Legislation under consideration could give Indiana dental hygienists more freedom in their work.
House Bill 1061 regards dental hygiene practice. As written, it would allow hygienists at a private practice to perform duties without a dentist on site, as long as the patient has been examined by a dentist within a certain time frame.
If approved, it would broaden opportunities for people to receive dental care, because hygienists would not have to rely on the presence of a dentist, said Munster resident Eileen Curosh, a trustee for the Indiana Dental Hygienists Association who works as a dental hygienist in Dyer.
"It opens up doors for dental hygienists who are underemployed and unemployed," she said.
Curosh was one of four hygienists who testified earlier this week in support of the bill. State Rep. Ed Clere, R-New Albany, chairman of the Public Health Committee, said the bill will be up for committee amendments and a vote on Wednesday.
The group representing Indiana dentists is not comfortable with the bill as is.
"We would not be able to support the bill in its current form," said Doug Bush, executive director of the Indiana Dental Association.
The association suggested amendments to the public health committee and would consider supporting the bill if those changes are made. The changes involve inserting controls and parameters in the bill to protect patient safety, he said.
The bill states that a hygienist in a private practice has 90 days from the time a dentists prescribes care to get the work done on a patient, but the dental association supports closing that window to no more than 45 days, Bush said.
"For some patients, their condition can change significantly in 90 days," he said.
That is especially concerning for children, those in nursing homes and people with disabilities, he said.
The bill also would allow hygienists to administer nitrous oxide – commonly known as laughing gas – to patients.
"We are suggesting there be some specific requirements on the use of that analgesic," Bush said.
The dental association recommended the legislation include training specifications.
"We're just trying to put some safety guidelines in place," he said.
In her testimony, Curosh spoke in favor of hygienists having the ability to administer nitrous oxide under director supervision of a dentist.
"Hygienists currently receive education for nitrous oxide and I am confident that the ISBDE (Indiana State Board of Dental Examiners) would provide the rules and regulations that would make it safe for all residents of our state," she said.
Curosh testified that she supports the removal of restrictions on prescriptive care.
She referenced House Bill 1172, which Indiana passed in 2008. It allowed dental hygienists to give local anesthesia and to practice under prescriptive supervision in public health facilities.
Curosh said the restrictions in that bill have made it underutilized.
"In order to achieve access to care, the limitations need to be changed," she said. "Many Hoosiers live in rural areas that lack access to care and many live in inner cities. Hygienists should be able to work in public health facilities and long term care facilities without a dentist physically present. Hygienists should be able to work in schools, again without a dentist physically present."
Currently, if a dentist is late to work, late back from lunch or takes a day off unexpectedly, the hygienist cannot work on patients, Curosh said.