JIM MATTOX Attorney General

Supreme Court Building P. 0. BOX 12548 Austin, TX. 78711. 2548 512,4752501 Telex 9101874-1367 Telecopier 51214750266

714 Jackson, Suite 700 Dallas, TX. 7520245OS 2la742.8944

4824 Alberta Ave., Suiie 180 El Paso, TX. 799052793 915/53534e4

1001 Texas, Suite 700 Houston, TX. 77002-3111 7131223~5886

SW Broadway, Suite 312 Lubbock, TX. 79401.3479 8061747-5238

4309 N. Tenth, Suite S McAlle”, TX. 78501-1885 5121882-4547

200 Main Plaza, Suite 400 San Antonio. TX. 78205.2797 51212254191

A” Equal Opportunity/ Affirmative Action Employer 

# The Attorney General of Texas

Decenber 31, 1985

Mr. William S.Na:L:; ExecutiveDirecto:: Texas StateBoard of Dental Examine:% 411West 13th Street, Suite 503 Austin,Texas 7wo1 OpinionNo. .TM-47.0
Re: Whether the Texas State Board of Dental Examinersmay allow the delegationto dentalhygienists cf smoothingroughenedroot surfaces
Dear Mr. Nail:
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. The legislature amended the definition of "dental hygiene" to read as follows:

The term 'dental hygiene,' and the practice thereof as used In this Act shall mean and is hereby defined as (a) the removal of accumulated matter, tartar, deposits, accretions or stains, exceptrlottled

enamel stains, from the natural and restoreclsurfaces of exposed human teeth, and restoraf:ions therefor in the human mouth, the smoothing;

of the roughened root surfaces, and the polishing;of said surfaces; (b) the making of topical application of drugs to the surface tissues of the human mouth aud to the exposed surface of human teeth; (c) the making of Dental X-rays; and (d) such other servicesand procedures as may 'XLprescribedby the Texas State Board of Dental Examiners in its Rules and Regulations; provide<,,

however, that such services, tasks, or proceduws defined as dentalhygiene are performed in compliance with Section 3 of this Article. (Emphasisin original).
Acts 1985, 69th Ls:g,. , ch. 80, 51, at 320 (underlinedlanguageaddedby Sixty-ninth Legirilature) (to be codified as article 4551e, 51, V.T.C.S.)

p. 1916Mr. 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 provisionwas also amended by the Sixty-ninthLegislar:ure.

The Texas State Board of Dental Examiners may by rule permit a licenseddentist 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 licensedhygienist shallnot be permitted to diagnose a dental disease or ailment,prescribe any treatment or a regimen thereof, prescribe, order, or disptn,semedication, or perform any procedurewhich F:s irreversible or which involves the intentionalcutting of the soft or hard tissue by any means. Plothingherein shall be construed to prevent a dentist from authorizing a dental hygienist employoil by said dentist to instructand 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 prohibit the incidental removal of cementurnby a dentalhygienist&ring the smoothingof 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 thoseamendments.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 ,%nymeans,' 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 smoothingof roughenedroot surfaces" to the list of tasks that make up tk.epractice of dental hygiene and (2) to provide that the prohibit!.cmson the delegation of certain kinds of tasks to dental hygienist,3are not intended to prohibit "the incidental removal of cementurn by a dental hygienist during the smoothing of roughenedroot 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

p. 1917Mr. 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 legislatureobviously contemplated that hygienistswould do sousiq themethod ormethods 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 smoothingof roughenedroo’tsurfacesby generallyacceptedmethods.
SUMMARY The Texas Ste,te Board of Dental Examiners may promulgatea rul'z allowingdentists to delegate to dental hygienists the smoothing of roughened root surfacesby gene,cally acceptedmethods.

Very trulyyours 

# J-h

.

JIM MATTOX AttorneyGeneral of Texas
JACKHIGHTOWBR FirstAssistantAttorney G,zneral
MARY KELLBR ExecutiveAssistantAttorwy General
ROBERT GRAY SpecialAssistantAttorney General
RICK GILPIN Chairman,Opinion Committe,?. Preparedby SarahWoelk AssistantAttorneyGeneral

p. 1918