Panel supports expanding independent dental hygienists’ authority with training and board oversight
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Summary
Witnesses including the Maine Dental Hygiene Association, Maine Dental Association, IPDH network and OPOR urged the committee to let independent practice dental hygienists administer local anesthesia and nitrous oxide if they secure board practice authorities and complete existing training; committee members asked for data on risks, malpractice, and interstate practice.
Representative Anne Marie Mastracchio told the committee LD 2030 would allow independent practice dental hygienists (IPDHs) who obtain the proper practice authority from the Board of Dental Practice to administer local anesthesia and nitrous oxide analgesia without a dentist present, expanding services IPDHs already provide to many MaineCare and underserved patients.
Bonnie Vaughn, past president of the Maine Dental Hygiene Association, said independent hygienists routinely serve adults covered by MaineCare and uninsured patients and often treat people who have not seen a dental provider for years. She told the committee that hygienists trained in local anesthesia perform procedures such as deep scaling and root planning and that board complaints about hygienist‑administered anesthesia have been “exceedingly rare.”
Therese Cahill, executive director of the Maine Dental Association, said the association supports LD 2030 if IPDHs have training and licensure authorities and encouraged collaborative partnerships with dentists for consultation. Courtney Vanna of the IPDH networking group said allowing anesthesia in IPDH practices can be the difference between patients receiving needed oral care and going without it.
Penny Valancourt of OPOR provided licensing counts: 1,466 licensed dental hygienists in Maine; 286 of those are IPDHs; 201 IPDHs hold local anesthesia authority; and 78 hold both local anesthesia and nitrous oxide authorities. Committee members probed differences in curricula, continuing education for out‑of‑state practitioners, whether a supervisory or mentoring period is needed, malpractice insurance requirements (not required under the Dental Practice Act), and data on adverse events. OPOR and witnesses said training programs include semester‑long courses on anesthetic administration and that the board’s standards of practice and reporting requirements are safeguards; they encouraged the board to review rules if the law changes.
The committee closed the public hearing after extensive questioning and requested additional information for work session consideration, including data on interstate practice models, adverse events, and potential implementation safeguards.