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STATE OF MICHIGAN  
MICHIGAN OFFICE OF ADMINISTRATIVE HEARINGS AND RULES  
DEPARTMENT OF LICENSING and REGULATORY AFFAIRS  
BUREAU OF PROFESSIONAL LICENSING  
-   -   -  
PUBLIC HEARING   
Friday, September 18, 2020  
1:00 p.m.  
-   -   -  
Held on-line via Zoom  
under Executive Order 2020-154  
 
 
-   -   -  
Re:     Dentistry - General Rules (MOAHR #2020-27-LR)  
 
HEARING FACILITATOR:  
Andria Ditschman, Analyst  
Bureau of Professional Licensing  
611 West Ottawa Street  
Lansing, Michigan  48909  
 
Also Present:   
     Kerry Ryan Przybylo  
     LeAnn Payne  
     Kimmy Catlin  
 
 
Reported by:  Marie T. Schroeder, CSR-2183  
    Metro Court Reporters, Inc.  
 
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Lansing, Michigan  
Friday, September 18, 2020  
1:00 p.m.   
-   -   -  
(Proceedings held via Zoom on-line)  
MS. DITSCHMAN:  My name is Andria  
Ditschman and I am an analyst for the Bureau of  
Professional Licensing in the Department of Licensing and  
Regulatory Affairs.  I'll be conducting the hearing  
today.  
This is a public hearing on proposed  
administrative rules entitled "Dentistry - General  
Rules."  We're conducting the hearing as required by the  
Administrative Procedures Act to allow the public to  
comment on the proposed changes to this rule set.  As  
with all other public hearings on draft rule sets, the  
only items discussed during this hearing will be the  
proposed changes to the rule set.  This hearing will not  
be covering any questions or discussions on any other  
issues.  
We are calling this hearing to order at  
1:00 p.m. on September 18, 2020, via Zoom under Executive  
Order 2020-154 in response to the COVID-19 pandemic.  The  
notice of public hearing was published in three  
newspapers of general circulation, the Grand Rapids Press  
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and the Flint Journal on September 6, 2020, and the  
Mining Journal on September 4, 2020, as well as the  
Michigan Register, Issue 16-2020, published on  
September 15, 2020.  
All comments should relate directly to  
the proposed rules.  If you have questions about the  
rules, you may place your comments on the record and the  
Department will review and consider them.  If you have  
suggested changes to the rules, please include the  
specific reasons why the changes should be in the public  
interest.  
We will take comments in the following  
manner:  For those using the Video Conference portion,  
those not calling on the telephone, we will use the Raise  
Your Hand feature in Zoom.  And I will call on  
individuals to speak and then they will be unmuted at  
that time.  So you unmute yourself, speak, and then mute  
yourself again.  
For participants that are available only  
by telephone, after we're done doing those by video  
conference we'll take those by telephone, and we will ask  
you to make comments.  
If you have a comment but do not wish to  
speak, you can please note that the Department will allow  
written comments, statements, emailed or postmarked to  
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BPL-BoardSupport@michigan.gov until 5:00 p.m. today.  
Also, if you are on the phone, to unmute  
yourself you will press *6.  
Those making comments should clearly and  
slowly say and spell your name and advise if you are  
speaking on behalf of yourself or an organization.  We  
will limit comments to three minutes per person.  
Remember that only one person can speak at a time.  
Other department staff from the Bureau of  
Professional Licensing attending today are Kerry  
Przybylo, LeAnn Payne, and Kimmy Catlin.  
So we will start now with those on Zoom.  
And you need to use the Raise Your Hand if you would like  
to speak.  
KERRY PRZYBYLO:  This is Kerry Przybylo  
speaking.  The reaction button at the bottom of your  
screen is where you can find the opportunity to Raise  
Your Hand.  
(Pause.)  
MS. CATLIN:  It looks like Ona has her  
hand up, Erdt.  
MS. ERDT:  Yes, hello.  My name is Ona  
Erdt, O-n-a, E-r-d-t.  And I am speaking on behalf of the  
Michigan Dental Assistants Association.  I am the  
Judicial Committee Chairman.  And we have several  
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comments and suggestions for the proposed rule changes.  
May I just go ahead and just get started?  
KERRY PRZYBYLO:  Yes.  
MS. ERDT:  O.K.  So Rule 338.11411.  
Under (b), Holding matrix for anterior resin restoration,  
we are recommending that that be removed from the rule.  
Rationale being that the MDAA feels that this is a duty  
for dental assistants, RDAs, RDHs, and it would just be  
compared to a second pair of hands as opposed to a duty.  
From our research it does not appear to be in the Public  
Health Code, so it could just be a rule removal.  
And I just keeping going, right, through  
my list?  O.K.    
The next one is under rule (i).  We are  
recommending that it be removed, that this be under  
assignment to the dental assistants.  And it is Removing  
orthodontic bands, brackets, and adhesives with  
non-tissue cutting issue.  The MDAA feels this is not an  
appropriate duty to assign to a non-licensed dental  
assistant.  It's our professional stance that no further  
duties should be assigned to a non-licensed assistant  
until they have been named in the Public Health Code and  
are required to have CPR inclusive education like all  
other dental providers.  A standard has been set for our  
industry and therefore it's not in the best interests of  
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the public to allow more duties.  In addition, the dental  
assistant is defined as a non-licensed person who may  
perform basics before each procedure.  Removing brackets  
and cement are pretty involved and non-basic and require  
formal education.  Orthodontic brackets, bands, and  
adhesive materials often are located subgingivally, and  
the RDA and RDH have training in that anatomy and soft  
tissue intraoral attachments and more.  But if -- but  
dental assistants that aren't licensed don't have that  
training.    
Under (o), we would like to recommend  
adding assignments of option to the dental assistants of  
applying commonly accepted medical emergency procedures,  
including CPR.  Medical emergencies are unpredictable and  
they can happen at any time, and many offices at times  
merely have office personnel who are non-licensed on the  
premise.  All team members should be knowledgeable and  
ready to provide medical care if needed.  The American  
Dental Association states that (inaudible) through  
academic and continuing education should be familiar with  
the prevention, diagnosis, and management of current --  
I'm sorry, of common emergency.  In addition, they should  
provide appropriate training to their staff so each  
person knows what to do and can act promptly.  The dental  
profession has set a standard of care for its members,  
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and therefore all dental team members should be trained,  
including the dental assistants.  
Under (u), we recommend removing this  
duty for the registered dental hygienist.  Currently RDAs  
and RDHs can cement and glue temporaries, and the RDAs  
can also place them.  The proposed language adds  
replacing for the RDH.  The RDA is formally trained to  
make temporaries, and it's in their clinical exam as  
well.  And it's the MDAA's stance that the duty of  
replacing not be provided to the RDH as their education  
does not provide the training, nor does their exam have a  
temporary clinical component like it does with the RDA.  
Rule (aa), we are recommending a change.  
Taking impressions for intraoral appliances including  
bite restorations is what it currently says.  
KERRY PRZYBYLO:  Ona?  
MS. ERDT:  Yes.  
KERRY PRZYBYLO:  Can I ask that you  
please slow down?  When you read, you speak a lot faster  
and the Court Reporter is having trouble keeping up with  
you.  So if you could just slow your pace a little bit,  
please.  
MS. ERDT:  You got it.  So for Rule (aa),  
it says Taking impressions for intraoral appliances,  
including bite restorations.  And we think that's  
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probably a type-o, and it should probably be taking  
impressions for intraoral appliances including bite  
registrations, as opposed to restorations.  So we are  
recommending that change.  
For (qq), we were hoping to get  
clarification why it is in there for Applying  
anticariogenic agents including, but not limited to,  
sealants, fluoride varnish, and fluoride applications.  
And that's what (s) says.  And then (z) says Applying  
desensitizing agents.  But then (qq) like combines all of  
these in one line.  But they already have been assigned  
that in lines (s) and (z).  So it seems kind of  
repetitive and kind of confusing why that is being added.  
(ss), we are hoping to get clarification.  
Again this is adding something for the RDH, and we are  
wondering what the difference is between line (ss) when  
line (q) says Classifying occlusion is already a duty  
they have.  (y) says Performing pulp vitality testing.  
So what is the difference between those and this (ss)  
that says Preliminary examining that includes both  
classifying occlusion and testing pulp vitality using an  
electric pulp tester.  
So we would like to understand what the  
implications are of this preliminary examining that's  
been added to the beginning of that sentence, and  
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combining these two it seems like, just for the RDH.  
For (uu), we were wondering, is there a  
difference in the line -- again it seems like it's  
combining two for the RDH only, so it's Placing and  
removing intra-coronal temporary sedative dressings.  The  
line (v) says Placing and removing a nonmetallic  
temporary or sedative restoration with non-tissue cutting  
instruments.  So we are wondering, shouldn't the language  
be different between what's a sedative restoration and  
sedative dressing?  Or are we talking about two different  
things?  
For line -- Now Rule 338.11701(12)(b), we  
are recommending a change.  It says currently:  Complete  
at least one hour of the required continuing education  
hours in dental ethics and jurisprudence.  
Hours earned through volunteer patient or  
supportive dental services provided for R338.11704a(1)(m)  
do not count toward the required hours for clinical  
issues.    
We recommend changing that to:  Complete  
at least one hour of your required continuing education  
hour in dental ethics and jurisprudence with inclusion of  
delegation of duties to dental auxiliaries, and again  
leaving the hours earned through volunteer patient  
supportive dental services.  
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And the rationale is, we at the MDAA have  
a huge concern over the amount of duties assigned by  
dentists to dental auxiliaries that are not within their  
scope of practice.  It goes unreported, but it's common  
knowledge, and we feel maybe this is in part due to lack  
of knowledge of the rules and in part because they can  
not find qualified staff, so they choose to delegate the  
duties illegally.  All dentists should understand the  
scope of practice for the dental assistant, the RDA, the  
RDH, and now the dental therapist.  
Recommend after (c), add:  Complete a  
minimum of three hours of the required dental continuing  
education hours and infection control in the dental  
setting.  So MDAA feels infection control training is  
imperative for the dentist as well as the rest of the  
team who have that already.  The dentist is ultimately in  
charge of making sure the office is in compliance, and  
they should be the one overseeing procedures and the  
training in the office for continuous -- for continuity.  
Infection control, as we know, is one of the most  
important procedures and especially like right now, you  
know, even more of a hot topic than it ever has been, and  
many offices are experiencing trouble in securing  
formally trained assistants.  So with less than 2,000  
already in the State that has this formal training, it's  
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now the responsibility of the dentist to ensure that the  
unlicensed assistants have the proper training in  
infection control.  
And then the last one is Rule 338.11704,  
after (c).  We recommend adding:  Complete at least one  
hour of the required continuing education hours in dental  
ethics and jurisprudence with inclusion of delegation of  
duties to dental auxilliary.  Dental assistants and --  
With the rationale being dental assistants and dental  
hygienists also perform duties illegally in the State,  
and again part of that could be just plain not having the  
knowledge.  So as these things are constantly changing,  
they should have to do these so they can keep up and they  
know what the delegation of duties is.  
That's all I have.  
MS. DITSCHMAN:  Thank you.  Is there  
anybody else that would like to make a comment?  If so,  
please use the reaction button to raise your hand.  
(Pause.)  
MS. DITSCHMAN:  I am not seeing anybody  
that wishes to make a comment, so let's go to those who  
are on the phone.  If you are on the telephone and you  
wish to make a comment, you must hit *6 to unmute  
yourself.  You can do so at this time.  
(Pause.)  
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MS. PAYNE:  Kerry, there is a comment in  
KERRY PRZYBYLO:  The comment is:  If you  
the Chat.  
supplied written comments, do we need to read them?  No.  
No, you do not.  We have them.  And so you do not need to  
repeat those on the record here.  Those comments will be  
accumulated with the comments that we receive on, at the  
hearing here, and compiled to be shown to the Board.  
All right.  I don't see anybody else that  
has a comment.  If that's the case, I think we'll stay on  
the record for another ten minutes or so, and then if we  
don't, we'll go off the record until someone chimes in to  
make a comment.  And if no comments are received, then we  
will formally close the hearing about 1:30.  So we'll go  
off the record until, unless someone chimes in with a  
comment.  
(Off the record at 1:21 p.m.)  
-   -   -  
(Back on the record at 1:24 p.m.)  
KERRY PRZYBYLO:  It looks like Sandy  
Sutton.  Do you have a comment to make, Sandy?  
MS. SUTTON:  Yes, I do.  I was waiting  
for some noise here to settle down.  Thank you.  
My name is Sandy Sutton.  I am  
representing from the Greater Detroit Dental Hygienists  
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Association.  I do have just a couple of things to add,  
and I will try to read slowly.  
For Rule 1101.1(a), "Allied dental  
personnel" means the dentist's supporting team who  
receives appropriate delegation from the dentists or  
dental therapist to participate in dental treatment.  We  
are requesting that we remove "dentists" and the word  
"the" prior to dentists in the second line, replacing it  
with "a", to read:  "Allied dental personnel" means the  
supporting team who receives appropriate delegation from  
a dentist or dental therapist to participate in dental  
treatment.  With the justification, it's showing  
unnecessary possessive ownership over the allied dental  
personnel.  And many practices have more than one  
dentist.  
Continuing on, in part (7), continuing  
education, R338.1170, in regards to license renewal.  
Under rule 1701,12(e), Complete no more than 30 hours of  
the required continuing education hours online or through  
electronic media, including videos, internet, web-based  
seminars, video conferences, online continuing education  
programs, and online journal articles.  All of those  
terms are not defined very well, and with current CEs  
being offered by virtual means only leads to much  
confusion.  According to the AGD, the only official  
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delivery method that are recognized are lecture, self  
instruction, and hands on class participation.  They  
state that the location can be listed as online or live  
webinar or live online lecture to differentiate.  
However, delivery methods are still only listed as  
lectures.  
Also, if only the allied dental personnel  
require one hour of infection control CE for license  
renewal, why is it the dentist does not have this  
provision.  We are wondering if this an oversight as  
they're not required, especially with this new age of  
COVID-19.  
That is all for our comments.  Thank  
you.  
KERRY PRZYBYLO:  Thank you, Sandy.  Does  
anybody else have a comment to make?  
(Pause.)  
Again, if you're calling on the phone,  
please hit *6 to unmute yourself so that we can hear you.  
(Pause.)  
All right.  I don't see any further  
comments.  Andria, would you like to explain the next  
step?  Heather Beavers, the dental policy specialist for  
Medicaid was asking in the Chat what the next steps were.  
MS. DITSCHMAN:  Sure.  So the next steps  
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are to take all of the comments that have been either  
sent in writing or made here today, and put them into a  
report.  That report will go to a work session, a work  
group session that is scheduled for September 29, from  
1:00 to 3:00 o'clock.  The rules committee will review  
those comments with the public there at the work session.  
Anyone is able to attend.  And the only comments that  
will be able to be made at that work session have to do  
with the comments that have been made here, not any  
additional comments.  
So the rules committee will make  
recommendations to the Board regarding all of the  
comments that have been made, and the Board will look  
over those comments on October 8th at 10:00 at their full  
Board meeting.  Following the board meeting of the Board,  
a decision regarding the comments that have been made  
will be sent to the joint committee on administrative  
rules.  
KERRY PRZYBYLO:  With that, are there any  
further comments?  If there are, please use the reaction  
button at the bottom to Raise Your Hand so that we may  
call on you.  
(Pause.)  
I don't see any further comments, so I  
think we will call this hearing to close at 1:29.  Again  
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the record for the hearing will remain open until 5:00  
p.m. today.  So if there are additional comments that you  
would like to send in writing, you can send them to  
BPL-Boardsupport, all one word, @Michigan.gov.  
Thank you for add tending.  We will  
close this session.  
(Hearing closed at 1:30 p.m.)  
-   -   -  
 
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C E R T I F I C A T E  
   I, Marie T. Schroeder, CSR-2183, do  
hereby certify that I reported in stenotype via Zoom, the  
public hearing had in the within-entitled matter before  
the Bureau of Professional Licensing, for the Michigan  
Office of Administrative Rules, LARA, on Friday,  
September 18, 2020; and do further certify that the  
foregoing transcript, consisting of 17 pages, is a true  
and correct transcript of my stenotype notes.  
 
 
Digitally signed by MarieT Schroeder  
DN: cn=MarieT Schroeder, o=Metro  
Court Reporters Inc, ou,  
email=metrostate@sbcglobal.net,  
c=US  
MarieT  
Schroeder  
Date: 2020.09.20 10:36:08 -04'00'  
_______________________________  
Marie T. Schroeder, CSR-2183  
                              P.O. Box 1313  
Walled Lake, Michigan  48390  
                              metrostate@sbcglobal.net  
 
 
Dated:  September 21, 2020    
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;