Rule Promulgation for RDH to Administer Local Anesthesia Under General Supervision

What's to Come from Recent Dental Board Actions

by Vicki Wilbers, MDA Executive Director

The MDA at its House of Delegates in 2021 and 2022 addressed the crippling amount of dental team shortages across the state of Missouri. These shortages continue to plague Missouri, especially in rural areas. In 2022 the MDA addressed changes to existing policies of the Association to ensure a seat at the table as changes are being considered by legislators and regulators when it comes to serving the oral health care needs of the underserved. 

Although the MDA has been in support of pilot projects whereby changes are made to scope of practice in small-scaled projects—in this instance, allowing local anesthesia to be administered by a registered dental hygienist (RDH) under general supervision of a dentist—something else morphed during the recent dental board meeting. 

The Missouri Dental Board (MDB) met on January 20, 2023 in open session. The Board again reviewed the request of the Missouri Dental Hygienists Association to consider a full promulgation of a rule to allow for RDHs to administer local anesthesia under general supervision. 

Concerns were expressed related to the RDH not being able to appropriately manage emergencies and regarding RDHs not having the ability to diagnosis conditions within their scope of practice. MDA expressed the need to first conduct a pilot program to assess the effectiveness and safety of this allowance prior to establishing a rule.

Regardless of these concerns expressed, the MDB adopted a motion to promulgate this rule. This means the MDB will outline the specific language to make a rule change and bring this back to the April MDB meeting. If that language is approved by the Board, the rule change language would go through the full rule promulgation process. The rule would be posted in the Missouri Register for 30 days, allowing for a public comment period, whereby anyone can make their support or opposition known to the adoption of said rule.