At their meeting on July 17, the Dental Quality Assurance Commission agreed to open rule making for delegation of duties for dental hygienists based on the following four proposals from the Dental Hygiene Collaboration Committee:
Head & Neck Exam and Cancer Screenings – add to general supervision
- While the dentist would still be responsible for the diagnosis and treatment planning, this proposal would allow hygienists to perform comprehensive clinical evaluations through examination of the head and neck.
Local Anesthetics – move to general supervision
- Hygienists are currently allowed to administer local anesthetic under close supervision. However, with this proposal, the Committee concluded that hygienists are sufficiently trained to administer local anesthetic without the dentist being present. The Journal of Dental Hygiene reported that complaints against hygienists in states that allow the administering of local anesthetic under general supervision are uncommon.
Impression tasks listed in dental assistant draft rule WAC 246-817-520 – move to general supervision
- This proposal would allow dental hygienists, without a dentist present, to take impressions, bite registrations, or digital scans of the teeth and jaws for diagnostic and opposing models, temporary oral devices, and temporary indirect restorations. Dental assistants are already allowed to perform these tasks under close supervision.
Oraverse – add to general supervision
- Oravese is a local anesthetic reversal agent that hygienists in upwards of fifteen states are currently allowed to administer. This proposal would allow hygienists in Washington state to administer Oraverse without a dentist present.
Several other proposals are currently under consideration but have not yet been delivered to the Commission for review. Those proposals include:
· Delivery of Oral Sedative – move to general supervision
· Delivery of Pre-medications – add to general supervision
· Use of Onset by a dental hygienist
It is important to note that “general supervision” still requires the supervising dentist examine and diagnose the patient, and subsequent instructions must be relayed to the dental hygienist by the supervising dentist.
Though the Commission agreed to consider these proposals, no formal rule changes have been adopted. Rule making changes impacting scope of practice can take several years to fully implement. Commission members anticipate opposition from members of the dental community relating to these proposals and are strongly encouraging interested stakeholders to weigh in with their concerns.