June 11, 2003, Introduced by Senators BIRKHOLZ, CHERRY, THOMAS and LELAND and referred to the Committee on Health Policy.
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending section 16611 (MCL 333.16611), as amended by 2002 PA
423.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 Sec. 16611. (1) An individual shall not engage in the
2 practice of dentistry, the practice as a dental hygienist, or the
3 practice as a dental assistant unless he or she is licensed or
4 otherwise authorized by this article.
5 (2) Deep scaling, root planing, and the removal of calcareous
6 deposits may only be performed by an individual licensed or
7 otherwise authorized by this article as a dental hygienist or a
8 dentist.
9 (3) The department shall not issue a dental hygienist's
10 license to an individual unless the individual has graduated from
1 a school or college for dental hygienists whose dental hygiene
2 program is accredited by the commission on dental accreditation
3 of the American dental association and approved by the
4 department. The school or college must be accredited by a
5 regional accrediting agency for colleges, universities, or
6 institutions of higher education that is recognized by the United
7 States department of education and approved by the department and
8 must conduct a curriculum consisting of not less than 2 academic
9 years for dental hygiene graduation with courses at the
10 appropriate level to enable matriculation into a more advanced
11 academic degree program.
12 (4) Upon delegation by a dentist under section 16215 and
13 under the direct supervision of a dentist, a dental hygienist may
14 administer intraoral
block and infiltration anesthesia to a
15 patient who is 18
years of age or older or nitrous
oxide
16 analgesia, or both, if the following criteria are met:
17 (a) The dental hygienist has successfully completed a course
18 in the administration of local anesthesia or nitrous oxide
19 analgesia, or both as applicable, offered by a dental or dental
20 hygiene program accredited by the commission on dental
21 accreditation of the American dental association and approved by
22 the department. A course described in this subdivision involving
23 local anesthesia administration must contain a minimum of 15
24 hours didactic instruction and 14 hours of clinical experience.
25 A course described in this subdivision involving nitrous oxide
26 analgesia administration must contain a minimum of 4 hours of
27 didatic instruction and 4 hours of clinical experience. The
1 courses of instruction shall include content in all of the
2 following:
3 (i) In the case of local anesthesia, the following:
4 (A) (i) Theory of
pain control.
5 (B) (ii) Selection
of pain control modalities.
6 (C) (iii) Anatomy.
7 (D) (iv) Neurophysiology.
8 (E) (v) Pharmacology
of local anesthetics.
9 (F) (vi) Pharmacology
of vasoconstrictors.
10 (G) (vii) Psychological
aspects of pain control.
11 (H) (viii) Systemic
complications.
12 (I) (ix) Techniques
of maxillary anesthesia.
13 (J) (x) Techniques
of mandibular anesthesia.
14 (K) (xi) Infection
control.
15 (L) (xii) Local
anesthesia medical emergencies.
16 (ii) In the case of nitrous oxide analgesia, the following:
17 (A) Nitrous oxide analgesia medical emergencies.
18 (B) Pharmacology of nitrous oxide.
19 (C) Nitrous oxide techniques.
20 (D) If such a course is available, selection of pain control
21 modalities.
22 (b) The dental hygienist has successfully completed a state
23 or regional
board-administered written examination on local
24 anesthesia either or both of the following within 18
months of
25 completion of the course
work required under subdivision (a): .
26 (i) Local anesthesia.
27 (ii) Nitrous oxide analgesia, if such a course is available
1 and approved by the department.
2 (c) The dental hygienist maintains and can show evidence of
3 current certification in basic or advanced cardiac life support
4 in compliance with R 338.11701 of the Michigan administrative
5 code.
6 (5) Application for certification in the administration of
7 local anesthesia and nitrous oxide under subsection (4) is at the
8 discretion of each individual dental hygienist and the
9 certification shall be issued or documented by the department or
10 its designee.
11 (6) Monitoring and assisting the administration of nitrous
12 oxide analgesia is at the discretion of each individual
13 registered dental assistant who fulfills the applicable
14 conditions imposed in subsection (7).
15 (7) Upon delegation by a dentist under section 16215 and
16 under the direct supervision of a dentist, a registered dental
17 assistant may assist and monitor the administration of nitrous
18 oxide analgesia by the dentist or dental hygienist if the
19 registered dental assistant has successfully completed a course
20 in the assisting and monitoring of the administration of nitrous
21 oxide analgesia offered by a dental or dental assisting program
22 accredited by the commission on dental accreditation of the
23 American dental association and approved by the department. The
24 course must contain a minimum of 5 hours of didactic instruction
25 and include content in all of the following:
26 (a) Nitrous oxide analgesia medical emergencies techniques.
27 (b) Pharmacology of nitrous oxide techniques.
1 (c) Nitrous oxide techniques.
2 (8) (6) As
used in this section: , "direct
3 (a) "Assisting" means setting up equipment and placing the
4 face mask. Assisting does not include titrating and turning on
5 or off equipment. The nitrous oxide levels must be preset by the
6 dentist or dental hygienist and shall not be adjusted by the
7 registered dental assistant.
8 (b) "Direct supervision" means that a dentist complies with
9 all of the following:
10 (i) (a) Designates
a patient of record upon whom the
11 procedures are to be performed and describes the procedures to be
12 performed.
13 (ii) (b) Examines
the patient before prescribing the
14 procedures to be performed and upon completion of the
15 procedures.
16 (iii) (c) Is
physically present in the office at the time
17 the procedures are being performed.
18 (c) "Monitoring" means observing levels, admonishing, and
19 reporting to the dentist or dental hygienist.