Case Information
*1 The Attorney General of Texas Decenber 31, 1985 JIM MATTOX
Attorney General Mr. William S. Na:L:; Opinion No. .TM-47.0
Supreme Court Building Executive Directo:: P. 0. BOX 12548 Texas State Board of Re: Whether the Texas State Board Austin, TX. 78711. 2548 512,4752501 Dental Examine:% of Dental Examiners may allow the Telex 9101874-1367 411 West 13th Street, Suite 503 delegation to dental hygienists cf Telecopier 51214750266 Austin, Texas 7wo1 smoothing roughened root surfaces 714 Jackson, Suite 700 Dear Nail:
Dallas, TX. 7520245OS 2la742.8944
You ask for a clarification of certain amendments made by the
Sixty-ninth Legislature to the Dental Hygiene Act. V.T.C.S. art. 4551e. 4824 Alberta Ave., Suiie 180 El Paso, TX. 799052793 915/53534e4 The legislature amended the definition of "dental hygiene" to
read as follows: 1001 Texas, Suite 700 The term 'dental hygiene,' and the practice Houston, TX. 77002-3111 thereof as used In this Act shall mean and is 7131223~5886 hereby defined as (a) the removal of accumulated matter, tartar, deposits, accretions or stains, SW Broadway, Suite 312 except rlottled enamel stains, from the natural and Lubbock, TX. 79401.3479 restorecl surfaces of exposed human teeth, and 8061747-5238 therefor in the human mouth, the restoraf:ions smoothing; of the roughened root surfaces, and the 4309 N. Tenth, Suite S polishing; of said surfaces; (b) the making of McAlle”, TX. 78501-1885 topical application of drugs to the surface 5121882-4547 tissues of the human mouth aud to the exposed
surface of human teeth; (c) the making of Dental 200 Main Plaza, Suite 400 San Antonio. TX. 78205.2797 [51212254191] X-rays ; and (d) such other services and procedures as may 'XL prescribed by the Texas State Board of Dental Examiners in its Rules and Regulations;
provide<,, however, that such services, tasks, or proceduws defined as dental hygiene are performed A” Equal Opportunity/ in compliance with Section 3 of this Article. Affirmative Action Employer (Emphasis in original).
Acts 1985, 69th Ls:g,. , ch. 80, 51, at 320 (underlined language added by Sixty-ninth Legirilature) (to be codified as article 4551e, 51, V.T.C.S.) William S. Nail - Page 2 (JM-420,)
Section 3(a) of article 4551e, V.T.C.S., governs delegation of certain tasks to dental h:rj;ienists. This provision was also amended by the Sixty-ninth Legislar:ure.
The Texas State Board of Dental Examiners may by rule permit a licensed dentist to delegate the performance of a service, task, or procedure to a licensed hygiendst under the direct or general supervision of the dentist; provided, however, that the licensed hygienist shall not be permitted to diagnose a dental disease or ailment, prescribe any treatment or a regimen thereof, prescribe, order, or disptn,se medication, or perform any procedure which F:s irreversible or which involves the intentional cutting of the soft or hard tissue by any means. Plothing herein shall be construed to prevent a dentist from authorizing a dental hygienist employoil by said dentist to instruct and educate a patient in good oral hygiene technique or to provide 2. medication as ordered by said dentist to said patient. This Act does not pro- hibit the incidental removal of cementurn by a dental hygienist&ring the smoothing of roughened root surfaces.
Id. 53, at 321 (underlined language added by 69th Leg.) (to be codified as art. 4551~. §3m:a), V.T.C.S.).
In regard to those amendments. you ask:
Assuming that 'the smoothing of the roughened root surfaces' is an irreversible procedure or 'involves the intentional cutting of the soft or hard tissue by ,%ny means,' may the dental board delegate to dental hygienists the permitted duty of smoothing of the roughened root surfaces in view of the language added by the Sixty-ninth Legislature to article 4551e, section 1.
The Sixty-ninth Legislature passed a bill the purposes of which were (1) to add "the smoothing of roughened root surfaces" to the list of tasks that make up tk.e practice of dental hygiene and (2) to provide that the prohibit!.cms on the delegation of certain kinds of tasks to dental hygienist,3 are not intended to prohibit "the inci- dental removal of cementurn by a dental hygienist during the smoothing of roughened root surfaces." Acts 1985, 69th Leg., ch. 80, at 320.
Ae a general rule, the, board may not allow dentists to delegate to dental hygienists irrev~erslble procedures or procedures involving the cutting of tissue. V.T.C.S. art. 4551e. 93(a). The legislative *3 Mr. William S. Nail - Page 3 (JM-420)
history of House Bill NC. 1229 informs us that the smoothing of roughened root surfaces, also known as "root planning," is a basic treatment for gum disease. Dental hygienists may perform the procedure in 43 other rotates, and the procedure is part of a hygienists's training. Bjll Analysis to H.B. No. 1229, prepared for House Committee on Public 'health, filed in Bill File to B.B. No. 1229, Legislative Reference Library. We assume that the smoothing of roughened root surfaces it;, by its nature, irreversible. You do not inform us whether generally accepted methods of smoothing roughened root surfaces involve the: cutting of tissue. Obviously, however, House Bill No. 1229 was intended to make clear that the board could permit dentists to delegate to hygienists the task of smoothing roughened root surfaces. The legislature obviously contemplated that hygienists would do so usiq the method or methods generally taught to them in their training. 'Thus, the board may permit a dentist to delegate to a hygienist Forking under the dentist's supervision the smoothing of roughened roo’t surfaces by generally accepted methods.
SUMMARY The Texas Ste,te Board of Dental Examiners may promulgate a rul'z allowing dentists to delegate to dental hygienists the smoothing of roughened root surfaces by gene,cally accepted methods.
J-h . Very truly yours JIM MATTOX Attorney General of Texas JACK HIGHTOWBR
First Assistant Attorney G,zneral
MARY KELLBR
Executive Assistant Attorwy General
ROBERT GRAY
Special Assistant Attorney General
RICK GILPIN
Chairman, Opinion Committe,?.
Prepared by Sarah Woelk
Assistant Attorney General