S T A T E O F N E W Y O R K
________________________________________________________________________
5848--B
Cal. No. 1042
2019-2020 Regular Sessions
I N S E N A T E
May 15, 2019
___________
Introduced by Sen. HARCKHAM -- read twice and ordered printed, and when
printed to be committed to the Committee on Higher Education --
reported favorably from said committee, ordered to first report,
amended on first report, ordered to a second report and ordered
reprinted, retaining its place in the order of second report --
amended on second report, ordered to a third reading, and to be
reprinted as amended, retaining its place in the order of third read-
ing
AN ACT to amend the education law, in relation to local block anes-
thesia, infiltration anesthesia, nitrous oxide, and dental assisting
practice
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 6605-b of the education law, as added by chapter
437 of the laws of 2001, is amended to read as follows:
§ 6605-b. Dental hygiene restricted local infiltration AND BLOCK
anesthesia/nitrous oxide analgesia [certificate] CERTIFICATES. 1. A
dental hygienist shall not administer or monitor nitrous oxide analgesia
or local infiltration anesthesia in the practice of dental hygiene with-
out a dental hygiene restricted local infiltration anesthesia/nitrous
oxide analgesia certificate and except under the personal supervision of
a dentist [and in conjunction with the performance of dental hygiene
procedures] authorized by law and in accordance with regulations promul-
gated by the commissioner. Personal supervision, for purposes of this
section, means that the supervising dentist remains in the dental office
where the local infiltration anesthesia or nitrous oxide analgesia
services are being performed, personally authorizes and prescribes the
use of local infiltration anesthesia or nitrous oxide analgesia for the
patient and, before dismissal of the patient, personally examines the
condition of the patient after the use of local infiltration anesthesia
or nitrous oxide analgesia is completed. It is professional misconduct
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03787-12-9
S. 5848--B 2
for a dentist to fail to provide the supervision required by this
section, and any dentist found guilty of such misconduct under the
procedures prescribed in section sixty-five hundred ten of this title
shall be subject to the penalties prescribed in section sixty-five
hundred eleven of this title.
2. A DENTAL HYGIENIST SHALL NOT ADMINISTER OR MONITOR NITROUS OXIDE
ANALGESIA OR LOCAL INFILTRATION OR BLOCK ANESTHESIA IN THE PRACTICE OF
DENTAL HYGIENE WITHOUT A DENTAL HYGIENE RESTRICTED LOCAL INFILTRATION
AND BLOCK ANESTHESIA/NITROUS OXIDE ANALGESIA CERTIFICATE AND EXCEPT
UNDER THE PERSONAL SUPERVISION OF A DENTIST AUTHORIZED BY LAW AND IN
ACCORDANCE WITH REGULATIONS PROMULGATED BY THE COMMISSIONER. PERSONAL
SUPERVISION, FOR PURPOSES OF THIS SECTION, MEANS THAT THE SUPERVISING
DENTIST REMAINS IN THE DENTAL OFFICE WHERE THE LOCAL INFILTRATION OR
BLOCK ANESTHESIA OR NITROUS OXIDE ANALGESIA SERVICES ARE BEING
PERFORMED, PERSONALLY AUTHORIZES AND PRESCRIBES THE USE OF LOCAL INFIL-
TRATION OR BLOCK ANESTHESIA OR NITROUS OXIDE ANALGESIA FOR THE PATIENT
AND, BEFORE DISMISSAL OF THE PATIENT, PERSONALLY EXAMINES THE CONDITION
OF THE PATIENT AFTER THE USE OF LOCAL INFILTRATION OR BLOCK ANESTHESIA
OR NITROUS OXIDE ANALGESIA IS COMPLETED. IT IS PROFESSIONAL MISCONDUCT
FOR A DENTIST TO FAIL TO PROVIDE THE SUPERVISION REQUIRED BY THIS
SECTION, AND ANY DENTIST FOUND GUILTY OF SUCH MISCONDUCT UNDER THE
PROCEDURES PRESCRIBED IN SECTION SIXTY-FIVE HUNDRED TEN OF THIS TITLE
SHALL BE SUBJECT TO THE PENALTIES PRESCRIBED IN SECTION SIXTY-FIVE
HUNDRED ELEVEN OF THIS TITLE.
3. The commissioner shall promulgate regulations establishing stand-
ards and procedures for the issuance of such [certificate] CERTIFICATES.
Such standards shall require completion of an educational program and/or
course of training or experience APPROPRIATE TO EACH CERTIFICATE suffi-
cient to ensure that a dental hygienist is specifically trained in the
administration and monitoring of nitrous oxide analgesia and local
infiltration anesthesia OR IS SPECIFICALLY TRAINED IN THE ADMINISTRATION
AND MONITORING OF NITROUS OXIDE ANALGESIA, LOCAL INFILTRATION ANES-
THESIA, AND BLOCK ANESTHESIA, the possible effects of such use, and in
the recognition of and response to possible emergency situations.
[3. The] A REASONABLE fee SHALL BE CHARGED for a dental hygiene
restricted local infiltration anesthesia/nitrous oxide analgesia certif-
icate [shall be twenty-five dollars] AND A REASONABLE FEE SHALL BE
CHARGED A DENTAL HYGIENE RESTRICTED LOCAL INFILTRATION
ANESTHESIA/NITROUS OXIDE ANALGESIA AND BLOCK ANESTHESIA CERTIFICATE and
shall EACH be paid on a triennial basis upon renewal of such certif-
icate. A certificate may be suspended or revoked in the same manner as a
license to practice dental hygiene.
§ 2. Subdivision 1 of section 6606 of the education law, as amended by
chapter 239 of the laws of 2013, is amended to read as follows:
1. The practice of the profession of dental hygiene is defined as the
performance of dental services which shall include removing calcareous
deposits, accretions and stains from the exposed surfaces of the teeth
which begin at the epithelial attachment and applying topical agents
indicated for a complete dental prophylaxis, removing cement, placing or
removing rubber dam, removing sutures, placing matrix band, providing
patient education, applying topical medication, placing and exposing
diagnostic dental X-ray films, performing topical fluoride applications
and topical anesthetic applications, polishing teeth, taking medical
history, charting caries, taking impressions for study casts, placing
and removing temporary restorations, administering and monitoring
nitrous oxide analgesia and administering and monitoring local infil-
S. 5848--B 3
tration AND BLOCK anesthesia, subject to certification in accordance
with section sixty-six hundred five-b of this article, and any other
function in the definition of the practice of dentistry as may be deleg-
ated by a licensed dentist in accordance with regulations promulgated by
the commissioner. The practice of dental hygiene may be conducted in the
office of any licensed dentist or in any appropriately equipped school
or public institution but must be done either under the supervision of a
licensed dentist or, in the case of a registered dental hygienist work-
ing for a hospital as defined in article twenty-eight of the public
health law, pursuant to a collaborative arrangement with a licensed and
registered dentist who has a formal relationship with the same hospital
in accordance with regulations promulgated by the department in consul-
tation with the department of health. Such collaborative arrangement
shall not obviate or supersede any law or regulation which requires
identified services to be performed under the personal supervision of a
dentist. When dental hygiene services are provided pursuant to a colla-
borative agreement, such dental hygienist shall instruct individuals to
visit a licensed dentist for comprehensive examination or treatment.
§ 3. Section 6608 of the education law, as amended by 239 of the laws
of 2013, is amended to read as follows:
§ 6608. Definition of practice of certified dental assisting. The
practice of certified dental assisting is defined as providing support-
ive services to a dentist in [his/her] HIS OR HER performance of dental
services authorized under this article. Such support shall include
providing patient education, taking preliminary medical histories and
vital signs to be reviewed by the dentist, placing and removing rubber
dams, selecting and prefitting provisional crowns, selecting and prefit-
ting orthodontic bands, removing orthodontic arch wires and ligature
ties, placing and removing matrix bands, taking impressions for study
casts or diagnostic casts, removing periodontal dressings, PLACING AND
REMOVING TEMPORARY RESTORATIONS, and such other dental supportive
services authorized by the dentist consistent with regulations promul-
gated by the commissioner, provided that such functions are performed
under the direct personal supervision of a licensed dentist in the
course of the performance of dental services. Such services shall not
include diagnosing and/or performing surgical procedures, irreversible
procedures or procedures that would alter the hard or soft tissue of the
oral and maxillofacial area or any other procedures determined by the
department. The practice of certified dental assisting may be conducted
in the office of any licensed dentist or in any appropriately equipped
school or public institution but must be done under the direct personal
supervision of a licensed dentist. Direct personal supervision, for
purposes of this section, means supervision of dental procedures based
on instructions given by a licensed dentist in the course of a procedure
who remains in the dental office where the supportive services are being
performed, personally diagnoses the condition to be treated, personally
authorizes the procedures, and before dismissal of the patient, who
remains the responsibility of the licensed dentist, evaluates the
services performed by the dental assistant. Nothing herein authorizes a
dental assistant to perform any of the services or functions defined as
part of the practice of dental hygiene in accordance with the provisions
of subdivision one of section sixty-six hundred six of this article,
except those functions authorized pursuant to this section. All dental
supportive services provided in this section may be performed by
currently registered dental hygienists either under a dentist's super-
vision, as defined in regulations of the commissioner, or, in the case
S. 5848--B 4
of a registered dental hygienist working for a hospital as defined in
article twenty-eight of the public health law, pursuant to a collabora-
tive arrangement with a licensed dentist in accordance with subdivision
one of section sixty-six hundred six of this article. Such collaborative
arrangement shall not obviate or supersede any law or regulation which
requires identified services to be performed under the personal super-
vision of a dentist.
§ 4. This act shall take effect immediately; provided that sections
one and two of this act shall take effect one year after it shall have
become a law.
