1 STATE OF OKLAHOMA
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2 1st Session of the 59th Legislature (2023)
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3 SENATE BILL 754 By: Paxton
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6 AS INTRODUCED
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7 An Act relating to the practice of dentistry;
7 amending 59 O.S. 2021, Section 328.3, which relates
8 to definitions used in the State Dental Act;
8 modifying and adding definitions; amending 59 O.S.
9 2021, Section 328.21, as amended by Section 3,
9 Chapter 158, O.S.L. 2022 (59 O.S. Supp. 2022, Section
10 328.21), which relates to application for license;
10 modifying allowed time period, type, and criteria of
11 examinations; adding available advanced procedures
11 for dental hygienist; specifying qualifications and
12 procedures for obtainment of advanced procedure
12 permit by credentials; amending 59 O.S. 2021, Section
13 328.22, which relates to specialty license; modifying
13 certain terminology and qualifications related to
14 specialty license; requiring dentist placing implants
14 to meet certain conditions; providing exemptions;
15 allowing Board of Dentistry to add certain
15 designation; amending 59 O.S. 2021, Section 328.24,
16 which relates to dental assistant permits; adding
16 expanded duty permits available to dental assistants;
17 broadening permitting provisions to apply to oral
17 maxillofacial surgery assistants; providing for
18 addition of expanded duties to licenses; amending 59
18 O.S. 2021, Section 328.32, as amended by Section 6,
19 Chapter 158, O.S.L. 2022 (59 O.S. Supp. 2022, Section
19 328.32), which relates to grounds for penalties;
20 modifying grounds for penalties; amending 59 O.S.
20 2021, Section 328.34, which relates to practice of
21 dental hygiene under supervision of dentist;
21 requiring certain supervision for advanced
22 procedures; removing certain definition; adding
22 references; modifying rulemaking authority of Board
23 for advanced procedures; authorizing licensed dentist
23 to allow teledentistry treatment by certain dental
24 hygienists for patients in certain long-term care
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 1 settings; providing for application for elder care
1 and public health advanced procedure permit; allowing
2 treatment of patients by dental hygienist upon
2 receipt of permit; requiring certain documentation,
3 recording, and maintenance of recording by dental
3 hygienist; requiring completion of certain
4 assessment; requiring supervising dentist to maintain
4 certain records; allowing certain dental assistants
5 to apply for public health and elder care expanded
5 duty permit; authorizing dental assistant with permit
6 to assist hygienist with treatment in certain
6 facilities; requiring patient records to list dental
7 assistant; providing for codification; providing an
7 effective date; and declaring an emergency.
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10 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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11 SECTION 1. AMENDATORY 59 O.S. 2021, Section 328.3, is
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12 amended to read as follows:
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13 Section 328.3. As used in the State Dental Act, the following
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14 words, phrases, or terms, unless the context otherwise indicates,
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15 shall have the following meanings:
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16 1. “Accredited dental college” means an institution whose
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17 dental educational program is accredited by the Commission on Dental
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18 Accreditation of the American Dental Association;
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19 2. “Accredited dental hygiene program” means a dental hygiene
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20 educational program which is accredited by the Commission on Dental
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21 Accreditation of the American Dental Association;
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22 3. “Accredited dental assisting program” means a dental
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23 assisting program which is accredited by the Commission on Dental
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24 Accreditation of the American Dental Association;
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 1 4. “Advanced procedure” means a dental procedure for which a
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2 dental hygienist has received special training in a course of study
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3 approved by the Board;
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4 5. “Board” means the Board of Dentistry;
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5 5. 6. “Certified dental assistant” means a dental assistant who
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6 has earned and maintains current certified dental assistant
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7 certification from the Dental Assisting National Board (DANB);
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8 6. 7. “Coronal polishing” means a procedure limited to the
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9 removal of plaque and stain from exposed tooth surfaces, utilizing a
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10 slow speed hand piece with a prophy/polishing cup or brush and
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11 polishing agent and is not prophylaxis. To be considered
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12 prophylaxis, examination for calculus and scaling must be done by a
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13 hygienist or dentist;
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14 7. 8. “Deep sedation” means a drug-induced depression of
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15 consciousness during which patients cannot be easily aroused but
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16 respond purposefully following repeated or painful stimulation. The
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17 ability to independently maintain ventilator function may be
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18 impaired. Patients may require assistance in maintaining a patent
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19 airway, and spontaneous ventilation may be inadequate.
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20 Cardiovascular function is usually maintained;
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21 8. 9. “Dentistry” means the practice of dentistry in all of its
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22 branches;
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 1 9. 10. “Dentist” means a graduate of an accredited dental
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2 college who has been issued a license by the Board to practice
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3 dentistry as defined in Section 328.19 of this title;
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4 10. 11. “Dental ambulatory surgical center (DASC)” means a
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5 facility that operates exclusively for the purpose of furnishing
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6 outpatient surgical services to patients. A DASC shall have the
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7 same privileges and requirements as a dental office and additionally
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8 must be an accredited facility by the appropriate entity;
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9 11. 12. “Dental office” means an establishment owned and
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10 operated by a dentist for the practice of dentistry, which may be
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11 composed of reception rooms, business offices, private offices,
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12 laboratories, and dental operating rooms where dental operations are
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13 performed;
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14 12. 13. “Dental hygiene” means the science and practice of the
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15 promotion of oral health and prevention and treatment of oral
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16 disease through the provision of educational, therapeutic, clinical,
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17 and preventive services;
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18 14. “Dental hygienist” means an individual who has fulfilled
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19 the educational requirements and is a graduate of an accredited
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20 dental hygiene program and who has passed an examination and has
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21 been issued a license by the Board and who is authorized to practice
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22 dental hygiene as hereinafter defined;
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23 13. 15. “Dental assistant or oral maxillofacial surgery
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24 assistant” means an individual working for a dentist, under the
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 1 dentist’s direct supervision or direct visual supervision, and
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2 performing duties in the dental office or a treatment facility
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3 including the limited treatment of patients in accordance with the
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4 provisions of the State Dental Act. A dental assistant or oral
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5 maxillofacial surgery assistant may assist a dentist with the
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6 patient; provided, this shall be done only under the direct
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7 supervision or direct visual supervision and control of the dentist
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8 and only in accordance with the educational requirements and rules
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9 promulgated by the Board;
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10 14. 16. “Dental laboratory” means a location, whether in a
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11 dental office or not, where a dentist or a dental laboratory
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12 technician performs dental laboratory technology;
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13 15. 17. “Dental laboratory technician” means an individual
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14 whose name is duly filed in the official records of the Board, which
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15 authorizes the technician, upon the laboratory prescription of a
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16 dentist, to perform dental laboratory technology, which services
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17 must be rendered only to the prescribing dentist and not to the
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18 public;
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19 16. 18. “Dental laboratory technology” means using materials
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20 and mechanical devices for the construction, reproduction or repair
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21 of dental restorations, appliances or other devices to be worn in a
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22 human mouth;
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23 17. 19. “Dental specialty” means a specialized practice of a
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24 branch of dentistry, recognized by the Board, where the dental
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 1 college and specialty program are accredited by the Commission on
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2 Dental Accreditation (CODA), or a dental specialty recognized by the
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3 Board, requiring a minimum number of hours of approved education and
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4 training and/or recognition by a nationally recognized association
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5 or accreditation board;
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6 18. 20. “Direct supervision” means the supervisory dentist is
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7 in the dental office or treatment facility and, during the
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8 appointment, personally examines the patient, diagnoses any
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9 conditions to be treated, and authorizes the procedures to be
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10 performed by a dental hygienist, dental assistant, or oral
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11 maxillofacial surgery assistant. The supervising dentist is
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12 continuously on-site and physically present in the dental office or
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13 treatment facility while the procedures are being performed and,
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14 before dismissal of the patient, evaluates the results of the dental
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15 treatment;
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16 19. 21. “Direct visual supervision” means the supervisory
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17 dentist has direct ongoing visual oversight which shall be
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18 maintained at all times during any procedure authorized to be
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19 performed by a dental assistant or an oral maxillofacial surgery
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20 assistant;
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21 20. 22. “Expanded duty” means a dental procedure for which a
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22 dental assistant has received special training in a course of study
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23 approved by the Board;
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 1 23. “Fellowship” means a program designed for post-residency
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2 graduates to gain knowledge and experience in a specialized field;
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3 21. 24. “General anesthesia” means a drug-induced loss of
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4 consciousness during which patients are not arousable, even by
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5 painful stimulation. The ability to independently maintain
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6 ventilator function is often impaired. Patients often require
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7 assistance in maintaining a patent airway, and positive pressure
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8 ventilation may be required because of depressed spontaneous
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9 ventilation or drug-induced depression of neuromuscular function.
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10 Cardiovascular function may be impaired;
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11 22. 25. “General supervision” means the supervisory dentist has
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12 diagnosed any conditions to be treated within the past thirteen (13)
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13 months, has personally authorized the procedures to be performed by
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14 a dental hygienist, and will evaluate the results of the dental
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15 treatment within a reasonable time as determined by the nature of
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16 the procedures performed, the needs of the patient, and the
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17 professional judgment of the supervisory dentist. General
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18 supervision may only be used to supervise a hygienist and may not be
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19 used to supervise an oral maxillofacial surgery assistant or dental
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20 assistant except as provided by Section 7 of this act;
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21 23. 26. “Indirect supervision” means the supervisory dentist is
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22 in the dental office or treatment facility and has personally
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23 diagnosed any conditions to be treated, authorizes the procedures to
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24 be performed by a dental hygienist, remains in the dental office or
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 1 treatment facility while the procedures are being performed, and
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2 will evaluate the results of the dental treatment within a
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3 reasonable time as determined by the nature of the procedures
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4 performed, the needs of the patient, and the professional judgment
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5 of the supervisory dentist. Indirect supervision may not be used
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6 for an oral maxillofacial surgery assistant or a dental assistant;
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7 24. 27. “Investigations” means an investigation proceeding,
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8 authorized under Sections 328.15A and 328.43a of this title, to
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9 investigate alleged violations of the State Dental Act or the rules
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10 of the Board;
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11 25. 28. “Laboratory prescription” means a written description,
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12 dated and signed by a dentist, of dental laboratory technology to be
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13 performed by a dental laboratory technician;
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14 26. 29. “Minimal sedation” means a minimally depressed level of
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15 consciousness, produced by a pharmacological method, that retains
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16 the patient’s ability to independently and continuously maintain an
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17 airway and respond normally to tactile stimulation and verbal
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18 command . Although cognitive function and coordination may be
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19 modestly impaired, ventilator and cardiovascular functions are
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20 unaffected;
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21 27. 30. “Mobile dental anesthesia provider” means a licensed
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22 and anesthesia-permitted dentist, physician or certified registered
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23 nurse anesthetist (CRNA) that has a mobile dental unit and provides
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24 anesthesia in dental offices and facilities in the state;
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 1 28. 31. “Mobile dental clinic” means a permitted motor vehicle
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2 or trailer utilized as a dental clinic, and/or that contains dental
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3 equipment and is used to provide dental services to patients on-site
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4 and shall not include a mobile dental anesthesia provider. A mobile
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5 dental clinic shall also mean and include a volunteer mobile dental
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6 facility that is directly affiliated with a church or religious
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7 organization as defined by Section 501(c)(3) or 501(d) of the United
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8 States Internal Revenue Code, the church or religious organization
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9 with which it is affiliated is clearly indicated on the exterior of
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10 the mobile dental facility, and such facility does not receive any
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11 form of payment either directly or indirectly for work provided to
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12 patients other than donations through the affiliated church or
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13 religious organization; provided, that the volunteer mobile dental
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14 facility shall be exempt from any registration fee required under
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15 the State Dental Act;
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16 29. 32. “Moderate sedation” means a drug-induced depression of
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17 consciousness during which patients respond purposefully to verbal
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18 commands, either alone or accompanied by light tactile stimulation.
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19 No interventions are required to maintain a patent airway, and
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20 spontaneous ventilation is adequate. Cardiovascular function is
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21 usually maintained;
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22 30. 33. “Prophylaxis” means the removal of any and all
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23 calcareous deposits, stains, accretions or concretions from the
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24 supragingival and subgingival surfaces of human teeth, utilizing
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 1 instrumentation by scaler or periodontal curette on the crown and
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2 root surfaces of human teeth including rotary or power-driven
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3 instruments. This procedure may only be performed by a dentist or
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4 dental hygienist;
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5 31. 34. “Patient” or “patient of record” means an individual
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6 who has given a medical history and has been examined and accepted
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7 by a dentist for dental care;
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8 32. 35. “Residencies” are programs designed for advanced
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9 clinical and didactic training in general dentistry or other
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10 specialties or other specialists at the post-doctoral level
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11 recognized by the Commission on Dental Accreditation (CODA) or the
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12 Board;
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13 33. 36. “Supervision” means direct supervision, direct visual
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14 supervision, indirect supervision or general supervision;
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15 34. 37. “Teledentistry” means the remote delivery of dental
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