A. As used in the Dental Health Care Act, "practice of dentistry" means:

1. (1) the diagnosis, treatment, correction, change, relief, prevention, prescription of remedy, surgical operation and adjunctive treatment for any disease, pain, deformity, deficiency, injury, defect, lesion or physical condition involving both the functional and aesthetic aspects of the teeth, gingivae, jaws and adjacent hard and soft tissue of the oral and maxillofacial regions, including the prescription or administration of any drug, medicine, biologic, apparatus, brace, anesthetic or other therapeutic or diagnostic substance or technique by an individual or the individual's agent or employee gratuitously or for any fee, reward, emolument or any other form of compensation whether direct or indirect;
2. (2) representation of an ability or willingness to do any act mentioned in Paragraph (1) of this subsection;
3. (3) the review of dental insurance claims for therapeutic appropriateness of treatment, including but not limited to the interpretation of radiographs, photographs, models, periodontal records and narratives;
4. (4) the offering of advice or authoritative comment regarding the appropriateness of dental therapies, the need for recommended treatment or the efficacy of specific treatment modalities for other than the purpose of consultation to another dentist; or

5. (5) with specific reference to the teeth, gingivae, jaws or adjacent hard or soft tissues of the oral and maxillofacial region in living persons, to propose, agree or attempt to do or make an examination or give an estimate of cost with intent to, or undertaking to:

   1. (a) perform a physical evaluation of a patient in an office or in a hospital, clinic or other medical or dental facility prior to, incident to and appropriate to the performance of any dental services or oral or maxillofacial surgery;
   2. (b) perform surgery, an extraction or any other operation or to administer an anesthetic in connection therewith;
   3. (c) diagnose or treat a condition, disease, pain, deformity, deficiency, injury, lesion or other physical condition;
   4. (d) correct a malposition;
   5. (e) treat a fracture;
   6. (f) remove calcareous deposits;
   7. (g) replace missing anatomy with an artificial substitute;
   8. (h) construct, make, furnish, supply, reproduce, alter or repair an artificial substitute or restorative or corrective appliance or place an artificial substitute or restorative or corrective appliance in the mouth or attempt to adjust it;
   9. (i) give interpretations or readings of dental radiographs;
   10. (j) provide limited diagnostic and treatment planning via teledentistry; or

   11. (k) do any other remedial, corrective or restorative work.

       B. As used in the Dental Health Care Act, "the practice of dental hygiene" means the application of the science of the prevention and treatment of oral disease through the provision of educational, assessment, preventive, clinical and other therapeutic services under the general supervision of a dentist. A dental hygienist in a collaborative practice may perform the procedures listed in this section without general supervision while the hygienist is in a cooperative working relationship with a consulting dentist, pursuant to rules promulgated by the board and the committee. "The practice of dental hygiene" includes:

6. (1) prophylaxis, which is the removal of plaque, calculus and stains from the tooth structures as a means to control local irritational factors;
7. (2) removing diseased crevicular tissue and related nonsurgical periodontal procedures;
8. (3) except in cases where a tooth exhibits cavitation of the enamel surface, assessing without a dentist's evaluation whether the application of pit and fissure sealants is indicated;
9. (4) except in cases where a tooth exhibits cavitation of the enamel surface, applying pit and fissure sealants without mechanical alteration of the tooth;
10. (5) applying fluorides and other topical therapeutic and preventive agents;
11. (6) exposing and assessing oral radiographs for abnormalities;
12. (7) screening to identify indications of oral abnormalities;
13. (8) performing dental hygiene-focused assessments;
14. (9) assessing periodontal conditions; and

15. (10) such other closely related services as permitted by the rules of the committee and the board.

    C. In addition to performing dental hygiene as defined in Subsection B of this section, a dental hygienist may apply preventive topical fluorides and remineralization agents without supervision in public and community medical facilities, schools, hospitals, long-term care facilities and such other settings as the committee may determine by rule ratified by the board, so long as the dental hygienist's license is not restricted pursuant to the Impaired Dentists and Dental Hygienists Act [61-5B-1 to 61-5B-11 NMSA 1978].

    D. In addition to performing dental hygiene as defined in Subsection B of this section, dental hygienists who have met the criteria as the committee shall establish and the board shall ratify may administer local anesthesia under indirect supervision of a dentist.

    E. The board may certify a dental hygienist to administer local anesthetic under the general supervision of a dentist if the dental hygienist, in addition to performing dental hygiene as defined in Subsection B of this section:

16. (1) has administered local anesthesia under the indirect supervision of a dentist for at least two years, during which time the dental hygienist has competently administered at least twenty cases of local anesthesia and can document this with a signed affirmation by the supervising dentist;
17. (2) administers local anesthetic under the written prescription or order of a dentist; and

18. (3) emergency medical services are available in accordance with rules promulgated by the board.

    F. A dental hygienist:

19. (1) may prescribe, administer and dispense a fluoride supplement, topically applied fluoride or topically applied antimicrobial only when the prescribing, administering or dispensing is performed:

    1. (a) under the supervision of a dentist;
    2. (b) pursuant to rules the board and the committee have adopted;
    3. (c) within the parameters of a drug formulary approved by the board in consultation with the board of pharmacy;
    4. (d) within the parameters of guidelines established pursuant to Section 61-5A-10 NMSA 1978; and
    5. (e) in compliance with state laws concerning prescription packaging, labeling and recordkeeping requirements; and

20. (2) shall not otherwise dispense dangerous drugs or controlled substances.

    G. A New Mexico licensed dental hygienist may be certified for collaborative dental hygiene practice in accordance with the educational and experience criteria established collaboratively by the committee and the board.

    H. An expanded-function dental auxiliary may perform the following procedures under the direct supervision of a dentist:

21. (1) placing and shaping direct restorations;
22. (2) taking final impressions, excluding those for fixed or removable prosthetics involving multiple teeth;
23. (3) cementing indirect and provisional restorations for temporary use;
24. (4) applying pit and fissure sealants without mechanical alteration of the tooth;
25. (5) placing temporary and sedative restorative material in hand-excavated carious lesions and unprepared tooth fractures;
26. (6) removal of orthodontic bracket cement; and

27. (7) fitting and shaping of stainless steel crowns to be cemented by a dentist.

    I. An expanded-function dental auxiliary may re-cement temporary or permanent crowns with temporary cement under the general supervision of a dentist in a situation that a dentist deems to be an emergency.

    J. An expanded-function dental auxiliary may perform other related functions for which the expanded-function dental auxiliary meets the training and educational standards established by the board and that are not expressly prohibited by the board.

    K. For the purpose of this section, "collaborative dental hygiene practice" means the application of the science of the prevention and treatment of oral disease through the provision of educational, assessment, preventive, clinical and other therapeutic services as specified in Subsection B of this section in a cooperative working relationship with a consulting dentist, but without general supervision as set forth by the rules established and approved by both the board and the committee.

History: Laws 1994, ch. 55, § 4; 1999, ch. 292, § 1; 2003, ch. 409, § 3; 2007, ch. 63, § 2; 2011, ch. 113, § 5.

ANNOTATIONS

The 2011 amendment, effective June 17, 2011, included limited diagnostic and treatment planning via teledentistry within the scope of the practice of dentistry; authorized dental hygienists in a collaborative practice to perform procedures listed in this section without general supervision; clarified the meaning of prophylaxis; included nonsurgical periodontal procedures, assessment of the need for pit and fissure sealants and oral radiographs for abnormalities, and performing dental hygiene-focused assessments within the scope of the practice of dental hygiene; provided for the certification of dental hygienists to administer local anesthetic; prescribed the conditions under which fluoride and antimicrobial substances may be prescribed, administered and dispensed by dental hygienists; and specified the procedures an expanded-function dental auxiliary may perform, including re-cementing crowns and related functions for which the auxiliary is educated and trained to perform.

The 2007 amendment, effective June 15, 2007, added a new Subsection C to authorize a dental hygienist to administer fluoride and remineralization treatments without supervision in facilities specified by rule of the dental hygienists committee.

The 2003 amendment, effective June 20, 2003, added present Paragraphs A(3) and A(4) and redesignated former Paragraph A(3) as present Paragraph A(5); substituted "radiographs" for "roentgenograms" following "readings of" near the end of present Subparagraph A(5)(i); in Subsection B, substituted "hygiene" for "hygienist" following "practice of dental" near the beginning, and inserted "application of the" preceding "science of the prevention" near the middle; inserted "without mechanical alteration of the tooth" following "pit and fissure" near the middle of Paragraph B(3); deleted "preliminary" preceding "assessment of" at the beginning of Paragraph B(6); deleted "and regulations" following "permitted by the rules" near the middle of Paragraph B(7); in Subsection D, inserted "New Mexico licensed" preceding "dental hygienist" near the beginning and deleted "The board may charge a fee not to exceed one hundred fifty dollars ($150) for each application for certification for collaborative dental hygiene practice" following "committee and the board" at the end; and in Subsection E, deleted "practice of" following "collaborative" near the beginning, inserted "practice" following "dental hygiene" near the beginning, inserted "the application of" preceding "the science of" near the beginning, deleted "jointly" following "forth by the rules" near the end and inserted "and approved by both" preceding "the board and" near the end.

The 1999 amendment, effective June 18, 1999, added Subsections D and E.

Former definition of dentistry not vague. — Laws 1919, ch. 35, § 9, defining the practice of dentistry, was not too vague, indefinite and uncertain to serve as basis for a criminal information for practicing dentistry contrary to the provisions of the act, the actions complained of being within the police power of the state. State v. Culdice, 1929-NMSC-007, 33 N.M. 641, 275 P. 371.

Board could not permit unlicensed persons to practice dentistry. — The board could not, by rules and regulations, allow unlicensed persons to perform services which, under statutory provisions, constitute the practice of dentistry. Family Dental Ctr. v. N.M. Bd. of Dentistry, 97 N.M. 464, 641 P.2d 495 (1982).

Actions by unlicensed assistants held to be unlawful practice. — Unlicensed assistants performing such dental services as taking impressions and adjusting dentures constitutes the unlawful practice of dentistry. Family Dental Ctr. v. N.M. Bd. of Dentistry, 1982-NMSC-020, 97 N.M. 464, 641 P.2d 495.

Supervision of dental hygienist. — No services which constitute dental hygiene can be performed unless a licensed dentist is physically and immediately present in the office or building where the work is being performed, in order that the dentist can meet the statutory duty to supervise the services of the dental hygienist. 1971 Op. Att'y Gen. No. 71-121 (rendered under prior law).

Am. Jur. 2d, A.L.R. and C.J.S. references. — 61 Am. Jur. 2d Physicians, Surgeons and Other Healers § 6.

70 C.J.S. Physicians, Surgeons, and Other Health-Care Providers § 5.