Provides that a dental hygienist shall not administer local block anesthesia without a 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 promulgated by the commissioner.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A284
SPONSOR: Paulin TITLE OF BILL:
An act to amend the education law, in relation to local block anesthesia
PURPOSE:
This bill allows hygienists to administer block anesthesia in addition
to the currently allowed local anesthesia and infiltration, in conform-
ance with regulations of the commissioner.
SUMMARY OF PROVISIONS:
This bill amends article 133, sections 6606 and 6605-b, of the education
law.
Section 1, subdivision 1 of the bill adds the administration of block
anesthesia to the list of duties dental hygienists may perform under the
supervision of a licensed dentist. Subdivision 2 specifies that the
commissioner shall establish the standards and procedures for the train-
ing certificate issuance, to ensure that the hygienist is specifically
trained in the administration of nitrous oxide analgesia, local infil-
tration and block anesthesia. Subdivision 3 provides that the department
shall charge $25 triennially for the issuance of the certificate.
Section 2 of the bill adds block anesthesia to the definition of prac-
tice of dental hygiene.
Section 3 provides that the bill shall take effect immediately.
JUSTIFICATION:
Dental hygienists are allowed to provide nitrous oxide analgesia and to
administer and monitor local infiltration anesthesia, but are not
currently allowed to provide block anesthesia. Block anesthesia is a
form of anesthesia that intra-orally anesthetizes an entire nerve group.
Many dental services require the use of block anesthesia and there are
no public safety issues inherent to allowing a qualified, trained dental
hygienist to administer it under the supervision of a dentist. Dental
hygienists interested in receiving certification in block anesthesia
will be required to complete additional training.
In fact, currently, 43 states allow dental hygienists to perform local
infiltration and all of those but two - New York and South Carolina also
allow for block anesthesia. This legislation will allow dental offices
to function more efficiently, thereby benefiting the patient and allow-
ing dentists and dental hygienists to provide greater access to care.
LEGISLATIVE HISTORY:
A.1046, 2021 and 2022, referred to higher education. Same as S.6399,
committed to rules in 2021 and passed Senate in 2022.
A.462, 2019 and 2020, referred to higher education. A.7732, 2017 and
2018, referred to higher education. Same as S.7200, 2018, referred to
higher education.
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
The bill shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
284
2023-2024 Regular Sessions
IN ASSEMBLY
January 4, 2023
___________
Introduced by M. of A. PAULIN, THIELE -- Multi-Sponsored by -- M. of A.
COOK -- read once and referred to the Committee on Higher Education
AN ACT to amend the education law, in relation to local block anesthesia
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 6605-b of the education law, as added by chapter
2 437 of the laws of 2001 and subdivision 1 as amended by chapter 198 of
3 the laws of 2022, is amended to read as follows:
4 § 6605-b. Dental hygiene restricted local infiltration and block
5 anesthesia/nitrous oxide analgesia certificate. 1. A dental hygienist
6 shall not administer or monitor nitrous oxide analgesia or local infil-
7 tration or block anesthesia in the practice of dental hygiene without a
8 dental hygiene restricted local infiltration and block
9 anesthesia/nitrous oxide analgesia certificate and except under the
10 personal supervision of a dentist and in accordance with regulations
11 promulgated by the commissioner. Personal supervision, for purposes of
12 this section, means that the supervising dentist remains in the dental
13 office where the local infiltration or block anesthesia or nitrous oxide
14 analgesia services are being performed, personally authorizes and
15 prescribes the use of local infiltration or block anesthesia or nitrous
16 oxide analgesia for the patient and, before dismissal of the patient,
17 personally examines the condition of the patient after the use of local
18 infiltration or block anesthesia or nitrous oxide analgesia is
19 completed. It is professional misconduct for a dentist to fail to
20 provide the supervision required by this section, and any dentist found
21 guilty of such misconduct under the procedures prescribed in section
22 sixty-five hundred ten of this title shall be subject to the penalties
23 prescribed in section sixty-five hundred eleven of this title.
24 2. The commissioner shall promulgate regulations establishing stand-
25 ards and procedures for the issuance of such certificate. Such standards
26 shall require completion of an educational program and/or course of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02127-01-3
A. 284 2
1 training or experience sufficient to ensure that a dental hygienist is
2 specifically trained in the administration and monitoring of nitrous
3 oxide analgesia and local infiltration or block anesthesia, the possible
4 effects of such use, and in the recognition of and response to possible
5 emergency situations.
6 3. The fee for a dental hygiene restricted local infiltration and
7 block anesthesia/nitrous oxide analgesia certificate shall be twenty-
8 five dollars and shall be paid on a triennial basis upon renewal of such
9 certificate. A certificate may be suspended or revoked in the same
10 manner as a license to practice dental hygiene.
11 § 2. Subdivision 1 of section 6606 of the education law, as amended by
12 chapter 239 of the laws of 2013, is amended to read as follows:
13 1. The practice of the profession of dental hygiene is defined as the
14 performance of dental services which shall include removing calcareous
15 deposits, accretions and stains from the exposed surfaces of the teeth
16 which begin at the epithelial attachment and applying topical agents
17 indicated for a complete dental prophylaxis, removing cement, placing or
18 removing rubber dam, removing sutures, placing matrix band, providing
19 patient education, applying topical medication, placing and exposing
20 diagnostic dental X-ray films, performing topical fluoride applications
21 and topical anesthetic applications, polishing teeth, taking medical
22 history, charting caries, taking impressions for study casts, placing
23 and removing temporary restorations, administering and monitoring
24 nitrous oxide analgesia and administering and monitoring local infil-
25 tration and block anesthesia, subject to certification in accordance
26 with section sixty-six hundred five-b of this article, and any other
27 function in the definition of the practice of dentistry as may be deleg-
28 ated by a licensed dentist in accordance with regulations promulgated by
29 the commissioner. The practice of dental hygiene may be conducted in the
30 office of any licensed dentist or in any appropriately equipped school
31 or public institution but must be done either under the supervision of a
32 licensed dentist or, in the case of a registered dental hygienist work-
33 ing for a hospital as defined in article twenty-eight of the public
34 health law, pursuant to a collaborative arrangement with a licensed and
35 registered dentist who has a formal relationship with the same hospital
36 in accordance with regulations promulgated by the department in consul-
37 tation with the department of health. Such collaborative arrangement
38 shall not obviate or supersede any law or regulation which requires
39 identified services to be performed under the personal supervision of a
40 dentist. When dental hygiene services are provided pursuant to a colla-
41 borative agreement, such dental hygienist shall instruct individuals to
42 visit a licensed dentist for comprehensive examination or treatment.
43 § 3. This act shall take effect immediately.
