House OK’s bill allowing dental hygienists to fill cavities, perform other basic services

TOPEKA — A bill that would let specially trained dental hygienists do temporary fillings, pull baby teeth and perform other basic dental services passed the House unanimously today.

The idea behind the measure is to free the limited number of dentists at urban and rural clinics to spend their time on more complicated work.

House Bill 2631 creates a new class of “Level III” hygienists who would receive more training than regular hygienists.

In addition to the cleaning and decay prevention functions now performed by hygienists, a Level III hygienist would be allowed to:

– Identify and remove decay, and place a temporary filling.

– Adjust dentures and check for sore spots.

– Extract loose baby teeth.

– Smooth sharp edges on teeth with powered drills.

– Use local dental anaesthesics, within limits.

Level III hygienists would be allowed to work with prisons, indigent health care clinics, low-income seniors and the developmentally disabled. They could also serve children in state custody, foster children and other children who meet the legal definition of dentally underserved.

A separate bill that would have provided for a larger expansion of services that could be performed by nondentists died after opposition from dentists, said state Rep. Geraldine Flaharty, D-Wichita.

The bill approved today had no organized opposition and passed the House 120-0.

Rep. Jim Ward, D-Wichita, called it a “baby step” toward broader dental services for the poor.

He said the concept is to help to low-cost clinics, such as the GraceMed Clinic in Wichita, that provide dental services to the poor.

“This helps them deliver services to a population, usually on Medicaid, that (private) dentists won’t take,” he said.

Dave Sanford, chief executive officer at GraceMed, characterized the vote as “a very small step in the right direction,” but added “it doesn’t come near to what really needs to happen” to improve access to dental services in Kansas.

He said the clinic has no plans to have dental hygienists perform the kind of services allowed by HB 2631. In fact, in many cases, it would increase costs for the clinic and inconvenience for patients, he said.

For example, if a hygienist did a temporary filling at a remote site, the patient would still need to come to the main clinic for their permanent filling.

He said it would be much more helpful to create a category for “registered dental practitioners,” who would be allowed to perform more permanent restorative services for hard-to-serve populations.

He said Fort Hays State University has offered to create such a program to train practitioners to provide basic service in western Kansas, which is suffering a dentist shortage.

He said the dental practitioner bill is likely to come up again next year.

“Hopefully it (HB 2631) gets us a step forward toward the registered dental practitioners,” he said. “That really would start to expand access to care.”