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: A284B Revised: 3/26/24
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 2 of the bill adds a new, higher level of certif-
ication, the dental hygiene block anesthesia certificate, which will
allow certified dental hygienists to administer or monitor block anes-
thesia under the supervision of a licensed dentist.
Subdivision 3 specifies that the commissioner shall establish the stand-
ards and procedures for the issuance of each certificate.
Subdivision 4 provides that the department shall charge $25 triennially
for the issuance of each 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 one year after it
shall have become law.
JUSTIFICATION:
Dental hygienists are currently allowed to provide nitrous oxide analge-
sia and to administer and monitor local infiltration anesthesia, but are
not authorized 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.
This bill provides for two separate certificates, the first of which
reflects the current status of the law requiring a dental hygienist to
obtain a certificate in order to administer or monitor nitrous oxide
analgesia or local infiltration anesthesia. This bill further creates a
second, higher level of certification building on the first, which would
authorize certified dental hygienists to administer or monitor block
anesthesia as well as nitrous oxide analgesia or local infiltration.
Hygienists interested in receiving certification in block anesthesia
will be required to complete additional training on top - but not dupli-
cative of - the training required for the Dental hygiene restricted
local infiltration anesthesia/nitrous oxide analgesia certificate. The
dental hygiene restricted local infiltration anesthesia/nitrous oxide
analgesia certificate is a prerequisite to the block anesthesia certif-
icate.
Currently, 43 states allow dental hygienists to perform local infil-
tration 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 5.6399,
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 5.7200, 2018, referred to
higher education.
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This bill shall take effect one year after it shall have become law.
STATE OF NEW YORK
________________________________________________________________________
284--B
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 --
recommitted to the Committee on Higher Education in accordance with
Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- again
reported from said committee with amendments, ordered reprinted as
amended and recommitted to said committee
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
5 anesthesia/nitrous oxide analgesia certificate. 1. A dental hygienist
6 shall not administer or monitor nitrous oxide analgesia or local infil-
7 tration anesthesia in the practice of dental hygiene without a dental
8 hygiene restricted local infiltration anesthesia/nitrous oxide analgesia
9 certificate and except under the personal supervision of a dentist and
10 in accordance with regulations promulgated by the commissioner. Personal
11 supervision, for purposes of this section, means that the supervising
12 dentist remains in the dental office where the local infiltration anes-
13 thesia or nitrous oxide analgesia services are being performed,
14 personally authorizes and prescribes the use of local infiltration anes-
15 thesia or nitrous oxide analgesia for the patient and, before dismissal
16 of the patient, personally examines the condition of the patient after
17 the use of local infiltration anesthesia or nitrous oxide analgesia is
18 completed. It is professional misconduct for a dentist to fail to
19 provide the supervision required by this section, and any dentist found
20 guilty of such misconduct under the procedures prescribed in section
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02127-04-4
A. 284--B 2
1 sixty-five hundred ten of this title shall be subject to the penalties
2 prescribed in section sixty-five hundred eleven of this title.
3 2. Dental hygiene block anesthesia certificate. A dental hygienist
4 shall not administer or monitor block anesthesia in the practice of
5 dental hygiene without a dental hygiene restricted local infiltration
6 anesthesia/nitrous oxide analgesia certificate and a dental hygiene
7 block anesthesia certificate and except under the personal supervision
8 of a dentist authorized by law and in accordance with regulations
9 promulgated by the commissioner. Personal supervision, for purposes of
10 this section, means that the supervising dentist remains in the dental
11 office where the block anesthesia services are being performed,
12 personally authorizes and prescribes the use of block anesthesia for the
13 patient and, before dismissal of the patient, personally examines the
14 condition of the patient after the use of block anesthesia is completed.
15 It is professional misconduct for a dentist to fail to provide the
16 supervision required by this section, and any dentist found guilty of
17 such misconduct under the procedures prescribed in section sixty-five
18 hundred ten of this title shall be subject to the penalties prescribed
19 in section sixty-five hundred eleven of this title.
20 3. The commissioner shall promulgate regulations establishing stand-
21 ards and procedures for the issuance of such [certificate] certificates.
22 Such standards shall require completion of an educational program and/or
23 course of training or experience appropriate to each certificate and
24 sufficient to ensure that a dental hygienist is specifically trained in
25 the administration and monitoring of nitrous oxide analgesia and local
26 infiltration anesthesia or is specifically trained in the administration
27 and monitoring of block anesthesia, the possible effects of such use,
28 and in the recognition of and response to possible emergency situations.
29 [3.] 4. The fee for a dental hygiene restricted local infiltration
30 anesthesia/nitrous oxide analgesia certificate shall be twenty-five
31 dollars and the fee for a dental hygiene block anesthesia certificate
32 shall be twenty-five dollars and shall be paid on a triennial basis upon
33 renewal of such certificate. A certificate may be suspended or revoked
34 in the same manner as a license to practice dental hygiene.
35 § 2. Subdivision 1 of section 6606 of the education law, as amended by
36 chapter 239 of the laws of 2013, is amended to read as follows:
37 1. The practice of the profession of dental hygiene is defined as the
38 performance of dental services which shall include removing calcareous
39 deposits, accretions and stains from the exposed surfaces of the teeth
40 which begin at the epithelial attachment and applying topical agents
41 indicated for a complete dental prophylaxis, removing cement, placing or
42 removing rubber dam, removing sutures, placing matrix band, providing
43 patient education, applying topical medication, placing and exposing
44 diagnostic dental X-ray films, performing topical fluoride applications
45 and topical anesthetic applications, polishing teeth, taking medical
46 history, charting caries, taking impressions for study casts, placing
47 and removing temporary restorations, administering and monitoring
48 nitrous oxide analgesia and administering and monitoring local infil-
49 tration and administering and monitoring block anesthesia, subject to
50 certification in accordance with section sixty-six hundred five-b of
51 this article, and any other function in the definition of the practice
52 of dentistry as may be delegated by a licensed dentist in accordance
53 with regulations promulgated by the commissioner. The practice of dental
54 hygiene may be conducted in the office of any licensed dentist or in any
55 appropriately equipped school or public institution but must be done
56 either under the supervision of a licensed dentist or, in the case of a
A. 284--B 3
1 registered dental hygienist working for a hospital as defined in article
2 twenty-eight of the public health law, pursuant to a collaborative
3 arrangement with a licensed and registered dentist who has a formal
4 relationship with the same hospital in accordance with regulations
5 promulgated by the department in consultation with the department of
6 health. Such collaborative arrangement shall not obviate or supersede
7 any law or regulation which requires identified services to be performed
8 under the personal supervision of a dentist. When dental hygiene
9 services are provided pursuant to a collaborative agreement, such dental
10 hygienist shall instruct individuals to visit a licensed dentist for
11 comprehensive examination or treatment.
12 § 3. This act shall take effect one year after it shall have become a
13 law.
