumulations, calculus, and concretions from the surfaces of
64 teeth; and
65 (vi) correct or attempt to correct malposition of teeth;
66 (b) to administer anesthetics necessary or proper in the practice of dentistry only as
67 allowed by an anesthesia permit obtained from the division;
68 (c) to administer and prescribe drugs related to and appropriate in the practice of
69 dentistry;
70 (d) to supervise the practice of a dental hygienist or dental assistant as established by
71 division rule made in collaboration with the board; or
72 (e) to represent oneself by any title, degree, or in any other way that one is a dentist.
73 (7) "Practice of dental hygiene" means, regarding humans:
74 (a) under the general supervision of a dentist to:
75 (i) perform preliminary clinical examination of human teeth and gums;
76 (ii) make preliminary instrumental examination of patients' teeth;
77 (iii) expose dental radiographs;
78 (iv) assess dental hygiene status and collaborate with the supervising dentist regarding
79 a dental hygiene treatment plan for a patient;
80 (v) remove deposits, accumulations, calculus, and concretions from the surfaces of
81 human teeth;
82 (vi) remove toxins and debris from subgingival surfaces;
83 (vii) provide dental hygiene care in accordance with a dentist's treatment plan for a
84 patient;
85 (viii) take impressions of teeth or jaws except for impressions or registrations to supply
86 artificial teeth as substitutes for natural teeth; [or]
87 (ix) administer and prescribe topical medicaments related to and appropriate in the

88 practice of dental hygiene, as defined in rule; or
89 [(ix)] (x) engage in other practices of dental hygiene as defined by division rule;
90 (b) under the indirect supervision of a dentist to administer in accordance with
91 standards and ethics of the professions of dentistry and dental hygiene:
92 (i) local anesthesia; or
93 (ii) nitrous oxide analgesia;
94 (c) under the public health supervision of a dentist to:
95 (i) review and update each medical history, and assess blood pressure, if indicated;
96 (ii) chart existing teeth and restorations;
97 (iii) x-ray as determined by the established protocol;
98 (iv) collaborate with the consulting dentist prior to treatment;
99 (v) probe to assess periodontal status;
100 (vi) deliver oral hygiene instruction and discuss disease prevention;
101 (vii) remove deposits, accumulations, calculus and concretions from surfaces of human
102 teeth;
103 (viii) apply topical preventative or prophylactic agents, including fluoride varnishes
104 and pit and fissure sealants; or
105 (ix) perform scaling and root planing;
106 [(c)] (d) to represent oneself by any title, degree, or in any other way as being a dental
107 hygienist; or
108 [(d)] (e) to direct a dental assistant when the supervising dentist is not on the premises.
109 (8) "Public health supervision" means practicing dental hygiene according to a general
110 protocol established with a consulting dentist whether or not the dentist is on the same
111 premises or has examined the patient, so long as the dentist is available for consultation.
112 [(8)] (9) "Supervising dentist" means a licensed dentist who has agreed to provide
113 supervision of a dental hygienist or unlicensed individual in accordance with the provisions of
114 this chapter.
115 [(9)] (10) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-69-501 .
116 [(10)] (11) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-69-502
117 and as may be further defined by rule.
118 Section 2. Section 58-69-801 is amended to read:

119 58-69-801. Dental hygienist -- Limitations on practice.
120 A dental hygienist licensed under this chapter may only practice dental hygiene:
121 (1) in an accredited dental or dental hygienist school to teach and demonstrate the
122 practice of dental hygiene;
123 (2) for a public health agency;
124 (3) under the supervision of a dentist, for an employee leasing company or temporary
125 personnel service company providing employees to a dentist or other person lawfully providing
126 dental services:
127 (a) under the indirect supervision of a dentist licensed under this chapter at any time
128 the dental hygienist is administering an anesthetic or analgesia as permitted under this chapter
129 or division rules made under this chapter;
130 (b) under the general supervision of a dentist licensed under this chapter within the
131 office of the supervising dentist and upon patients of record of the supervising dentist; and
132 (c) under the general supervision of a dentist licensed under this chapter, and the
133 practice is conducted outside of the office of the supervising dentist, if:
134 (i) the dental hygiene work performed is authorized by the supervising dentist as a part
135 of and in accordance with the supervising dentist's current treatment plan for the patient;
136 (ii) no anesthetic or analgesia is used;
137 (iii) the supervising dentist has determined the patient's general health and oral health
138 are so that the dental hygiene work can be performed under general supervision and with an
139 acceptable level of risk or injury as determined by the supervising dentist;
140 (iv) the supervising dentist accepts responsibility for the dental hygiene work
141 performed under general supervision; and
142 (v) (A) the dental hygienist's work is performed on a patient who is homebound or
143 within a hospital, nursing home, or public health agency or institution; and
144 (B) the patient is the supervising dentist's patient of record and the dentist has
145 examined the patient within six months prior to the patient's receiving treatment from a dental
146 hygienist under this Subsection[.] (3); and
147 (4) in a nursing home, assisted living center, hospital, rehabilitation center, Title I
148 school Headstart school, migrant worker facility, group home for the elderly, disabled or youth
149 facility, home health services facility, mobile public health clinic or a community health center,

150 and in other categories of public health facilities as authorized by the board:
151 (a) under general supervision as defined in Subsection 58-69-102 (4); or
152 (b) under public health supervision as defined in Subsection 58-69-102 (6) so long as
153 the dental hygienist:
154 (i) contacts the consulting dentist prior to treatment;
155 (ii) informs the patient that the dental hygiene treatment is not a substitute for
156 comprehensive dental treatment;
157 (iii) refers patients for diagnosis and treatment by a dentist;
158 (iv) maintains liability insurance coverage;
159 (v) has at least five years experience as a licensed dental hygienist;
160 (vi) is currently certified in intermediate CPR training; and
161 (vii) documents participation in courses in infection control, medically compromised
162 patients, and medical emergencies within each continuing education cycle.