Sec. 258.001. IMPERMISSIBLE DELEGATIONS. A dentist may not delegate: (1) an act to an individual who, by board order, is prohibited from performing the act; (2) any of the following acts to a person not licensed as a dentist or dental hygienist: (A) the removal of calculus, deposits, or accretions from the natural and restored surfaces of exposed human teeth and restorations in the human mouth; (B) root planing or the smoothing and polishing of roughened root surfaces or exposed human teeth; or (C) any other act the delegation of which is prohibited by board rule; (3) any of the following acts to a person not licensed as a dentist: (A) comprehensive examination or diagnosis and treatment planning; (B) a surgical or cutting procedure on hard or soft tissue; (C) the prescription of a drug, medication, or work authorization; (D) the taking of an impression for a final restoration, appliance, or prosthesis; (E) the making of an intraoral occlusal adjustment; (F) direct pulp capping, pulpotomy, or any other endodontic procedure; (G) the final placement and intraoral adjustment of a fixed or removable appliance; or (H) the placement of any final restoration; (4) the authority to an individual to administer a local anesthetic agent, inhalation sedative agent, parenteral sedative agent, or general anesthetic agent, including as a teledentistry dental service as that term is defined by Section 111.001 , if the individual is not licensed as: (A) a dentist with a permit issued by the board for the procedure being performed, if a permit is required; (B) a certified registered nurse anesthetist licensed by the Texas Board of Nursing, only if the delegating dentist holds a permit issued by the board for the procedure being performed, if a permit is required; or (C) a physician anesthesiologist licensed by the Texas Medical Board; or (5) the authority to a dental hygienist to administer a local anesthetic agent unless: (A) the dental hygienist: (i) administers the local anesthetic agent by infiltration for purposes of a procedure the dental hygienist is authorized to perform; (ii) has passed a board-approved certification examination relating to the administration of a local anesthetic agent; (iii) either: (a) has completed a board-approved course of study designed to train dental hygienists to administer a local anesthetic agent by infiltration; or (b) during the preceding year, was authorized to administer a local anesthetic agent by: (1) a branch of the United States armed forces; or (2) another state with clinical and didactic education requirements substantially equivalent to the requirements of a course approved by the board under Sub-subparagraph (a); and (iv) complies with any applicable rules adopted by the board establishing minimum standards for the administration of a local anesthetic agent; (B) the delegating dentist is physically present in the facility where the procedure is occurring and is continuously aware of the patient's physical status and well-being; and (C) the patient to whom the local anesthetic agent is administered is: (i) at least 18 years of age; and (ii) not sedated, or is sedated using only nitrous oxide-oxygen inhalation.
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