A dentist may not delegate certain dental procedures or anesthesia tasks to unqualified people, and local anesthetic delegation to a dental hygienist is allowed only if all listed conditions are met.
Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not delegate: (1) an act to an individual who, by board order, is prohibited from performing the act; (2) any of the following acts to a person not licensed as a dentist or dental hygienist: (A) the removal of calculus, deposits, or accretions from the natural and restored surfaces of exposed human teeth and restorations in the human mouth; (B) root planing or the smoothing and polishing of roughened root surfaces or exposed human teeth; or (C) any other act the delegation of which is prohibited by board rule; (3) any of the following acts to a person not licensed as a dentist: (A) comprehensive examination or diagnosis and treatment planning; (B) a surgical or cutting procedure on hard or soft tissue; (C) the prescription of a drug, medication, or work authorization; (D) the taking of an impression for a final restoration, appliance, or prosthesis; (E) the making of an intraoral occlusal adjustment; (F) direct pulp capping, pulpotomy, or any other endodontic procedure; (G) the final placement and intraoral adjustment of a fixed or removable appliance; or (H) the placement of any final restoration; (4) the authority to an individual to administer a local anesthetic agent, inhalation sedative agent, parenteral sedative agent, or general anesthetic agent, including as a teledentistry dental service as that term is defined by Section 111.001, if the individual is not licensed as: (A) a dentist with a permit issued by the board for the procedure being performed, if a permit is required; (B) a certified registered nurse anesthetist licensed by the Texas Board of Nursing, only if the delegating dentist holds a permit issued by the board for the procedure being performed, if a permit is required; or (C) a physician anesthesiologist licensed by the Texas Medical Board; or (5) the authority to a dental hygienist to administer a local anesthetic agent unless: (A) the dental hygienist: (i) administers the local anesthetic agent by infiltration for purposes of a procedure the dental hygienist is authorized to perform; (ii) has passed a board-approved certification examination relating to the administration of a local anesthetic agent; (iii) either: (a) has completed a board-approved course of study designed to train dental hygienists to administer a local anesthetic agent by infiltration; or (b) during the preceding year, was authorized to administer a local anesthetic agent by: (1) a branch of the United States armed forces; or (2) another state with clinical and didactic education requirements substantially equivalent to the requirements of a course approved by the board under Sub-subparagraph (a); and (iv) complies with any applicable rules adopted by the board establishing minimum standards for the administration of a local anesthetic agent; (B) the delegating dentist is physically present in the facility where the procedure is occurring and is continuously aware of the patient's physical status and well-being; and (C) the patient to whom the local anesthetic agent is administered is: (i) at least 18 years of age; and (ii) not sedated, or is sedated using only nitrous oxide-oxygen inhalation. Added by Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999. Amended by: Acts 2007, 80th Leg., R.S., Ch. 889 (H.B. 2426), Sec. 37, eff. September 1, 2007. Acts 2021, 87th Leg., R.S., Ch. 811 (H.B. 2056), Sec. 14, eff. September 1, 2021. Acts 2023, 88th Leg., R.S., Ch. 868 (H.B. 3824), Sec. 1, eff. September 1, 2023.