The Texas State Board of Dental Examiners met on November 20, 2009, to take up and consider several rules including proposals for the enactment of recently passed state laws.
The Board took final action on a number of rules. Of greatest interest, were rules expanding the scope of work that can be performed by dental assistants, as well as rules for the implementation of an informal process for handling minor rules violations. Both issues were the result of legislation supported by TAGD in the last legislative session.
Dental Assistant Duties
Under the new rules, a dental assistant working under general supervision may provide interim treatment of minor emergency conditions that cause pain or discomfort to the patient if treatment is considered reversible and doesn't require cutting hard and soft tissue. In such cases, the dentist must believe the assistant has been properly trained to provide the treatment, must delegate the procedure orally or in writing before the dental assistant performs the procedure, retains responsibility for the procedure, and must schedule a follow-up appointment with the patient within a reasonable time.
The rules also state that dental assistants with at least two years of experience who have complete required coursework will be able to receive certificates to perform coronal polishing and/or apply pit and fissure sealants under direct supervision. Eight hours of education are required to obtain each certificate. As a result, a dental assistant wishing to obtain certificates for both applying sealants and coronal polishing will need to take a total of 16 hours of approved training. Previously, only dental assistants working for Medicaid providers or practicing in underserved areas were eligible for certification to apply sealants.
To renew a certificate, a dental assistant must complete six (6) hours of continuing education annually. A dental assistant holding two or more certificates must complete twelve (12) hours of continuing education each year to renew all of the certificates held by the assistant.
Certifications requiring continuing education include: radiology, applying pit and fissure sealants, and coronal polishing. There are no continuing education requirements for assistants holding certification for nitrous oxide.
The rules also added requirements to the dental assistant radiology certificate holders regarding registration display, address changes and registration fee payments.
***Note: Under general supervision, it is not necessary for the dentist who employs or is in charge of the dental assistant and responsible for supervising their services to physically be in the office at the time the assistant is providing services (i.e. minor emergency treatment or radiology).
In cases requiring direct supervision (i.e. applying sealants and doing coronal polishing), the supervising dentist is not required to be in the treatment room but must be in the office.
Informal Administrative Penalty Procedures
In addition, the board approved implementation of an alternative informal system providing an option for administrative penalties rather than more formal proceedings in cases where a minor violation does not impact patient care. The standard schedule of penalties for administrative violations ranges from $250 - $500. For example, failing to display registration in a dental office would be a $250 penalty while it would be $500 for failure to provide records to a patient. A penalty assessed under this process may not exceed $1,000 for each violation and may not exceed $3,000 in a calendar year. The Board will still make information regarding these penalties available to the public. It is hoped that instituting this process will speed up resolution of minor violations and allow the enforcement staff to dedicate more resources to dealing with more serious alleged violations.
Other Rules:
Reflecting changes in state law, the board also adopted rules to increase the terms of state board members to no more than two consecutive full six years terms (as compared to only one term), as well as a number of non-substantive administrative changes.
The rules will go into effect 20 days after publication in the Texas Register later this month. A more detailed analysis of the rules will be published in a future issue of GP and a copy of the complete text of the rules is available on the SBDE web site at www.tsbde.state.tx.us.
TSBDE Meeting: New Rules Adopted 
