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Unofficial Opinion 96-3

Unofficial Opinion 96-3

February 13, 1996
To: 

Representative
District 44

Re: 

Whether the scope of practice of dentistry includes certain surgical procedures.

You have requested an opinion regarding whether the practice of dentistry includes certain surgical procedures which are apparently being performed by some dentists in this state. In particular, you have asked whether a dentist may perform the following procedures:

1. Augmentation of the chin, with either autogenous or alloplastic material; that is, increasing the size of the chin beyond the existing size by means of an implant; 2. Augmentation of the midface, with either autogenous or alloplastic material; 3. Rhinoplasty, or plastic surgery on the nose, either reconstructive, restorative, or cosmetic. Dorland's Illustrated Medical Dictionary 1460 (28th ed. 1994); 4. Blepharoplasty, or plastic surgery of the eyelids. Dorland's Illustrated Medical Dictionary 206 (28th ed. 1994); 5. Rhytidectomy, or plastic surgery to eliminate wrinkles from the facial skin by excising loose or redundant tissue. Dorland's Illustrated Medical Dictionary 1463 (28th ed. 1994); 6. Chemical peel, or chemabrasion, the superficial destruction and exfoliation of the epidermis and the upper layer of the dermis by application of a cauterant to the skin. Dorland's Illustrated Medical Dictionary 308 (28th ed. 1994); 7. Dermabrasion, planing of the skin done by mechanical means. Dorland's Illustrated Medical Dictionary 446 (28th ed. 1994); and, 8. Suction-assisted lipectomy, or the excision of a mass of subcutaneous adipose tissue. Dorland's Illustrated Medical Dictionary 947 (28th ed. 1994).

For the reasons discussed below, it is my unofficial opinion that a dentist performing a dental operation may also perform those procedures which are necessary or incidental to the proper performance of said operation and the proper treatment of the patient provided that such procedures are limited to the human oral cavity, teeth, gingiva, alveolar process, maxilla, mandible or associated structures, or associated contiguous masticatory structures.

Dentists {1} are authorized to perform "any dental operation whatsoever on the human oral cavity, teeth, gingiva, alveolar process, maxilla, mandible or associated structures, or associated contiguous masticatory structures." O.C.G.A. § 43-11-17(a)(4) (emphasis added); see also O.C.G.A. § 43-11-17(a)(1). Prior to 1991, O.C.G.A. § 43-11-17(a)(1) and (4) authorized dentists to perform "any operation whatsoever on the human mouth, teeth, gums, or jaws." In 1991, the legislature amended the statute first by replacing the terms "mouth, teeth, gums, or jaws" with more anatomically specific terms and second by explicitly limiting operations to "dental" operations. 1991 Ga. Laws 450. Significantly, the original version of the bill which amended O.C.G.A. § 43-11-17 only inserted the revised anatomical terms. 1991 House Bill 315. A substitute bill passed by the Health and Ecology Committee of the House specifically added the term "dental." 1991 Ga. House Journal, Regular Session, pp. 888 and 1012.

Under the current statute, the legislature has limited dentists' authority to perform operations in two ways. A surgical procedure is within the scope of the practice of dentistry only if the procedure is a "dental" operation and only if the procedure is limited to the parts of the human body enumerated in the statute.

The term "dental" is not defined in the laws regulating the practice of dentistry. However, a dental license is statutorily a limited license to practice medicine. 1989 Op. Att'y Gen. 89-49. Therefore, the practice of dentistry must be within the scope of that license to avoid engaging in the unlicensed practice of medicine. 1989 Op. Att'y Gen. 89-49; see Foster v. Georgia Bd. of Chiropractic Examiners, 257 Ga. 409, 416 (1987).

The answer to your inquiry as to whether a dentist may perform certain procedures could vary based on the circumstances. There may be instances in which a dentist performing a dental operation must, in order to properly perform the procedure and properly treat the patient, do other necessary and incidental procedures. See 1968 Op. Att'y Gen. 68-62 (Dentists may prescribe drugs necessary or incidental to the practice of dentistry); 1983 Op. Att'y Gen. 83-52 (Optometrists may perform screening for ocular disease incident to the practice of optometry). A determination of whether a particular procedure was necessary or incidental to the performance of a particular dental operation on a particular patient should be made on a case-by-case basis, with the limitation that it must be performed on those parts of the body identified in O.C.G.A. § 43-11-17(a)(1) and (4). Furthermore, a challenge to whether a particular procedure was within the scope of dental practice could come from the Dental Board, the Composite State Board of Medical Examiners or from a patient in a private civil action.

Based on the above, it is my unofficial opinion that a dentist performing a dental operation may also perform those procedures which are necessary or incidental to the proper performance of said operation and the proper treatment of the patient provided that such procedures are limited to the human oral cavity, teeth, gingiva, alveolar process, maxilla, mandible or associated structures, or associated contiguous masticatory structures.

Prepared by:

THOMAS K. BOND
Assistant Attorney General

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{1} The scope of practice of dentistry is the same for all licensed dentists. O.C.G.A. § 43-11-17. While the Georgia Board of Dentistry recognizes specialties, the Board does not license such specialties separately. That scope of practice is defined by law, not by the curriculum of schools of dentistry or by the training an individual dentist has received. See Foster v. Georgia Bd. of Chiropractic Examiners, 257 Ga. 409, 412 (1987) (Despite claim that chiropractors were educated and trained to use nutritional supplements, Court rejected argument that prescribing such supplements was within scope of chiropractic).