dental hygienists; scope of
practice
HB 2543 allows a dental hygienist licensed by the Board of Dental Examiners (Board) who meets certain requirements criteria to perform dental hygiene without the supervision of dentist.
According to the Board, there are approximately 3,100 dentists, 2,400 dental hygienists and 12 denturists licensed to provide dental care in Arizona. Currently, A.R.S. 32-1281 defines what duties a dental hygienist may perform under either general or direct supervision:
|
General Supervision – Means the dentist is available for consultation over authorized procedures, whether or not the dentist is in the office |
Direct Supervision – Means the dentist is available for consultation over authorized procedures, if the dentist in the office |
|
Duties Permitted Under General Supervision 1. Prophylaxis. 2. Scaling. 3. Closed subgingival curettage. 4. Root planing. 5. Administering local anesthetics and nitrous oxide. 6. Placing of periodontal sutures. 7. Polishing of natural and restored surfaces of the teeth. 8. Examining the oral cavity and surrounding structures. 9. Periodontal examination. 10. Recording of clinical findings. 11. Compiling case histories. 12. Expose and process dental radiographs. 13. Perform all functions authorized and deemed appropriate for dental assistants. 14. Apply preventive and therapeutic agents, used in relation to dental hygiene procedures, to the hard and soft tissues. |
Duties Permitted under Direct Supervision 1. Administering local anesthetics. 2. Administering nitrous oxide analgesia. 3. Placing an interrupted suture interdentally to secure soft tissue papillae which may have inadvertently become displaced during root planing or closed curettage procedures performed by the dental hygienist, except that a dental hygienist may not position and suture soft tissue flaps which are reflected for surgical access and treatment. |
In addition, a dental hygienist may only perform dental hygiene in the following settings:
1. On a patient of record of a dentist within that dentist's office.
2. In a health care facility, nursing home, public health agency or institution on patients who have been examined by a dentist within the previous year.
3. In a homebound setting on patients who have been examined by a dentist within the previous twelve months.
The National Conference of State Legislatures reported in October 2001 that 24 states have passed legislation to expand the scope of practice for dental hygienists. The extent of the expanded scope of practice within each state varies. Generally, states have expanded the scope of practice for dental hygienists by issuing restricted licenses, limiting practice settings or putting restrictions on the type of persons served.
The issue of expanding the scope of practice for dental hygienists was addressed in a sunrise report submitted by the Arizona State Dental Hygienists Association to the Joint Legislative Audit Committee (JLAC). A sunrise report is required to be submitted pursuant to section 32-3104 if a health professional group proposes to expand its scope of practice. On December 5, 2001, the Health Committee of Reference reviewed the sunrise application and gave approval to the proposal that was outlined in the report.