Session of 1998
                   
HOUSE BILL No. 2725
         
By Committee on Health and Human Services
         
1-27
            9             AN ACT concerning the dental practices act; relating to authorized prac-
10             tices; amending K.S.A. 1997 Supp. 65-1423 and 65-1456 and repealing
11             the existing sections.
12            
13       Be it enacted by the Legislature of the State of Kansas:
14           Section 1. K.S.A. 1997 Supp. 65-1423 is hereby amended to read as
15       follows: 65-1423. Nothing in this act shall apply to the following practices,
16       acts and operations:
17           (a) To the practice of a person licensed to practice medicine and
18       surgery under the laws of this state, unless such person practices dentistry
19       as a specialty; or
20           (b) to the performance by a licensed nurse of a task as part of the
21       administration of an anaesthetic for a dental operation under the direct
22       supervision of a licensed dentist or person licensed to practice medicine
23       and surgery so long as the anaesthetic given under the direct supervision
24       of a licensed dentist is consistent with the anaesthetic the dentist is au-
25       thorized to administer under K.S.A. 65-1444 and amendments thereto
26       and consistent with subsection (a) of K.S.A. 65-1162 and amendments
27       thereto and subsection (e) of K.S.A. 65-1163 and amendments thereto;
28           (c) to the giving by a registered nurse anesthetist of an anaesthetic
29       for a dental operation in an interdependent role as a member of a phy-
30       sician or dentist directed health care team;
31           (d) the practice of dentistry in the discharge of their official duties
32       by graduate dentists or dental surgeons in the United States army, navy,
33       air force, marines, public health service, coast guard or veterans' bureau;
34           (e) the practice of dentistry by a licensed dentist of other states or
35       countries at meetings of the Kansas state dental association or compo-
36       nents thereof, or other like dental organizations approved by the board,
37       while appearing as clinicians;
38           (f) to the filling of prescriptions of a licensed and registered dentist
39       as hereinafter provided by any person or persons, association, corporation
40       or other entity, for the construction, reproduction or repair of prosthetic
41       dentures, bridges, plates or appliances to be used or worn as substitutes
42       for natural teeth, provided that such person or persons, associations, cor-
43       poration or other entity, shall not solicit or advertise, directly or indirectly

HB 2725

2

  1       by mail, card, newspaper, pamphlet, radio or otherwise, to the general
  2       public to construct, reproduce or repair prosthetic dentures, bridges,
  3       plates or other appliances to be used or worn as substitutes for natural
  4       teeth;
  5           (g) to the use of roentgen or x-ray machines or other rays for making
  6       radiograms or similar records, of dental or oral tissues under the super-
  7       vision of a licensed dentist or physician except that such service shall not
  8       be advertised by any name whatever as an aid or inducement to secure
  9       dental patronage, and no person shall advertise that such person has,
10       leases, owns or operates a roentgen or x-ray machine for the purpose of
11       making dental radiograms of the human teeth or tissues or the oral cavity,
12       or administering treatment thereto for any disease thereof;
13           (h) except as hereinafter limited to the performance of any dental
14       service of any kind by any person who is not licensed under this act, if
15       such service is performed under the supervision of a dentist licensed
16       under this act at the office of such licensed dentist except that such non-
17       licensed person shall not be allowed to perform or attempt to perform
18       the following dental operations or services:
19           (1) Any and all removal of or addition to the hard or soft tissue of the
20       oral cavity;
21           (2) any and all diagnosis of or prescription for treatment for disease,
22       pain, deformity, deficiency, injury or physical condition of the human
23       teeth or jaws, or adjacent structure;
24           (3) any and all correction of malformation of teeth or of the jaws;
25           (4) any and all administration of general or local anaesthesia of any
26       nature in connection with a dental operation; or
27           (5) a prophylaxis, except that individuals who are not licensed but
28       who are operating under the on-site supervision of a dentist may remove
29       extraneous deposits, stains and debris from the teeth above the gum line
30       so long as they have completed necessary training as established by the
31       board.
32           (i) As used in this section:
33           (1) ``Removal of or addition to the hard or soft tissue of the oral
34       cavity'' means: (A) A surgical or cutting procedure on hard or soft tissues;
35       (B) the grafting of hard or soft tissues; (C) the final placement or intraoral
36       adjustment of a fixed crown or fixed bridge; and (D) root planing or the
37       smoothing of roughened root surfaces.
38           (2) ``Diagnosis of or prescription for treatment for disease, pain, de-
39       formity, deficiency, injury or physical condition of the human teeth or
40       jaws or adjacent structure'' means: (A) A comprehensive examination; (B)
41       diagnosis and treatment planning; and (C) the prescription of a drug,
42       medication or work authorization.
43           (3) ``Correction of malformation of teeth or the jaws'' means surgery,

HB 2725

3

  1       cutting or any other irreversible procedure.
  2           (4) ``General or local anesthesia of any nature in connection with a
  3       dental operation'' means any general anaesthetic and any local anaesthetic
  4       whether block or infiltration but shall not include the administration and
  5       monitoring of the analgesic use of nitrous oxide or oxygen, or both.
  6           Sec. 2. K.S.A. 1997 Supp. 65-1456 is hereby amended to read as
  7       follows: 65-1456. (a) The board may suspend or revoke the license, license
  8       certificate and renewal certificate of any registered and licensed dentist
  9       who shall permit any dental hygienist operating under such dentist's su-
10       pervision to perform any operation other than that permitted under the
11       provisions of article 14 of chapter 65 of the Kansas Statutes Annotated,
12       or acts amendatory thereof, and may suspend or revoke the license of any
13       hygienist found guilty of performing any operation other than those per-
14       mitted under article 14 of chapter 65 of the Kansas Statutes Annotated,
15       or acts amendatory thereof. No license or certificate of any dentist or
16       dental hygienist shall be suspended or revoked in any administrative pro-
17       ceedings without first complying with the notice and hearing require-
18       ments of the Kansas administrative procedure act.
19           (b) The practice of dental hygiene shall include those educational,
20       preventive, and therapeutic procedures which result in the removal of
21       extraneous deposits, stains and debris from the teeth and the rendering
22       of smooth surfaces of the teeth to the depths of the gingival sulci. In-
23       cluded among those educational, preventive and therapeutic procedures
24       are the instruction of the patient as to daily personal care, protecting the
25       teeth from dental caries, the scaling and polishing of the crown surfaces
26       and the planing of the root surfaces, in addition to the curettage of those
27       soft tissues lining the free gingiva to the depth of the gingival sulcus and
28       such additional educational, preventive and therapeutic procedures as the
29       board may establish by rules and regulations.
30           (c) Subject to such prohibitions, limitations and conditions as the
31       board may prescribe by rules and regulations, any licensed dental hy-
32       gienist may practice dental hygiene and may also perform such dental
33       service as may be performed by a dental assistant under the provisions of
34       K.S.A. 65-1423 and amendments thereto.
35           (d) Except as otherwise provided in this section, the practice of dental
36       hygiene shall be performed under the direct or indirect supervision of a
37       licensed dentist at the office of such licensed dentist. The board may
38       designate by rules and regulations the procedures which may be per-
39       formed by a dental hygienist under direct supervision and the procedures
40       which may be performed under the indirect supervision of a licensed
41       dentist. As used in this section, ``indirect supervision'' means that the
42       dentist is in the dental office, authorizes the procedures and remains in
43       the dental office while the procedures are being performed and ``direct

HB 2725

4

  1       supervision'' means that the dentist is in the dental office, personally
  2       diagnoses the condition to be treated, personally authorizes the procedure
  3       and before dismissal of the patient evaluates the performance.
  4           (e) The practice of dental hygiene may be performed at an adult care
  5       home, hospital long-term care unit, state institution, local health depart-
  6       ment or indigent health care clinic on a resident of a facility, client or
  7       patient thereof so long as:
  8           (1) A licensed dentist has delegated the performance of the service,
  9       task or procedure;
10           (2) the dental hygienist is under the supervision and responsibility of
11       the dentist;
12           (3) either the supervising dentist is personally present or the services,
13       tasks and procedures are limited to the cleaning of teeth, education and
14       preventive care;
15           (4) the supervising dentist examines the patient at the time the dental
16       hygiene procedure is performed or has examined the patient during the
17       12 calendar months preceding performance of the procedure;
18           (5) nothing in this subsection (e) shall be construed to prevent a den-
19       tal hygienist from providing dental education in a school setting; and
20           (6) the provisions of this subsection (e) shall expire on July 1, 1998.
21           (f) The board may issue a permit to a licensed dental hygienist to
22       provide dental screening as an employee of the state of Kansas, or any
23       subdivision thereof, at any public institution or facility under the super-
24       vision of the governing body of such public institution or facility under
25       such terms and conditions as the board may reasonably establish in such
26       permit. Such permit shall be for a period of one year and shall be subject
27       to renewal annually at the time the license for dental hygiene is renewed.
28           (g) In addition to the duties specifically mentioned in subsection (b)
29       of K.S.A. 65-1456, and amendments thereto, any duly licensed and reg-
30       istered dental hygienist may:
31           (1) Give fluoride treatments as a prophylactic measure, as defined by
32       the United States public health service and as recommended for use in
33       dentistry;
34           (2) remove overhanging restoration margins and periodontal surgery
35       materials by hand scaling instruments; and
36           (3) administer local block and infiltration anaesthesia and nitrous ox-
37       ide. (A) The administration of local anaesthesia shall be performed only
38       under the direct supervision of a licensed dentist at the office of the
39       licensed dentist. (B) Each dental hygienist who administers local anaes-
40       thesia shall have completed courses of instruction in local anaesthesia and
41       nitrous oxide which have been approved by the board.
42           (h) (1) The courses of instruction required in subsection (g)(3)(B) of
43       K.S.A. 65-1456, and amendments thereto, shall provide a minimum of 12

HB 2725

5

  1       hours of instruction at a teaching institution accredited by the American
  2       dental association.
  3           (2) The courses of instruction shall include courses which provide
  4       both didactic and clinical instruction in: (A) Theory of pain control; (B)
  5       anatomy; (C) medical history; (D) pharmacology; and (E) emergencies
  6       and complications.
  7           (3) Certification in cardiac pulmonary resuscitation shall be required
  8       in all cases.
  9           Sec. 3. K.S.A. 1997 Supp. 65-1423 and 65-1456 are hereby repealed.
10           Sec. 4. This act shall take effect and be in force from and after its
11       publication in the statute book.
12      
13