Dental Group Accuses State of Violations as Trial Starts

Attorneys for California dentists and dental hygienists clashed Friday before a judge hearing opening arguments in a lawsuit seeking to halt a Cal State Northridge pilot project in which hygienists are working without supervision of dentists.

The project, approved and monitored by the state Office of Statewide Health Planning and Development, is the first effort in the United States to assess the economic viability of independent practice by dental hygienists.

Hygienists have for decades worked primarily as employees of dentists and proposed the project to test whether they can perform basic procedures such as tooth cleaning and X-raying on their own.

Health Threat Charged

The suit, brought by the California Dental Assn., representing 14,000 of the state’s 20,000 dentists, charges that state health officials have violated rules and regulations in operating the pilot program. The dentists also charge that independent hygienists pose a threat to public health.

The suit names as defendants the state health planning office, the 15 hygienists who have begun to practice in the project and trustees of the California State University system.

Approved in 1981, the California State University, Northridge, project languished for lack of funding until last year.

In his opening argument before Superior Court Judge Rothwell B. Mason, Alan G. Perkins, representing the dental association, charged that the health planning office failed to hold a required public hearing twice--when the project was approved, and in 1986, when CSUN told the health agency of many changes in the design of the study.

The changes were so dramatic, Perkins said, that “it is basically a new project.”

He said the original proposal, for example, called for all participants to work within two miles of CSUN. As the project now stands, 15 hygienists have set up practices, some more than 200 miles from the campus.

Informal Hearings

Diana Woodward Hagle, the deputy attorney general representing the state health office and state university system, said she will try to prove that no formal public hearings were necessary. Informal meetings, which included representatives of the California Dental Assn., were within the law.

She said that the hygiene project had been set up properly under the Health Manpower Pilot Projects Act of 1972, which sanctions experiments in health-care delivery that would otherwise violate state law.

Such pilot projects provide a way to assess novel methods of delivering health care “in a hothouse environment” before legislation is introduced to legalize the innovations, Hagle told the judge.

Frank A. Uribie, attorney for the 15 hygienists, said the dental association’s suit was invalid because the four-year statute of limitations had expired.

In asking the court to reject the suit, Uribie said that the dental society had ample opportunity over more than five years from the time the hygiene project was proposed to go to court to stop it.

Slow to Act

“They didn’t bring any action until the participants had established their businesses and spent a lot of money to buy equipment,” Uribie said.

The California Dental Hygienists Assn. has put up $25,000 for legal costs of the hygienists. Kathleen Alvarez, president of the association, and other hygienists observing the trial said the dentists’ suit was motivated by unfounded fears of a new source of competition in an already-competitive field.

The trial will continue next week.