BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 667
                                                                  Page  1

          Date of Hearing:   April 28, 2009

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                 Mary Hayashi, Chair
                     AB 667 (Block) - As Amended:  April 2, 2009
           
          SUBJECT  :   Topical fluoride application.

           SUMMARY  :   Clarifies that any person, including dental  
          assistants and non-health care personnel, may apply topical  
          fluoride varnish in public health and school-based settings  
          according to the prescription and protocol of a dentist or  
          physician. Specifically,  this bill  :  

          1)Permits a dental assistant to apply topical fluoride under the  
            general direction of a licensed dentist or physician when  
            operating in a school-based setting or public health program.

          2)Specifies that any person may apply topical fluoride,  
            including fluoride varnish, within a public health setting or  
            public health program, according to the prescription and  
            protocol issued and established by a dentist or physician.

          3)Clarifies that the topical fluoride program is required to be  
            under the direction of a licensed dentist and may include  
            self-application or application by another person in  
            accordance with the prescription and protocol established by  
            the dentist.
           
          EXISTING LAW  :

          1)Permits a dental assistant to perform specified duties,  
            including topical fluoride applications, under the general  
            supervision of a supervising licensed dentist.

          2)Establishes community dental disease prevention programs  
            (CDDPP) that may be offered to school children in preschool  
            through sixth grade, and in classes for individuals with  
            exceptional needs, by a local sponsor.  Permits the local  
            sponsor to be a city or county health department, county  
            office of education, superintendent of schools office, school  
            district, or other public or private nonprofit agency approved  
            by the Department of Public Health (DPH).

          3)Requires the CDDPP components to include educational programs  








                                                                  AB 667
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            that promote dental health and specified preventive services,  
            including ongoing plaque control, dental sealants, and  
            supervised application of topical prophylactic agents for  
            caries prevention, as approved by DPH.

          4)Requires students of public and private elementary and  
            secondary schools, except students of community colleges, to  
            be provided the opportunity to receive within the school year  
            the topical application of fluoride or other decay-preventing  
            agent in a manner approved by DPH.  Specifies that the topical  
            application program must be under the general direction of a  
            licensed dentist and may include self-application.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :    

           Purpose of this bill  .  According to author's office, "This bill  
          would clarify current law to ensure that any person (including  
          non-healthcare professionals) may apply fluoride varnish once a  
          prescription and established protocol have been issued for its  
          use in public health and school-based settings.  This simple  
          clarification would create a cost-effective and safe opportunity  
          to help reduce dental disease in high-risk populations."

           Background  .  According to information provided by the bill's  
          sponsors, the California Dental Association (CDA), tooth decay  
          affects over 50% of California's children by the time they reach  
          kindergarten, and low-income children are at greatest risk.   
          Children with high-risk factors for tooth decay benefit most  
          from the application of fluoride varnish, a newer form of  
          high-concentration topical fluoride that is easily "painted" on  
          teeth two to four times a year.  According to CDA, most  
          community and school-based health programs use less effective  
          fluoride rinses or supplements because they can be administered  
          by non-health care providers, such as teachers, parents, or  
          volunteers, once they have been prescribed by a dentist or  
          physician.  However, the law is currently unclear regarding  
          whether it is legal for these non-healthcare personnel to  
          administer fluoride varnish.  

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           








                                                                  AB 667
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          California Dental Association (sponsor)

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301