Senator Stephen H. Urquhart proposes the following substitute bill:




Chief Sponsor: Stephen H. Urquhart

House Sponsor: V. Lowry Snow


8     General Description:
9          This bill amends provisions related to the practice of dental hygiene.
10     Highlighted Provisions:
11          This bill:
12          ▸     modifies the scope of practice for a licensed dental hygienist; and
13          ▸     modifies unlawful conduct standards for a licensed dental hygienist.
14     Money Appropriated in this Bill:
15          None
16     Other Special Clauses:
17          None
18     Utah Code Sections Affected:
19     AMENDS:
20          58-69-102, as enacted by Laws of Utah 1996, Chapter 116
21          58-69-501, as enacted by Laws of Utah 1996, Chapter 116
22          58-69-801, as enacted by Laws of Utah 1996, Chapter 116

24     Be it enacted by the Legislature of the state of Utah:
25          Section 1. Section 58-69-102 is amended to read:

26          58-69-102. Definitions.
27          In addition to the definitions in Section 58-1-102, as used in this chapter:
28          (1) "Board" means the Dentist and Dental Hygienist Licensing Board created in
29     Section 58-69-201.
30          (2) "Dental assistant" means an unlicensed individual who engages in, directly or
31     indirectly, supervised acts and duties as defined by division rule made in collaboration with the
32     board.
33          (3) "Direct supervision" means the supervising dentist is present and available for
34     face-to-face communication with the person being supervised when and where professional
35     services are being provided.
36          (4) "General supervision" means that the supervising dentist is available for
37     consultation regarding work the supervising dentist has authorized, without regard as to
38     whether the supervising dentist is located on the same premises as the person being supervised.
39          (5) "Indirect supervision" means that the supervising dentist is present within the
40     facility in which the person being supervised is providing services and is available to provide
41     immediate face-to-face communication with the person being supervised.
42          [(7)] (6) "Practice of dental hygiene" means, regarding humans:
43          (a) under the general supervision of a dentist, or under a written agreement with a
44     dentist licensed under this chapter, as provided in Section 58-69-801, to:
45          (i) perform preliminary clinical examination of human teeth and gums;
46          (ii) make preliminary instrumental examination of patients' teeth;
47          (iii) expose dental radiographs;
48          (iv) assess dental hygiene status and collaborate with the supervising dentist regarding
49     a dental hygiene treatment plan for a patient;
50          (v) remove deposits, accumulations, calculus, and concretions from the surfaces of
51     human teeth;
52          (vi) remove toxins and debris from subgingival surfaces;
53          (vii) provide dental hygiene care in accordance with a dentist's treatment plan for a
54     patient;
55          (viii) take impressions of teeth or jaws except for impressions or registrations to supply
56     artificial teeth as substitutes for natural teeth; or

57          (ix) engage in other practices of dental hygiene as defined by division rule;
58          (b) under the indirect supervision of a dentist to administer in accordance with
59     standards and ethics of the professions of dentistry and dental hygiene:
60          (i) local anesthesia; or
61          (ii) nitrous oxide analgesia;
62          (c) to represent oneself by any title, degree, or in any other way as being a dental
63     hygienist; or
64          (d) to direct a dental assistant when the supervising dentist is not on the premises.
65          [(6)] (7) "Practice of dentistry" means the following, regarding humans:
66          (a) to offer, undertake, or represent that a person will undertake by any means or
67     method to:
68          (i) examine, evaluate, diagnose, treat, operate, or prescribe therapy for any disease,
69     pain, injury, deficiency, deformity, or any other condition of the human teeth, alveolar process,
70     gums, jaws, or adjacent hard and soft tissues and structures in the maxillofacial region;
71          (ii) take an appropriate history and physical consistent with the level of professional
72     service to be provided and the available resources in the facility in which the service is to be
73     provided;
74          (iii) take impressions or registrations;
75          (iv) supply artificial teeth as substitutes for natural teeth;
76          (v) remove deposits, accumulations, calculus, and concretions from the surfaces of
77     teeth; and
78          (vi) correct or attempt to correct malposition of teeth;
79          (b) to administer anesthetics necessary or proper in the practice of dentistry only as
80     allowed by an anesthesia permit obtained from the division;
81          (c) to administer and prescribe drugs related to and appropriate in the practice of
82     dentistry;
83          (d) to supervise the practice of a dental hygienist or dental assistant as established by
84     division rule made in collaboration with the board; or
85          (e) to represent oneself by any title, degree, or in any other way that one is a dentist.
86          (8) "Public health setting" means:
87          (a) an individual's residence, if the individual is unable to leave the residence;

88          (b) a school, as part of a school-based program;
89          (c) a nursing home;
90          (d) an assisted living or long-term care facility;
91          (e) a community health center;
92          (f) a federally-qualified health center; or
93          (g) a mobile dental health program that employs a dentist who is licensed under this
94     chapter.
95          [(8)] (9) "Supervising dentist" means a licensed dentist who has agreed to provide
96     supervision of a dental hygienist or unlicensed individual in accordance with the provisions of
97     this chapter.
98          [(9)] (10) "Unlawful conduct" [is as] means the same as that term is defined in Sections
99     58-1-501 and 58-69-501.
100          [(10)] (11) "Unprofessional conduct" [is as] means the same as that term is defined in
101     Sections 58-1-501 and 58-69-502 and as may be further defined by rule.
102          Section 2. Section 58-69-501 is amended to read:
103          58-69-501. Unlawful conduct.
104          "Unlawful conduct" includes, in addition to the definition in Section 58-1-501:
105          (1) administering anesthesia or analgesia in the practice of dentistry or dental hygiene
106     if the individual does not hold a current permit issued by the division authorizing that
107     individual to administer the type of anesthesia or analgesia used;
108          (2) practice of dental hygiene by a licensed dental hygienist when not under the
109     supervision of a dentist, or under a written agreement with a dentist who is licensed under this
110     chapter and who is a Utah resident, in accordance with the provisions of this chapter; or
111          (3) directing or interfering with a licensed dentist's judgment and competent practice of
112     dentistry.
113          Section 3. Section 58-69-801 is amended to read:
114          58-69-801. Dental hygienist -- Limitations on practice.
115          A dental hygienist licensed under this chapter may only practice dental hygiene:
116          (1) in an accredited dental or dental hygienist school to teach and demonstrate the
117     practice of dental hygiene;
118          (2) for a public health agency;

119          (3) under the supervision of a dentist, for an employee leasing company or temporary
120     personnel service company providing employees to a dentist or other person lawfully providing
121     dental services:
122          (a) under the indirect supervision of a dentist licensed under this chapter at any time
123     the dental hygienist is administering an anesthetic or analgesia as permitted under this chapter
124     or division rules made under this chapter;
125          (b) under the general supervision of a dentist licensed under this chapter within the
126     office of the supervising dentist and upon patients of record of the supervising dentist; and
127          (c) under the general supervision of a dentist licensed under this chapter, and the
128     practice is conducted outside of the office of the supervising dentist, if:
129          (i) the dental hygiene work performed is authorized by the supervising dentist as a part
130     of and in accordance with the supervising dentist's current treatment plan for the patient;
131          (ii) no anesthetic or analgesia is used;
132          (iii) the supervising dentist has determined the patient's general health and oral health
133     are so that the dental hygiene work can be performed under general supervision and with an
134     acceptable level of risk or injury as determined by the supervising dentist;
135          (iv) the supervising dentist accepts responsibility for the dental hygiene work
136     performed under general supervision; and
137          (v) (A) the dental hygienist's work is performed on a patient who is homebound or
138     within a hospital, nursing home, or public health agency or institution; and
139          (B) the patient is the supervising dentist's patient of record and the dentist has
140     examined the patient within six months prior to the patient's receiving treatment from a dental
141     hygienist under this Subsection[.] (3); and
142          (4) under a written agreement with a dentist who is licensed under this chapter and who
143     is a Utah resident if:
144          (a) the dental hygienist practices in a public health setting;
145          (b) the dentist is available in person, by phone, or by electronic communication;
146          (c) the agreement provides that the dental hygienist shall refer a patient with a dental
147     need to a licensed dentist; and
148          (d) the dental hygienist obtains from each patient an informed consent form that
149     provides that treatment by a dental hygienist is not a substitute for a dental examination by a

150     dentist.