To clarify and update language and criteria for successfully passing the examination of dental hygienists.

 

DEPARTMENT OF HEALTH
Board of Dentistry

RULE NO: RULE TITLE
64B5-2.0135: Dental Hygiene Examination
PURPOSE AND EFFECT: To clarify and update language and criteria for successfully passing the examination of dental hygienists.
SUMMARY: This rule will clarify and update language and criteria for successfully passing examination of dental hygienists.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared. The Board determined that small businesses would not be affected by this rule.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC 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 FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Sue Foster, Executive Director, Board of Dentistry, 4052 Bald Cypress Way, Bin #C08, Tallahassee, FL 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 one portion of the examination shall be a clinical (or practical) examination. A final grade of 75 or better on the written portion and a final grade of 3 or better on the clinical (or practical) portion is required to achieve a passing score. An applicant who passes one portion of the examination and not the other need only retake the failed portion that he failed.

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

(b) Any dental hygiene applicant who fails to pass the clinical portion of the examination in three 3 attempts shall not be eligible for reexamination until successful completion of he successfully completes 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 his 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) The clinical (or practical) portion of the examination consists of two parts requires a candidate to perform a complete prophylaxis. 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. In addition, root planing will be performed on 4 designated teeth, none of which shall be primary teeth. More specifically, the clinical (or practical) portion of the examination shall consist of 3 parts and shall be weighted as to each part as follows:

(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. Scaling/calculus removal 70%.

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

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. Polishing 10%.

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. Root planing 20%.

(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 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. The total time allowed for the clinical (or practical) portion will be 150 minutes and the clinical (or practical) portion is to be performed on a patient provided by the applicant. It is the applicant’s responsibility to provide a patient whose medical history permits dental treatment, who is at least 18 years of age, and who has a minimum of 20 natural teeth with generalized light to moderate calculus, both supra and submarginal. The applicant’s patient must have a minimum of 4 teeth, none of which shall have a full crown restoration, with not less than 4 mm. pockets which require root planing at least one of which shall be a multi-rooted molar which is in proximal contact with at least one other tooth. In order that the examination may be conducted in an efficient and orderly manner, an applicant will be allowed no more than three attempts to qualify a patient during the specified check-in period.

(5) The patient based part of the clinical examination shall have the following areas assessed in determining a grade: The following criteria shall be utilized in grading the three (3) parts of the clinical (or practical) portion of the examination. Failure to meet this criteria shall be regarded as an error.

(a) Presence of stain on assigned teeth. Scaling/calculus removal:

1. Complete removal of all supra- marginal calculus from each tooth without laceration to the surrounding tissues.

2. Complete removal of all submarginal calculus from each tooth without laceration to the surrounding tissues.

(b) Presence of supragingival calculus on assigned teeth. Polishing: Complete removal of all plaque from each tooth without abrasion.

(c) Presence of subgingival calculus on assigned teeth. Root planing: Smoothing of all rough root surfaces.

(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: The three parts of the clinical (or practical) portion of the examination shall be graded 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. For the scaling/calculus removal part, an applicant’s score will be based on the absence of or number of corroborated errors committed.

 

Errors	Grade
=8	0
7	1
6	2
5	3
4	4
0–3	5

 

 

(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. For the polishing part, an applicant’s score will be based on the absence of or number of corroborated errors committed.

 

Errors	Grade
=8	0
7	1
6	2
5	3
4	4
0–3	5

 

(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

For the root planing part, an applicant’s score will be based on the absence of or number of corroborated errors committed. Only four teeth will be evaluated and at least one of which shall be a multi-rooted molar. The four teeth will be identified by the applicant and authorized by the examiner prior to the beginning of the clinical (or practical) part.

 

Errors	Grade
=4	0.0
3	0.5
2	2.0
1	3.5
0	5

 

(7) Three examiners will independently evaluate all treatment criteria in accordance with a detailed analytic scoring guide and specific scoring criteria for the patient 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. 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.

(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. Every candidate who is scheduled to take the clinical (or practical) portion of the examination or who is scheduled to retake the clinical (or practical) portion 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.

(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 Specific 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,__________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Dentistry

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Dentistry

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: July 31, 2009

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: September 4, 2009