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Washington State Dental Association

DQAC Update - 1/27/17

On Friday, January 27, 2017, the Dental Quality Assurance Commission (DQAC) held a public meeting to discuss ongoing business, including changes to moderate sedation with parenteral agents, acts that may be performed by licensed dental hygienists under general and close supervision, dentist delegation to dental assistants and expanded function dental auxiliaries, and examination content.

The Commission held a rules hearing for the proposed changes to WAC 246-817-760 - Moderate sedation with parenteral agents. Following the hearing and reviewing public commentary, the rule was passed unanimously and will enter the final phase of rulemaking. 
 
The following rules have been recently approved by the Commission or are currently under review: 

Effective as of January 13, 2017 - Acts that may be performed by licensed dental hygienists under general and close supervision (WAC 246-817-550 and 560)

The adopted rules contain the following changes:

• The addition of head and neck examination to general supervision;
• The addition of administering local anesthetics including reversal agents and buffered anesthetic under general supervision when certain conditions are met, and the clarification of when these tasks are required under close supervision;
• The addition of taking specific impressions to general supervision;
• The addition of the delivery of pre-medication for antibiotic prophylaxis to general supervision; and
• The amendment of the administration of local anesthetics in close supervision by adding reversal agents, buffered anesthetic, and reference when general supervision is appropriate under WAC 246-817-550 (6)

Dentist delegation to dental assistants and expanded function dental auxiliaries (WAC 246-817-510, 520 ,525 , 540, and 545) Rules adopted at 12/9/16 Rules Hearing, effective date TBD

The proposed changes to the dental assistant allowable tasks include:

• Adding placing cavity liners and bases;
• Adding sterilize equipment and disinfect operatories;
• Adding bonding attachments for clear removable orthodontic aligners;
• Adding a dental assistant cannot intra-orally adjust or finish permanent restoration as part of polishing restorations;
• Adding apply bonding agents to perform acid etch;
• Adding remove orthodontic cement and orthodontic bonded resin material to fixed orthodontic appliances;
• Detailing specific types of impressions and added digital scans;
• Clarifying that starting and stopping the flow of nitrous oxide as part of assist in administration of inhalation minimal sedation (nitrous oxide);
• Clarifying select and fit orthodontic bands;
• Clarifying a dentist shall determine teethe are free of calculus before dismissing the patient after a dental assistant performs coronal polish;
• Rewording place, expose, and process radiographs;
• Rewording placing a matrix and wedge for a direct restoration after a dentist has prepared the teeth;
• Rewording fabricate, cement, and remove temporary crowns or temporary bridges;
• Rewording prepare teeth for the bonding of orthodontic appliances;
• Rewording give patient education in oral hygiene;
• Adding language to require a dentist to ensure the dental assistant has demonstrated the skills necessary to perform each task competently, specifically to address use of high speed versus slow speed hand pieces; and
• Deleting taking health histories 

The proposed changes to the dental assistant prohibited tasks include:

• Rewording intra-orally adjust and finish permanent restorations; and
• Deleting semi-permanent from placing of permanent restorations in natural teeth

The proposed changes to the expanded function dental auxiliary (EFDA) allowable tasks include:

• Deleting all dental assistant tasks and referred to dental assistant rule;
• Rewording place, carve, finish, and polish direct restorations; 
• Rewording place, expose, and process radiographs; and
• Adding language to require a dentist to ensure the EFDA has demonstrated the skills necessary to perform each task competently

The proposed changes to the expanded function dental auxiliary prohibited tasks include:

• Rewording intra-orally adjust and finish permanent inlays, crowns, and bridges; and
• Correcting reference to WAC 246-817-520 (4) (e)

Examination content (WAC 246-817-120) 

The Commission is proposing amendments to clarify that a complete clinical examination from one testing organization is required for dentist licensure as well as restricting the number of attempts to pass an examination as the current rule does not include such a requirement. The proposed rule would add a requirement that all exam sections must be completed/passed through one testing agency, change the Canadian clinical examination as acceptable, and include minor grammar edits. 

More information on these rule changes can be found online on the Department of Health’s website. All public comments should be submitted to DQAC Program Manager, Jennifer Santiago, at jennifer.santiago@doh.wa.gov

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