Arizona
SB
1377, a bill establishing the role of licensed dental
therapist, has passed the full Senate and has been sent to the House for
further consideration.
Education and Licensure
The
proposed bill requires the Board of Dental Examiners to establish a uniform and
reasonable standard of minimum education requirements consistent with
accreditation standards of the American Dental Association Commission on Dental
Accreditation for dental therapy education programs and to determine the
reputability and classification of dental therapy schools in accordance with their
compliance with specified standards.
The
proposed bill also allows a recognized dental therapy school to grant advance
standing or credit for prior learning to a student who has prior experience or
coursework determined to be equivalent to didactic and clinical education in
its accredited program.
SB
1377 requires, after graduating from an accredited dental therapy education
program and successfully passing the required examinations and before entering
into a written collaborative practice agreement, a licensed dental therapist to
complete 1,000 hours of dental therapy clinical practice under the direct
supervision of a dentist.
Further,
SB 1377 requires dental therapy education programs to emphasize treatment
methods that reduce the need for analgesics. The proposed bill also prohibits a
dental therapist from dispensing a Schedule II controlled substance that is an opioid.
Collaborative Practice Agreement
Under the proposed bill, a written collaborative practice agreement
between a dentist and a dental therapist shall do the following (this list is
not exhaustive):
- Address any limit on services and procedures to be
performed by the dental therapist, including types of populations and any
age-specific or procedure-specific practice protocol, such as case selection criteria,
assessment guidelines and imaging frequency.
- Address any limit on practice settings established
by the supervising dentist and the level of supervision required for various services
or treatment settings.
- Establish practice protocols, including for
informed consent, recordkeeping, managing medical emergencies and providing
care to patients with complex medical conditions, including requirements for
consultation before initiating care.
Scope of Practice
The
proposed bill provides that pursuant to a written collaborative practice
agreement, a licensed dental therapist may do any of the following: perform
oral evaluations and assessments of dental disease and formulate individualized
treatment plans, provide oral health instruction and disease prevention education,
and prepare and place direct restorations in primary and permanent teeth. A
complete listing of procedures allowed under the scope of practice may be found
in Sec. 32-1276.02 of SB 1377.
Kansas
SB
312 has unanimously passed the full Senate and been sent
to the House, where it has been referred to the House Committee on Health and
Human Services. The bill would establish the role of licensed dental therapist.
SB
308 has been referred to the Committee on Public Health
and Welfare for further consideration. The bill would also establish the role
of licensed dental therapist.
Below
is a brief overview of SB 312, as that piece of proposed legislation is
currently moving more quickly through the legislative process. On March 14, a
hearing will be held on SB 312 by the House
Committee on Health and Human Services.
Education and Licensure
To
qualify to practice as a dental therapist under the proposed bill, a person (a)
would be required to be a licensed dental hygienist and a graduate of a dental
therapist education program approved by the Kansas Dental Board that requires
the study of dental therapy, (b) is determined by the Board to have standards
of education not less than that required for accreditation by the American Dental Association Commission on
Dental Accreditation, or (c) prior to such
accreditation process for dental therapy programs, is approved by a licensing
entity of another state or federal jurisdiction and that requires no less than
500 hours of clinical training. In addition, the individual must pass a
comprehensive, competency-based clinical examination approved by the Board and administered
independently of an institution that provides dental therapist education.
Scope of Practice and Supervision
Under
the proposed legislation, the practice of dental therapy would be performed
under the direct or general supervision of a licensed dentist. A licensed
dental therapist would be allowed to perform the following services under
direct supervision: extraction of erupted primary teeth that are non-ankylosed and
that have a majority resorption of all root structures, preparation and
placement of direct restoration fabricated or made directly inside the mouth in
primary and permanent teeth, preparation and placement of preformed crowns on
primary teeth, indirect pulp capping on permanent teeth, and indirect pulp
capping on primary teeth.[1]
A complete listing of procedures allowed under general supervision may be found
in Sect. 2 of SB 312.
Wisconsin
On Feb. 14, a committee hearing was held on SB 784 and AB 945, the bills would establish the role of licensed
dental therapist. SB 784 has two primary bill sponsors and 11
co-sponsors.
Education and Licensure
To
qualify to practice as a dental therapist under the proposed bill, a person
would be required to have graduated from an accredited dental therapy school
and completed a dental therapy program administered by an accredited dental or
dental hygiene school, if the school certifies to the examining board that the
applicant’s education substantially conformed to the education standards
established by the Commission on Dental Accreditation of the American Dental
Association. In addition, the individual must pass a national board dental
therapy examination and a dental therapy clinical examination administered by a
regional testing service approved by the examining board.
Scope of Practice
The
scope of practice of a dental therapist shall, subject to the terms of a
collaborative management agreement, be limited to providing the following: perform oral evaluations and assessments of dental
disease and formulate individualized treatment plans; provide oral health
instruction and disease prevention education; and prepare and place direct
restorations in primary and permanent teeth. A complete listing of procedures
allowed under the scope of practice may be found in Sec. 40 of SB 784.
Collaborative Management Agreement and Supervision
Under
the proposed legislation, a dental therapist may provide dental therapy
services only under the general supervision of a qualifying dentist with which
the dental therapist has entered into a collaborative management agreement.[2]
A
written collaborative practice agreement between a dentist and a dental
therapist must do the following (this list is not exhaustive): address any
limit on services and procedures to be performed by the dental therapist,
including types of populations and any age-specific or procedure-specific practice
protocol; and establish practice protocols, including protocols for
recordkeeping, managing medical emergencies and providing care to patients with
specific medical conditions, treatments or medications. No dentist may have
collaborative management agreements with more than five dental therapists at
any time.
[1]
The proposed bill defines “direct supervision”
to mean the supervision of tasks and
procedures with the presence of the dentist
in the office or on the premises at the time the tasks or procedures are being performed
where the dentist personally diagnoses
the condition to be treated, personally authorizes the
procedure and, before dismissal of the patient, evaluates the dental therapist’s performance.
[2]
The proposed bill defines "general
supervision" of a dental therapist by a dentist
to mean that a task or procedure be performed by a dental
therapist with the prior
knowledge and consent of the dentist, but does not require the presence of the dentist in the office or on the premises
at the time a task or procedure is being performed
by the dental therapist and does not require prior examination or diagnosis of a patient by the
dentist before the dental therapist provides dental therapy services to the patient.