The leadership of the North Carolina Dental Society has reviewed Dr. Meskin’s editorial, "Look Who’s Practicing Dentistry?" (October JADA). The editorial is based on an incorrect statement of North Carolina law.
The editorial correctly refers to the development of a program in North Carolina that allows medical auxiliary personnel in the offices of pediatricians and medical family practitioners to offer screening for oral disorders, to apply fluoride varnish and to counsel the caregivers of Medicaid-eligible children up to the age of 3 years. As stated in the editorial, this program was encouraged by public concerns regarding inadequate access to dental services by segments of the Medicaid population.
However, the editorial incorrectly states that "state-employed dental hygienists cannot participate [in the screening, fluoride varnish and counseling program], since their dental practice act requires them to be under the direct supervision of dentists."
In fact, North Carolina law specifically provides that public health dental hygienists, employed by or under contract with the State Public Health Dental Program or local health departments, who are working under direction of a public health dentist and serving local or state government program patients are excepted from the state’s general requirement of on-site, direct dentist supervision.
Relevant sections of the General Statutes of North Carolina, Article 16 of Chapter 90, the "Dental Hygiene Act," provide as follows:
" ‘Supervision’ as used in this Article shall mean that acts are deemed to be under the supervision of a licensed dentist when performed in a locale where a licensed dentist is physically present during the performance of such acts and such acts are being performed pursuant to the dentist’s order, control and approval."1
"A dental hygienist may practice only under the supervision of one or more licensed dentists. This subsection shall be deemed to be complied with in the case of dental hygienists employed by or under contract with a local health department or state government dental public health program and especially trained by the Dental Health Section of the Department of Health and Human Services as public health hygienists, while performing their duties for the persons officially served by the local health department or state government program under the direction of a duly licensed dentist employed by that program or by the Dental Health Section of the Department of Health and Human Services."2
Under this statutory authority, state-employed public health hygienists in North Carolina, working under direction of public health dentists, are authorized by law to perform screening, to apply fluoride varnish and to provide counseling services without on-site direct dentist supervision and, in fact, they have been doing so.
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REFERENCES
90–221(f)(1981).