Legislation and Rules That Affect Orthodontic Practice in California

• Regulations on Registered Orthodontic Assistant (ROA)

News of Legislation and Regulations:

Assembly Bill # 2637-Dental Auxiliaries

The Registered Orthodontic Assistant legislation is moving through the state relatively unopposed, as all stakeholders have largely agreed upon the framework for the bill.  The California Senate Committee on Business, Professions and Economic Development held a hearing on the bill on Monday, June 23rd..  The bill to amend and revise portions of the Business and Professions Code related to dentistry was authored by Assemblyman Eng, has been referred to the Senate Appropriations Committee. 

Background information:

Recent talks between numerous dental organizations, including CAO, working to develop regulations governing the training of ROA’s and other specialty assistant categories, have concluded that a final agreement that would allow existing dental assisting education programs to conform to new standards could not be reached by the January 1, 2007 legislative deadline.

We expect legislation to be approved that postpones that deadline to January 1, 2008.

For much of this year, CAO leaders have been working with CDA, the dental assistant alliance, the Committee on Dental Assistants (COMDA), and the Dental Board regarding a new specialty assistant training curriculum.

In early negotiations, on-the-job training (OJT) was eliminated as an educational pathway.  Since that time, with the insistence of a number of dental specialty groups including CAO, the “in-office” educational model has been reconsidered as a training option. CAO continues to insist on this alternative training pathway.

The school-based program proposed by the assisting community relies primarily on didactic and pre-clinical education, with less emphasis on practical experience.

Overall, CAO has proposed the implementation of regulations that will define the education and training requirements necessary to achieve minimum competence in the duties a registered orthodontic assistant is authorized to perform. Such an approach takes into account the combination of didactic and practical instruction, clinical training, and supervised work experience, that when taken together are most likely to provide the greatest number of opportunities for improving dental assisting skills efficiently.

“The goal is to encourage entrance into the dental profession, create a career ladder, redesign the education and training to be responsive to the contemporary practice of dentistry, maximize office productivity, and reduce the need for dentists to provide additional training to assistants” said Cathy Mudge, assistant vice president of CDA Public Policy.

Those who achieve RDA status before January 1, 2007 will be allowed to perform all specialty assistant duties, with a few exceptions that will require additional training, including the selecting, pre-positioning, curing, and removing of brackets. And those seeking ROA status will be required to successfully complete the ROA training and not the standard RDA courses.

After Jan. 1, 2007, those seeking RDA status will be required to complete the training programs that teach all the new duties for each specialty assistant category. Again, those seeking ROA category will only be required to complete the ROA training and not that for the RDA.

The project of developing specialty assistant categories began about ten years ago when COMDA started a state mandated review of dental assisting. Little progress was made over the years until scope of practice legislation was passed in 2002 and discussions began shortly thereafter about specialty dental assisting categories.

CAO leaders believe the new ROA program has the potential to increase the pool of qualified orthodontic staff, which will positively affect access to dental care. However, the debate over the regulatory language will ultimately decide the likelihood of this increased orthodontic (and other specialty) staff availability.

Assuming thdeadline is e postponed to January 1, 2007, training programs will begin accepting students soon after that date. Although we expect training to be available in early 2007, the Dental Board will not be able to issue licenses for the specialty assistants until January 2008.

More on RDA Licensure Requirements.

Senate Bill # 1634-Health Care Coverage, Cleft Palate ("Congenital Orofacil Anomalies: Orthodontic Services")

This bill would require health care service plan contracts and policies to cover orthodontic services deemed medically necessary by a cleft palate or craniofacial team.  The California Senate Committee on Health  held a hearing on Tuesday, June 24th and referred the measure back to the California Assembly Committee on Appopriations.  The bill, authored by Senators Steinberg, Aanestad and Cedillo would amend sections of the Health and Safety Code and Insurance Code relating to health care coverage. 

Summary of CDC Guidelines for Infection Control in Dentistry

The Center for Disease Control and Prevention (CDC) released  guidelines for infection control for dentistry on December 19, 2003 - 10 years after the previous update of such guidelines.

Download a summary of how the new CDC guidelines may effect California orthodontists (PDF- 37KB).

You can view the full 68 page guideline at: www.cdc.gov/OralHealth/infectioncontrol/guidelines/index.htm.

For further information on state regulations and dental practice in California, please click here.