The Board proposes the rule amendment to delete unnecessary language and to add new language to update the requirements for the dental hygiene exam.

 

DEPARTMENT OF HEALTH
Board of Dentistry

RULE NO.: RULE TITLE:
64B5-2.0135: Dental Hygiene Examination

PURPOSE AND EFFECT: The Board proposes the rule amendment to delete unnecessary language and to add new language to update the requirements for the dental hygiene exam.

SUMMARY: The proposed changes will delete unnecessary language and to add new language to update the requirements for the dental hygiene exam.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COST:

During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members, determined that a Statement of Estimated Regulatory Cost (SERC) was not necessary and that these rule amendments will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time. The Board has determined that this will not have an adverse impact on small business, or likely increase regulatory costs in excess of $200,000 in the aggregate within 1 year after implementation of the rule.

Any person who wishes to provide information regarding the statement of estimated costs, or to provide a proposal for a lower regulatory cost alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 456.017, 466.004(4), 466.007 FS.
LAW IMPLEMENTED: 456.017, 466.007, 466.009(3) FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FLORIDA ADMINISTRATIVE WEEKLY.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Susan Foster, Executive Director, Board of Dentistry, 4052 Bald Cypress Way, Bin #C08, Tallahassee, Florida 32399-3258

 

THE FULL TEXT OF THE PROPOSED RULE IS:

64B5-2.0135 Dental Hygiene Examination.

(1) The Board specifies that the dental hygiene licensure examination administered by the Department of Health shall consist of two portions. One portion of the examination shall consist of a written examination and the second one portion of the examination shall be a clinical (or practical) examination. An applicant who passes one portion of the examination and not the other need only retake the failed portion.

(a) An applicant must successfully complete both portions of the examination within an eighteen (18) thirteen month period in order to qualify for licensure. If the applicant fails to successfully complete both portions within that time period, then the applicant must retake the entire examination.

(b) Each applicant for dental hygiene licensure is required to complete the examinations as provided for in Section 466.007, F.S. The examinations for dental hygiene shall consist of a written examination and a practical or clinical examination. The practical or clinical examination is the dental hygiene examination developed by the American Board of Dental Examiners, Inc. (ADEX), or its successor entity if the successor entity is determined by the Board to comply with the provision of Section 466.007, Florida Statutes. The ADEX dental hygiene examination is inclusive of a comprehensive clinical skills examination covering the full scope of dental hygiene practice. Any ADEX dental hygiene examination administered after June 1, 2010 will meet the clinical examination requirement. Any dental hygiene applicant who fails to pass the clinical portion of the examination in three attempts shall not be eligible for reexamination until successfull completion of one academic semester of clinical course work at the senior clinical practice level at a dental hygiene school approved by the American Dental Association Commission on Accreditation. The applicant must furnish proof from the accredited dental hygiene school of successful completion of the course work required by this rule. Applicants who fail to establish compliance with this rule shall automatically be denied permission to sit for reexamination.

(c) All examinations will be conducted in English.

(2) The written portion of the examination shall test on the law and rules of the State of Florida regulating the practice of dentistry and dental hygiene.

(a) A final grade of 75% or better is required to pass the written portion of the examination.

(b) Applicants will be given no more than 90 minutes to complete the written portion of the examination.

(3) Provided the Board maintains representation on the board of directors of the American Board of Dental Examiners, Inc., and the examination development committee of the American Board of Dental Examiners, Inc., the clinical examination procedures and criteria of the ADEX dental hygiene examination are approved by the Board. The clinical (or practical) portion of the examination consists of two parts. One part of the clinical examination shall consist of a computer based assessment involving simulated patients and one part of the clinical examination shall consist of a patient based assessment.

(a) The simulated patient part of the clinical examination requires applicants to take and pass a computer based examination which includes health assessments, oral condition evaluations, radiograph interpretations, and infection control practices.

1. A final grade of 75% or better is required to pass the simulated patient part of the clinical examination. Passing scores earned on the Florida certified computer based assessment provided to obtain North East Regional Board of Dental Examiners, Inc. status can be used to fulfill this requirement if the examination was taken after January 6, 2010.

2. Applicants will be given no more than 120 minutes to complete the simulated patient part of the clinical examination.

(b) The patient based part of the clinical examination requires an applicant to demonstrate clinical skills in performing a partial prophylaxis, scaling, root planning, coronal polishing and pocket depth measurements on selected teeth.

1. A final grade of 75% or better is required to pass the patient based part of the clinical examination.

2. Applicants will be given no more than 180 minutes to seat a patient, present the patient for acceptance and complete the treatment phase of the patient based part of the clinical examination.

3. Applicants will be give no more than 90 minutes to complete the treatment phase of the patient based part of the clinical examination.

4. The patient based part of the clinical examination is to be performed on a patient provided by the applicant.

(c) An applicant who passes one part of the clinical examination portion, either the simulated patient part or the patient based part, and not the other need only retake the failed clinical part.

(4) Demonstration of periodontal skills on a patient (root planing, scaling of subgingival calculus, and plaque, stain and supragingival calculas removal from the coronal part of the teeth selected and pocket depth measurement assessment) must be performed within a selected dental quadrant with a minimum of six and a maximum of eight teeth, none of which shall have a full crown restoration. Of the six to eight teeth, two may be contiguous molars in another quadrant if necessary to meet the criteria. Three of the teeth shall have pockets identified by the applicant at least 4 mm. in depth. Twelve surfaces with moderate subgingival calculus detectable by visual or tactile means must be identified and treated by the applicant (no more than four surfaces may be on incisors); at least one tooth shall be a multi-rooted molar which shall be in proximal contact with at least one other tooth; five surfaces must be on interproximal surfaces of posterior teeth, i.e. molars or premolars, and at least three of those inter-proximal surfaces must be on molars; none of the six to eight teeth shall be primary teeth. Each selected tooth must have at least one surface of calculus selected for removal. Six pocket depth measurements on each of one anterior and one posterior tooth selected by the examiners must be made by the applicant.

(5) The patient based part of the clinical examination shall have the following areas assessed in determining a grade:

(a) Presence of stain on assigned teeth.

(b) Presence of supragingival calculus on assigned teeth.

(c) Presence of subgingival calculus on assigned teeth.

(d) Root roughness on assigned teeth.

(e) Accuracy of pocket depth measurements.

(f) Management of soft and hard tissue.

(6) The grading system used during the patient based part of the clinical examination is as follows:

(a) Case acceptance of the patient based part of the clinical examination is evaluated as to whether or not the patient meets the published examination requirements.

(b) Treatment evaluation of the patient based part of the clinical examination is evaluated as to the presence and removal of applicant identified sub-gingival calculus, removal of plaque/supra-gingival calculus and stain from the selected teeth coronal surfaces and the accuracy, ± 1 mm., of pocket depth measurements on the two teeth selected by the examiner. Additionally, patient comfort and damage to soft and hard tissues are evaluated.

(c) The examiners use four competency levels to rate clinical skills:

Mandatory Zero – Complete failure and critically deficient

Marginally Substandard – Below minimal acceptable dental treatment

Minimally Acceptable – Minimal acceptable dental treatment

Satisfactory – Optimal dental treatment

(7) Three examiners will independently evaluate all treatment criteria in accordance with a detailed analytic scoring guide and specific scoring criteria for the atient based part of the clinical examination and the median competency level in each category (criteria) is determined. These median competency levels are translated into a numerical score. Applicants must earn at least 75% of the maximum possible raw score to pass that part.

(a) The scores for the patient based part of the clinical examination may also be affected by certain conduct or errors on the part of an applicant that warrant a penalty deduction from the examination score. Penalties may be assessed in areas such as patient management, compromised infection control, violation of examination guidelines, etc. and will be computed into the final score.

(b) Management of soft tissue is considered adequate in the absence of trauma or mutilation. Additionally, a grade of zero (0) is mandatory if there is gross mutilation of gingival tissue or if the applicant fails to attempt or complete the part.

(8) To take the patient based part of the clinical examination, it is the applicant’s responsibility to provide a patient who is at least 18 years of age and whose medical history is consistent with that prescribed by the Board and who meets at least the minimum patient qualifications within the selected dental quadrant in order to qualify as a patient for examination.

(a) The patient based part of the clinical examination may be terminated at any time by the Examination Administrator in the interest of patient safety.

(b) An applicant will not be able to submit a patient if less than 120 minutes remain in the assigned examination period.

(c) An applicant who does not submit a patient within the assigned examination period will receive a grade of mandatory zero (0).

(9) Applicants for examination or re-examination must have taken and successfully completed the National Board of Dental Hygiene examination and received a National Board Certificate within the past ten (10) years.

(10) Every applicant who is scheduled to take or retake the patient based part of the clinical examination must secure liability insurance coverage for injuries which may be sustained or may be claimed to have been sustained by a dental patient in the course of the examination and present proof of such coverage to the credentials committee before he or she will be allowed to perform any procedures on a live patient.

(11) Candidates for the dental hygiene state clinical boards may assess patients for suitability as board patients at any dental office under the direct supervision of a dentist, or at any accredited dental hygiene program or accredited dental school under direct supervision of a program faculty member.

Rulemaking Authority 456.017, 466.004(4), 466.007 FS. Law Implemented 456.017, 466.007, 466.009(3) FS. History–New 3-16-82, Amended 5-2-84, 5-19-85, 10-8-85, 12-8-85, Formerly 21G-2.135, Amended 12-31-86, 10-19-87, 2-21-88, 5-29-88, Formerly 21G-2.0135, 61F5-2.0135, Amended 11-15-95, Formerly 59Q-2.0135, Amended 10-31-01, 7-6-05, 12-31-09, 10-10-10,  ________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Council of Dental Hygiene

NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Board of Dentistry

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: May 20, 2011

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: September 23, 2011