(a) In addition to the duties that a dentist may delegate pursuant to the Dental Practice Act and Board Rules, a Texas-licensed dental hygienist (hygienist) may perform the following services and procedures in the dental office of his/her supervising Texas-licensed dentist (dentist) or dentists who are legally engaged in the practice of dentistry in this state or under the supervision of a supervising dentist in an alternate setting:      
        (1) remove accumulated matter, tartar, deposits, accretions, or stains, other than mottled enamel stains, from the natural and restored surface of exposed human teeth and restorations in the human mouth;       
        (2) smooth roughened root surfaces;       
        (3) polish exposed human teeth, restorations in the human mouth, or roughened root surfaces;       
        (4) topically apply drugs to the surface tissues of the human mouth or the exposed surface of human teeth;       
        (5) make dental x-rays;       
        (6) apply pit and fissure sealants; and       
        (7) monitor patients receiving nitrous oxide/oxygen inhalation conscious sedation only after obtaining approval from the board, and only under the direct supervision of a Texas licensed dentist. The board will issue a nitrous oxide monitoring endorsement after a hygienist provides proof of successful completion of a board approved course, that includes examination, on the monitoring of the administration of nitrous oxide.       
      (b) Dental hygienists may use lasers in the practice of dental hygiene under the direct supervision of a dentist, so long as they do not perform any procedure that is irreversible or involves the intentional cutting of soft or hard tissue.      
        (1) Prior to using a laser for non-diagnostic purposes, dental hygienists must complete no less than twelve hours of in-person continuing education in laser utilization specific to the procedures to be performed by the dental hygienist using the laser. Three of the twelve required hours must include clinical simulation laser training similar to the procedures to be performed by the dental hygienist. The continuing education must be provided by an educational course provider recognized by the Board. Dental hygienists must maintain documentation of the satisfactory completion of the required continuing education courses.       
        (2) Use of lasers by dental hygienists must be in accordance with the minimum standard of care and limited to the dental hygienist's scope of practice.       
        (3) A dentist who supervises a dental hygienist in the use of lasers must have laser education and training sufficient to adequately supervise the dental hygienist, including but not limited to meeting the continuing education requirements required of dental hygienists in subsection (b)(1) of this section. Pursuant to §258.003 of the Dental Practice Act, the delegating dentist is responsible for all dental acts delegated to the dental hygienist, including the use of lasers.       
        (4) The dental hygienist must comply with the Dental Practice Act and Board Rules in the use of lasers. The dental hygienist may be subject to disciplinary action for any act that violates the Dental Practice Act or Board Rules.       
     Source Note:        The provisions of this §115.2 adopted to be effective January 1, 1976; amended to be effective April 18, 1979, 4 TexReg 1209; amended to be effective October 10, 1979, 4 TexReg 3502; amended to be effective October 11, 1979, 4 TexReg 3502; amended to be effective June 12, 1980, 5 TexReg 2187; amended to be effective April 19, 1984, 9 TexReg 1947; amended to be effective September 1, 1986, 11 TexReg 3349; amended to be effective February 1, 1988, 12 TexReg 4473; amended to be effective January 5, 1990, 14 TexReg 6756; amended to be effective February 21, 1990, 15 TexReg 707; amended to be effective July 17, 1990, 15 TexReg 3804; amended to beeffective February 20, 1992, 17 TexReg 1095; amended to be effective March 18, 1997, 22 TexReg 2495; amended to be effective July  10, 2001, 26 TexReg 5004; amended to be effective February 25, 2007, 32 TexReg 627; amended to be effective June 23, 2015, 40 TexReg 3818; amended to be effective March 16, 2023, 48 TexReg 1449