AN ACT to amend Tennessee Code Annotated, Title 4 and Title 63, Chapter 5, relative to dental professions.
SB1926 updates Tennessee’s dental hygiene laws to expand what dental hygienists may do under a dentist’s supervision and to create limited prescriptive authority for certain non-controlled dental products. Before a dentist sees a new patient, a hygienist working under direct supervision may complete diagnostic radiographs, assess and record hard and soft tissue data, perform prophylaxis, and apply fluoride agents. For existing patients, those same services may be performed under general supervision before the dentist’s visit.
The bill also broadens the statutory definition of dental hygiene to include prescribing authority for a narrow list of items: fluoride agents, topical oral anesthetic agents, silver diamine fluoride, curodont, sealants, and desiccation therapy. The authority is limited to products that are not controlled substances and do not require federal DEA licensure. The Board of Dentistry is directed to set by rule the education and training requirements for this authority, including a training course for placing silver diamine fluoride. The act takes effect immediately for rulemaking purposes, with the substantive changes taking effect January 1, 2027.
This bill amends Tennessee Code Annotated Title 63, Chapter 5, governing dental professions, by expanding the scope of practice for dental hygienists and authorizing a limited form of prescriptive authority. It affects dentists, dental hygienists, the Board of Dentistry, and dental practices that may use hygienists more independently for routine preventive and diagnostic services. It also requires the board to adopt rules on training and qualifications, including silver diamine fluoride placement, before the new authority becomes operative.
The available voting history suggests broad support for the bill. It passed the Senate Health and Welfare Committee unanimously, then cleared floor votes by large margins, including a 32-1 vote on third consideration and a final 89-0 passage. The lack of recorded committee discussion makes it difficult to identify detailed arguments, but the vote pattern indicates the measure was generally viewed favorably and not highly controversial overall.
The main policy issue is the expansion of dental hygienists’ authority, especially the new ability to perform certain services before a dentist sees the patient and to prescribe a limited set of dental-related agents. Potential concerns would likely center on scope-of-practice boundaries, supervision standards, patient safety, and the adequacy of training requirements, particularly for silver diamine fluoride. However, the recorded votes show little visible opposition, suggesting any concerns were limited or resolved through amendment and rulemaking authority.