JIM MATTOX 

Attorney General 

Supreme Court Building 

P. 0. BOX 12548 

Austin, TX. 78711. 2548 

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A” Equal Opportunity/ 

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The Attorney General of Texas 

Decenber 31, 1985 

Mr. William S. Na:L:; 

Executive Directo:: 

Texas State Board of 

Dental Examine:% 

411 West 13th Street, Suite 503 

Austin, Texas 7wo1 

Opinion No. .TM-47.0 

Re: Whether the Texas State Board 

of Dental Examiners may allow the 

delegation to dental hygienists cf 

smoothing roughened root 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, 

except rlottled enamel stains, from the natural and 

restorecl surfaces 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 services and procedures 

as may 'XL prescribed by the Texas State Board of 

Dental Examiners in its Rules and Regulations; 

provide<,, however, that such services, tasks, or 

proceduws defined as dental hygiene are performed 

in compliance with Section 3 of this Article. 

(Emphasis in original). 

Acts 1985, 69th Ls:g,. , ch. 80, 51, at 320 (underlined language added by 

Sixty-ninth Legirilature) (to be codified as article 4551e, 51, 

V.T.C.S.) 

p. 1916 
Mr. 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 provision was also amended 

by the Sixty-ninth Legislar:ure. 

The Texas State Board of Dental Examiners may 

by rule permit a licensed dentist 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 licensed hygienist shall not be permitted 

to diagnose a dental disease or ailment, prescribe 

any treatment or a regimen thereof, prescribe, 

order, or disptn,se medication, or perform any 

procedure which F:s irreversible or which involves 

the intentional cutting of the soft or hard tissue 

by any means. Plothing herein shall be construed 

to prevent a dentist from authorizing a dental 

hygienist employoil by said dentist to instruct and 

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 cementurn by a 

dental hygienist&ring the smoothing of 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 those amendments. 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 ,%ny means,' 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 smoothing of roughened root surfaces" to the list 

of tasks that make up tk.e practice of dental hygiene and (2) to 

provide that the prohibit!.cms on the delegation of certain kinds of 

tasks to dental hygienist,3 are not intended to prohibit "the incidental removal of cementurn by a dental hygienist during the smoothing 

of roughened root 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. 1917 
Mr. 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 legislature obviously contemplated that 

hygienists would do so usiq the method or methods 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 

smoothing of roughened roo’t surfaces by generally accepted methods. 

SUMMARY 

The Texas Ste,te Board of Dental Examiners may 

promulgate a rul'z allowing dentists to delegate to 

dental hygienists the smoothing of roughened root 

surfaces by gene,cally accepted methods. 

Very truly yours J-h . 

JIM MATTOX 

Attorney General of Texas 

JACK HIGHTOWBR 

First Assistant Attorney G,zneral 

MARY KELLBR 

Executive Assistant Attorwy General 

ROBERT GRAY 

Special Assistant Attorney General 

RICK GILPIN 

Chairman, Opinion Committe,?. 

Prepared by Sarah Woelk 

Assistant Attorney General 

p. 1918