as amended, Bocanegra.
begin deleteOral health: virtual dental homes. end delete
law, the Dental Practice Act, establishes the Dental Board of California. Existing law creates, within the jurisdiction of the board, a Dental Hygiene Committee of California, that is responsible for regulation of registered dental hygienists, registered dental hygienists in alternative practice, and registered dental hygienists in extended functions.
This bill would declare the intent of the Legislature to enact legislation that would incorporate into law the new duties of dental assistants and dental hygienists being tested in a specified pilot project and address barriers to expanding the Virtual Dental Home system of care, as specified, as a cost-effective mechanism to improve the oral health of California’s most underserved and vulnerable citizens.end delete
begin deleteno end delete.
State-mandated local program: no.
The people of the State of California do enact as follows:
(a) A registered dental assistant may perform all of
4the following duties:
5(1) All duties that a dental assistant is allowed to perform.
6(2) Mouth-mirror inspections of the oral cavity, to include
7charting of obvious lesions, existing restorations, and missing
9(3) Apply and activate bleaching agents using a nonlaser
11(4) Use of automated caries detection devices and materials to
12gather information for diagnosis by the dentist.
intraoral images for computer-aided design (CAD),
15(6) Pulp vitality testing and recording of findings.
16(7) Place bases, liners, and bonding agents.
17(8) Chemically prepare teeth for bonding.
18(9) Place, adjust, and finish direct provisional restorations.
19(10) Fabricate, adjust, cement, and remove indirect provisional
20restorations, including stainless steel crowns when used as a
22(11) Place post-extraction dressings after inspection of the
23surgical site by the supervising licensed dentist.
24(12) Place periodontal dressings.
25(13) Dry endodontically treated canals using absorbent paper
27(14) Adjust dentures extra-orally.
28(15) Remove excess cement from surfaces of teeth with a hand
30(16) Polish coronal surfaces of the teeth.
31(17) Place ligature ties and archwires.
32(18) Remove orthodontic bands.
33(19) All duties that the board may prescribe by regulation.
34(b) A registered dental assistant may only perform the following
35additional duties if he or she has completed a board-approved
36registered dental assistant educational program in those duties, or
37if he or she has provided evidence, satisfactory to the board, of
38having completed a board-approved course in those duties.
P4 1(1) Remove excess cement with an ultrasonic scaler from
2supragingival surfaces of teeth undergoing orthodontic treatment.
3(2) The allowable duties of an orthodontic assistant permitholder
4as specified in Section 1750.3. A registered dental assistant shall
5not be required to complete further instruction in the duties of
6placing ligature ties and archwires, removing orthodontic bands,
7and removing excess cement from tooth surfaces with a hand
9(3) The allowable duties of a dental sedation assistant
10permitholder as specified in Section 1750.5.
11(4) The application of pit and fissure sealants.
13(c) Except as provided in Section 1777, the supervising licensed
14dentist shall be responsible for determining whether each
15authorized procedure performed by a registered dental assistant
16should be performed under general or direct supervision.
17(d) This section shall become operative on January 1, 2010.
(a) A registered dental assistant in extended functions
21licensed on or after January 1, 2010, is authorized to perform all
22duties and procedures that a registered dental assistant is authorized
23to perform as specified in and limited by Section 1752.4, and those
24duties that the board may prescribe by regulation.
25(b) A registered dental assistant in extended functions licensed
26on or after January 1, 2010, is authorized to perform the following
27additional procedures under direct supervision and pursuant to the
28order, control, and full professional responsibility of a licensed
30(1) Conduct preliminary evaluation of the patient’s oral health,
31including, but not limited to, charting, intraoral and extra-oral
32evaluation of soft tissue, classifying occlusion, and myofunctional
34(2) Perform oral health assessments in school-based, community
35health project settings under the direction of a dentist, registered
36dental hygienist, or registered dental hygienist in alternative
38(3) Cord retraction of gingiva for impression procedures.
39(4) Size and fit endodontic master points and accessory points.
40(5) Cement endodontic master points and accessory points.
P5 1(6) Take final impressions for permanent indirect restorations.
2(7) Take final impressions for tooth-borne removable prosthesis.
3(8) Polish and contour existing amalgam restorations.
4(9) Place, contour, finish, and adjust all direct restorations.
5(10) Adjust and cement permanent indirect restorations.
6(11) Other procedures authorized by regulations adopted by the
8(c) All procedures required to be performed under direct
9supervision shall be checked and approved by the supervising
10licensed dentist prior to the patient’s dismissal from the office.
(a) Each person who holds a license as a registered
26dental assistant in extended functions on the operative date of this
27section may only perform those procedures that a registered dental
28assistant is allowed to perform as specified in and limited by
29Section 1752.4, and the procedures specified in paragraphs (1) to
30(6), inclusive, until he or she provides evidence of having
31completed a board-approved course in the additional procedures
32specified in paragraphs (1), (2), (5), and (7) to (11), inclusive, of
33subdivision (b) of Section
34 1753.5, and an examination as specified in Section 1753.4:
35(1) Cord retraction of gingiva for impression procedures.
36(2) Take final impressions for permanent indirect restorations.
37(3) Formulate indirect patterns for endodontic post and core
39(4) Fit trial endodontic filling points.
40(5) Apply pit and fissure sealants.
P6 1(6) Remove excess cement from subgingival tooth surfaces with
2a hand instrument.
3(b) This section shall become operative on January 1, 2010.
A registered dental hygienist is authorized to perform
7the following procedures under general supervision:
8(a) Preventive and therapeutic interventions, including oral
9prophylaxis, scaling, and root planing.
10(b) Application of topical, therapeutic, and subgingival agents
11used for the control of caries and periodontal disease.
12(c) The taking of impressions for bleaching trays and application
13and activation of agents with nonlaser, light-curing devices.
14(d) The taking of impressions for bleaching trays and placements
15of in-office, tooth-whitening devices.
(a) The Legislature finds and declares the
8(1) Significant portions of California’s population suffer from
9significant oral health disparities. Untreated dental disease can
10have serious consequences for overall health and the ability to be
11a productive member of society.
12(2) Reports from the United States Surgeon General and the
13Institute of Medicine of the National Academics indicate that these
14oral health disparities tend to be concentrated in people with low
15incomes, disadvantaged children, individuals with disabilities and
16chronic medical conditions, dependent older adults, and people
17living in rural areas.
18(3) Approximately one-fourth of all children in California have
19never visited a dental office and two-thirds of all children in the
20state suffer from poor oral health by the time they reach the 3rd
22(4) Low-income adults no longer have coverage under the state’s
23Denti-Cal program for other than emergency services and too many
24of them are stigmatized by having missing teeth, miss work because
25of dental infections, or end up in hospital emergency departments.
26(5) A new model of delivering oral health services, called the
27Virtual Dental Home, has been demonstrating a community-based,
28prevention-focused, telehealth-facilitated system of care in
29California, supported by the Health Workforce Pilot Project No.
30172, administered by the Office of Statewide Health Planning and
32(6) The Virtual Dental Home system of care brings care to
33community locations where the most underserved and vulnerable
34children and adults receive educational, social, and general health
35services. It emphasizes prevention and early intervention and
36targets those at highest risk for developing dental disease. This
37system delivers oral health at a very low cost per child or adult
38and has the potential to save the state overall oral health expenses.
39(b) It is the intent of the Legislature to enact legislation to
40incorporate the new duties of dental assistants and dental hygienists
P9 1being tested in the Health Workforce Pilot Project No. 172 into
2law and to address barriers to expanding the Virtual Dental Home
3system of care as a cost-effective mechanism to improve the oral
4health of California’s most underserved and vulnerable citizens.