Prescriptive Authority Certification

A licensed dental hygienist in Tennessee must obtain certification to prescribe fluoride agents, topical oral anesthetic agents, and nonsystemic oral antimicrobials to any patient. (1) Application and Qualifications for Certification (a) Tennessee licensed dental hygienists are eligible to take a Board-approved prescriptive authority certification course, and must successfully complete such course in order to obtain a prescriptive authority certification. The Board-approved course must include dosage and writing recommendations and the limitations of dental hygiene prescribing authority pursuant to T.C.A. § 63-5-108(h), which became effective July 1, 2020. (b) Tennessee licensed dental hygienists, who have successfully completed a comparable dental hygiene training program or course on prescriptive authority in another state, which is equivalent to the Board-approved course, are eligible to apply directly to the Board for a prescriptive authority certification without additional training, provided the program or course is determined by the Board consultant to be equivalent to the Board- approved course in Tennessee. The information regarding content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certification or permit must be received directly from the other state board. If it is determined that the course is not equivalent, the licensed dental hygienist will be required to comply with the provisions of subparagraph (1)(a) of this rule before certification can be issued. (c) Tennessee licensed dental hygienists applying for a prescriptive authority certification must have actively practiced as a licensed dental hygienist for no less than 1600 hours. (d) Tennessee licensed dental hygienists applying for a prescriptive authority certification must submit proof of successful completion of a two (2) hour pharmacology continuing education course. (2) Prescriptive Authority Certification (a) Licensed dental hygienists with a prescriptive authority certification shall be limited to prescribing fluoride agents, topical oral anesthetic agents, and nonsystemic oral antimicrobials that are not controlled substances under state and federal drug laws; and do not require a license from the federal drug enforcement agency. (b) Licensed dental hygienists with a prescriptive authority certification shall only prescribe for patients under the general supervision of a licensed dentist, as provided in T.C.A. § RULES GOVERNING THE PRACTICE OF DENTAL HYGIENISTS CHAPTER 0460-03 63-5-115 (b)(2). A prescription written by a dental hygienist under this section must be reviewed by a dentist within 30 days. (c) Licensed dental hygienists with a prescriptive authority certification shall prominently display, at their place of employment, the current certification, which is received upon licensure and renewal. (d) A prescriptive authority certification is only valid as long as the licensed dental hygienist has a current license to practice dental hygiene. If the license expires or is retired, the certification is also considered expired or retired and the dental hygienist may not prescribe fluoride agents, topical oral anesthetic agents, and nonsystemic oral antimicrobials to any patient until the license is renewed, reinstated or reactivated. (3) Allowable Percentages of Agents that May be Prescribed by a Licensed Dental Hygienist with a Prescriptive Authority Certification (a) Topical anti-caries treatments using sodium fluoride unless otherwise stated: 1. Toothpastes - 1.1 percent (or stannous fluoride 0.4 percent); 2. Topical gels - 1.1 percent (or stannous fluoride 0.4 percent); 3. Oral rinses - 0.05 percent, 0.2 percent, 0.44 percent, 0.5 percent or oral rinse concentrate at 0.63 percent stannous fluoride; 4. Fluoride varnish - 5 percent; 5. Prophy paste - 1.25 percent; and 6. Fluoride paste - 5 percent (b) Topical oral anesthetic agent: 1. Up to 20 percent benzocaine; 2. Up to 2 percent viscous lidocaine; and 3. Cetacaine to include 14 percent benzocaine, 2 percent butamben and 2 percent tetracaine hydrochloride (c) Nonsystemic oral antimicrobials/topical anti-infectives: 1. Chlorhexidine gluconate rinses - 0.12 percent; 2. Arestin - minocycline hydrochloride microspheres, 1mg inserted into periodontal sulcus; and 3. Atridox - doxycycline hyclate 10% gel inserted into periodontal sulcus