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AN ACT concerning dentistry; relating to the dental practices act; con-
  cerning the practice of dental hygienists; definitions; amending K.S.A.
  1996 Supp. 65-1423, 65-1444 and 65-1456 and repealing the existing
  sections.
Be it enacted by the Legislature of the State of Kansas:
  Section 1.  K.S.A. 1996 Supp. 65-1423 is hereby amended to read as
follows: 65-1423. Nothing in this act shall apply to the following practices,
acts and operations:
  (a)  To the practice of a person licensed to practice medicine and
surgery under the laws of this state, unless such person practices dentistry
as a specialty; or
  (b)  to the performance by a licensed nurse of a task as part of the
administration of an anaesthetic for a dental operation under the direct
supervision of a licensed dentist or person licensed to practice medicine
and surgery so long as the anaesthetic given under the direct supervision
of a licensed dentist is consistent with the anaesthetic the dentist is au-
thorized to administer under K.S.A. 65-1444 and amendments thereto
and consistent with subsection (a) of K.S.A. 65-1162 and amendments
thereto and subsection (e) of K.S.A. 65-1163 and amendments thereto;
  (c)  to the giving by a registered nurse anesthetist of an anaesthetic
for a dental operation in an interdependent role as a member of a phy-
sician or dentist directed health care team.;
  (d)  the practice of dentistry in the discharge of their official duties
by graduate dentists or dental surgeons in the United States army, navy,
air force, marines, public health service, coast guard or veterans' bureau;
or
  (e)  the practice of dentistry by a licensed dentist of other states or
countries at meetings of the Kansas state dental association or compo-
nents thereof, or other like dental organizations approved by the board,
while appearing as clinicians;
  (f)  to the filling of prescriptions of a licensed and registered dentist
as hereinafter provided by any person or persons, association, corporation
or other entity, for the construction, reproduction or repair of prosthetic
dentures, bridges, plates or appliances to be used or worn as substitutes
for natural teeth, provided that such person or persons, associations, cor-
poration or other entity, shall not solicit or advertise, directly or indirectly
by mail, card, newspaper, pamphlet, radio or otherwise, to the general
public to construct, reproduce or repair prosthetic dentures, bridges,
plates or other appliances to be used or worn as substitutes for natural
teeth;
  (g)  to the use of roentgen or x-ray machines or other rays for making
radiograms or similar records, of dental or oral tissues under the super-
vision of a licensed dentist or physician except that such service shall not
be advertised by any name whatever as an aid or inducement to secure
dental patronage, and no person shall advertise that such person has,
leases, owns or operates a roentgen or x-ray machine for the purpose of
making dental radiograms of the human teeth or tissues or the oral cavity,
or administering treatment thereto for any disease thereof;
  (h)  except as hereinafter limited to the performance of any dental
service of any kind by any person who is not licensed under this act, if
such service is performed under the supervision of a dentist licensed
under this act at the office of such licensed dentist except that such non-
licensed person shall not be allowed to perform or attempt to perform
the following dental operations or services:
  (1)  Any and all removal of or addition to the hard or soft tissue of the
oral cavity;
  (2)  any and all diagnosis of or prescription for treatment for disease,
pain, deformity, deficiency, injury or physical condition of the human
teeth or jaws, or adjacent structure;
  (3)  any and all correction of malformation of teeth or of the jaws;
  (4)  any and all administration of general or local anaesthesia of any
nature in connection with a dental operation; or
  (5)  a prophylaxis.
  (i)  As used in this section:
  (1)  ``Removal of or addition to the hard or soft tissue of the oral cav-
ity'' means: (A) A surgical or cutting procedure on hard or soft tissues;
(B) the grafting of hard or soft tissues; (C) the final placement or intraoral
adjustment of a fixed crown or fixed bridge; and (D) root planing or the
smoothing of roughened root surfaces.
  (2)  ``Diagnosis of or prescription for treatment for disease, pain, de-
formity, deficiency, injury or physical condition of the human teeth or
jaws or adjacent structure'' means: (A) A comprehensive examination; (B)
diagnosis and treatment planning; and (C) the prescription of a drug,
medication or work authorization.
  (3)  ``Correction of malformation of teeth or the jaws'' means surgery,
cutting or any other irreversible procedure.
  (4)  ``General or local anesthesia of any nature in connection with a
dental operation'' means any general anaesthetic and any local anaesthetic
whether block or infiltration but shall not include the administration and
monitoring of the analgesic use of nitrous oxide or oxygen, or both.
  Sec. 2.  K.S.A. 1996 Supp. 65-1444 is hereby amended to read as
follows: 65-1444. (a) A dentist shall have the right to prescribe drugs or
medicine, perform such surgical operations, administer analgesia, local
anaesthetics and use such appliances as may be necessary to the proper
practice of dentistry. Dentists may be authorized to administer intrave-
nous sedation and general anaesthetics subject to rules and regulations
concerning qualifications of such dentists as may be adopted by the board.
Dentists who are determined by the board to have been regularly engaged
in the practice of intravenous sedation or general anaesthesia in a com-
petent manner for the three years immediately prior to January 1, 1994,
shall have met the education and training requirements for such practice,
but such person shall be subject to all other rules and regulations con-
cerning intravenous sedation and general anaesthesic anaesthesia.
  (b)  A dentist may utilize an assistant not licensed by the board in the
administration and monitoring of nitrous oxide or oxygen, or both, if that
person has satisfactorily completed a course of instruction in those func-
tions which has been approved by the board.
  (c)  (1) The course of instruction shall include a minimum of six hours
of instruction at a teaching institution accredited by the American dental
association.
  (2)  The course of instruction shall include satisfactory completion of
courses which offer both didactic and clinical instruction in: (A) Theory
of pain control; (B) anatomy; (C) medical history; (D) pharmacology; and
(E) emergencies and complications.
  (3)  Certification in cardiac pulmonary resuscitation shall be required
in all cases.
  Sec. 3.  K.S.A. 1996 Supp. 65-1456 is hereby amended to read as
follows: 65-1456. (a) The board may suspend or revoke the license, license
certificate and renewal certificate of any registered and licensed dentist
who shall permit any dental hygienist operating under such dentist's su-
pervision to perform any operation other than that permitted under the
provisions of article 14 of chapter 65 of the Kansas Statutes Annotated,
or acts amendatory thereof, and may suspend or revoke the license of any
hygienist found guilty of performing any operation other than those per-
mitted under article 14 of chapter 65 of the Kansas Statutes Annotated,
or acts amendatory thereof. No license or certificate of any dentist or
dental hygienist shall be suspended or revoked in any administrative pro-
ceedings without first complying with the notice and hearing require-
ments of the Kansas administrative procedure act.
  (b)  The practice of dental hygiene shall include those educational,
preventive, and therapeutic procedures which result in the removal of
extraneous deposits, stains and debris from the teeth and the rendering
of smooth surfaces of the teeth to the depths of the gingival sulci. In-
cluded among those educational, preventive and therapeutic procedures
are the instruction of the patient as to daily personal care, protecting the
teeth from dental caries, the scaling and polishing of the crown surfaces
and the planing of the root surfaces, in addition to the curettage of those
soft tissues lining the free gingiva to the depth of the gingival sulcus and
such additional educational, preventive and therapeutic procedures as the
board may establish by rules and regulations.
  (c)  Subject to such prohibitions, limitations and conditions as the
board may prescribe by rules and regulations, any licensed dental hy-
gienist may practice dental hygiene and may also perform such dental
service as may be performed by a dental assistant under the provisions of
K.S.A. 65-1423 and amendments thereto.
  (d)  Except as otherwise provided in this section, the practice of dental
hygiene shall be performed under the direct or indirect supervision of a
licensed dentist at the office of such licensed dentist. The board may
designate by rules and regulations the procedures which may be per-
formed by a dental hygienist under direct supervision and the procedures
which may be performed under the indirect supervision of a licensed
dentist. As used in this section, ``indirect supervision'' means that the
dentist is in the dental office, authorizes the procedures and remains in
the dental office while the procedures are being performed and ``direct
supervision'' means that the dentist is in the dental office, personally
diagnoses the condition to be treated, personally authorizes the procedure
and before dismissal of the patient evaluates the performance.
  (e)  The practice of dental hygiene may be performed at an adult care
home, hospital long-term care unit, state institution, local health depart-
ment or indigent health care clinic on a resident of a facility, client or
patient thereof so long as:
  (1)  A licensed dentist has delegated the performance of the service,
task or procedure;
  (2)  the dental hygienist is under the supervision and responsibility of
the dentist;
  (3)  either the supervising dentist is personally present or the services,
tasks and procedures are limited to the cleaning of teeth, education and
preventive care;
  (4)  the supervising dentist examines the patient at the time the dental
hygiene procedure is performed or has examined the patient during the
12 calendar months preceding performance of the procedure;
  (5)  nothing in this subsection (e) shall be construed to prevent a den-
tal hygienist from providing dental education in a school setting; and
  (6)  the provisions of this subsection (e) shall expire on July 1, 1998.
  (f)  The board may issue a permit to a licensed dental hygienist to
provide dental screening as an employee of the state of Kansas, or any
subdivision thereof, at any public institution or facility under the super-
vision of the governing body of such public institution or facility under
such terms and conditions as the board may reasonably establish in such
permit. Such permit shall be for a period of one year and shall be subject
to renewal annually at the time the license for dental hygiene is renewed.
  (g)  In addition to the duties specifically mentioned in subsection (b)
of K.S.A. 65-1456, and amendments thereto, any duly licensed and reg-
istered dental hygienist may:
  (1)  Give fluoride treatments as a prophylactic measure, as defined by
the United States public health service and as recommended for use in
dentistry;
  (2)  remove overhanging restoration margins and periodontal surgery
materials by hand scaling instruments; and
  (3)  administer local block and infiltration anaesthesia and nitrous ox-
ide. (A) The administration of local anaesthesia shall be performed only
under the direct supervision of a licensed dentist at the office of the li-
censed dentist.  (B) Each dental hygienist who administers local anaesthe-
sia shall have completed courses of instruction in local anaesthesia and
nitrous oxide which have been approved by the board.
  (h)  (1) The courses of instruction required in subsection (g)(3)(B) of
K.S.A. 65-1456, and amendments thereto, shall provide a minimum of 12
hours of instruction at a teaching institution accredited by the American
dental association.
  (2)  The courses of instruction shall include courses which provide
both didactic and clinical instruction in: (A) Theory of pain control; (B)
anatomy; (C) medical history; (D) pharmacology; and (E) emergencies
and complications.
  (3)  Certification in cardiac pulmonary resuscitation shall be required
in all cases.
  Sec. 4.  K.S.A. 1996 Supp. 65-1423, 65-1444 and 65-1456 are hereby
repealed.
  Sec. 5.  This act shall take effect and be in force from and after its
publication in the statute book.