Dental Hygiene Florida Laws and Rules

466.001- Legislative Purpose and Intent (Purpose of the law)

Ensure that every dentist or dental hygienist practicing in this state meets minimum requirements for safe practice without undue clinical interference by persons not licensed.

Dentistry

_______ is the healing art which is concerned with the exam, diagnosis, treatment planning and care of conditions within the human oral cavity and adjacent tissues and structures.

Dental Hygiene

______ is the rendering of educational, preventive and therapeutic dental services and any related extra oral procedure required in the performance of services.

Board of Dentistry members include:

11 members total:

7 dentists actively practicing

2 hygienists actively practicing

2 lay persons non dental related

How many years experience must dentists/hygienists have on BOD

At least 5 years clinical preceding the appointment on BOD.

Must remain in clinical practice while on BOD

How many term years do dental hygiene board members serve?

4

What is the maximum number of years a board member may serve?

10

Who appoints the BOD members?

Governor of Florida

One board member of the board must be at least ____ years old.

60

466.024 Delegation of Duties; Expanded functions

-Dentists may not delegate irremediable tasks except as provided by law

-Remediable tasks may be delegated if they pose no risk

-May only delegate remediable tasks defined by law or rule

-Dentists delegate NON-dentists

Authorization for irremediable tasks under general supervision is

13 months

Who designates remediable and delegable tasks?

BOD

Intraoral treatment tasks which are irreversible and create unalterable changes within the oral cavity or structures?

Irremediable (anesthetic)

Intraoral treatment tasks which are reversible and do not create unalterable changes within the oral cavity or structures and do not cause an increased risk to the patient?

Remediable tasks (rubber dam, matrix band, polish amalgam)

Applying topical with jet spray is what type of task?

Irremediable

A Dental Hygienist who applies bleaching solution, activates light source, monitors and removes in-office bleaching materials is performing a ______ task.

Remediable

The practicing dentist is out of the country and a patient comes into the office with an emergency. Which remediable task is the hygienist/assistant able to perform?

Recementing temporary crown with temporary cement.

The use of laser or a laser type device is considered to be what type of task?

Irremediable

Who may perform emergency remediable tasks under conditions specified in the laws?

both DH and DA

Continuing Education

-A hygienist can be excused from CE requirements due to hardship.

-You have the option to be placed on inactive status if you pay the inactive status fee.

How many CE hours are required for dental hygienists?

24 credits biennially

How many CE hours are required for dentists?

30 credits biennially

How many minutes are equivalent to one hour of CE?

50 Minutes

*One half hour or one hour of CE credit shall be awarded for each 25 or 50 minutes of actual classroom or clinical instruction, respectively. No CE credit shall be awarded for participation of less than 25 minutes.

Extra CE credits

-Up to 11 CE Hrs for being expert witness

-Up to 3 CE Hrs for each semester teaching

-Up to 4 CE Hrs for attending BOD discipline meeting

Pro Bono CE Credit

1 CE for every 1 Hr of Pro Bono Work. Max 7Hrs Biennium

In a percentage, what is the highest amount that can be completed from probono work?

25%

What is not an appropriate topic for CE

Chemotherapeutic Agents

Which is an appropriate educational activity or topic for CE?

Board approved individual study

Which of the following is an example of a CE a dental hygienist would take?

Patient Stress Management

When are licensees excused from CE?

In the 1st biennium of licensure

How long should you keep receipts, vouchers or certificates as necessary document completion of CE courses?

4 years

Who of the following are required to take CE credits?

Practicing hygienist and dentist

A DDS or DH takes a 10 hr. course on HIV/AIDS. The remaining 9 hrs. could count toward their 24/ 30 hrs. required for license renewal ?

True

If 40 hrs of CE are taken in 1 biennium, the remaining hours taken can count towards the renewal requirement for the next biennium?

False

Prescriptions

-Dentists can prescribe drugs and administer anesthesia and sedation subject to limitations (scope of training)

-The board will define rules on training certification, limits of use, and mechanism to assure compliance

- Dentist MUST have CPR training every 2 years and resuscitation equipment in good working order.

Can a dental hygienist prescribe fluoride or chlorhexidine to a pt of record?

-Hygienists can only recommend fl and chlorhexidine, not prescribe it.

-Some pts will not buy chlorhexidine or fl at a dental office (typically due to cost). The dentist may write a prescription for the pharmacy to dispense it for the pt.

What needs to be included on an Rx?

-Patient name and address

DDS name, address, and license#

-Name, business address, license# of DH

-Statement of specific services authorized

-Statement of frequency

-ORIGINAL Rx is given to Patient. Copy goes in their chart

Which of the following is legal of a DDS writing Rx?

Writing within the scope of dentistry

How long is a Dental Hygiene Rx good for?

2 years (24 months)

What must be included on a Rx for a prescription strength fluoride gel?

DDS license number

Analgesia

Absence of pain without loss of consciousness

Anesthesia

the loss of feeling or sensation, especially loss of the sensation of pain.

Local Anesthesia

the loss of sensation of pain in a specific area of the body, generally produced by a topically applied agent or injected agent without causing the loss of consciousness

General Anesthesia

a controlled state of unconsciousness, produced by a pharmacological agent, accompanied by a partial or complete loss of protective reflexes, including the ability to independently maintain an airway and respond purposefully to physical stimulation or verbal command. This modality includes administration of meds via parenteral routes (oral, rectal or transmucosal)

Deep Sedation

a controlled state of depressed consciousness accompanied by partial loss of protective reflexes, including either or both the inability to continually maintain airway or respond to stimulation.

In order to administer Anesthesia in any form, the DDS or DH must possess an active CPR certification

True

Anesthesia permit

$35 application fee

Certified copy of transcripts from school

Diploma

Copy of CPR card

If the DDS uses anesthesia in the office, the staff must be trained in anticonvulsants?

True

What is a dental hygienist allowed to do in regards to NO

DH are NOT allowed to turn it on, but can monitor/adjust and turn off

Nitrous Oxide:

DA works under ________ supervision.

DH works under _________ supervision.

Direct; Indirect

Conscious and General Sedation requirements

-60 didactic hours

-2 people must be present in order for DDS to perform conscious sedation

-3 people must be present in order for DDS to perform general sedation

Nitrous Oxide

-Only agents allowed for inhalation in the dental office are nitrous and oxygen

-Nitrous may be used with a single dose enternal sedative

Who grants sedation permits?

BOD

Any DDS practicing in FL must notify the BOD in writing by registered mail, postmarked within ______ hrs of any mortality or other incident occurring in the outpatient facilities

48

A complete written report shall be filed with the BOD within ______ days of the mortality or other incident.

30 days

A DH under the ________ supervision of a DDS may administered local anesthesia, including block anesthesia, infiltration anesthesia. If the patient is 15 years of age?

None! The patient must be 18 years old in order for the DH to administer local anesthesia.

Nitrous Oxide produces an

altered state of consciousness

With conscious sedation:

a) the patient must be slightly awake

b) the patient must be under 100lbs

c) must not effect physical ability

c) must not effect physical ability

What is the minimum oxygen level required when administering nitrous oxide?

25%

Any CRDH administering local anesthesia must notify the BOD in writing by registered mail within ____ of any adverse occurrence that was related to or the result of the administering of local anesthesia. A complete written report shall be filed with the BOD within _____ of the mortality or other adverse occurrence.

24 hours; 30 days

What equipment should be present in ER/recovery rooms when using sedation?

O2 tank

EKG machine

Defibrillator

Thermometer

BP cuff

A bronchodilator is needed in the recovery room when performing sedation in the dental office?

True

Oral antibiotics are needed in the recovery room when performing sedation in the dental office?

False

A patient who has received xrays, exam from DDS and Tx plan is considered _______

Pt of record

Pt records

-Dentist of record shall be primarily responsible regardless of who provides tx

-Tx rendered by someone else in office must be noted by name or initials

Records may be transferred with the written consent of the patient

True

Original dentist must retain written statement signed by the owner dentist, the person that received the records, and two witnesses that list the date of transfer and persons to whom records were transferred to

True

Dentist of record may be relieved of responsibility to maintain records if he/she leaves practice where tx was rendered and transfers custody of records to owner of practice (must retain written statement)

True

What is the minimum a patient record must contain?

-Appropriate medical history

-Written dental records should include patient history, exam results, test results, which justify course of treatment (tx plan)

Transfer Records

-Within 90 days of a dentists death, the dentists estate or agent must transfer all patient records to another Florida licensed dentist and must be accessible by each patient for at least 4 years

-If a dentist relocates he must place patient records in the care of a Florid licensed dentist for at least 4 years from the date of the patient was last examined.

-In all cases, records need to be in same county as the practice was located

Dental Laboratories (pt record)

Dental laboratories must keep pt records for 4 years following the date the prescription was issued.

How long must patient records remain in the office?

4 years from the date of the pts last appt.

If there are multiple dentists seeing a pt ad there is no dentist of record on file who is the dentist of record?

The dentist who owns the practice.

If a new pt comes in to see a hygienist but is not a pt of record, and the dentist has to leave due to an emergency, how do you proceed?

Reschedule the patient with the dentist first before any tx is provided by the hygienist.

Who owns the pts record or chart?

The dentist

In the event that a dentist dies, where do all the "pt of record" files go?

To another Florida licensed dentist

Advertising

-Means any statements ORAL or WRITTEN disseminated to the public for the purpose of selling professional services or inducing the public to enter into any obligation relating to such professional services

-Must identify FL licensed dentist who assumes total responsibility for advertisement (license number, commonly used name, current address and phone number)

How long is the advertisement good for if there is no expiration date on it?

It is good for 90 days.

Purpose of advertising

To allow public access to information which provides a sufficient basis to make an informed selection

In person and telephone solicitation is

Prohibited

Dentists can apply to advertise through a referral service, but will be responsible for such advertisement content

It must state in reasonable size print and say that referral is for dentists who pay or have been selected for membership

No dentist shall disseminate advertising that is:

-False, deceptive, or misleading

-Contains laudatory statements

-Is intended to create false expectations

-Relates to the quality of dental services as compared to others

-Contains representations that would deceive an ordinarily prudent person

-Is intended to appeal to layperson's fears

Advertising of HIV/AIDS Status

-Public fear regarding the possibility of HIV transmission from health care workers to patients, although scientifically unfounded, has resulted in concerns regarding the safety of dental care.

No dental health care licensee may represent that he or she is HIV neg or free from AIDS. Any such advertisement or notice must clearly state:

THIS NEGATIVE HIV TEST CANNOT GUARANTEE THAT I AM CURRENTLY FREE OF HIV

When advertising HIV status you MUST

Inform the pt that current status guarantees nothing

Sterilization

Process by which ALL forms of life within an environment are totally destroyed

How often are sterilizers monitored?

Every 40 hours (2400 minutes) or at least once every 30 days, whichever comes first.

Disinfection

The destruction of inhibition of most pathogenic bacteria while they are in their active growth phase and the inactivation of some viruses

How long should heat sensitive instruments soak (how long are instruments left in cold sterile)?

At least 10 hours

Before sterilization

Instruments must be cleaned to remove debris.

Ex: scrubbing with soap or a detergent and water, ultrasonic cleaner

At least one of the following procedures must be used in order to provide proper sterilization:

-Steam under pressure (autoclave)

-Dry-heat

-Chemical Vapor

-Ethylene oxide

-Disinfectant/sterilant EPA or FDA approved

**Note: Ethylene glycol is NOT a form of sterilization

Sterilization by disinfectant-

If none of the other sterilization techniques can be used

-Registered by the EPA

-CDC only recommends usage

**Note: Isopropyl alcohol is NOT a form of disinfectant

How should impressions be treated that are sent to the lab?

Labeled: treat as infectious material and sealed in an impervious container.

Extracted teeth

-May be rendered non-biohazardous by disinfection

-Need to be scrubbed and sterilized if using for scientific, educational or testing purposes

-Should be cleaned of adherent patient material by scrubbing or an ultrasonic cleaner

When handling soiled which is NOT appropriate

a. carry instruments in a closed container

b. use regular examination gloves

c. wear mask and eye wear

d. use ultrasonic cleaner (if available)

use regular examination gloves

Who would be the enforcement of making guidelines and rules for contaminants pertaining to blood, saliva, and other bodily fluids?

a. dept of health (DOH)

b. Environmental Protection Agency (EPA)

c. centers for disease control (CDC)

d. board of dentistry (BOD)

CDC

Which PPE is NOT required

a. gloves

b. mask

c. eye protection

d. All the above are required

Eye protection

**Note: eye protection is recommended, but not mandatory

Grounds for disciplinary action

-Failure to report other healthcare specialists known to have violated the law

-Failing to report in writing within 30 days any actions against ones license elsewhere

-MINOR VIOLATION- failure to notify within 10 days of change of address

Can a dentist/hygienist accept fees during a suspension period?

-NO, when a license is suspended you may not accept fees from anyone.

-This includes your employer, 3rd party or insurance.

-Fines may range from $500- $10,000

Change of address

-Must be submitted to BOD w/in 10 days

-Penalty: $250 fine