The Board proposes the rule promulgation to create a rule for the delegation of remediable restorative functions, supervision level, and training and experience requirements for dental hygienists.

 

DEPARTMENT OF HEALTH

Board of Dentistry

RULE NO.:RULE TITLE:

64B5-16.0061Delegation of Remediable Restorative Functions to Dental Hygienists; Supervision Level; and Training and Experience Requirements.

PURPOSE AND EFFECT: The Board proposes the rule promulgation to create a rule for the delegation of remediable restorative functions, supervision level, and training and experience requirements for dental hygienists.

SUMMARY: A rule will be promulgated for the delegation of remediable restorative functions, supervision level, and training and experience requirements for dental hygienists.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: 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 Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.

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.

RULEMAKING AUTHORITY: 456.013, 466.024 FS.

LAW IMPLEMENTED: 456.013, 466.024(1) FS.

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

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

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

64B5-16.0061 Delegation of Remediable Restorative Functions to Dental Hygienists; Supervision Level; and Training and Experience Requirements.

Notwithstanding any other rule provision to the contrary, a dentist may delegate remedial intraoral restorative functions to a Dental Hygienist in strict compliance with the provisions of this rule. All functions delegated under this rule shall be performed under direct supervision.

(1) Delegable Restorative Functions:  After a dentist has prepared a tooth, a dentist may delegate to a dental hygienist, who has met the mandatory training requirements of this rule, the task of placing, packing and contouring amalgam and composite restorations and the fitting and contouring of stainless-steel crowns (tasks). However, a dental hygienist shall not permanently cement stainless steel crowns.  

(a) The tasks shall only be performed using a slow speed handpiece and hand instruments.

(b) The delegating dentist shall not supervise more than four (4) dental hygienists or dental assistants in combination who are simultaneously performing the tasks pursuant to this rule or a rule authorizing the same or similar delegable tasks for dental assistants. 

(c) The delegating dentist shall ensure that the patient’s dental chart is annotated to reflect the initials of the dental hygienist who performed the tasks.

(d) The delegating dentist shall also ensure that the patient’s dental chart reflects that the final restoration was verified by the delegating dentist and the result of the verification shall also be documented.

(2) Mandatory Training Course Prerequisites:  To be eligible to be admitted into the mandatory training course required in subsection (3), a dental hygienist (Candidate) shall meet the following conditions:

(a) The Candidate shall be at least 18 years of age.

(b) The Candidate shall be a high school graduate or have a High School Equivalency Certificate.

(c) The Candidate shall have a current Basic Life Support for Healthcare Provider certificate.

(d) The Candidate shall have an active unrestricted dental hygiene license from any U.S. state or territory.  The Candidate shall have never had a dental hygiene license suspended or revoked in any jurisdiction.

(e) Within 24 months prior to being admitted to the mandatory training course in subsection (3), the Candidate must have documented proof of 2400 hours of clinical work experience in either a dental office or as an educator of dental hygiene or is a graduate of a dental hygiene program, accredited by a dental accrediting entity recognized by the United States Department of Education, within 24 months prior to being admitted to the mandatory training course.

(3) Mandatory Training Course:  The mandatory training course shall be offered by a dental or dental hygiene school or program that is accredited by a dental accrediting entity recognized by the United States Department of Education. The training course must be specifically designed and implemented to comply with the provisions of this rule. The training program shall ensure that the candidate meets all the qualifications in subsection (2) before accepting the candidate into the training program.  At a minimum, the training shall include and contain the following:

(a) 85 clock hours including a minimum of 5 hours dedicated to preclinical didactic hours, and a clinical portion consisting of a minimum 55 hours dedicated to simulated lab and a minimum of 25 hours dedicated to live patients. The pre-clinical didactic hours may be offered online.  At the completion of the preclinical didactic hours, the course shall require the passing of an initial written examination prior to the clinical portion of the training.  A passing score shall require a score of 75 percent or above.

(b) A clinical and lab session for Amalgam Restorations Class I, II, and V, which shall include live patients.   

(c) A clinical and lab session for Composite Restorations Class I, II, III, and V, which shall include live patients.

(d) A clinical and lab session to size, fit and contour, but not permanently cement, stainless steel crowns, which shall include live patients.

(e) The training program shall verify competency by requiring an exit or final written examination and clinical examination that includes live patients.  The written portion of the examination shall include a section covering the Laws and Rules of Dentistry in Florida. A passing score shall require a 75 percent or above on both the written and clinical examination and the examinations shall not be weighted to achieve an overall score of 75 percent or better. The clock hours dedicated to the exit or final written and clinical examination shall not count towards the required minimum 85 total clock hours required by the course.

(f) Upon the successful completion of the training course, a certificate of successful completion of the Restorative Function Course shall be issued.

(4) Documentation of Training:  A Dentist who delegates tasks pursuant to this rule shall ensure that a copy of the Restorative Function Course training certificate is immediately available at the location where tasks are delegated, and the certificate shall be produced by the dentist when requested by the Board Office or any authorized inspector.

(5) Responsibility:  The delegating and supervising dentist shall remain fully responsible for all delegated tasks and for ensuring that the dental hygienist meets the training requirements of this rule. 

Rulemaking Authority 456.013, 466.024 FS. Law Implemented 456.013, 466.024(1) FS. History–New                                   .

 

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: February 15, 2019

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: March 15, 2019