GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1997

H	3 

HOUSE BILL 564
Committee Substitute Favorable 4/15/97
Committee Substitute #2 Favorable 4/30/97

Short Title:  Supervising Dental Hygienists.	(Public)

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Sponsors:

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Referred to:  

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March 20, 1997

A BILL TO BE ENTITLED
AN ACT TO AMEND THE DEFINITION OF DENTAL HYGIENIST, TO ALLOW DENTAL HYGIENISTS TO PERFORM CERTAIN ACTS WITHOUT THE ON-SITE SUPERVISION OF A LICENSED DENTIST, TO ALLOW DENTISTS TO EMPLOY MORE THAN TWO DENTAL HYGIENISTS AT ONE TIME AND TO STUDY ALTERNATIVE DENTAL HYGIENE EDUCATION AND TRAINING.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 90-221 reads as rewritten:
"§ 90-221.  Definitions.
	 ”The following definitions apply in this Article:
(1)	Dental hygiene. – The performance of the following functions: 
a.	Complete oral prophylaxis.
b.	Application of preventive agents to oral structures.
c.	Exposure and processing of radiographs.
d.	Administration of medicaments prescribed by a licensed dentist.
e.	Preparation of diagnostic aids and written records of oral conditions for interpretation by the dentist.
f.	Any other functions permitted by rules of the Board consistent with this Article.
	 ”(2)	Dental hygienist. – A person who is a graduate of a Board-accredited school of dental hygiene, who has been licensed by the Board, and who practices dental hygiene as prescribed by the Board.
	 ”(3)	License. – A certificate issued to any applicant upon completion of requirements for admission to practice dental hygiene.
	 ”(4)	Renewal certificate. – The annual certificate of renewal of license to continue practice of dental hygiene in the State of North Carolina.
	 ”(5)	Board. – The North Carolina State Board of Dental ”Examiners created by Chapter 139, Public Laws of 1879, and Chapter 178, Public Laws of 1915 as continued in existence by G.S. 90-22.
	 ”(6)	Supervision. –supervision of a dental hygienist by a licensed dentist is when the acts performed by the dental hygienist are performed in a locale where a licensed dentist is physically present during the performance of the acts and the acts are performed pursuant to the dentist's order, control, and approval."
Section 2.  G.S. 90-233 reads as rewritten:
"§ 90-233. Practice of dental hygiene; exceptions to on-site supervision.
(a)	A dental hygienist may practice only under the supervision of one or more licensed dentists. Provided, however, that:
(1)	Dental hygienists employed by the Department of Environment, Health, and Natural Resources and especially trained by that Department as public health hygienists are considered to be practicing under the supervision of a licensed dentist while performing their duties in the public schools under the direction of a duly licensed dentist.
(2)	In isolated and nonroutine incidents, when it becomes necessary for the supervising dentist to be absent from the dental office for not more than two hours in any day, the supervising dentist may assign to licensed and registered dental hygienists legally delegable duties to be performed in the dentist's absence if both the dental hygienist and the patient, who must be a patient of record, consent.
(3)	A dental hygienist who has completed five years of dentist, on-site, supervised clinical experience may practice without a dentist on-site in a nursing home, as defined in G.S. 131E-101(6), under the authorization of a licensed dentist and under the following conditions:
a.	The dentist must preexamine each patient no more than 45 days prior to the initiation of treatment, prepare a written treatment plan for the patient, and examine the patient at least one time per year thereafter, so long as treatment continues; and
b.	A dental hygienist may not practice in a nursing home unless a health care professional, trained in emergency medical treatment, is present on the premises during any dental hygiene treatment.
(b)	A dentist in private practice may not supervise more than three dental hygienists at one time.  However, the Board may adopt rules authorizing the supervision of more than three dental hygienists in specific circumstances which the Board deems appropriate.
(c)	Dental hygiene may be practiced only by the holder of a license or provisional license currently in effect and duly issued by the Board. The following acts, practices, functions or operations, however, shall not constitute the practice of dental hygiene within the meaning of this Article:
(1)	The teaching of dental hygiene in a school or college approved by the Board in a board-approved program by an individual licensed as a dental hygienist in any state in the United States.
(2)	Activity which would otherwise be considered the practice of dental hygiene performed by students enrolled in a school or college approved by the Board in a board-approved dental hygiene program under the direct supervision of a dental hygienist or a dentist duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of G.S. 90-29(c)(3), acting as an instructor.
(3)	Any act or acts performed by an assistant to a dentist licensed to practice in this State when said act or acts are authorized and permitted by and performed in accordance with rules and regulations promulgated by the Board.
(4)	Dental assisting and related functions as a part of their instructions by students enrolled in a course in dental assisting conducted in this State and approved by the Board, when such functions are performed under the supervision of a dentist acting as a teacher or instructor who is either duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of G.S. 90-29(c)(3)."
Section 3.  The Department of Community Colleges, the University of North Carolina at Chapel Hill, and the Board of Dental Examiners are directed, under their statutory and independent powers, to consider developing dental hygiene education and training programs that include night classes, remote teleconferencing, and other reasonable measures, consistent with the standards set by the Commission of Dental Accreditation, to assist dental hygiene students who desire or need to continue their employment while they attend school.
Section 4.  This act is effective when it becomes law.