BILL NUMBER: AB 2637	CHAPTERED
	BILL TEXT

	CHAPTER  499
	FILED WITH SECRETARY OF STATE  SEPTEMBER 28, 2008
	APPROVED BY GOVERNOR  SEPTEMBER 28, 2008
	PASSED THE SENATE  AUGUST 20, 2008
	PASSED THE ASSEMBLY  AUGUST 29, 2008
	AMENDED IN SENATE  AUGUST 14, 2008
	AMENDED IN SENATE  JUNE 17, 2008
	AMENDED IN ASSEMBLY  MAY 1, 2008

INTRODUCED BY   Assembly Member Eng

                        FEBRUARY 22, 2008

   An act to amend Sections 1680, 1721.5, 1725, 1741, 1750, 1750.1,
1752.1, 1765, 1771, and 1777 of, to amend and renumber Sections
1753.1, 1754, and 1770 of, to amend, renumber, add, and repeal
Sections 1756 and 1757 of, to add Sections 1750.5, 1752.3, 1752.4,
and 1753.4 to, to add and repeal Sections 1754.5, 1755, 1756.1,
1756.2, and 1758 of, to repeal Sections 1751.1, 1752, 1752.2, 1752.5,
and 1753.5 of, and to repeal and add Sections 1750.2, 1750.3,
1750.4, 1751, 1752.6, and 1753 of, the Business and Professions Code,
relating to dentistry.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2637, Eng. Dental auxiliaries.
   Existing law, the Dental Practice Act, provides for the licensure
and regulation of dentists by the Dental Board of California and
dental auxiliaries by the Committee on Dental Auxiliaries. Existing
law, on and after, January 1, 2010, authorizes an unlicensed dental
assistant to perform basic supportive dental procedures, as defined,
subject to a determination by the supervising licensed dentist that
the dental assistant is competent to perform those procedures.
Existing law, until January 1, 2011, requires the board to license as
a registered dental assistant a person who files an application
prior to September 1, 2009, and submits specified written evidence of
either graduation from a specified educational program or specified
work experience that is satisfactory to the board. Existing law, on
and after January 1, 2010, requires the board to license as a
registered dental assistant in extended functions a person who
submits specified evidence of current licensure as a registered
dental assistant or completion of the requirements for licensure,
successful completion of a specified extended functions postsecondary
program, and board-approved courses in radiation safety, infection
control, California dental law, and basic life support, and
satisfactory performance on a specified written examination and a
clinical or practical examination. Existing law, on and after January
1, 2010, also requires the board to license a person who meets
specified requirements as a registered orthodontic assistant,
registered surgery assistant, registered restorative assistant, or
registered restorative assistant in extended functions.
   This bill would repeal those provisions governing registered
orthodontic assistants, registered surgery assistants, registered
restorative assistants, and registered restorative assistants in
extended functions.
   The bill would, on and after January 1, 2010, specify the duties
that a dental assistant is authorized to perform under the general or
direct supervision of a supervising licensed dentist.
   The bill would revise and recast the registered dental assistant
provisions and would authorize the board to license a person as a
registered dental assistant if he or she files an application and
submits written evidence, satisfactory to the board, of either (1)
graduation from a board-approved educational program in registered
dental assisting, or (2) for individuals applying prior to January 1,
2010, satisfactory work experience, as defined, of at least 12
months or, for individuals applying on and after January 1, 2010,
satisfactory work experience of at least 15 months, and satisfactory
performance on a written and practical examination administered by
the committee. The bill would also require that those individuals
applying on or after January 1, 2010, pass a written examination in
law and ethics and complete board-approved courses in the act,
infection control, and basic life support. The bill would, on and
after January 1, 2010, impose specific content requirements for the
written and practical examinations and would require the board to
appoint a registered dental assistant examination committee to assign
specific procedures for the practical examination. The bill would,
commencing January 1, 2010, specify the duties a registered dental
assistant is authorized to perform. The bill would specify that the
fee for the written examination in law and ethics shall not exceed
the actual cost of the examination.
   The bill would, on and after January 1, 2010, modify the
requirements for a license as a registered dental assistant in
extended functions to include, among other things, completion of a
board-approved course in the application of pit and fissure sealants
and passage of a written examination and a clinical or practical
examination. The bill would specify the duties and procedures a
registered dental assistant in extended functions, licensed on or
after January 1, 2010, is authorized to perform, as well as those
additional procedures that may be performed under the direct
supervision of a licensed dentist. The bill would, commencing January
1, 2010, also require applicants for a registered dental assistant
in extended functions license to complete a specified examination
regarding certain procedures.
   The bill would, commencing January 1, 2010, authorize the board to
issue an orthodontic assistant permit or a dental sedation assistant
permit to a person who files a completed application, including a
fee, and provides proof of certain eligibility requirements. The bill
would authorize a dental assistant, a registered dental assistant,
or a registered dental assistant in extended functions to apply for
and maintain an orthodontic assistant permit or a dental sedation
assistant permit. The bill would also, commencing January 1, 2010,
specify the duties that may be performed by an orthodontic assistant
permitholder or a dental sedation assistant permitholder under the
direct supervision of a licensed dentist or, with respect to dental
sedation assistant permitholders, another specified licensed health
care professional. The bill would subject these permitholders to
board established continuing education and renewal requirements. The
bill would specify that the fee for these permits shall not exceed
$50 and that the fee for the written examination for these permits
shall not exceed the actual cost of the examination.
   The bill would require the board, commencing January 1, 2010, at
least once every 7 years, to review the allowable duties for the
various dental auxiliary categories, the supervision level for those
categories, and the settings under which those duties may be
performed, and to update the regulations as necessary.
   The bill would require a dental assisting program or course, a
permit program or course, a registered dental assistant program, a
registered dental assistant in extended function program, an
orthodontic assistant permit course, a dental sedation assistant
permit course, and an infection control course to meet various
requirements, relating to, among other things, administration,
facilities, supervision, curriculum, instruction, equipment, and
examinations in order to secure and maintain approval by the board.
   Existing law provides that it is a misdemeanor for any person who
does not have a license issued by the board to hold himself or
herself out as licensed by the board in specified categories of
dental practice.
   This bill would revise these provisions to make it a misdemeanor
for a person to, without a license or permit issued by the board,
hold himself or herself out as, among other things, a registered
dental assistant, orthodontic assistant permitholder, or dental
sedation assistant permitholder. By expanding the scope of an
existing crime, the bill would impose a state-mandated local program.

   Existing law provides that all fees collected under the Dental
Practice Act in connection with the practice of a dental auxiliary
are deposited in the State Dental Auxiliary Fund, in the Professions
and Vocations Fund.
   This bill would abolish the State Dental Auxiliary Fund and would
create the State Dental Assistant Fund, to which would be transferred
funds in the State Dental Auxiliary Fund related to dental
assistants for specific use, and in which would be deposited all
funds from the regulation of dental assistants. The bill would make
funds in the State Dental Assistant Fund subject to appropriation by
the Legislature in the annual Budget Act.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1680 of the Business and Professions Code is
amended to read:
   1680.  Unprofessional conduct by a person licensed under this
chapter is defined as, but is not limited to, any one of the
following:
   (a) The obtaining of any fee by fraud or misrepresentation.
   (b) The employment directly or indirectly of any student or
suspended or unlicensed dentist to practice dentistry as defined in
this chapter.
   (c) The aiding or abetting of any unlicensed person to practice
dentistry.
   (d) The aiding or abetting of a licensed person to practice
dentistry unlawfully.
   (e) The committing of any act or acts of sexual abuse, misconduct,
or relations with a patient that are substantially related to the
practice of dentistry.
   (f) The use of any false, assumed, or fictitious name, either as
an individual, firm, corporation, or otherwise, or any name other
than the name under which he or she is licensed to practice, in
advertising or in any other manner indicating that he or she is
practicing or will practice dentistry, except that name as is
specified in a valid permit issued pursuant to Section 1701.5.
   (g) The practice of accepting or receiving any commission or the
rebating in any form or manner of fees for professional services,
radiograms, prescriptions, or other services or articles supplied to
patients.
   (h) The making use by the licensee or any agent of the licensee of
any advertising statements of a character tending to deceive or
mislead the public.
   (i) The advertising of either professional superiority or the
advertising of performance of professional services in a superior
manner. This subdivision shall not prohibit advertising permitted by
subdivision (h) of Section 651.
   (j) The employing or the making use of solicitors.
   (k) The advertising in violation of Section 651.
   () The advertising to guarantee any dental service, or to perform
any dental operation painlessly. This subdivision shall not prohibit
advertising permitted by Section 651.
   (m) The violation of any of the provisions of law regulating the
procurement, dispensing, or administration of dangerous drugs, as
defined in Chapter 9 (commencing with Section 4000) or controlled
substances, as defined in Division 10 (commencing with Section 11000)
of the Health and Safety Code.
   (n) The violation of any of the provisions of this division.
   (o) The permitting of any person to operate dental radiographic
equipment who has not met the requirements of Section 1656.
   (p) The clearly excessive prescribing or administering of drugs or
treatment, or the clearly excessive use of diagnostic procedures, or
the clearly excessive use of diagnostic or treatment facilities, as
determined by the customary practice and standards of the dental
profession.
   Any person who violates this subdivision is guilty of a
misdemeanor and shall be punished by a fine of not less than one
hundred dollars ($100) or more than six hundred dollars ($600), or by
imprisonment for a term of not less than 60 days or more than 180
days, or by both a fine and imprisonment.
   (q) The use of threats or harassment against any patient or
licensee for providing evidence in any possible or actual
disciplinary action, or other legal action; or the discharge of an
employee primarily based on the employee's attempt to comply with the
provisions of this chapter or to aid in the compliance.
   (r) Suspension or revocation of a license issued, or discipline
imposed, by another state or territory on grounds that would be the
basis of discipline in this state.
   (s) The alteration of a patient's record with intent to deceive.
   (t) Unsanitary or unsafe office conditions, as determined by the
customary practice and standards of the dental profession.
   (u) The abandonment of the patient by the licensee, without
written notice to the patient that treatment is to be discontinued
and before the patient has ample opportunity to secure the services
of another dentist, registered dental hygienist, registered dental
hygienist in alternative practice, or registered dental hygienist in
extended functions and provided the health of the patient is not
jeopardized.
   (v) The willful misrepresentation of facts relating to a
disciplinary action to the patients of a disciplined licensee.
   (w) Use of fraud in the procurement of any license issued pursuant
to this chapter.
   (x) Any action or conduct that would have warranted the denial of
the license.
   (y) The aiding or abetting of a licensed dentist, dental
assistant, registered dental assistant, registered dental assistant
in extended functions, dental sedation assistant permitholder,
orthodontic assistant permitholder, registered dental hygienist,
registered dental hygienist in alternative practice, or registered
dental hygienist in extended functions to practice dentistry in a
negligent or incompetent manner.
   (z) The failure to report to the board in writing within seven
days any of the following: (1) the death of his or her patient during
the performance of any dental or dental hygiene procedure; (2) the
discovery of the death of a patient whose death is related to a
dental or dental hygiene procedure performed by him or her; or (3)
except for a scheduled hospitalization, the removal to a hospital or
emergency center for medical treatment for a period exceeding 24
hours of any patient to whom oral conscious sedation, conscious
sedation, or general anesthesia was administered, or any patient as a
result of dental or dental hygiene treatment. With the exception of
patients to whom oral conscious sedation, conscious sedation, or
general anesthesia was administered, removal to a hospital or
emergency center that is the normal or expected treatment for the
underlying dental condition is not required to be reported. Upon
receipt of a report pursuant to this subdivision the board may
conduct an inspection of the dental office if the board finds that it
is necessary. A dentist shall report to the board all deaths
occurring in his or her practice with a copy sent to the Dental
Hygiene Committee of California if the death was the result of
treatment by a registered dental hygienist, registered dental
hygienist in alternative practice, or registered dental hygienist in
extended functions. A registered dental hygienist, registered dental
hygienist in alternative practice, or registered dental hygienist in
extended functions shall report to the Dental Hygiene Committee of
California all deaths occurring as the result of dental hygiene
treatment, and a copy of the notification shall be sent to the board.

   (aa) Participating in or operating any group advertising and
referral services that are in violation of Section 650.2.
   (ab) The failure to use a fail-safe machine with an appropriate
exhaust system in the administration of nitrous oxide. The board
shall, by regulation, define what constitutes a fail-safe machine.
   (ac) Engaging in the practice of dentistry with an expired
license.
   (ad) Except for good cause, the knowing failure to protect
patients by failing to follow infection control guidelines of the
board, thereby risking transmission of bloodborne infectious diseases
from dentist, dental assistant, registered dental assistant,
registered dental assistant in extended functions, dental sedation
assistant permitholder, orthodontic assistant permitholder,
registered dental hygienist, registered dental hygienist in
alternative practice, or registered dental hygienist in extended
functions to patient, from patient to patient, and from patient to
dentist, dental assistant, registered dental assistant, registered
dental assistant in extended functions, dental sedation assistant
permitholder, orthodontic assistant permitholder, registered dental
hygienist, registered dental hygienist in alternative practice, or
registered dental hygienist in extended functions. In administering
this subdivision, the board shall consider referencing the standards,
regulations, and guidelines of the State Department of Public Health
developed pursuant to Section 1250.11 of the Health and Safety Code
and the standards, guidelines, and regulations pursuant to the
California Occupational Safety and Health Act of 1973 (Part 1
(commencing with Section 6300) of Division 5 of the Labor Code) for
preventing the transmission of HIV, hepatitis B, and other
blood-borne pathogens in health care settings. The board shall review
infection control guidelines, if necessary, on an annual basis and
proposed changes shall be reviewed by the Dental Hygiene Committee of
California to establish a consensus. The committee shall submit any
recommended changes to the infection control guidelines for review to
establish a consensus. As necessary, the board shall consult with
the Medical Board of California, the California Board of Podiatric
Medicine, the Board of Registered Nursing, and the Board of
Vocational Nursing and Psychiatric Technicians, to encourage
appropriate consistency in the implementation of this subdivision.
   The board shall seek to ensure that all appropriate dental
personnel are informed of the responsibility to follow infection
control guidelines, and of the most recent scientifically recognized
safeguards for minimizing the risk of transmission of bloodborne
infectious diseases.
   (ae) The utilization by a licensed dentist of any person to
perform the functions of any registered dental assistant, registered
dental assistant in extended functions, dental sedation assistant
permitholder, orthodontic assistant permitholder, registered dental
hygienist, registered dental hygienist in alternative practice, or
registered dental hygienist in extended functions who, at the time of
initial employment, does not possess a current, valid license or
permit to perform those functions.
   (af) The prescribing, dispensing, or furnishing of dangerous drugs
or devices, as defined in Section 4022, in violation of Section
2242.1.
  SEC. 2.  Section 1721.5 of the Business and Professions Code is
amended to read:
   1721.5.  (a) All funds received by the Treasurer pursuant to
Section 1725 shall be placed in the State Dental Assistant Fund for
the purposes of administering this chapter as it relates to dental
assistants, registered dental assistants, registered dental
assistants in extended functions, dental sedation assistant
permitholders, and orthodontic assistant permitholders. Expenditure
of these funds shall be subject to appropriation by the Legislature
in the annual Budget Act.
   (b) On July 1, 2009, all moneys in the State Dental Auxiliary
Fund, other than the moneys described in Section 1945, shall be
transferred to the State Dental Assistant Fund. The board's authority
to expend those funds, as appropriated in the 2008 Budget Act, shall
continue in order to carry out the provisions of this chapter as
they related to dental assistants licensed under this chapter for the
2008-09 fiscal year, including the payment of any encumbrances
related to dental assistants licensed under this chapter incurred by
the State Dental Auxiliary Fund.
  SEC. 3.  Section 1725 of the Business and Professions Code is
amended to read:
   1725.  The amount of the fees prescribed by this chapter that
relate to the licensing and permitting of dental assistants shall be
established by board resolution and subject to the following
limitations:
   (a) The application fee for an original license shall not exceed
twenty dollars ($20). On and after January 1, 2010, the application
fee for an original license shall not exceed fifty dollars ($50).
   (b) The fee for examination for licensure as a registered dental
assistant shall not exceed fifty dollars ($50) for the written
examination and shall not exceed sixty dollars ($60) for the
practical examination.
   (c) The fee for application and for the issuance of an orthodontic
assistant permit or a dental sedation assistant permit shall not
exceed fifty dollars ($50).
   (d) The fee for the written examination for an orthodontic
assistant permit or a dental sedation assistant permit shall not
exceed the actual cost of the examination.
   (e) The fee for the written examination in law and ethics for a
registered dental assistant shall not exceed the actual cost of the
examination.
   (f) The fee for examination for licensure as a registered dental
assistant in extended functions shall not exceed the actual cost of
the examination.
   (g) The fee for examination for licensure as a registered dental
hygienist shall not exceed the actual cost of the examination.
   (h) For third- and fourth-year dental students, the fee for
examination for licensure as a registered dental hygienist shall not
exceed the actual cost of the examination.
   (i) The fee for examination for licensure as a registered dental
hygienist in extended functions shall not exceed the actual cost of
the examination.
   (j) The board shall establish the fee at an amount not to exceed
the actual cost for licensure as a registered dental hygienist in
alternative practice.
   (k) The biennial renewal fee for a registered dental assistant
whose license expires on or after January 1, 1991, shall not exceed
sixty dollars ($60). On or after January 1, 1992, the board may set
the renewal fee for a registered dental assistant license, registered
dental assistant in extended functions license, dental sedation
assistant permit, or orthodontic assistant permit in an amount not to
exceed eighty dollars ($80).
   (l) The delinquency fee shall not exceed twenty-five dollars ($25)
or one-half of the renewal fee, whichever is greater. Any delinquent
license or permit may be restored only upon payment of all fees,
including the delinquency fee.
   (m) The fee for issuance of a duplicate registration, license,
permit, or certificate to replace one that is lost or destroyed, or
in the event of a name change, shall not exceed twenty-five dollars
($25).
   (n) The fee for each curriculum review and site evaluation for
educational programs for registered dental assistants that are not
accredited by a board-approved agency, or the Chancellor's office of
the California Community Colleges shall not exceed one thousand four
hundred dollars ($1,400).
   (o) The fee for review of each approval application for a course
that is not accredited by a board-approved agency, or the Chancellor'
s office of the California Community Colleges shall not exceed three
hundred dollars ($300).
   (p) No fees or charges other than those listed in subdivisions (a)
to (o), inclusive, above shall be levied by the board in connection
with the licensure or permitting of dental assistants, registered
dental assistant educational program site evaluations and course
evaluations pursuant to this chapter.
   (q) Fees fixed by the board pursuant to this section shall not be
subject to the approval of the Office of Administrative Law.
   (r) Fees collected pursuant to this section shall be deposited in
the State Dental Assistant Fund.
  SEC. 4.  Section 1741 of the Business and Professions Code is
amended to read:
   1741.  As used in this article:
   (a) "Board" means the Dental Board of California.
   (b) "Direct supervision" means supervision of dental procedures
based on instructions given by a licensed dentist, who must be
physically present in the treatment facility during the performance
of those procedures.
    (c) "General supervision" means supervision of dental procedures
based on instructions given by a licensed dentist but not requiring
the physical presence of the supervising dentist during the
performance of those procedures.
  SEC. 5.  Section 1750 of the Business and Professions Code, as
amended by Section 6 of Chapter 588 of the Statutes of 2007, is
amended to read:
   1750.  (a) A dental assistant is a person who may perform basic
supportive dental procedures as authorized by this article under the
supervision of a licensed dentist and who may perform basic
supportive procedures as authorized pursuant to subdivision (b) of
Section 1751 under the supervision of a registered dental hygienist
in alternative practice.
   (b) The supervising licensed dentist shall be responsible for
determining the competency of the dental assistant to perform
allowable functions.
   (c) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2010, deletes or extends
that date.
  SEC. 6.  Section 1750 of the Business and Professions Code, as
amended by Section 7 of Chapter 588 of the Statutes of 2007, is
amended to read:
   1750.  (a) A dental assistant is an individual who, without a
license, may perform basic supportive dental procedures, as
authorized by Section 1750.1 and by regulations adopted by the board,
under the supervision of a licensed dentist. "Basic supportive
dental procedures" are those procedures that have technically
elementary characteristics, are completely reversible, and are
unlikely to precipitate potentially hazardous conditions for the
patient being treated.
   (b) The supervising licensed dentist shall be responsible for
determining the competency of the dental assistant to perform the
basic supportive dental procedures, as authorized by Section 1750.1.
   (c) The employer of a dental assistant shall be responsible for
ensuring that the dental assistant who has been in continuous
employment for 120 days or more, has already successfully completed,
or successfully completes, all of the following within a year of the
date of employment:
   (1) A board-approved course in the Dental Practice Act.
   (2) A board-approved course in infection control.
   (3) A course in basic life support offered by an instructor
approved by the American Red Cross or the American Heart Association,
or any other course approved by the board as equivalent and that
provides the student the opportunity to engage in hands-on simulated
clinical scenarios.
   (d) The employer of a dental assistant shall be responsible for
ensuring that the dental assistant maintains certification in basic
life support.
   (e) This section shall become operative on January 1, 2010.
  SEC. 7.  Section 1750.1 of the Business and Professions Code is
amended to read:
   1750.1.  (a) A dental assistant may perform the following duties
under the general supervision of a supervising licensed dentist:
   (1) Extra-oral duties or procedures specified by the supervising
licensed dentist, provided that these duties or procedures meet the
definition of a basic supportive procedure specified in Section 1750.

   (2) Operate dental radiography equipment for the purpose of oral
radiography if the dental assistant has complied with the
requirements of Section 1656.
   (3) Perform intraoral and extraoral photography.
   (b) A dental assistant may perform the following duties under the
direct supervision of a supervising licensed dentist:
   (1) Apply nonaerosol and noncaustic topical agents.
   (2) Apply topical fluoride.
   (3) Take intraoral impressions for all nonprosthodontic
appliances.
   (4) Take facebow transfers and bite registrations.
   (5) Place and remove rubber dams or other isolation devices.
   (6) Place, wedge, and remove matrices for restorative procedures.
   (7) Remove post-extraction dressings after inspection of the
surgical site by the supervising licensed dentist.
   (8) Perform measurements for the purposes of orthodontic
treatment.
   (9) Cure restorative or orthodontic materials in operative site
with a light-curing device.
   (10) Examine orthodontic appliances.
   (11) Place and remove orthodontic separators.
   (12) Remove ligature ties and archwires.
   (13) After adjustment by the dentist, examine and seat removable
orthodontic appliances and deliver care instructions to the patient.
   (14) Remove periodontal dressings.
   (15) Remove sutures after inspection of the site by the dentist.
   (16) Place patient monitoring sensors.
   (17) Monitor patient sedation, limited to reading and transmitting
information from the monitor display during the intraoperative phase
of surgery for electrocardiogram waveform, carbon dioxide and end
tidal carbon dioxide concentrations, respiratory cycle data,
continuous noninvasive blood pressure data, or pulse arterial oxygen
saturation measurements, for the purpose of interpretation and
evaluation by a supervising licensed dentist who shall be at the
patient's chairside during this procedure.
   (18) Assist in the administration of nitrous oxide when used for
analgesia or sedation. A dental assistant shall not start the
administration of the gases and shall not adjust the flow of the
gases unless instructed to do so by the supervising licensed dentist
who shall be present at the patient's chairside during the
implementation of these instructions. This paragraph shall not be
construed to prevent any person from taking appropriate action in the
event of a medical emergency.
   (c) Under the supervision of a registered dental hygienist in
alternative practice, a dental assistant may perform intraoral
retraction and suctioning.
   (d) The board may specify additional allowable duties by
regulation.
   (e) The duties of a dental assistant or a dental assistant holding
a permit in orthodontic assisting or in dental sedation do not
include any of the following procedures unless specifically allowed
by law:
   (1) Diagnosis and comprehensive treatment planning.
   (2) Placing, finishing, or removing permanent restorations.
   (3) Surgery or cutting on hard and soft tissue including, but not
limited to, the removal of teeth and the cutting and suturing of soft
tissue.
   (4) Prescribing medication.
   (5) Starting or adjusting local or general anesthesia or oral or
parenteral conscious sedation, except for the administration of
nitrous oxide and oxygen, whether administered alone or in
combination with each other and except as otherwise provided by law.
   (f) The duties of a dental assistant are defined in subdivision
(a) of Section 1750 and do not include any duty or procedure that
only an orthodontic assistant permitholder, dental sedation assistant
permitholder, registered dental assistant, registered dental
assistant in extended functions, registered dental hygienist, or
registered dental hygienist in alternative practice is allowed to
perform.
   (g) This section shall become operative on January 1, 2010.
  SEC. 8.  Section 1750.2 of the Business and Professions Code is
repealed.
  SEC. 9.  Section 1750.2 is added to the Business and Professions
Code, to read:
   1750.2.  (a) On and after January 1, 2010, the board may issue an
orthodontic assistant permit to a person who files a completed
application including a fee and provides evidence, satisfactory to
the board, of all of the following eligibility requirements:
   (1) Completion of at least 12 months of work experience as a
dental assistant.
   (2) Successful completion of a board-approved course in the Dental
Practice Act and a board-approved, course in infection control.
   (3) Successful completion of a course in basic life support
offered by an instructor approved by the American Red Cross or the
American Heart Association, or any other course approved by the board
as equivalent.
   (4) Successful completion of a board-approved orthodontic
assistant course, which may commence after the completion of six
months of work experience as a dental assistant.
   (5) Passage of a written examination administered by the board
after completion of all of the other requirements of this
subdivision. The written examination shall encompass the knowledge,
skills, and abilities necessary to competently perform the duties
specified in Section 1750.3.
   (b) A person who holds an orthodontic assistant permit pursuant to
this section shall be subject to the same continuing education
requirements for registered dental assistants as established by the
board pursuant to Section 1645 and the renewal requirements of
Article 6 (commencing with Section 1715).
  SEC. 10.  Section 1750.3 of the Business and Professions Code is
repealed.
  SEC. 11.  Section 1750.3 is added to the Business and Professions
Code, to read:
   1750.3.  A person holding an orthodontic assistant permit pursuant
to Section 1750.2 may perform the following duties under the direct
supervision of a licensed dentist:
   (a) All duties that a dental assistant is allowed to perform.
   (b) Prepare teeth for bonding, and select, preposition, and cure
orthodontic brackets after their position has been approved by the
supervising licensed dentist.
   (c) Remove only orthodontic brackets and attachments with removal
of the bonding material by the supervising licensed dentist.
   (d) Size, fit, and cement orthodontic bands.
   (e) Remove orthodontic bands and remove excess cement from
supragingival surfaces of teeth with a hand instrument.
   (f) Place and ligate archwires.
   (g) Remove excess cement with an ultrasonic scaler from
supragingival surfaces of teeth undergoing orthodontic treatment.
   (h) Any additional duties that the board may prescribe by
regulation.
  SEC. 12.  Section 1750.4 of the Business and Professions Code is
repealed.
  SEC. 13.  Section 1750.4 is added to the Business and Professions
Code, to read:
   1750.4.  (a) On and after January 1, 2010, the board may issue a
dental sedation assistant permit to a person who files a completed
application including a fee and provides evidence, satisfactory to
the board, of all of the following eligibility requirements:
   (1) Completion of at least 12 months of work experience as a
dental assistant.
   (2) Successful completion of a board-approved course in the Dental
Practice Act and a board-approved, course in infection control.
   (3) Successful completion of a course in basic life support
offered by an instructor approved by the American Red Cross or the
American Heart Association, or any other course approved by the board
as equivalent.
   (4) Successful completion of a board-approved dental sedation
assistant course, which may commence after the completion of six
months of work experience as a dental assistant.
   (5) Passage of a written examination administered by the board
after completion of all of the other requirements of this
subdivision. The written examination shall encompass the knowledge,
skills, and abilities necessary to competently perform the duties
specified in Section 1750.5.
   (b) A person who holds a permit pursuant to this section shall be
subject to the continuing education requirements established by the
board pursuant to Section 1645 and the renewal requirements of
Article 6 (commencing with Section 1715).
    SEC. 14.  Section 1750.5 is added to the Business and Professions
Code, to read:
   1750.5.  A person holding a dental sedation assistant permit
pursuant to Section 1750.4 may perform the following duties under the
direct supervision of a licensed dentist or other licensed health
care professional authorized to administer conscious sedation or
general anesthesia in the dental office:
   (a) All duties that a dental assistant is allowed to perform.
   (b) Monitor patients undergoing conscious sedation or general
anesthesia utilizing data from noninvasive instrumentation such as
pulse oximeters, electrocardiograms, capnography, blood pressure,
pulse, and respiration rate monitoring devices. Evaluation of the
condition of a sedated patient shall remain the responsibility of the
dentist or other licensed health care professional authorized to
administer conscious sedation or general anesthesia, who shall be at
the patient's chairside while conscious sedation or general
anesthesia is being administered.
   (c) Drug identification and draw, limited to identification of
appropriate medications, ampule and vial preparation, and withdrawing
drugs of correct amount as verified by the supervising licensed
dentist.
   (d) Add drugs, medications, and fluids to intravenous lines using
a syringe, provided that a supervising licensed dentist is present at
the patient's chairside, limited to determining patency of
intravenous line, selection of injection port, syringe insertion into
injection port, occlusion of intravenous line and blood aspiration,
line release and injection of drugs for appropriate time interval.
The exception to this duty is that the initial dose of a drug or
medication shall be administered by the supervising licensed dentist.

   (e) Removal of intravenous lines.
   (f) Any additional duties that the board may prescribe by
regulation.
   (g) The duties listed in subdivisions (b) to (e), inclusive, may
not be performed in any setting other than a dental office or dental
clinic.
  SEC. 15.  Section 1751 of the Business and Professions Code, as
amended by Section 13 of Chapter 588 of the Statutes of 2007, is
repealed.
  SEC. 16.  Section 1751 is added to the Business and Professions
Code, to read:
   1751.  (a) At least once every seven years, the board shall review
the allowable duties for dental assistants, registered dental
assistants, registered dental assistants in extended functions,
dental sedation assistant permitholders, and orthodontic assistant
permitholders, the supervision level for these categories, and the
settings under which these duties may be performed, and shall update
the regulations as necessary to keep them current with the state of
the dental practice.
   (b) This section shall become operative on January 1, 2010.
  SEC. 17.  Section 1751.1 of the Business and Professions Code is
repealed.
  SEC. 18.  Section 1752 of the Business and Professions Code, as
amended by Section 14 of Chapter 588 of the Statutes of 2007, is
repealed.
  SEC. 19.  Section 1752 of the Business and Professions Code, as
amended by Section 15 of Chapter 588 of the Statutes of 2007, is
repealed.
  SEC. 20.  Section 1752.1 of the Business and Professions Code is
amended to read:
   1752.1.  (a) The board may license as a registered dental
assistant a person who files an application and submits written
evidence, satisfactory to the board, of one of the following
eligibility requirements:
   (1) Graduation from an educational program in registered dental
assisting approved by the board, and satisfactory performance on a
written and practical examination administered by the board.
   (2) For individuals applying prior to January 1, 2010, evidence of
completion of satisfactory work experience of at least 12 months as
a dental assistant in California or another state and satisfactory
performance on a written and practical examination administered by
the board.
   (3) For individuals applying on or after January 1, 2010, evidence
of completion of satisfactory work experience of at least 15 months
as a dental assistant in California or another state and satisfactory
performance on a written and practical examination administered by
the board.
   (b) For purposes of this section, "satisfactory work experience"
means performance of the duties specified in Section 1750.1 in a
competent manner as determined by the employing dentist, who shall
certify to such satisfactory work experience in the application.
   (c) The board shall give credit toward the work experience
referred to in this section to persons who have graduated from a
dental assisting program in a postsecondary institution approved by
the Department of Education or in a secondary institution, regional
occupational center, or regional occupational program, that are not,
however, approved by the board pursuant to subdivision (a). The
credit shall equal the total weeks spent in classroom training and
internship on a week-for-week basis. The board, in cooperation with
the Superintendent of Public Instruction, shall establish the minimum
criteria for the curriculum of nonboard-approved programs.
Additionally, the board shall notify those programs only if the
program's curriculum does not meet established minimum criteria, as
established for board-approved registered dental assistant programs,
except any requirement that the program be given in a postsecondary
institution. Graduates of programs not meeting established minimum
criteria shall not qualify for satisfactory work experience as
defined by this section.
   (d) In addition to the requirements specified in subdivision (a),
each applicant for registered dental assistant licensure on or after
July 1, 2002, shall provide evidence of having successfully completed
board-approved courses in radiation safety and coronal polishing as
a condition of licensure. The length and content of the courses shall
be governed by applicable board regulations.
   (e) In addition to the requirements specified in subdivisions (a)
and (d), individuals applying for registered dental assistant
licensure on or after January 1, 2010, shall demonstrate satisfactory
performance on a written examination in law and ethics administered
by the board and shall provide written evidence of successful
completion within five years prior to application of all of the
following:
   (1) A board-approved course in the Dental Practice Act.
   (2) A board-approved course in infection control.
   (3) A course in basic life support offered by an instructor
approved by the American Red Cross or the American Heart Association,
or any other course approved by the board as equivalent.
   (f) A registered dental assistant may apply for an orthodontic
assistant permit or a dental sedation assistant permit, or both, by
submitting written evidence of the following:
   (1) Successful completion of a board-approved orthodontic
assistant or dental sedation assistant course, as applicable.
   (2) Passage of a written examination administered by the board
that shall encompass the knowledge, skills, and abilities necessary
to competently perform the duties of the particular permit.
   (g) A registered dental assistant with permits in either
orthodontic assisting or dental sedation assisting shall be referred
to as an "RDA with orthodontic assistant permit," or "RDA with dental
sedation assistant permit," as applicable. These terms shall be used
for reference purposes only and do not create additional categories
of licensure.
   (h) Completion of the continuing education requirements
established by the board pursuant to Section 1645 by a registered
dental assistant who also holds a permit as an orthodontic assistant
or dental sedation assistant shall fulfill the continuing education
requirements for the permit or permits.
  SEC. 21.  Section 1752.2 of the Business and Professions Code is
repealed.
  SEC. 22.  Section 1752.3 is added to the Business and Professions
Code, to read:
   1752.3.  (a) On and after January 1, 2010, the written examination
for registered dental assistant licensure required by Section 1752.1
shall comply with Section 139.
   (b) On and after January 1, 2010, the practical examination for
registered dental assistant licensure required by Section 1752.1
shall consist of three of the procedures described in paragraphs (1)
to (4), inclusive. The specific procedures shall be assigned by a
registered dental assistant examination committee appointed by the
board and shall be graded by examiners appointed by the board. The
procedures shall be performed on a fully articulated maxillary and
mandibular typodont secured with a bench clamp. Each applicant shall
furnish the required materials necessary to complete the examination.

   (1) Place a base or liner.
   (2) Place, adjust, and finish a direct provisional restoration.
   (3) Fabricate and adjust an indirect provisional restoration.
   (4) Cement an indirect provisional restoration.
  SEC. 23.  Section 1752.4 is added to the Business and Professions
Code, to read:
   1752.4.  (a) A registered dental assistant may perform all of the
following duties:
   (1) All duties that a dental assistant is allowed to perform.
   (2) Mouth-mirror inspections of the oral cavity, to include
charting of obvious lesions, existing restorations, and missing
teeth.
   (3) Apply and activate bleaching agents using a nonlaser
light-curing device.
   (4) Use of automated caries detection devices and materials to
gather information for diagnosis by the dentist.
   (5) Obtain intraoral images for computer-aided design (CAD),
milled restorations.
   (6) Pulp vitality testing and recording of findings.
   (7) Place bases, liners, and bonding agents.
   (8) Chemically prepare teeth for bonding.
   (9) Place, adjust, and finish direct provisional restorations.
   (10) Fabricate, adjust, cement, and remove indirect provisional
restorations, including stainless steel crowns when used as a
provisional restoration.
   (11) Place post-extraction dressings after inspection of the
surgical site by the supervising licensed dentist.
   (12) Place periodontal dressings.
   (13) Dry endodontically treated canals using absorbent paper
points.
   (14) Adjust dentures extra-orally.
   (15) Remove excess cement from surfaces of teeth with a hand
instrument.
   (16) Polish coronal surfaces of the teeth.
   (17) Place ligature ties and archwires.
   (18) Remove orthodontic bands.
   (19) All duties that the board may prescribe by regulation.
   (b) A registered dental assistant may only perform the following
additional duties if he or she has completed a board-approved
registered dental assistant educational program in those duties, or
if he or she has provided evidence, satisfactory to the board, of
having completed a board-approved course in those duties.
   (1) Remove excess cement with an ultrasonic scaler from
supragingival surfaces of teeth undergoing orthodontic treatment.
   (2) The allowable duties of an orthodontic assistant permitholder
as specified in Section 1750.3. A registered dental assistant shall
not be required to complete further instruction in the duties of
placing ligature ties and archwires, removing orthodontic bands, and
removing excess cement from tooth surfaces with a hand instrument.
   (3) The allowable duties of a dental sedation assistant
permitholder as specified in Section 1750.5.
   (4) The application of pit and fissure sealants.
   (c) Except as provided in Section 1777, the supervising licensed
dentist shall be responsible for determining whether each authorized
procedure performed by a registered dental assistant should be
performed under general or direct supervision.
   (d) This section shall become operative on January 1, 2010.
  SEC. 24.  Section 1752.5 of the Business and Professions Code is
repealed.
  SEC. 25.  Section 1752.6 of the Business and Professions Code is
repealed.
  SEC. 26.  Section 1752.6 is added to the Business and Professions
Code, to read:
   1752.6.  A registered dental assistant licensed on and after
January 1, 2010, shall provide evidence of successful completion of a
board-approved course in the application of pit and fissure sealants
prior to the first expiration of his or her license that requires
the completion of continuing education as a condition of renewal. The
license of a registered dental assistant who does not provide
evidence of successful completion of that course shall not be renewed
until evidence of course completion is provided.
  SEC. 27.  Section 1753 of the Business and Professions Code is
repealed.
  SEC. 28.  Section 1753 is added to the Business and Professions
Code, to read:
   1753.  (a) On and after January 1, 2010, the board may license as
a registered dental assistant in extended functions a person who
submits written evidence, satisfactory to the board, of all of the
following eligibility requirements:
   (1) Current licensure as a registered dental assistant or
completion of the requirements for licensure as a registered dental
assistant.
   (2) Successful completion of a board-approved course in the
application of pit and fissure sealants.
   (3) Successful completion of either of the following:
   (A) An extended functions postsecondary program approved by the
board in all of the procedures specified in Section 1753.5.
   (B) An extended functions postsecondary program approved by the
board to teach the duties that registered dental assistants in
extended functions were allowed to perform pursuant to board
regulations prior to January 1, 2010, and a course approved by the
board in the procedures specified in paragraphs (1), (2), (5), and
(7) to (11), inclusive, of subdivision (b) of Section 1753.5.
   (4) Passage of a written examination and a clinical or practical
examination administered by the board. The board shall designate
whether the written examination shall be administered by the board or
by the board-approved extended functions program.
   (b) A registered dental assistant in extended functions may apply
for an orthodontic assistant permit or a dental sedation assistant
permit, or both, by providing written evidence of the following:
   (1) Successful completion of a board-approved orthodontic
assistant or dental sedation assistant course, as applicable.
   (2) Passage of a written examination administered by the board
that shall encompass the knowledge, skills, and abilities necessary
to competently perform the duties of the particular permit.
   (c) A registered dental assistant in extended functions with
permits in either orthodontic assisting or dental sedation assisting
shall be referred to as an "RDAEF with orthodontic assistant permit,"
or "RDAEF with dental sedation assistant permit," as applicable.
These terms shall be used for reference purposes only and do not
create additional categories of licensure.
   (d) Completion of the continuing education requirements
established by the board pursuant to Section 1645 by a registered
dental assistant in extended functions who also holds a permit as an
orthodontic assistant or dental sedation assistant shall fulfill the
continuing education requirement for such permit or permits.
  SEC. 29.  Section 1753.1 of the Business and Professions Code is
amended and renumbered to read:
   1753.5.  (a) A registered dental assistant in extended functions
licensed on or after January 1, 2010, is authorized to perform all
duties and procedures that a registered dental assistant is
authorized to perform as specified in and limited by Section 1752.4,
and those duties that the board may prescribe by regulation.
   (b) A registered dental assistant in extended functions licensed
on or after January 1, 2010, is authorized to perform the following
additional procedures under direct supervision and pursuant to the
order, control, and full professional responsibility of a licensed
dentist:
   (1) Conduct preliminary evaluation of the patient's oral health,
including, but not limited to, charting, intraoral and extra-oral
evaluation of soft tissue, classifying occlusion, and myofunctional
evaluation.
   (2) Perform oral health assessments in school-based, community
health project settings under the direction of a dentist, registered
dental hygienist, or registered dental hygienist in alternative
practice.
   (3) Cord retraction of gingiva for impression procedures.
   (4) Size and fit endodontic master points and accessory points.
   (5) Cement endodontic master points and accessory points.
   (6) Take final impressions for permanent indirect restorations.
   (7) Take final impressions for tooth-borne removable prosthesis.
   (8) Polish and contour existing amalgam restorations.
   (9) Place, contour, finish, and adjust all direct restorations.
   (10) Adjust and cement permanent indirect restorations.
   (11) Other procedures authorized by regulations adopted by the
board.
   (c) All procedures required to be performed under direct
supervision shall be checked and approved by the supervising licensed
dentist prior to the patient's dismissal from the office.
  SEC. 30.  Section 1753.4 is added to the Business and Professions
Code, to read:
   1753.4.  On and after January 1, 2010, each applicant for
licensure as a registered dental assistant in extended functions
shall successfully complete an examination consisting of the
procedures described in subdivisions (a) and (b). On and after
January 1, 2010, each person who holds a current and active
registered dental assistant in extended functions license issued
prior to January 1, 2010, who wishes to perform the duties specified
in paragraphs (1), (2), (5), and (7) to (11), inclusive, of
subdivision (b) of Section 1753.5, shall successfully complete an
examination consisting of the procedures described in subdivision
(b). The specific procedures shall be assigned by a registered dental
assistant in extended functions examination committee appointed by
the board and shall be graded by examiners appointed by the board.
Each applicant shall furnish the required materials necessary to
complete the examination.
   (a) Successful completion of the following two procedures on a
patient provided by the applicant. The prepared tooth, prior to
preparation, shall have had mesial and distal contact. The
preparation performed shall have margins at or below the free
gingival crest and shall be one of the following: 7/8 crown, 3/4
crown, or full crown, including porcelain fused to metal. Alginate
impression materials alone shall not be acceptable:
   (1) Cord retraction of gingiva for impression procedures.
   (2) Take a final impression for a permanent indirect restoration.
   (b) Successful completion of two of the following procedures on a
simulated patient head mounted in appropriate position and
accommodating an articulated typodont in an enclosed intraoral
environment, or mounted on a dental chair in a dental operatory:
   (1) Place, condense, and carve an amalgam restoration.
   (2) Place and contour a nonmetallic direct restoration.
   (3) Polish and contour an existing amalgam restoration.
  SEC. 31.  Section 1753.5 of the Business and Professions Code is
repealed.
  SEC. 32.  Section 1754 of the Business and Professions Code is
amended and renumbered to read:
   1752.4.  (a) By September 15, 1993, the board, upon recommendation
of the board and consistent with this article, standards of good
dental practice, and the health and welfare of patients, shall adopt
regulations relating to the functions that may be performed by
registered dental assistants under direct or general supervision, and
the settings within which registered dental assistants may work. At
least once every seven years thereafter, the board shall review the
allowable duties of registered dental assistants, the supervision
level, and settings under which they may be performed, and shall
update the regulations as needed to keep them current with the state
of the practice.
   (b) A registered dental assistant may apply pit and fissure
sealants under the general supervision of a licensed dentist, after
providing evidence to the board of having completed a board-approved
course in that procedure.
   (c) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2010, deletes or extends
that date.
  SEC. 33.  Section 1754.5 is added to the Business and Professions
Code, to read:
   1754.5.  As used in this article, the following definitions shall
apply:
   (a) "Didactic instruction" means lectures, demonstrations, and
other instruction without active participation by students. The
approved provider or its designee may provide didactic instruction
via electronic media, home study materials, or live lecture
methodology if the provider has submitted that content for approval.
   (b) "Laboratory instruction" means instruction in which students
receive supervised experience performing procedures using study
models, mannequins, or other simulation methods. There shall be at
least one instructor for every 14 students who are simultaneously
engaged in laboratory instruction.
   (c) "Preclinical instruction" means instruction in which students
receive supervised experience performing procedures on students,
faculty, or staff members. There shall be at least one instructor for
every six students who are simultaneously engaged in preclinical
instruction.
   (d) "Clinical instruction" means instruction in which students
receive supervised experience in performing procedures in a clinical
setting on patients. Clinical instruction shall only be performed
upon successful demonstration and evaluation of preclinical skills.
There shall be at least one instructor for every six students who are
simultaneously engaged in clinical instruction.
   (E) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 34.  Section 1755 is added to the Business and Professions
Code, to read:
   1755.  (a) (1) The criteria in subdivisions (b) to (h), inclusive,
shall be met by a dental assisting program or course and all
orthodontic assisting and dental sedation assisting permit programs
or courses to secure and maintain approval by the board as provided
in this article.
   (2) The board may approve, provisionally approve, or deny approval
of any program or course.
   (3) Program and course records shall be subject to inspection by
the board at any time.
   (4) The board may withdraw approval at any time that it determines
that a program or course does not meet the requirements established
in this section or any other requirements of law.
   (5) All programs and courses shall be established at the
postsecondary educational level or deemed equivalent thereto by the
board.
   (b) The program or course director shall possess a valid, active,
and current license issued by the board. The program or course
director shall actively participate in and be responsible for the
day-to-day administration of the program or course, including the
following requirements:
   (1) Maintaining for a period of not less than five years copies of
curricula, program outlines, objectives, and grading criteria, and
copies of faculty credentials, licenses, and certifications, and
individual student records, including those necessary to establish
satisfactory completion of the program or course.
   (2) Informing the board of any major change to the program or
course content, physical facilities, or faculty, within 10 days of
the change.
   (3) Ensuring that all staff and faculty involved in clinical
instruction meet the requirements set forth in this article.
   (c) No faculty member shall instruct in any procedure that he or
she is not licensed or permitted to perform. Each faculty member
shall have been licensed or permitted for a minimum of two years and
possess experience in the subject matter he or she is teaching.
   (d) A certificate or other evidence of completion shall be issued
to each student who successfully completes the program or course and
shall include the student's name, the name of the program or course,
the total number of program or course hours, the date of completion,
and the signature of the program or course director or his or her
designee.
   (e) Facilities and class scheduling shall provide each student
with sufficient opportunity, with instructor supervision, to develop
minimum competency in all duties for which the program or course is
approved to instruct.
   (1) The location and number of general use equipment and
armamentaria shall ensure that each student has the access necessary
to develop minimum competency in all of the duties for which the
program or course is approved to instruct. The program or course
provider may either provide the specified equipment and supplies or
require that the student provide them. Nothing in this section shall
preclude a dental office that contains the equipment required by this
section from serving as a location for laboratory instruction.
   (2) The minimum requirement for armamentaria includes infection
control materials specified by the Division of Occupational Safety
and Health and the regulations of the board, protective eyewear,
mask, and gloves for each student and faculty member, and appropriate
eye protection for each piece of equipment.
   (3) Clinical instruction shall be of sufficient duration to allow
the procedures to be performed to clinical proficiency. Operatories
shall be sufficient in number to allow a ratio of at least one
operatory for every five students who are simultaneously engaged in
clinical instruction.
   (A) Each operatory shall contain functional equipment, including a
power-operated chair for treating patients in a supine position,
operator and assistant stools, air-water syringe, adjustable light,
oral evacuation equipment, work surface, and adjacent hand-washing
sink.
   (B) Each operatory shall be of sufficient size to simultaneously
accommodate one student, one instructor, and one patient.
   (f) The program or course shall establish written clinical and
laboratory protocols to ensure adequate asepsis, infection, and
hazard control and disposal of hazardous wastes, that comply with the
board's regulations and other federal, state, and local
requirements. The program or course shall provide these protocols to
all students, faculty, and appropriate staff to ensure compliance
with these protocols. Adequate space shall be provided for preparing
and sterilizing all armamentarium. All reusable armamentarium shall
be sterilized and nonreusable items properly disposed.
                                         (g) A written policy on
managing emergency situations shall be made available to all
students, faculty, and staff. All faculty and staff involved in the
direct provision of patient care shall be certified in basic life
support procedures, including cardiopulmonary resuscitation.
Recertification intervals may not exceed two years. The program or
course director shall ensure and document compliance by faculty and
staff. A program or course shall not be required to ensure that
students complete instruction in basic life support prior to
performing procedures on patients.
   (h) A detailed program or course outline shall clearly state
curriculum subject matter and specific instruction hours in the
individual areas of didactic, laboratory, and clinical instruction.
General program or course objectives and specific instructional unit
objectives shall be stated in writing, and shall include theoretical
aspects of each subject as well as practical application. Objective
evaluation criteria shall be used for measuring student progress
toward attainment of specific program or course objectives. Students
shall be provided with all of the following:
   (1) Specific unit objectives and the evaluation criteria that will
be used for all aspects of the curriculum including written,
practical, and clinical examinations.
   (2) Standards of performance that state the minimum number of
satisfactory performances that are required for each procedure.
   (3) Standards of performance for laboratory, preclinical, and
clinical functions, those steps that constitute a critical error and
would cause the student to fail the procedure, and a description of
each of the grades that may be assessed for each procedure.
   (i) (1) If an extramural clinical facility is utilized, students
shall, as part of an extramural organized program of instruction, be
provided with planned, supervised clinical instruction. Laboratory
and preclinical instruction shall be performed under the direct
supervision of program or course faculty and shall not be provided in
extramural facilities.
   (2) The program or course director, or a designated faculty
member, shall be responsible for selecting extramural clinical sites
and evaluating student competence in performing procedures both
before and after the clinical assignment.
   (3) The program or course director, or a designated faculty
member, shall orient dentists who intend to provide extramural
clinical facilities prior to the student assignment. Orientation
shall include the objectives of the program or course, the student's
preparation for the clinical assignment, and a review of procedures
and criteria to be used by the dentist in evaluating the student
during the assignment. The program or course faculty and extramural
clinic personnel shall use the same objective evaluation criteria.
   (4) There shall be a written contract of affiliation with each
extramural clinical facility, which shall describe the settings in
which the clinical training will be received, and affirm that the
dentist and clinic personnel acknowledge the legal scope of duties
and infection control requirements, that the clinical facility has
the necessary equipment and armamentaria appropriate for the
procedures to be performed, and that the equipment and armamentaria
are in safe operating condition.
   (j) Any additional requirements that the board may prescribe by
regulation.
   (k) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 35.  Section 1756 of the Business and Professions Code is
amended and renumbered to read:
   1753.1.  (a) The board may license as a registered dental
assistant in extended functions a person who satisfies all of the
following eligibility requirements:
   (1) Status as a registered dental assistant.
   (2) Completion of clinical training approved by the board in a
facility affiliated with a dental school under the direct supervision
of the dental school faculty.
   (3) Satisfactory performance on an examination required by the
board.
   (b) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2010, deletes or extends
that date.
  SEC. 36.  Section 1756 is added to the Business and Professions
Code, to read:
   1756.  In addition to the requirements of Section 1755, the
following criteria shall be met by a course in infection control, as
required in Sections 1750, 1750.2, 1750.4, and 1752.1, to secure and
maintain approval by the board:
   (a) Adequate provisions for the supervision and operation of the
course in infection control shall be made. Notwithstanding Section
1755, faculty shall not be required to be licensed by the board, but
faculty shall have experience in the instruction of the infection
control regulations and guidelines issued by the board and the
Division of Occupational Safety and Health (Cal-DOSH). In addition to
the requirements of Section 1755, all faculty responsible for
clinical evaluation shall have completed a two-hour methodology
course in clinical evaluation.
   (b) A course in infection control shall be of sufficient duration
for the student to develop minimum competency in all aspects of
infection control regulations and guidelines issued by the board and
Cal-DOSH, but in no event less than eight hours, including at least
four hours of didactic instruction, at least two hours of laboratory
or preclinical instruction, and at least two hours of clinical
instruction. Preclinical instruction shall utilize instruments,
surfaces, and situations where contamination is simulated, without
actual contamination, from bloodborne and other pathogens being
present.
   (c) The minimum requirements for equipment and armamentaria shall
include personal protective equipment, FDA-approved sterilizer,
ultrasonic unit or instrument processing device, sharps container,
selection of instruments, equipment, and armamentaria that are
necessary to instruct or demonstrate proper hazardous waste disposal,
consistent with Cal-DOSH regulations, local, state, and federal
mandates, and all other armamentaria required to instruct or properly
demonstrate the subjects described in the course content.
   (d) Areas of instruction shall include, at a minimum, the
instruction specified in subdivisions (e) and (f).
   (e) Didactic instruction shall include, at a minimum, the
following as they relate to the infection control regulations of the
board and of Cal-DOSH:
   (1) Basic dental science and microbiology as they relate to
infection control in dentistry.
   (2) Legal and ethical aspects of infection control procedures.
   (3) Terms and protocols specified in the regulations of the board
regarding the minimum standards for infection control.
   (4) Principles of modes of disease transmission and prevention.
   (5) Principles, techniques, and protocols of hand hygiene,
personal protective equipment, surface barriers and disinfection,
sterilization, sanitation, and hazardous chemicals associated with
infection control.
   (6) Principles and protocols of sterilizer monitoring and the
proper loading, unloading, storage, and transportation of instruments
to work area.
   (7) Principles and protocols associated with sharps management.
   (8) Principles and protocols of infection control for laboratory
areas.
   (9) Principles and protocols of waterline maintenance.
   (10) Principles and protocols of regulated and nonregulated waste
management.
   (11) Principles and protocols related to injury and illness
prevention, hazard communication, general office safety, exposure
control, postexposure requirements, and monitoring systems for
radiation safety and sterilization systems.
   (f) Preclinical instruction shall include three experiences in the
following areas, with one used for a practical examination. Clinical
instruction shall include two experiences in the following areas,
with one used for a clinical examination:
   (1) Apply hand cleansing products and perform hand cleansing
techniques and protocols.
   (2) Apply, remove, and dispose of patient treatment gloves,
utility gloves, overgloves, protective eyewear, masks, and clinical
attire.
   (3) Apply the appropriate techniques and protocols for the
preparation, sterilization, and storage of instruments including, at
a minimum, application of personal protective equipment, precleaning,
ultrasonic cleaning, rinsing, sterilization wrapping, internal or
external process indicators, labeling, sterilization, drying,
storage, and delivery to work area.
   (4) Preclean and disinfect contaminated operatory surfaces and
devices, and properly use, place, and remove surface barriers.
   (5) Maintain sterilizer including, at a minimum, proper instrument
loading and unloading, operation cycle, spore testing, and handling
and disposal of sterilization chemicals.
   (6) Apply work practice controls as they relate to the following
classification of sharps: anesthetic needles or syringes, orthodontic
wires, and broken glass.
   (7) Apply infection control protocol for the following laboratory
devices: impressions, bite registrations, and prosthetic appliances.
   (8) Perform waterline maintenance, including use of water tests
and purging of waterlines.
   (g) Each student shall pass a written examination that reflects
the curriculum content, which may be administered at intervals
throughout the course as determined by the course director.
   (h) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 37.  Section 1756.1 is added to the Business and Professions
Code, to read:
   1756.1.  In addition to the requirements of Section 1755, the
following criteria shall be met by a orthodontic assistant permit
course to secure and maintain approval by the board. The board may
approve orthodontic assistant permit courses prior to January 1,
2010, and recognize the completion of orthodontic assistant permit
courses by students prior to January 1, 2010, but the board may not
issue an orthodontic assistant permit to students graduating from
orthodontic assistant permit courses until on or after January 1,
2010.
   (a) The course shall be of sufficient duration for the student to
develop minimum competence in all of the duties that orthodontic
assistant permitholders are authorized to perform, but in no event
less than 84 hours, including at least 24 hours of didactic
instruction, at least 28 hours of laboratory instruction, and at
least 32 hours of clinical instruction.
   (b) The minimum requirements for equipment and armamentaria shall
include banded or bonded orthodontic typodonts in the ratio of at
least one for every four students, bench mount or dental chair
mounted mannequin head, curing light, regular typodont with full
dentition and soft gingiva in the ratio of at least one for every
four students, and a selection of orthodontic instruments and adjunct
material for all of the procedures that orthodontic assistant
permitholders are authorized to perform.
   (c) All faculty responsible for clinical evaluation shall have
completed a two-hour methodology course in clinical evaluation prior
to conducting clinical evaluations of students.
   (d) Areas of instruction shall include, at a minimum, the
instruction specified in subdivisions (e) to (j), inclusive. In
addition to the requirements of those subdivisions, instruction shall
include basic background information on orthodontic practice,
including orthodontic treatment review, charting, patient education,
and legal and infection control requirements as they apply to
orthodontic practice.
   (e) The following requirements shall be met for sizing, fitting,
cementing, and removing orthodontic bands:
   (1) Didactic instruction shall include the following:
   (A) Theory of band positioning and tooth movement.
   (B) Characteristics of band material including malleability,
stiffness, ductility, and work hardening.
   (C) Techniques for orthodontic banding and removal, including all
of the following:
   (i) Armamentaria.
   (ii) General principles of fitting and removing bands.
   (iii) Normal placement requirements of brackets, tubes, lingual
sheaths, lingual cleats, and buttons onto bands.
   (iv) Orthodontic cements and adhesive materials: classifications,
armamentaria, and mixing technique.
   (v) Cementing bands: armamentaria, mixing technique, and band
cementation procedures.
   (vi) Procedure for removal of bands after cementation.
   (2) Laboratory instruction shall include typodont experience in
the sizing, fitting, cementing, and removal of four posterior first
molar bands a minimum of two times, with the cementing and removal of
two first molar bands used as a practical examination.
   (3) Clinical instruction shall include the sizing, fitting,
cementing, and removal of four posterior first molar bands on at
least two patients.
   (f) The following requirements shall be met for preparing teeth
for bonding:
   (1) Didactic instruction shall include the following: chemistry of
etching materials and tooth surface preparation, application and
time factors, armamentaria, and techniques for tooth etching.
   (2) Laboratory instruction shall include typodont experience with
etchant application in preparation for subsequent bracket bonding on
four anterior and four posterior teeth a minimum of four times each,
with one of each of the four times used for a practical examination.
   (3) Clinical instruction shall include etchant application in
preparation for bracket bonding on anterior and posterior teeth on at
least two patients.
   (g) The following requirements shall be met for bracket
positioning, bond curing, and removal of orthodontic brackets.
   (1) Didactic instruction shall include the following:
   (A) Characteristics and methods of orthodontic bonding.
   (B) Armamentaria.
   (C) Types of bracket bonding surfaces.
   (D) Bonding material characteristics, application techniques, and
curing time factors.
   (E) Procedure for direct and indirect bracket bonding.
   (F) Procedures for bracket or tube removal.
   (2) Laboratory instruction shall include typodont experience with
selecting, prepositioning, tooth etching, positioning, curing and
removing of four anterior and four posterior brackets a minimum of
four times each, with one each of the four times used for a practical
examination.
   (3) Clinical instruction shall include selecting, adjusting,
prepositioning, etching, curing and removal of anterior and posterior
brackets on at least two patients.
   (h) The following requirements shall be met for archwire placement
and ligation:
   (1) Didactic instruction shall include the following:
   (A) Archwire characteristics.
   (B) Armamentaria.
   (C) Procedures for placement of archwire previously adjusted by
the dentist.
   (D) Ligature systems, purpose and types, including elastic, wire,
and self-ligating.
   (2) Laboratory instruction shall include typodont experience on
the following:
   (A) The insertion of a preformed maxillary and mandibular archwire
a minimum of four times per arch, with one of each of the four times
used for a practical examination.
   (B) Ligation of maxillary and mandibular archwire using elastic or
metal ligatures or self-ligating brackets a minimum of four times
per arch, with one of each of the four times used for a practical
examination.
   (3) Clinical instruction shall include the following:
   (A) Insertion of a preformed maxillary and mandibular archwire on
at least two patients.
   (B) Ligating both preformed maxillary and mandibular archwires
using a combination of elastic and metal ligatures or self-ligating
brackets on at least two patients for each.
   (i) The following requirements shall be met for cement removal
with a hand instrument:
   (1) Didactic instruction shall include, armamentaria and
techniques of cement removal using hand instruments and related
materials.
   (2) Laboratory instruction shall include typodont experience on
the removal of excess cement supragingivally from an orthodontically
banded typodont using a hand instrument four times, with one of the
four times used for a practical examination.
   (3) Clinical instruction shall include removal of excess cement
supragingivally from orthodontic bands with a hand instrument on at
least two patients.
   (j) Instruction for cement removal with an ultrasonic scaler shall
be in accordance with the regulations of the board governing courses
in the removal of excess cement from teeth under orthodontic
treatment with an ultrasonic scaler.
   (k) Each student shall pass a written examination that reflects
the curriculum content, which may be administered at intervals
throughout the course as determined by the course director.
   (l) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 38.  Section 1756.2 is added to the Business and Professions
Code, to read:
   1756.2.  In addition to the requirements of Section 1755, the
following criteria shall be met by a dental sedation assistant permit
course to secure and maintain approval by the board. The board may
approve a dental sedation assistant permit course prior to January 1,
2010, and recognize the completion of these courses by students
prior to January 1, 2010, but the board may not issue a dental
sedation assistant permit to students graduating from dental sedation
assistant permit courses until on or after January 1, 2010. As used
in this section, "IV" means "intravenous."
   (a) (1) The course director or faculty may, in lieu of a license
issued by the board, possess a valid, active, and current license
issued in California as a certified registered nurse anesthetist or a
physician and surgeon.
   (2) All faculty responsible for clinical evaluation shall have
completed a two-hour methodology course in clinical evaluation prior
to conducting clinical evaluations of students.
   (b) The course shall be of a sufficient duration for the student
to develop minimum competence in all of the duties that dental
sedation assistant permitholders are authorized to perform, but in no
event less than 110 hours, including at least 40 hours of didactic
instruction, at least 32 hours of combined laboratory and preclinical
instruction, and at least 38 hours of clinical instruction.
   (c) (1) The following are minimum requirements for equipment and
armamentaria: one pulse oximeter for each six students; one automated
external defibrillator (AED) or AED trainer; one capnograph or
teaching device for monitoring of end tidal CO2; blood pressure cuff
and stethoscope for each six students; one pretracheal stethoscope
for each six students; one electrocardiogram machine, one automatic
blood pressure/pulse measuring system/machine, and one oxygen
delivery system including oxygen tank; one IV start kit for each
student; one venous access device kit for each student; IV equipment
and supplies for IV infusions including hanging device infusion
containers and tubing for each six students; one sharps container for
each six students; packaged syringes, needles, needleless devices,
practice fluid ampules and vials for each student; stopwatch or timer
with second hand for each six students; one heart/lung sounds
mannequin or teaching device; tonsillar or pharyngeal suction tip,
endotracheal tube forceps, endotracheal tube and appropriate
connectors, suction equipment for aspiration of oral and pharyngeal
cavities, and laryngoscope in the ratio of at least one for each six
students; any other monitoring or emergency equipment that the
regulations of the board require for the administration of general
anesthesia or conscious sedation; and a selection of instruments and
supplemental armamentaria for all of the procedures that dental
sedation assistant permitholders are authorized to perform.
   (2) Each operatory used for preclinical or clinical training shall
contain either a surgery table or a power-operated chair for
treating patients in a supine position, an irrigation system or
sterile water delivery system as they pertain to the specific
practice, and all other equipment and armamentarium required to
instruct in the duties that dental sedation assistant permitholders
are authorized to perform.
   (3) All students, faculty, and staff involved in the direct
provision of patient care shall be certified in basic life support
procedures, including the use of an automatic electronic
defibrillator.
   (d) Areas of instruction shall include, at a minimum, the
instruction specified in subdivisions (e) to (n), inclusive, as they
relate to the duties that dental sedation assistant permitholders are
authorized to perform.
   (e) General didactic instruction shall include:
   (1) Patient evaluation and selection factors through review of
medical history, physical assessment, and medical consultation.
   (2) Characteristics of anatomy and physiology of the circulatory,
cardiovascular, and respiratory systems, and the central and
peripheral nervous system.
   (3) Characteristics of anxiety management related to the surgical
patient, relatives, and escorts, and characteristics of anxiety and
pain reduction techniques.
   (4) Overview of the classification of drugs used by patients for
cardiac disease, respiratory disease, hypertension, diabetes,
neurological disorders, and infectious diseases.
   (5) Overview of techniques and specific drug groups utilized for
sedation and general anesthesia.
   (6) Definitions and characteristics of levels of sedation achieved
with general anesthesia and sedative agents, including the
distinctions between conscious sedation, deep sedation, and general
anesthesia.
   (7) Overview of patient monitoring during conscious sedation and
general anesthesia.
   (8) Prevention, recognition, and management of complications.
   (9) Obtaining informed consent.
   (f) (1) With respect to medical emergencies, didactic instruction
shall include an overview of medical emergencies, including, but not
limited to, airway obstruction, bronchospasm or asthma, laryngospasm,
allergic reactions, syncope, cardiac arrest, cardiac dysrhythmia,
seizure disorders, hyperglycemia and hypoglycemia, drug overdose,
hyperventilation, acute coronary syndrome including angina and
myocardial infarction, hypertension, hypotension, stroke, aspiration
of vomitus, and congestive heart failure.
   (2) Laboratory instruction shall include the simulation and
response to at least the following medical emergencies: airway
obstruction, bronchospasm, emesis and aspiration of foreign material
under anesthesia, angina pectoris, myocardial infarction,
hypotension, hypertension, cardiac arrest, allergic reaction,
convulsions, hypoglycemia, syncope, and respiratory depression. Both
training mannequins and other students or staff may be used for
simulation. Instruction shall include at least two experiences each,
one of each of which shall be used for a practical examination.
   (g) With respect to sedation and the pediatric patient, didactic
instruction shall include the following:
   (1) Psychological considerations.
   (2) Patient evaluation and selection factors through review of
medical history, physical assessment, and medical consultation.
   (3) Definitions and characteristics of levels of sedation achieved
with general anesthesia and sedative agents, with special emphasis
on the distinctions between conscious sedation, deep sedation, and
general anesthesia.
   (4) Review of respiratory and circulatory physiology and related
anatomy, with special emphasis on establishing and maintaining a
patent airway.
   (5) Overview of pharmacology agents used in contemporary sedation
and general anesthesia.
   (6) Patient monitoring.
   (7) Obtaining informed consent.
   (8) Prevention, recognition, and management of complications,
including principles of basic life support.
   (h) With respect to physically, mentally, and neurologically
compromised patients, didactic instruction shall include the
following: an overview of characteristics of Alzheimer's disease,
autism, cerebral palsy, Down's syndrome, mental retardation, multiple
sclerosis, muscular dystrophy, Parkinson's disease, schizophrenia,
and stroke.
   (i) With respect to health history and patient assessment,
didactic instruction shall include, but not be limited to, the
recording of the following:
   (1) Age, sex, weight, physical status (American Society of
Anesthesiologists Classification), medication use, general health,
any known or suspected medically compromising conditions, rationale
for anesthesia or sedation of the patient, visual examination of the
airway, and auscultation of the heart and lungs as medically
required.
   (2) General anesthesia or conscious sedation records including a
time-oriented record with preoperative, multiple intraoperative, and
postoperative pulse oximetry and blood pressure and pulse readings,
amounts of time of drug administration, length of procedure,
complications of anesthesia or sedation, and a statement of the
patient's condition at time of discharge.
   (j) With respect to monitoring heart sounds with
pretracheal/precordial stethoscope and ECG/EKG and use of AED:
   (1) Didactic instruction shall include the following:
   (A) Characteristics of pretracheal/precordial stethoscope.
   (B) Review of anatomy and physiology of circulatory system: heart,
blood vessels, and cardiac cycle as it relates to EKG.
   (C) Characteristics of rhythm interpretation and waveform analysis
basics.
   (D) Characteristics of manual intermittent and automatic blood
pressure and pulse assessment.
   (E) Characteristics and use of an AED.
   (F) Procedure for using a pretracheal/precordial stethoscope for
monitoring of heart sounds.
   (G) Procedure for use and monitoring of the heart with an ECG/EKG
machine, including electrode placement, and the adjustment of such
equipment.
   (H) Procedure for using manual and automatic blood
pressure/pulse/respiration measuring system.
   (2) Preclinical instruction shall include at least three
experiences on another student or staff person for each of the
following, one of each of which shall be used for an examination.
Clinical instruction shall include at lease three experiences on a
patient for each of the following, one of each of which shall be used
for a clinical examination:

  (A) Assessment of blood pressure and pulse both manually and
utilizing an automatic system.
   (B) Placement and assessment of an electrocardiogram (ECG/EKG).
Instruction shall include the adjustment of such equipment.
   (C) Monitoring and assessment of heart sounds with a
pretracheal/precordial stethoscope.
   (D) Use of an AED or AED trainer.
   (k) With respect to monitoring lung/respiratory sounds with
pretracheal/precordial stethoscope and monitoring oxygen saturation
end tidal CO2 with pulse oximeter and capnograph:
   (1) Didactic instruction shall include the following:
   (A) Characteristics of pretracheal/precordial stethoscope, pulse
oximeter and capnograph for respiration monitoring.
   (B) Review of anatomy and physiology of respiratory system to
include the nose, mouth, pharynx, epiglottis, larynx, trachea,
bronchi, bronchioles, and alveolus.
   (C) Characteristics of respiratory monitoring/lung sounds:
mechanism of respiration, composition of respiratory gases, oxygen
saturation.
   (D) Characteristics of manual and automatic respiration
assessment.
   (E) Procedure for using a pretracheal/precordial stethoscope for
respiration monitoring.
   (F) Procedure for using and maintaining pulse oximeter for
monitoring oxygen saturation.
   (G) Procedure for use and maintenance of capnograph.
   (H) Characteristics for monitoring blood and skin color and other
related factors.
   (I) Procedures and use of an oxygen delivery system.
   (J) Characteristics of airway management to include armamentaria
and use.
   (2) Preclinical and clinical instruction shall include at least
three experiences on a student or staff person for each of the
following, one of each of which shall be used for an examination.
Clinical instruction shall include at least three experiences on a
patient for each of the following, one of which shall be used for a
clinical examination:
   (A) Assessment of respiration rates.
   (B) Monitoring and assessment of lung sounds and ventilation with
a pretracheal/precordial stethoscope.
   (C) Monitoring oxygen saturation with a pulse oximeter.
   (D) Use of an oxygen delivery system.
   (l) With respect to drug identification and draw:
   (1) Didactic instruction shall include:
   (A) Characteristics of syringes and needles including use, types,
gauges, lengths, and components.
   (B) Characteristics of drug, medication, and fluid storage units,
use, type, components, identification of label including generic and
brand names, strength, potential adverse reactions, expiration date,
and contraindications.
   (C) Characteristics of drug draw including armamentaria, label
verification, ampule and vial preparation, and drug withdrawal
techniques.
   (2) Laboratory instruction shall include at least three
experiences in the withdrawal of fluids from a vial or ampule in the
amount specified by faculty, one of which shall be for a practical
examination.
   (3) Clinical instruction shall include at least three experiences
in the evaluation of vial or container labels for identification of
content, dosage, and strength and in the withdrawal of fluids from a
vial or ampule in the amount specified by faculty or the extramural
facility dentist.
   (m) With respect to adding drugs, medications, and fluids to IV
lines:
   (1) Didactic instruction shall include:
   (A) Characteristics of adding drugs, medications, and fluids to IV
lines in the presence of a licensed dentist.
   (B) Armamentaria.
   (C) Procedures for adding drugs, medications, and fluids,
including amount and time intervals.
   (D) Procedures for adding drugs, medications, and fluids by IV
bolus.
   (E) Characteristics of patient observation for signs and symptoms
of drug response.
   (2) Laboratory instruction shall include at least three
experiences of adding fluids to an existing IV line on a venipuncture
training arm or in a simulated environment, one of which shall be
used for a practical examination.
   (3) Clinical instruction shall include at least three experiences
adding fluids to existing IV lines on at least three patients in the
presence of a licensed dentist.
   (n) With respect to the removal of IV lines:
   (1) Didactic instruction shall include overview and procedures for
the removal of an IV line.
   (2) Laboratory instruction shall include at least three
experiences on a venipuncture training arm or in a simulated
environment for IV removal, one of which shall be used for a
practical examination.
   (3) Clinical instruction shall include at least three experiences
removing IV lines on at least three patients in the presence of a
licensed dentist.
   (o) Each student shall pass a written examination that reflects
the curriculum content, which may be administered at intervals
throughout the course as determined by the course director.
   (p) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 39.  Section 1757 of the Business and Professions Code is
amended and renumbered to read:
   1753.6.  (a) Each person who holds a license as a registered
dental assistant in extended functions on the operative date of this
section may only perform those procedures that a registered dental
assistant is allowed to perform as specified in and limited by
Section 1752.4, and the procedures specified in paragraphs (1) to
(6), inclusive, until he or she provides evidence of having completed
a board-approved course in the additional procedures specified in
paragraphs (1), (2), (5), and (7) to (11), inclusive, of subdivision
(b) of Section 1753.5, and an examination as specified in Section
1753.4:
   (1) Cord retraction of gingiva for impression procedures.
   (2) Take final impressions for permanent indirect restorations.
   (3) Formulate indirect patterns for endodontic post and core
castings.
   (4) Fit trial endodontic filling points.
   (5) Apply pit and fissure sealants.
   (6) Remove excess cement from subgingival tooth surfaces with a
hand instrument.
   (b) This section shall become operative on January 1, 2010.
  SEC. 40.  Section 1757 is added to the Business and Professions
Code, to read:
   1757.  (a) A registered dental assistant program shall receive
board approval prior to operation.
   (1) In order for a registered dental assistant program to secure
and maintain approval by the board, it shall meet the requirements of
Section 1755 and the following requirements:
   (A) Programs approved on or after January 1, 2009, shall meet all
of the requirements of this section.
   (B) Programs approved prior to January 1, 2009, shall meet all of
the requirements of this section except as otherwise specified. Such
a program shall continue to be approved only if it has certified to
the board no later than April 30, 2009, on a form specified by the
board, that it shall, no later than July 1, 2009, comply with all of
the requirements of this section in providing instruction in all
duties that registered dental assistants will be allowed to perform
on and after January 1, 2010. The certification to the board shall
contain the date on which the program will begin teaching those
duties.
   (2) A program shall notify the board in writing if it wishes to
increase the maximum student enrollment for which it is approved and
shall provide whatever additional documentation the board requires to
reapprove the program for the increased enrollment prior to
accepting additional students.
   (3) The board may at any time conduct a thorough evaluation of an
approved educational program's curriculum and facilities to determine
whether the program meets the requirements for continued approval.
   (4) The board may, in lieu of conducting its own investigation,
accept the findings of any commission or accreditation agency
approved by the board and adopt those findings as its own.
   (b) Programs shall have an advisory committee consisting of an
equal number of registered dental assistants and dentists, including
at least two registered dental assistants and two dentists, all
currently licensed by the board. The advisory committee shall meet at
least once each academic year with the program director, faculty,
and appropriate institutional personnel to monitor the ongoing
quality and performance of the program. Programs that admit students
at different phases shall meet at least twice each year.
   (c) Adequate provision for the supervision and operation of the
program shall be made. In addition to the requirements of Section
1755, the following requirements shall be met:
   (1) Each program faculty member shall have successfully completed
a board-approved course in the application of pit and fissure
sealants.
   (2) By January 1, 2010, each faculty member shall have completed a
board-approved course in instructional methodology of at least 30
hours, unless he or she holds any one of the following: a
postgraduate degree in education, a Ryan Designated Subjects
Vocational Education Teaching Credential, a Standard Designated
Subjects Teaching Credential, or, a Community College Teaching
Credential. Each faculty member employed on or after January 1, 2010,
shall complete a course in instructional methodology within six
months of employment.
   (3) The program director shall have teaching responsibilities that
are less than those of a full-time faculty member. He or she shall
actively participate in and be responsible for the day-to-day
administration of the program including the following:
   (A) Participating in budget preparation and fiscal administration,
curriculum development and coordination, determination of teaching
assignments, supervision and evaluation of faculty, establishment of
mission criteria and procedures, design and operation of program
facilities, and selection of extramural facilities and coordination
of instruction in those facilities.
   (B) Holding periodic faculty meetings to provide for subject
matter correlation and curriculum evaluation, and coordinating
activities of full-time, part-time, and volunteer faculty.
   (C) Maintaining for not less than five years' copies of minutes of
all advisory committee meetings.
   (4) The owner or school administrator shall be responsible for the
compliance of the program director with the provisions of this
section and Section 1755.
   (d) The program shall have sufficient financial resources
available to support the program and to comply with this section. If
the program or school requires approval by any other governmental
agency, that approval shall be obtained prior to application to the
board for approval and shall be maintained at all times. The failure
to maintain that approval shall result in the automatic withdrawal of
board approval of the program.
   (e) The program shall be of sufficient duration for the student to
develop minimum competence in performing dental assistant and
registered dental assistant duties, but in no event less than 800
hours, including at least 275 hours of didactic instruction, at least
260 hours of laboratory instruction, and at least 85 hours of
preclinical and clinical instruction conducted in the program's
facilities under the direct supervision of program faculty. No more
than 20 hours shall be devoted to instruction in clerical,
administrative, practice management, or similar duties. A program
approved prior to January 1, 2009, shall comply with board
regulations with regard to required program hours until the date
specified in the written certification from the program to the board
that it will begin teaching the duties that registered dental
assistants will be authorized to perform on and after January 1,
2010.
   (f) In addition to the requirements of Section 1755 with regard to
extramural instruction, no more than 25 percent of the required
clinical instruction shall take place in extramural clinical
facilities, and no more than 25 percent of extramural clinical
instruction shall take place in a speciality dental practice.
   (g) Facilities and class scheduling shall provide each student
with sufficient opportunity, with instructor supervision, to develop
minimum competency in all duties that registered dental assistants
are authorized to perform. The following requirements are in addition
to those contained in Section 1755:
   (1) The following are minimum requirements for equipment and
armamentaria during laboratory, preclinical, and clinical sessions as
appropriate to each type of session and in ratios specified in
Section 1070.2 of Title 16 of the California Code of Regulations:
amalgamator, model trimmers, dental rotary equipment, vibrators,
light curing devices, functional typodont and bench mounts,
functional orthodontically banded typodonts, facebows, automated
blood pressure device, EKG machine, pulse oximeters, capnograph or
simulated device, sets of hand instruments for each procedure,
respiration device, camera for intraoral use, camera for extraoral
use, CAD machine or simulated device, caries detection device, and
all other equipment and armamentaria required to teach dental
assistant and registered dental assistant duties.
   (2) One permanently preassembled tray for each procedure shall be
provided for reference purposes.
   (3) Provision shall be made for reasonable access to current and
diverse dental and medical reference texts, current journals,
audiovisual materials, and other necessary resources. Library
holdings, which may include access through the Internet, shall
include materials relating to all subject areas of the program
curriculum.
   (4) Emergency materials shall include, but not be limited to, an
oxygen tank that is readily available and functional. Medical
materials for treating patients with life-threatening conditions
shall be available for instruction and accessible to the operatories.
Facilities that do not treat patients shall maintain a working model
of a kit of such emergency materials for instructional purposes.
   (h) The curriculum shall be established, reviewed, and amended as
necessary to allow for changes in the practice of dentistry and
registered dental assisting. Programs that admit students in phases
shall provide students with basic instruction prior to participation
in any other portion of the program that shall, at a minimum, include
tooth anatomy, tooth numbering, general program guidelines and
safety precautions, and infection control and sterilization protocols
associated with and required for patient treatment. All programs
shall provide students with additional instruction in the infection
control regulations and guidelines of the board and Cal-DOSH prior to
the student's performance of procedures on patients.
   (i) (1) A program approved prior to January 1, 2009, shall comply
with board regulations with regard to program content until the date
specified in the written certification from the program to the board,
as specified in subparagraph (B) of paragraph (1) of subdivision
(a), after which time the program content shall meet the requirements
of paragraph (2).
   (2) Programs receiving initial approval on or after January 1,
2009, shall meet all the requirements of Section 1755, and
subdivisions (j) and (k) of this section, and shall include the
following additional content:
   (A) A radiation safety course that meets all of the requirements
of the regulations of the board.
   (B) A coronal polishing course that meets all of the requirements
of the regulations of the board.
   (C) A pit and fissure sealant course that meets all of the
requirements of the regulations of the board.
   (D) A course in basic life support provided by an instructor
approved by the American Red Cross or the American Heart Association,
or any other course approved by the board as equivalent.
   (3) On and after January 1, 2009, a program that desires to
provide instruction in the following areas shall apply separately for
approval to provide the following courses:
   (A) A course in the removal of excess cement with an ultrasonic
scaler, which course shall meet the requirements of the regulations
of the board.
   (B) An orthodontic assistant permit course that shall meet the
requirements of Section 1756.1, except that a program shall not be
required to obtain separate approval to teach the duties of placing
ligature ties and archwires, removing orthodontic bands, and removing
excess cement from surfaces of teeth with a hand instrument.
Notwithstanding Section 1756.1, an orthodontic assistant permit
course provided by a registered dental assistant program, to the
students enrolled in such program, shall be no less than 60 hours,
including at least 12 hours of didactic instruction, at least 26
hours of preclinical instruction, and at least 22 hours of clinical
instruction.
   (C) A dental sedation assistant permit course that shall meet the
requirements of Section 1756.2.
   (j) General didactic instruction shall include, at a minimum, the
following:
   (1) Principles of general anatomy, physiology, oral embryology,
tooth histology, and head-neck anatomy.
   (2) Principles of abnormal conditions related to and including
oral pathology, orthodontics, periodontics, endodontics, pediatric
dentistry, oral surgery, prosthodontics, and esthetic dentistry.
   (3) Legal requirements and ethics related to scope of practice,
unprofessional conduct, and, patient records and confidentiality.
   (4) Principles of infection control and hazardous communication
requirements in compliance with the board's regulations and other
federal, state, and local requirements.
   (5) Principles and federal, state, and local requirements related
to pharmacology.
   (6) Principles of medical-dental emergencies and first aid
management, including symptoms and treatment.
   (7) Principles of the treatment planning process including medical
health history data collection, patient and staff confidentiality,
and charting.
   (8) Principles of record classifications including management,
storage, and retention protocol for all dental records.
   (9) Principles and protocols of special needs patient management.
   (10) Principles, protocols, and armamentaria associated with all
dental assisting chairside procedures.
   (11) Principles, protocols, manipulation, use, and armamentaria
for dental materials.
   (12) Principles and protocols for oral hygiene preventative
methods including, plaque identification, toothbrushing and flossing
techniques, and nutrition.
   (13) Principles, protocols, armamentaria, and procedures
associated with operative and specialty dentistry.
   (14) Principles, protocols, armamentaria, and procedures for each
duty that dental assistants and registered dental assistants are
allowed to perform.
   (k) Laboratory and clinical instruction shall be of sufficient
duration and content for each student to achieve minimum competence
in the performance of each procedure that dental assistant and
registered dental assistant is authorized to perform.
   (l) Each student shall pass a written examination that reflects
the curriculum content, which may be administered at intervals
throughout the course as determined by the course director.
   (m) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 41.  Section 1758 is added to the Business and Professions
Code, to read:
   1758.  (a) In addition to the requirements of Section 1755, the
following criteria shall be met by an educational program for
registered dental assistants in extended functions (RDAEF) to secure
and maintain approval by the board. A program approved prior to
January 1, 2009, shall comply with board regulations with regard to
program content until the date specified in a written certification
from the program to the board that it will begin teaching the duties
that RDAEFs will be allowed to perform beginning January 1, 2010,
which may include the instruction of existing RDAEFs in the
additional duties specified in Section 1753.6. The certification
shall be filed with the board no later than July 1, 2009, and the
date on which the program shall comply with the program content
specified in this section shall be no later than January 1, 2010.
   (1) A program applying for approval to teach all of the duties
specified in Section 1753.5 shall comply with all of the requirements
of this section. The board may approve RDAEF programs prior to
January 1, 2010, and recognize the completion of these approved
programs by students prior to January 1, 2010, but shall not issue a
license to students graduating from such programs until on or after
January 1, 2010.
   (2) A program applying for approval to teach existing RDAEFs the
additional duties specified in Section 1753.6 shall comply with all
of the requirements of this section, except as follows:
   (A) The program shall be no less than 288 hours, including at
least 76 hours of didactic instruction, at least 180 hours of
laboratory instruction, and at least 32 hours of clinical
instruction.
   (B) Students shall not be required to complete instruction related
to the placement of gingival retraction cord, the taking of final
impressions for permanent indirect restorations, or the fitting of
master and accessory points.
   (b) In order to be admitted to the program, each student shall
possess a valid, active, and current license as a registered dental
assistant issued by the board and shall provide evidence of
successful completion of a board-approved pit and fissure sealant
course.
   (c) Adequate provision for the supervision and operation of the
program shall be made. Notwithstanding the requirements of Section
1755, the program director and each faculty member of an approved
RDAEF program shall possess a valid, active, and current license as a
dentist or an RDAEF. In addition to the requirements of Section
1755, all faculty members responsible for clinical evaluation shall
have completed a six-hour teaching methodology course in clinical
evaluation prior to conducting clinical evaluations of students.
   (d) The program shall be of sufficient duration for the student to
develop minimum competence in all of the duties that RDAEFs are
authorized to perform, but in no event less than 380 hours, including
at least 100 hours of didactic instruction, at least 200 hours of
laboratory instruction, and at least 80 hours of clinical
instruction. All instruction shall be provided under the direct
supervision of program staff.
   (e) The following requirements are in addition to the requirements
of Section 1755:
   (1) The following are minimum requirements for equipment and
armamentaria:
   (A) Laboratory facilities with individual seating stations for
each student and equipped with air, gas and air, or electric driven
rotary instrumentation capability. Each station or operatory shall
allow an articulated typodont to be mounted in a simulated head
position.
   (B) Clinical simulation facilities that provide simulated patient
heads mounted in appropriate position and accommodating an
articulated typodont in an enclosed intraoral environment, or mounted
on a dental chair in a dental operatory. Clinical simulation spaces
shall be sufficient to permit one simulation space for each two
students at any one time.
   (C) Articulated typodonts of both deciduous and permanent
dentitions with flexible gingival tissues and with prepared teeth for
each procedure to be performed in the laboratory and clinical
simulation settings. One of each type of typodont is required for
each student.
   (D) A selection of restorative instruments and adjunct materials
for all procedures that RDAEFs are authorized to perform.
   (2) Notwithstanding Section 1755, there shall be at least one
operatory for every two students who are simultaneously engaged in
clinical instruction.
   (f) Areas of instruction shall include, at a minimum, the
instruction specified in subdivisions (g) to (m), inclusive. In
addition to the requirements of those subdivisions, didactic
instruction shall include the following:
   (1) The following instruction as it relates to each of the
procedures that RDAEFs are authorized to perform: restorative and
prosthetic treatment review; charting; patient education; legal
requirements; indications and contraindications; problem solving
techniques; laboratory, preclinical, and clinical criteria and
evaluation; and infection control protocol implementation.
   (2) Dental science, including dental and oral anatomy, histology,
oral pathology, normal or abnormal anatomical and physiological tooth
descriptions, tooth morphology, basic microbiology relating to
infection control, and occlusion.
   (3) Characteristics and manipulation of dental materials related
to each procedure.
   (4) Armamentaria for all procedures.
   (5) Principles, techniques, criteria, and evaluation for
performing each procedure, including implementation of infection
control protocols.
   (6) Occlusion: the review of articulation of maxillary and
mandibular arches in maximum intercuspation.
   (7) Tooth isolation and matrix methodology review.
   (g) General laboratory instruction shall include:
   (1) Rubber dam application for tooth isolation in both maxillary
and mandibular arches and for deciduous and permanent dentitions. A
minimum of four experiences per arch is required, with two anterior
and two posterior applications, with one of the applications used for
a practical examination.
   (2) Matrix placement for amalgam, and nonmetallic restorative
material restorations in both primary and permanent dentitions, with
three experiences for each cavity classification and for each
material.
   (3) Base, liner, and etchant placement on three posterior teeth
for each base, liner, or etchant, with one of the three teeth used
for a practical examination.
   (h) With respect to preliminary evaluation of the patient's oral
health, including, but not limited to, charting, intraoral and
extraoral evaluation of soft tissue, classifying occlusion, and
myofunctional evaluation:
   (1) Didactic instruction shall include the following:
   (A) Normal anatomical structures: oral cavity proper, vestibule,
and lips.
   (B) Deviations from normal to hard tissue abnormalities to soft
tissue abnormalities.
   (C) Overview of classifications of occlusion and myofunction.
   (D) Sequence of oral inspection: armamentaria, general patient
assessment, review of medical history form, review of dental history
form, oral cavity mouth-mirror inspection, and charting existing
conditions.
   (2) Preclinical instruction shall include performing an oral
inspection on at least two other students.
               (3) Clinical instruction shall include performing an
oral inspection on at least two patients, with one of the two
patients used for a clinical examination.
   (i) With respect to sizing, fitting, and cementing endodontic
master points and accessory points:
   (1) Didactic instruction shall include the following:
   (A) Review of objectives, canal preparation, filling of root canal
space.
   (B) Description and goals of filling technique using lateral
condensation techniques.
   (C) Principles and techniques of fitting, cementing master and
accessory points using lateral condensation including,
characteristics, manipulation, use of gutta percha and related
materials, and criteria for an acceptable master and accessory points
technique using lateral condensation.
   (2) Laboratory instruction shall include fitting master and
cementing cones on extracted teeth or assimilated teeth with canals,
with two experiences each on a posterior and anterior tooth.
   (j) With respect to gingival retraction, general instruction shall
include:
   (1) Review of characteristics of tissue management as it relates
to gingival retraction with cord and electrosurgery.
   (2) Description and goals of cord retraction.
   (3) Principles of cord retraction, including characteristics and
manipulation of epinephrine, chemical salts classification of cord,
characteristics of single versus double cord technique, and
techniques and criteria for an acceptable cord retraction technique.
   (k) With respect to final impressions for permanent indirect and
toothborne restorations:
   (1) Didactic instruction shall include the following:
   (A) Review of characteristics of impression material and custom.
   (B) Description and goals of impression taking for permanent
indirect restorations and toothborne prosthesis.
   (C) Principles, techniques, criteria, and evaluation of impression
taking for permanent indirect restorations and toothborne
prosthesis.
   (2) Laboratory instruction shall include the following:
   (A) Cord retraction and final impressions for permanent indirect
restorations, including impression taking of prepared teeth in
maxillary and mandibular arches, one time per arch with elastomeric
impression materials.
   (B) Impressions for toothborne removable prostheses, including
taking a total of four impressions on maxillary and mandibular arches
with simulated edentulous sites and rest preparations on at least
two supporting teeth in each arch.
   (3) Clinical instruction shall include taking final impressions on
five cord retraction patients, with one used for a clinical
examination.
   (l) With respect to placing, contouring, finishing, and adjusting
direct restorations:
   (1) Didactic instruction shall include the following:
   (A) Review of cavity preparation factors and restorative material.

   (B) Review of cavity liner, sedative, and insulating bases.
   (C) Characteristics and manipulation of direct filling materials.
   (D) Amalgam restoration placement, carving, adjusting and
finishing, which includes principles, techniques, criteria and
evaluation, and description and goals of amalgam placement, adjusting
and finishing in children and adults.
   (E) Glass-ionomer restoration placement, carving, adjusting,
contouring and finishing, which includes, principles, techniques,
criteria and evaluation, and description and goals of glass-ionomer
placement and contouring in children and adults.
   (F) Composite restoration placement, carving, adjusting,
contouring and finishing in all cavity classifications, which
includes, principles, techniques, criteria, and evaluation.
   (2) Laboratory instruction shall include typodont experience on
the following:
   (A) Placement of Class I, II, and V amalgam restorations in eight
prepared permanent teeth for each classification, and in four
deciduous teeth for each classification.
   (B) Placement of Class I, II, III, and V composite resin
restorations in eight prepared permanent teeth for each
classification, and in four deciduous teeth for each classification.
   (C) Placement of Class I, II, III, and V glass-ionomer
restorations in four prepared permanent teeth for each
classification, and in four deciduous teeth for each classification.
   (3) Clinical simulation and clinical instruction shall include
experience with typodonts mounted in simulated heads on a dental
chair or in a simulation laboratory as follows:
   (A) Placement of Class I, II, and V amalgam restorations in four
prepared permanent teeth for each classification, with one of each
classification used for a clinical examination.
   (B) Placement of Class I, II, III, and V composite resin
restorations in four prepared permanent teeth for each
classification, with one of each classification used for a clinical
examination.
   (C) Placement of Class I, II, III, and V glass-ionomer
restorations in four prepared permanent teeth for each
classification, with one of each classification used for a clinical
examination.
   (m) With respect to adjusting and cementing permanent indirect
restorations:
   (1) Didactic instruction shall include the following:
   (A) Review of fixed prosthodontics related to classification and
materials for permanent indirect restorations, general crown
preparation for permanent indirect restorations, and laboratory
fabrication of permanent indirect restorations.
   (B) Interocclusal registrations for fixed prosthesis, including
principles, techniques, criteria, and evaluation.
   (C) Permanent indirect restoration placement, adjustment, and
cementation, including principles, techniques, criteria, and
evaluation.
   (2) Laboratory instruction shall include:
   (A) Interocclusal registrations using elastomeric and resin
materials. Two experiences with each material are required.
   (B) Fitting, adjustment, and cementation of permanent indirect
restorations on one anterior and one posterior tooth for each of the
following materials, with one of each type used for a practical
examination: ceramic, ceramometal, and cast metallic.
   (3) Clinical experience for interocclusal registrations shall be
performed on four patients who are concurrently having final
impressions recorded for permanent indirect restorations, with one
experience used for a clinical examination.
   (n) Each student shall pass a written examination that reflects
the curriculum content, which may be administered at intervals
throughout the course as determined by the course director.
   (o) This section shall remain in effect only until January 1,
2011, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2011, deletes or extends
that date.
  SEC. 42.  Section 1765 of the Business and Professions Code is
amended to read:
   1765.  No person other than a licensed dental hygienist or a
licensed dentist may engage in the practice of dental hygiene or
perform dental hygiene procedures on patients, including, but not
limited to, supragingival and subgingival scaling, dental hygiene
assessment, and treatment planning, except for the following persons:

   (a) A student enrolled in a dental or a dental hygiene school who
is performing procedures as part of the regular curriculum of that
program under the supervision of the faculty of that program.
   (b) A dental assistant, registered dental assistant, or registered
dental assistant in extended functions acting in accordance with the
provisions of this chapter.
   (c) A registered dental hygienist, registered dental hygienist in
alternative practice, or registered dental hygienist in extended
functions licensed in another jurisdiction performing a clinical
demonstration for educational purposes.
  SEC. 43.  Section 1770 of the Business and Professions Code, as
amended by Section 25 of Chapter 588 of the Statutes of 2007, is
amended and renumbered to read:
   1753.7.  (a) A licensed dentist may simultaneously utilize in his
or her practice no more than two registered dental assistants in
extended functions or registered dental hygienists in extended
functions licensed pursuant to Sections 1753.1 and 1918.
   (b) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2010, deletes or extends
that date.
  SEC. 44.  Section 1770 of the Business and Professions Code, as
amended by Section 26 of Chapter 588 of the Statutes of 2007, is
amended and renumbered to read:
   1753.7.  (a) A licensed dentist may simultaneously utilize in his
or her practice no more than three registered dental assistants in
extended functions or registered dental hygienists in extended
functions licensed pursuant to Section 1753 or 1918.
   (b) This section shall become operative on January 1, 2010.
  SEC. 45.  Section 1771 of the Business and Professions Code is
amended to read:
   1771.  Any person, other than a person who has been issued a
license or permit by the board, who holds himself or herself out as a
registered dental assistant, orthodontic assistant permitholder,
dental sedation assistant permitholder, or registered dental
assistant in extended functions, or uses any other term indicating or
implying he or she is licensed or permitted by the board as such, is
guilty of a misdemeanor.
  SEC. 46.  Section 1777 of the Business and Professions Code is
amended to read:
   1777.  While employed by or practicing in a primary care clinic or
specialty clinic licensed pursuant to Section 1204 of the Health and
Safety Code, in a primary care clinic exempt from licensure pursuant
to subdivision (c) of Section 1206 of the Health and Safety Code, or
a clinic owned and operated by a hospital that maintains the primary
contract with a county government to fill the county's role under
Section 17000 of the Welfare and Institutions Code, the following
shall apply:
   (a) A dental assistant, registered dental assistant, or registered
dental assistant in extended functions may perform any extraoral
duty under the direct supervision of a registered dental hygienist or
registered dental hygienist in alternative practice.
   (b) A registered dental assistant or a registered dental assistant
in extended functions may perform the following procedures under the
direct supervision of a registered dental hygienist or a registered
dental hygienist in alternative practice, pursuant to subdivision (b)
of Section 1763:
   (1) Coronal polishing.
   (2) Application of topical fluoride.
   (3) Application of sealants, after providing evidence to the board
of having completed a board-approved course in that procedure.
  SEC. 47.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.