An Act To Align the Laws Governing Dental Therapy with Standards Established by the American Dental Association Commission on Dental Accreditation
Sec. 1. 22 MRSA §3174-XX, as amended by PL 2015, c. 429, §5, is further amended to read:
§ 3174-XX. Dental therapy reimbursement
Sec. 2. 24 MRSA §2317-B, sub-§21, as enacted by PL 2013, c. 575, §4 and affected by §10, is amended to read:
Sec. 3. 24-A MRSA §2765-A, as amended by PL 2015, c. 429, §12, is further amended to read:
§ 2765-A. Coverage for services provided by dental therapist
Sec. 4. 24-A MRSA §2847-U, as amended by PL 2015, c. 429, §14, is further amended to read:
§ 2847-U. Coverage for services provided by dental therapist
Sec. 5. 32 MRSA §18302, sub-§§5, 7 and 8, as enacted by PL 2015, c. 429, §21, are further amended to read:
Sec. 6. 32 MRSA §18302, sub-§29, as enacted by PL 2015, c. 429, §21, is amended to read:
Sec. 7. 32 MRSA §18345, sub-§2, ¶¶C and F, as enacted by PL 2015, c. 429, §21, are amended to read:
(1) Verification of having successfully completed a of a master's degree in dental hygiene therapy from a program that: accredited by the American Dental Association Commission on Dental Accreditation or its successor organization;
(a) Is accredited by the American Dental Association Commission on Dental Accreditation or a successor organization;
(b) Is a minimum of 4 semesters;
(c) Is consistent with the model curriculum for educating dental hygiene therapists adopted by the American Association of Public Health Dentistry or a successor organization;
(d) Is consistent with existing dental hygiene therapy programs in other states approved by the board; and
(e) Meets the requirements for dental hygiene therapy education programs adopted by board rule;
(2) Verification of a bachelor's degree or higher in dental hygiene, master's degree in dental hygiene therapy or dental therapy from a school accredited from a program that meets the requirements by board rule consistent with the accreditation standards identified by the American Dental Association Commission on Dental Accreditation or a its successor organization;
(3) Verification of passing a clinical examination and all other examinations required by board rule. The clinical examination must be a comprehensive, competency-based clinical examination approved by the board and administered independently of an institution providing dental hygiene therapy education;
(4) Verification of having engaged in 2,000 hours of supervised clinical practice under the supervision of a dentist and in conformity with rules adopted by the board, during which supervised clinical practice the applicant is authorized to practice pursuant to paragraph F.
For purposes of meeting the clinical requirements of this subparagraph, an applicant's hours of supervised clinical experience while enrolled in the dental hygiene therapy program under subparagraph (1) may be included as well as hours completed under the supervision of a dentist licensed in another state or a Canadian province, provided that as long as the applicant was operating lawfully under the laws and rules of that state or province; and
(5) A copy of the written practice agreement and standing orders required by section 18377, subsection 3; and
(6) Verification of a current advanced cardiac life support certification;
(1) Verification of meeting the requirements of paragraph C, subparagraphs (1) to (3) and (6); and
(2) A copy of the written agreement in conformity with rules adopted by the board between the applicant and a dentist who will provide levels of supervision consistent direct supervision with the scope of practice outlined in section 18377 and in conformity with rules adopted by the board , subsection 1, paragraph A and levels of supervision consistent with the scope of practice outlined in section 18374, subsections 1 and 2.
During the period of provisional authority the applicant may be compensated for services performed as a dental hygiene therapist. The period of provisional authority may not exceed 3 years.
Sec. 8. 32 MRSA §18351, last ¶, as amended by PL 2017, c. 388, §12, is further amended to read:
An individual who practices under a resident dentist license or as a provisional dental hygiene therapist may not apply for inactive status.
Sec. 9. 32 MRSA §18371, sub-§5, as enacted by PL 2015, c. 429, §21, is amended to read:
Sec. 10. 32 MRSA §18377, as enacted by PL 2015, c. 429, §21, is amended to read:
§ 18377. Dental therapist
(1) Perform oral health assessments, pulpal disease assessments for primary and young teeth, simple cavity preparations and restorations and simple extractions;
(2) Prepare and place stainless steel crowns and aesthetic anterior crowns for primary incisors and prepare, place and remove space maintainers;
(3) Provide referrals;
(4) Administer local anesthesia and nitrous oxide analgesia;
(5) Perform preventive services;
(6) Conduct urgent management of dental trauma, perform suturing, extract primary teeth and perform nonsurgical extractions of periodontally diseased permanent teeth if authorized in advance by the supervising dentist;
(7) Provide, dispense and administer anti-inflammatories, nonprescription analgesics, antimicrobials, antibiotics and anticaries materials;
(8) Administer radiographs; and
(9) Perform other related services and functions authorized by the supervising dentist and for which the dental hygiene therapist is trained.
(1) The services and procedures and the practice settings for those services and procedures that the dental hygiene therapist may provide, together with any limitations on those services and procedures;
(2) Any age-specific and procedure-specific practice protocols, including case selection criteria, assessment guidelines and imaging frequency;
(3) Procedures to be used with patients treated by the dental hygiene therapist for obtaining informed consent and for creating and maintaining dental records;
(4) A plan for review of patient records by the supervising dentist and the dental hygiene therapist;
(5) A plan for managing medical emergencies in each practice setting in which the dental hygiene therapist provides care;
(6) A quality assurance plan for monitoring care, including patient care review, referral follow-up and a quality assurance chart review;
(7) Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed;
(8) Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation prior to initiating care; and
(9) Specific written protocols, including a plan for providing clinical resources and referrals, governing situations in which the patient requires treatment that exceeds the scope of practice or capabilities of the dental hygiene therapist.
SUMMARY
This bill makes the following changes to the laws affecting dental therapists.
1. It changes the name of the occupation licensed from "dental hygiene therapist" to "dental therapist" to conform to the name used by other state licensing boards and the American Dental Association Commission on Dental Accreditation.
2. It identifies the educational requirement as a master's degree in dental therapy. It also clarifies that a dental therapy program must either be accredited by the American Dental Association Commission on Dental Education or approved by the Board of Dental Practice by rulemaking consistent with the curriculum standards of a dental therapy program as adopted by the American Dental Association Commission on Dental Education.
3. It requires a provisional dental therapist and a dental therapist to maintain a current certification in advanced cardiac life support.
4. It clarifies the level of supervision of a provisional dental therapist to require both direct and general supervision as identified in a written practice agreement with a supervising dentist. It authorizes a dental therapist to practice under the general supervision instead of direct supervision of a dentist pursuant to a written practice agreement.
5. It removes the practice setting requirements.