Supreme Court Rejects Appeal of Dental Ruling

The state Supreme Court in San Francisco dealt a setback this week to an experimental program, administered through Cal State Northridge, that allowed some dental hygienists to work without the supervision of dentists.

The high court’s decision left in place a ruling by the 3rd Circuit Court of Appeal in Sacramento last year that the pilot project was illegally expanded and should be halted.

Under state law, dental hygienists must be supervised by a dentist. Under the Health Management Pilot Program begun in 1981, 15 dental hygienists in Reseda were allowed to work without supervision. Dentists were to make random examinations on and calls to patients as a check on their work.

The program was expanded to several sites in 1986 and was monitored by two dentists visiting the sites every two months.

The California Dental Assn. filed suit the next year, arguing that hygienists are not educated to diagnose dental diseases or serve as primary health-care providers.

The Court of Appeal ruled that the Office of Statewide Health Planning and Development exceeded its authority by approving the expanded program. The court said the changes made in 1986 effectively created a new project that required the state to hold public hearings.

Many hygienists battled to save the project, saying they relied on the program’s continued existence when they spent from $25,000 to $45,000 to set up independent offices.

The state health planning office and a group of hygienists appealed the decision to the California Supreme Court, which on Wednesday refused to hear the appeal, sending the case back to Sacramento Superior Court.

Paul A. Lombardo, attorney for the dental association, said the Superior Court should immediately implement an order by the Court of Appeal to order the state to halt the program.

Phil Perry, assistant director of the health planning office, said there is still a chance the project will survive, perhaps in an altered form.

Deputy Atty. Gen. Theodore Garelis said the program is still in operation until the Superior Court acts. He said the next step is up to the hygienists, who will have to request new hearings and reapproval for the program.