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  S.B. No. 455
 
 
 
 
AN ACT
  relating to the regulation of the practice of dental assistants,
  including the delegation of certain dental acts.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subsection (a), Section 258.002, Occupations
  Code, is amended to read as follows:
         (a)  A licensed dentist may delegate to a qualified and
  trained dental assistant acting under the dentist's general or
  direct supervision any dental act that a reasonable and prudent
  dentist would find is within the scope of sound dental judgment to
  delegate if:
               (1)  in the opinion of the delegating dentist, the act:
                     (A)  can be properly and safely performed by the
  person to whom the dental act is delegated; and
                     (B)  is performed in a customary manner and is not
  in violation of this subtitle or any other statute; [and]
               (2)  the person to whom the dental act is delegated does
  not represent to the public that the person is authorized to
  practice dentistry; and
               (3)  the person to whom the dental act is delegated
  holds the appropriate certificate, if a certificate is required to
  perform the act.
         SECTION 2.  Chapter 265, Occupations Code, is amended by
  adding Section 265.0001 to read as follows:
         Sec. 265.0001.  DEFINITIONS.  In this chapter:
               (1)  "Coronal polishing" means the removal of plaque
  and extrinsic stain from exposed natural and restored tooth
  surfaces using an appropriate rotary instrument with rubber cup or
  brush and polishing agent, including the use of a toothbrush.
               (2)  "Interim treatment of a minor emergency dental
  condition" means treatment of a condition that:
                     (A)  arises unexpectedly;
                     (B)  causes pain or discomfort to the patient;
                     (C)  is considered reversible;
                     (D)  does not require cutting hard or soft tissue;
  and
                     (E)  in the opinion of the treating dentist, may
  be performed by a properly trained dental assistant.
         SECTION 3.  Section 265.002, Occupations Code, is amended to
  read as follows:
         Sec. 265.002.  SUPERVISION, DIRECTION, AND RESPONSIBILITY.
  (a)  In this subtitle, a dental assistant is under the direct
  supervision, direction, and responsibility of a dentist if the
  dentist:
               (1)  employs the dental assistant or is in charge of the
  dental assistant; and
               (2)  is physically present in the dental office when
  the dental assistant performs a delegated dental act.
         (b)  For purposes of Subsection (a)(2), physical presence
  does not require that the supervising dentist be in the treatment
  room when the dental assistant performs the service as long as the
  dentist is in the dental office.
         (c)  In this subtitle, a dental assistant is under the
  general supervision, direction, and responsibility of a dentist if
  the dentist:
               (1)  employs the dental assistant or is in charge of the
  dental assistant; and
               (2)  is responsible for supervising the services to be
  performed by the dental assistant.
         SECTION 4.  Section 265.003, Occupations Code, is amended to
  read as follows:
         Sec. 265.003.  PERMITTED DUTIES. (a)  A dental assistant
  who is not professionally licensed may[:
               [(1)]  be employed by and work in the office of a
  licensed and practicing dentist[;] and
               [(2)]  perform one or more delegated dental acts under:
               (1)  the direct supervision, direction, and
  responsibility of the dentist, including:
                     (A)  the application of a pit and fissure sealant;
                     (B)  coronal polishing, if the dental assistant
  holds a certificate under Section 265.006; and
                     (C)  the application of fluoride varnish; or
               (2)  the general supervision, direction, and
  responsibility of the dentist, limited to:
                     (A)  the making of dental x-rays in compliance
  with Section 265.005; and
                     (B)  the provision of interim treatment of a minor
  emergency dental condition to an existing patient of the treating
  dentist.
         (a-1)  A treating dentist who delegates the provision of
  interim treatment of a minor emergency dental condition to a dental
  assistant under Subsection (a)(2)(B) shall:
               (1)  delegate the procedure orally or in writing before
  the dental assistant performs the procedure;
               (2)  retain responsibility for the procedure; and
               (3)  schedule a follow-up appointment with the patient
  within a reasonable time.
         (b)  A dental assistant who applies [may apply] a pit and
  fissure sealant under Subsection (a) may cleanse the occlusal and
  smooth surfaces of the teeth immediately before and for the sole
  purpose of preparing the tooth area for the placement of the pit and
  fissure sealant or orthodontic bonding resin.  A procedure
  performed by a dental assistant under this subsection may not be
  billed as a prophylaxis [only if:
               [(1)     the assistant is certified to apply a pit and
  fissure sealant under Section 265.004; and
               [(2)  the dentist described by Subsection (a):
                     [(A)  is a Medicaid provider; or
                     [(B)     practices in an area determined to be
  underserved by the Texas Department of Health].
         SECTION 5.  Subsection (b), Section 265.004, Occupations
  Code, is amended to read as follows:
         (b)  To qualify for a certificate, an applicant must:
               (1)  have at least two years' experience as a dental
  assistant; and
               (2)  have successfully completed a minimum of eight 
  [16] hours of clinical and didactic education in pit and fissure
  sealants taken through an accredited dental hygiene program or a
  dental assisting program accredited by the Commission on Dental
  Accreditation of the American Dental Association and approved by
  the board.
         SECTION 6.  Chapter 265, Occupations Code, is amended by
  adding Section 265.006 to read as follows:
         Sec. 265.006.  CORONAL POLISHING CERTIFICATE.  (a)  The
  board shall issue a coronal polishing certificate to a dental
  assistant who qualifies under this section.
         (b)  To qualify for a coronal polishing certificate, an
  applicant must have at least two years' experience as a dental
  assistant and:
               (1)  have successfully completed at least eight hours
  of clinical and didactic education in coronal polishing taken
  through a dental assisting program accredited by the Commission on
  Dental Accreditation of the American Dental Association and
  approved by the board that includes courses on:
                     (A)  oral anatomy and tooth morphology relating to
  retention of plaque and stain;
                     (B)  indications, contraindications, and
  complications of coronal polishing;
                     (C)  principles of coronal polishing, including
  armamentarium, operator and patient positioning, technique, and
  polishing agents;
                     (D)  infection control procedures;
                     (E)  polishing coronal surfaces of teeth; and
                     (F)  jurisprudence relating to coronal polishing;
  or
               (2)  present proof to the board that the assistant has:
                     (A)  graduated from a dental assisting program
  accredited by the Commission on Dental Accreditation of the
  American Dental Association and approved by the board that includes
  specific didactic course work and clinical training in coronal
  polishing; or
                     (B)  received certification of completion of
  requirements specified by the Dental Assisting National Board and
  approved by the board.
         SECTION 7.  Chapter 265, Occupations Code, is amended by
  adding Section 265.007 to read as follows:
         Sec. 265.007.  CONTINUING EDUCATION FOR CERTIFICATE
  HOLDERS.  (a)  To renew a certificate issued under this chapter, a
  dental assistant must complete six hours of continuing education
  each year in areas covering dental assistant duties.
         (b)  A dental assistant holding two or more certificates
  authorized by this chapter is required to complete 12 hours of
  continuing education each year to renew all of the certificates
  held by the assistant.
         (c)  A dental assistant may fulfill continuing education
  requirements through board-approved self-study, interactive
  computer courses, or lecture courses.
         SECTION 8.  The following provisions of the Occupations Code
  are repealed:
               (1)  Subsection (b), Section 258.002;
               (2)  Subsection (d), Section 265.004; and
               (3)  Subsections (j) and (k), Section 265.005.
         SECTION 9.  The change in law made by this Act to Subsection
  (b), Section 265.004, Occupations Code, applies only to an
  application for a pit and fissure sealant certificate under that
  section that is filed on or after the effective date of this Act. An
  application filed before that date is governed by the law in effect
  on the date the application was filed, and the former law is
  continued in effect for that purpose.
         SECTION 10.  The change in law made by this Act by the
  enactment of Section 265.007, Occupations Code, applies to a
  certificate issued under Chapter 265, Occupations Code, that
  expires on or after the effective date of this Act. A holder of a
  certificate issued under that chapter that expires before the
  effective date of this Act may renew that certificate by complying
  with the law in effect at the time the certificate was issued, and
  the former law is continued in effect for that purpose.
         SECTION 11.  This Act takes effect September 1, 2009.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 455 passed the Senate on
  April 30, 2009, by the following vote:  Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 455 passed the House on
  May 25, 2009, by the following vote:  Yeas 142, Nays 0, one
  present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor