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Association testifies in favor of teledentistry bill

Dr. Brad Hylan testified last week before the Ohio Senate Health, Human Services & Medicaid Committee in favor of House Bill 184. The bill provides for teledentistry in Ohio.

Below is the testimony provided by Dr. Hylan:

Mr. Chairman, Ranking Member and members of the committee - I am Brad Hylan, DDS, Board Member of the Ohio EFDA Association.

I am presenting the Ohio EFDA Association’s testimony in support of Substitute House Bill 184. We are grateful to Representatives Gavarone and DeVitis and to the Ohio Dental Association for bringing this bill forward.

HB 184 establishes a responsible way to utilize telemedicine while using the whole dental care delivery team to ensure that those in Ohio’s “hard to reach” places have access to basic oral health.

We want to specifically address the use of EFDAs in telemedicine.

First let us give you a brief introduction to EFDAs. Ohio created Expanded Function Dental Auxiliaries by law in 1976.

An Ohio EFDA is a certified dental assistant (CDA), certified Ohio dental assistant (CODA), or a licensed dental hygienist who has graduated from an expanded functions training program and passed the Ohio EFDA state board.

Dental students and foreign-trained dentists may also become EFDAs.

EFDAs are permitted to perform advanced remedial intra-oral procedures that involve the placement of preventative or restorative materials limited to sealants and metallic and nonmetallic restorative materials. Almost all EFDAs are also certified for radiology, and take x-rays.

Our profession, whether called EFDAs or by another name, exists in nearly all the states. Recognition of them varies from state-to-state between licensure, certification, and registration.

In Ohio, EFDAs are registered with the Ohio State Dental Board, though our training could easily be described as licensure-level. And while we are currently not required to complete continuing education for registration renewal, our profession would welcome it.

The Board may grant registration to practice as an expanded function dental auxiliary in the State of Ohio to applicants meeting the following requirements:

• Complete an EFDA education or training course accredited by the Commission on Dental Accreditation of the American Dental Association or the higher learning commission of the North Central Association of Colleges and Schools;

• Proof of having successfully passed the examination administered by the Commission on Dental Testing in Ohio or the Commission on Dental Competency Assessments.

• Proof of current certification to perform basic life-support procedures certified by either the American Red Cross, the American Heart Association or the American Health and Safety Institute; and

• Provide a copy of a vaccination record showing one of the following: all THREE legible dates or the 1st and 2nd shot dates with the third being scheduled.

All of this may only be done AFTER the EFDA candidate completes all the requirements to become a certified dental assistant (CDA), certified Ohio dental assistant (CODA), or a licensed dental hygienist.

Ohio’s EFDAs are well-trained to perform the duties prescribed in House Bill 184 in a teledentistry setting.

The bill allows EFDAs to provide services when a dentist is not present as long as he or she is employed by the dentist, an associate dentist or entity, or a government agency.

In a teledentistry setting, the bill allows EFDAs to perform the following:

• Application of pit and fissure sealants;

• Recementation of temporary crowns;

• Application of topical fluoride;

• Application of fluoride varnish;

• Application of disclosing solutions;

• Application of desensitizing agents;

• Caries susceptibility testing;

• Instruction on oral hygiene home care (brush & floss)

• Additional procedures as authorized by the Dental Board in rules.

• The bill also allows EFDAs to provide services when the dentist is available through synchronous, real-time communication.

• The bill specifies that the dentist is responsible for safety and quality of service when using teledentistry.

• Under current law, neither EFDAs nor hygienists are allowed to place interim therapeutic restorations or apply silver diamine flouride. The bill allows it with training requirements:

• One year and 1500 hours experience;

• Completion of an emergency prevention course;

• A skills evolution by the dentist;

• Compliance with written protocols established by the dentist.

Most of the duties prescribed in HB 184 are not new to EFDAs and our profession is well trained to perform them in a teledentistry setting under the direction of a licensed dentist.

It is the strong belief of our association that dental care in Ohio is rightly driven by licensed dentists. The dentist is responsible for patient safety, quality of care, and assumes all liability not only for himself or herself but for the entire care delivery team.

Ohio’s dentists believe that EFDAs are trained and qualified to perform the duties identified in HB 184 in a teledentistry setting.

Our association appreciates the recognition of the profession in this bill and believes that together we can make significant gains in access to dental care in our state.

We urge your support for Substitute House Bill 184.

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