State Level Topics

The Texas State Board of Dental Examiners established a blue-ribbon panel to review de-identified data surrounding dental anesthesia-related deaths and adverse events over the past five years. Recommendations were due to the Texas Legislature by Jan. 11, 2017.

The Dental Board of California commissioned a study to investigate dental pediatric anesthesia cases. State Senator Jerry Hill requested that a subcommittee assess whether California’s laws, regulations and policies are sufficient to guard against the unnecessary use of general anesthesia in the treatment of pediatric patients, and whether the laws assure patient safety. State actions on this study are anticipated. Numerous other states are assessing their sedation guidelines as well.

In July of this year, in support of patient safety and access, the AGD submitted written comments to the American Dental Association’s (ADA) Council on Dental Education and Licensure (CDEL) with regard to CDEL’s proposed changes to the ADA’s Guidelines for the Use of Sedation and General Anesthesia by Dentists and Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students. The AGD will engage in discussions about the proposed sedation guidelines of the ADA House of Delegates at the upcoming 2016 ADA annual meeting, Oct. 20–27 in Denver.

AGD believes that diluting in the patient experience requirements for parenteral moderate sedation by combining these requirements with enteral moderate sedation, as suggested in the new guidelines, would pose an unnecessary risk for patients undergoing moderate parenteral sedation in the future.

Following the Supreme Court’s decision in the 2014 case, North Carolina State Board of Dental Examiners v. Federal Trade Commission (FTC), in which the Court held that state licensing boards can invoke state-action immunity only if they are subject to active supervision by the state, the FTC took action to enforce the ruling with a May 31, 2017 administrative complaint filed against the Louisiana Real Estate Appraisers Board.

In the complaint, the FTC alleges that the Board restrained price competition for real estate appraisal services by requiring appraisers to charge prices at or above a level determined by a survey of recent fees paid by customers.  The complaint cites the lack of independent state supervision of the Board’s discretionary actions.

The complaint will be heard by a federal administrative law judge in January, 2018.

In March, 2017, FTC Acting Chairman Maureen Ohlhausen announced the creation of the Economic Liberty Task Force, which will be working to identify occupational licensing restrictions deemed unnecessary and onerous, and to produce recommendations for state officials related to occupational licensing reform.

New Jersey, North Dakota, and Tennessee are among the states that have seen legislation introduced seeking to ensure compliance with the Supreme Court ruling.  These bills would add a state-appointed regulatory officer to state regulatory and licensing boards, who would be tasked with reviewing and potentially vetoing proposed regulations.

Mississippi passed a law creating an Occupational Licensing Review Commission, composed of designees of the Governor, Secretary of State, and the Attorney General, which must approve by majority any proposed regulation from an occupational licensing board.

Arkansas Dental Specialty Licensing Bill Becomes Law

HB 1250 became law on March 16, 2017, and provides that a specialist license does not limit a licensed dentist’s ability to practice in any other area of dentistry for which the dentist is qualified, including general dentistry.  Also, the law provides that a dentist may hold themselves out to the public as a specialist and as a dentist who provides general dentistry services if the dentist practices their specialty at least 50% of the time they practice dentistry during a calendar year.

California Sedation Law Passes Assembly

AB 224 was approved by the Assembly, and is currently pending before the Senate Committee on Business, Professions, and Economic Development.

The bill seeks to require at least two people to be present during procedures on children under seven years of age, with one being a general anesthesia permit holder, or a nurse anesthetist supervised by a general anesthesia permit holder.  The bill also seeks to extend licensing criteria for dentists administering deep and minimal sedation, among other changes.

Georgia Passes Dental Hygienists Supervision Law

HB 154 was signed into law by Georgia Governor Nathan Deal on May 8, 2017, with an effective date of January 1, 2018.

The law allows dental hygienists to perform functions in certain settings, such as qualified health centers and school-based health clinics, under the general supervision of a dentist.  The functions include: application of sealants and oral prophylaxis and assessment; fluoride treatment; oral hygiene instruction; and exposure and processing of radiographs if provided for by specific standing order from the supervising dentist.

Washington Passes Corporate Dentistry Law

SB 5322 was signed into law on May 16, 2017 by Governor Jay Inslee.  The law, with an effective date of July 23, 2017, confirms that dentists have the option to contract for administrative support services and that only dentists licensed in Washington can own dental practices in the state.  Also, the law prohibits any third party from interfering with dentists’ independent clinical judgement, such as imposing limitations on the amount of time a dentist spends with a patient, placing conditions on the number of patients a dentist must treat in a certain period of time, and limiting a dentist’s ability to decide on a treatment course for a patient, among others.