SB 1040 First Engrossed
20121040e1
1 A bill to be entitled
2 An act relating to the practice of dentistry; amending
3 s. 466.006, F.S.; revising the eligibility
4 requirements for taking the examinations required to
5 practice dentistry if the applicant is a graduate of a
6 certain dental college or school; amending s. 466.007,
7 F.S.; revising the eligibility requirements for taking
8 the examinations required to practice dental hygiene;
9 revising the licensing requirements to practice as a
10 dental hygienist; amending s. 466.017, F.S.;
11 authorizing dental hygienists to administer certain
12 local anesthesia under the direct supervision of a
13 licensed dentist if certain educational requirements
14 are met; requiring dental hygienists to maintain
15 current certification in basic or advanced
16 cardiopulmonary resuscitation or advanced cardiac life
17 support with recertification every 2 years; amending
18 s. 466.023, F.S.; revising the scope and area of
19 practice for dental hygienists, to conform to changes
20 made by this act; amending s. 466.024, F.S.; revising
21 the delegated duties that are found to be remediable
22 and delegable, to conform to changes made by this act;
23 providing an effective date.
24
25 Be It Enacted by the Legislature of the State of Florida:
26
27 Section 1. Subsection (3) of section 466.006, Florida
28 Statutes, is amended to read:
29 466.006 Examination of dentists.—
30 (3) If an applicant is a graduate of a dental college or
31 school not accredited in accordance with paragraph (2)(b) or of
32 a dental college or school not approved by the board, the
33 applicant is shall not be entitled to take the examinations
34 required in this section to practice dentistry until she or he
35 satisfies one of the following:
36 (a) Completes a program of study, as defined by the board
37 by rule, at an accredited American dental school and
38 demonstrates receipt of a D.D.S. or D.M.D. from said school; or
39 (b) Submits proof of having successfully completed at least
40 2 consecutive academic years at a full-time supplemental general
41 dentistry program accredited by the American Dental Association
42 Commission on Dental Accreditation. This program must provide
43 didactic and clinical education at the level of a D.D.S. or
44 D.M.D. program accredited by the American Dental Association
45 Commission on Dental Accreditation Completes a 2-year
46 supplemental dental education program at an accredited dental
47 school and receives a dental diploma, degree, or certificate as
48 evidence of program completion.
49 Section 2. Subsections (2) and (4) of section 466.007,
50 Florida Statutes, are amended, and subsections (5) and (6) are
51 added to that section, to read:
52 466.007 Examination of dental hygienists.—
53 (2) An applicant is shall be entitled to take the
54 examinations required in this section to practice dental hygiene
55 in this state if the applicant:
56 (a) Is 18 years of age or older.
57 (b)1. Is a graduate of a dental hygiene college or school
58 approved by the board or accredited by the Commission on
59 Accreditation of the American Dental Association or its
60 successor entity, if any, or any other dental hygiene program
61 accrediting entity recognized by the United States Department of
62 Education agency; or
63 2. Is a graduate of a dental college or school accredited
64 in accordance with s. 466.006(2)(b), or a graduate of an
65 unaccredited dental college or school, and has met the
66 requirements of subsection (3).
67 (c)1. In the case of a graduate of a dental hygiene college
68 or school under subparagraph (2)(b)1.:
69 a. Has successfully completed the National Board of Dental
70 Hygiene examination at any time before the date of application
71 within 10 years of the date of application;
72 b. Has been certified by the American Dental Association
73 Joint Commission on National Dental Examinations at any time
74 before the date of application within 10 years of the date of
75 application; and
76 c. Effective January 1, 1997, has completed coursework that
77 which is comparable to an associate in science degree;.
78 d. Has not been disciplined by a board, except for citation
79 offenses or minor violations; and
80 e. Has not been convicted of or pled nolo contendere to,
81 regardless of adjudication, any felony or misdemeanor related to
82 the practice of a health care profession.
83 2. In the case of a graduate of a dental college or school
84 under subparagraph (2)(b)2., has successfully completed either
85 the National Board of Dental Hygiene Examination or the National
86 Board of Dental Examiners dental Examination, within 10 years of
87 the date of application.
88 (4) Effective July 1, 2012, to be licensed as a dental
89 hygienist in this state, an applicant must successfully complete
90 the following:
91 (a) A written examination on the laws and rules of this
92 state regulating the practice of dental hygiene.
93 (b) A practical or clinical examination approved by the
94 board. Effective July 1, 2012, and thereafter, the examination
95 shall be the Dental Hygiene Examination produced by the American
96 Board of Dental Examiners, Inc. (ADEX) or its successor entity,
97 if any, if the board finds that the successor entity’s clinical
98 examination meets or exceeds the provisions of this section. The
99 board shall approve the ADEX Dental Hygiene Examination if the
100 board has attained and continues to maintain representation on
101 the ADEX House of Representatives, the ADEX Dental Hygiene
102 Examination Development Committee, and such other ADEX Dental
103 Hygiene committees as the board deems appropriate through
104 rulemaking to ensure that the standards established in this
105 section are maintained organizationally. The ADEX Dental Hygiene
106 Examination or the examination produced by its successor entity
107 is a comprehensive examination in which an applicant must
108 demonstrate skills within the dental hygiene scope of practice
109 on a live patient and any other components that the board deems
110 necessary for the applicant to successfully demonstrate
111 competency for purpose of licensure. The ADEX Dental Hygiene
112 Examination or the examination by the successor entity
113 administered in this state shall be graded by dentists and
114 dental hygienists licensed in this state who are employed by the
115 department for this purpose.
116 (5) Effective July 1, 2012, an applicant who has completed
117 the ADEX Dental Hygiene Examination in a jurisdiction other than
118 this state and who has obtained a passing score may practice
119 dental hygiene in this state if the applicant:
120 (a) Has successfully completed the National Board Dental
121 Hygiene Examination at any time before the date of application;
122 and
123 (b) Has been certified by the American Dental Association
124 Joint Commission on National Dental Examinations at any time
125 before the date of application, as specified by state law.
126 (6)(a) A passing score on the ADEX Dental Hygiene
127 Examination administered out of state shall be considered the
128 same as a passing score for the ADEX Dental Hygiene Examination
129 administered in this state and graded by licensed dentists and
130 dental hygienists.
131 (b) If an applicant fails to pass the ADEX Dental Hygiene
132 Examination in three attempts, the applicant is not eligible to
133 retake the examination unless the applicant completes additional
134 education requirements as specified by the board. The practical
135 or clinical examination shall test competency in areas to be
136 established by rule of the board which shall include testing the
137 ability to adequately perform a prophylaxis. On or after October
138 1, 1986, every applicant who is otherwise qualified shall be
139 eligible to take the examination a total of three times,
140 notwithstanding the number of times the applicant has previously
141 failed. If an applicant fails the examination three times, the
142 applicant shall no longer be eligible to take the examination
143 unless he or she obtains additional educational requirements
144 established by the board. The department shall require a
145 mandatory standardization exercise pursuant to s. 456.017(1)(b)
146 for all examiners prior to each practical or clinical
147 examination and shall retain for employment only those dentists
148 and dental hygienists who have substantially adhered to the
149 standard of grading established at such exercise. It is the
150 intent of the Legislature that the examinations relate to those
151 procedures which are actually performed by a dental hygienist in
152 general practice.
153 Section 3. Present subsection (4) of section 466.017,
154 Florida Statutes, is amended, subsections (5) and (6) are
155 renumbered as subsections (7) and (8), respectively, and new
156 subsections (5) and (6) are added to that section, to read:
157 466.017 Prescription of drugs; anesthesia.—
158 (4) A dentist or dental hygienist who administers or
159 employs the use of any form of anesthesia must possess a
160 certification in either basic cardiopulmonary resuscitation for
161 health professionals or advanced cardiac life support approved
162 by the American Heart Association or the American Red Cross or
163 an equivalent agency-sponsored course with recertification every
164 2 years. Each dental office which uses any form of anesthesia
165 must have immediately available and in good working order such
166 resuscitative equipment, oxygen, and other resuscitative drugs
167 as are specified by rule of the board in order to manage
168 possible adverse reactions.
169 (5) A dental hygienist under the direct supervision of a
170 dentist may administer local anesthesia, including intraoral
171 block anesthesia, soft tissue infiltration anesthesia, or both,
172 to a nonsedated patient who is 18 years of age or older, if the
173 following criteria are met:
174 (a) The dental hygienist has successfully completed a
175 course in the administration of local anesthesia which is
176 offered by a dental or dental hygiene program accredited by the
177 Commission on Dental Accreditation of the American Dental
178 Association or approved by the board. The course must include a
179 minimum of 30 hours of didactic instruction and 30 hours of
180 clinical experience, and instruction in:
181 1. Theory of pain control.
182 2. Selection-of-pain-control modalities.
183 3. Anatomy.
184 4. Neurophysiology.
185 5. Pharmacology of local anesthetics.
186 6. Pharmacology of vasoconstrictors.
187 7. Psychological aspects of pain control.
188 8. Systematic complications.
189 9. Techniques of maxillary anesthesia.
190 10. Techniques of mandibular anesthesia.
191 11. Infection control.
192 12. Medical emergencies involving local anesthesia.
193 (b) The dental hygienist presents evidence of current
194 certification in basic or advanced cardiac life support.
195 (c) The dental hygienist possesses a valid certificate
196 issued under subsection (6).
197 (6) Any dental hygienist seeking a certificate to
198 administer local anesthesia must apply to the department, remit
199 an application fee, and submit proof of successful completion of
200 a course in the administration of local anesthesia pursuant to
201 subsection (5). The board shall certify, and the department
202 shall issue a certificate to, any dental hygienist who fulfills
203 the qualifications of subsection (5). The board shall establish
204 a one-time application fee not to exceed $35. The certificate is
205 not subject to renewal but is part of the dental hygienist’s
206 permanent record and must be prominently displayed at the
207 location where the dental hygienist is authorized to administer
208 local anesthesia. The board shall adopt rules necessary to
209 administer subsection (5) and this subsection.
210 Section 4. Subsection (7) is added to section 466.023,
211 Florida Statutes, to read:
212 466.023 Dental hygienists; scope and area of practice.—
213 (7) A dental hygienist may administer local anesthesia as
214 provided in ss. 466.017 and 466.024.
215 Section 5. Subsection (1) of section 466.024, Florida
216 Statutes, is amended to read:
217 466.024 Delegation of duties; expanded functions.—
218 (1) A dentist may not delegate irremediable tasks to a
219 dental hygienist or dental assistant, except as provided by law.
220 A dentist may delegate remediable tasks to a dental hygienist or
221 dental assistant when such tasks pose no risk to the patient. A
222 dentist may only delegate remediable tasks so defined by law or
223 rule of the board. The board by rule shall designate which tasks
224 are remediable and delegable, except that the following are by
225 law found to be remediable and delegable:
226 (a) Taking impressions for study casts but not for the
227 purpose of fabricating any intraoral restorations or orthodontic
228 appliance.
229 (b) Placing periodontal dressings.
230 (c) Removing periodontal or surgical dressings.
231 (d) Removing sutures.
232 (e) Placing or removing rubber dams.
233 (f) Placing or removing matrices.
234 (g) Placing or removing temporary restorations.
235 (h) Applying cavity liners, varnishes, or bases.
236 (i) Polishing amalgam restorations.
237 (j) Polishing clinical crowns of the teeth for the purpose
238 of removing stains but not changing the existing contour of the
239 tooth.
240 (k) Obtaining bacteriological cytological specimens not
241 involving cutting of the tissue.
242 (l) Administering local anesthesia pursuant to s.
243 466.017(5).
244
245 This subsection does not limit delegable tasks to those
246 specified herein.
247 Section 6. This act shall take effect upon becoming a law.