BILL NO. 166

(as introduced)

2nd Session, 63rd General Assembly
Nova Scotia
68 Elizabeth II, 2019

 

Government Bill

 

Denturists Act
(amended)

 

The Honourable Randy Delorey
Minister of Health and Wellness

First Reading: October 2, 2019

(Explanatory Notes)

Second Reading: October 3, 2019

Third Reading: October 17, 2019 (LINK TO BILL AS PASSED)

Explanatory Notes

Clause 1

(a) amends the definition of "denturism" to include the practice of inserting dentures over implants;

(b) adds definitions of "alters any oral tissue", "implant abutment", "implant-bar-supported denture", "implant-retained or tissue-supported denture", "implant services", "implant team", "patient-removable denture" and "removable partial denture"; and

(c) repeals the definition of "removable denture".

Clause 2 allows the Denturist Licensing Board to make regulations prescribing standards of practice.

Clause 3 adds a requirement that denturists hold professional liability insurance or coverage in an amount approved by the Board.

Clause 4 amends the activities that denturists are prohibited from engaging in.

Clause 5 allows the Registrar, with or without receipt of a written complaint, to conduct a full and proper investigation and appoint persons to conduct an investigation or practice audit.

Clause 6

(a) amends the requirement for denturists to ensure that patients who receive removable dentures have oral health examinations; and

(b) requires denturists to communicate with patients regarding who their primary care provider is, and to work collaboratively with an implant team when providing implant services.

An Act to Amend Chapter 25
of the Acts of 2000,
the Denturists Act

Be it enacted by the Governor and Assembly as follows:

1 Section 2 of Chapter 25 of the Acts of 2000, the Denturists Act, is amended by

(a) relettering clause (a) as (aa);

(b) adding immediately before clause (aa) the following clause:

(a) "alters any oral tissue" means any procedure involving the cutting into or use of lasers on the tissue;

(c) striking out "into an edentulous or partially edentulous arch or arches," in the sixth and seventh lines of subclause (e)(i);

(d) adding at the end of subclause (e)(i) the following paragraphs:

(A) into an edentulous or partially edentulous arch or arches,

(B) onto implant abutments where the denture is an implant-retained or tissue-supported denture, or

(C) onto an implant bar where the denture is an implant-bar-supported denture,

(e) striking out "removable" in the first line of subclause (e)(ii) and substituting "patient-removable";

(f) adding "and" immediately after "arches," in the third line of subclause (e)(ii);

(g) adding immediately after subclause (e)(ii) the following subclause:

(iii) the making of impressions and determining jaw relations for the purpose of, or with a view to, the making, producing, reproducing, constructing, furnishing, supplying, altering or repairing of a mouth guard to protect the patient for sporting or recreational purposes and to protect against injury, but not for medical purposes,

(h) striking out "and includes the making, reproducing, constructing, furnishing, supplying, altering and repairing of any removable denture in respect of which a service is performed under subclause (i) or (ii), but does not include the adjustment or fitting of dentures in the mouth" in the twelfth to sixteenth lines of clause (e) and substituting "and includes implant services in respect of which a service is performed under subclause (i), (ii) or (iii), but does not include the alteration of the fixed components of a dental implant";

(i) adding immediately after clause (i) the following clauses:

(ia) "implant abutment" means a separate component attached to a dental implant that serves to support or retain a patient-removable denture;

(ib) "implant-bar-supported denture" means a patient-removable denture attached to an implant bar that may or may not be supported by tissue;

(ic) "implant-retained or tissue-supported denture" means a patient-removable denture attached to one or more implant abutments that is also supported by tissue;

(id) "implant services" means the making, producing, reproducing, constructing, furnishing, supplying, relining, rebasing, altering, repairing of and adding to any patient-removable denture, where the denture is an implant-bar-supported denture or an implant-retained or tissue-supported denture;

(ie) "implant team" means all oral health care providers involved in the provision of implant services, including a dentist;

(j) adding immediately after clause (l) the following clause:

(la) "patient-removable denture" means a denture designed to be removed by the wearer that replaces one or more natural teeth with artificial teeth, and includes removable dentures that replace all teeth or removable partial dentures that use clasps to gain retention from remaining natural teeth, but does not include appliances that do not replace oral structures and are worn by a patient in a course of treatment of a disease or an abnormal condition;

and

(k) repealing clause (s) and substituting the following clause:

(s) "removable partial denture" means a denture designed to be removed by the wearer that replaces one or more natural teeth with artificial teeth, and includes removable dentures that use clasps to gain retention from remaining natural teeth, but does not include
(i) removable dentures that replace all teeth, and

(ii) appliances that do not replace oral structures but are worn by a patient in a course of treatment of a disease or an abnormal condition;

2 Clause 7(1)(q) of Chapter 25 is amended by adding "and standards of practice" immediately after "ethics" in the first line.

3 Subsection 12(1) of Chapter 25 is amended by adding immediately after clause (b) the following clause:

(ba) satisfies the Board that the person holds professional liability insurance or coverage in an amount approved by the Board;

4 Section 24 of Chapter 25 is amended by

(a) adding "(1)" immediately after the Section number;

(b) repealing subclause (d)(i);

(c) striking out "prostheses" in the first line of subclause (d)(ii) and substituting "dentures";

(d) adding ", where the dentures cannot be removed by the wearer" immediately after "implants" in the second line of subclause (d)(ii);

(e) repealing subclauses (d)(iii) and (vii) and substituting the following clause:

(iii) temporomandibular joint appliances,

(f) adding the following clauses after clause (d):

(e) alteration of the mouth or teeth structures such as tooth reduction or the preparation of support cavities and guiding planes;

(f) obturation of oral defects as a result of, but not limited to, cleft palate, trauma or oncological treatment; or

(g) acts related to orthodontics.

and

(g) adding the following subsections:

(2) No denturist shall engage in the practice of denturism as defined in paragraphs 2(e)(i)(B) and (C) unless the denturist is practicing in accordance with the educational requirements and standards of practice provided for by the Board.

(3) Notwithstanding subclause 24(1)(d)(iii), a denturist may engage in the trying, fitting, adjusting or replacement of mouth guards to protect the wearer for sporting or recreational purposes, but not for medical purposes.

5 Subsection 34(3) of Chapter 25 is amended by striking out "Without" in the first line and substituting "With or without".

6 Section 75 of Chapter 25 is repealed and the following Section substituted:

75 A denturist shall

(a) take all reasonable steps to ensure that a patient who receives a removable partial denture, an implant-bar-supported denture or an implant-retained or tissue-supported denture has, within the preceding ninety days, had an oral health examination by a dentist to determine the patient's oral health status;

(b) communicate to a patient receiving an implant-bar-supported denture or an implant-retained or tissue-supported denture that a dentist is the primary care provider to manage the oral health condition of the patient; and

(c) work collaboratively with an implant team when providing implant services.

 

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This page and its contents published by the Office of the Legislative Counsel, Nova Scotia House of Assembly, and © 2019 Crown in right of Nova Scotia. Created October 29, 2019. Send comments to legc.office@novascotia.ca.