102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB0335

 

Introduced 2/19/2021, by Sen. Rachelle Crowe

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 25/4  from Ch. 111, par. 2304
225 ILCS 25/17  from Ch. 111, par. 2317

    Amends the Illinois Dental Practice Act. Provides that a person who uses teledentistry is considered to practice dentistry under the Act. Provides that a dentist may not delegate teledentistry services unless authorized in the Act. Changes the definition of "branches of dentistry" to include dental anesthesiology. Changes the definition of "teledentistry" to include limited patient diagnosis and treatment planning (rather than patient care) using synchronous and asynchronous communications under an Illinois licensed dentist's authority (rather than a dentist's authority).


LRB102 10201 SPS 15524 b

 

 

A BILL FOR

 

SB0335LRB102 10201 SPS 15524 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4 and 17 as follows:
 
6    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 4. Definitions. As used in this Act:
9    "Address of record" means the designated address recorded
10by the Department in the applicant's or licensee's application
11file or license file as maintained by the Department's
12licensure maintenance unit. It is the duty of the applicant or
13licensee to inform the Department of any change of address and
14those changes must be made either through the Department's
15website or by contacting the Department.
16    "Department" means the Department of Financial and
17Professional Regulation.
18    "Secretary" means the Secretary of Financial and
19Professional Regulation.
20    "Board" means the Board of Dentistry.
21    "Dentist" means a person who has received a general
22license pursuant to paragraph (a) of Section 11 of this Act and
23who may perform any intraoral and extraoral procedure required

 

 

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1in the practice of dentistry and to whom is reserved the
2responsibilities specified in Section 17.
3    "Dental hygienist" means a person who holds a license
4under this Act to perform dental services as authorized by
5Section 18.
6    "Dental assistant" means an appropriately trained person
7who, under the supervision of a dentist, provides dental
8services as authorized by Section 17.
9    "Expanded function dental assistant" means a dental
10assistant who has completed the training required by Section
1117.1 of this Act.
12    "Dental laboratory" means a person, firm or corporation
13which:
14        (i) engages in making, providing, repairing or
15    altering dental prosthetic appliances and other artificial
16    materials and devices which are returned to a dentist for
17    insertion into the human oral cavity or which come in
18    contact with its adjacent structures and tissues; and
19        (ii) utilizes or employs a dental technician to
20    provide such services; and
21        (iii) performs such functions only for a dentist or
22    dentists.
23    "Supervision" means supervision of a dental hygienist or a
24dental assistant requiring that a dentist authorize the
25procedure, remain in the dental facility while the procedure
26is performed, and approve the work performed by the dental

 

 

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1hygienist or dental assistant before dismissal of the patient,
2but does not mean that the dentist must be present at all times
3in the treatment room.
4    "General supervision" means supervision of a dental
5hygienist requiring that the patient be a patient of record,
6that the dentist examine the patient in accordance with
7Section 18 prior to treatment by the dental hygienist, and
8that the dentist authorize the procedures which are being
9carried out by a notation in the patient's record, but not
10requiring that a dentist be present when the authorized
11procedures are being performed. The issuance of a prescription
12to a dental laboratory by a dentist does not constitute
13general supervision.
14    "Public member" means a person who is not a health
15professional. For purposes of board membership, any person
16with a significant financial interest in a health service or
17profession is not a public member.
18    "Dentistry" means the healing art which is concerned with
19the examination, diagnosis, treatment planning and care of
20conditions within the human oral cavity and its adjacent
21tissues and structures, as further specified in Section 17.
22    "Branches of dentistry" means the various specialties of
23dentistry which, for purposes of this Act, shall be limited to
24the following: endodontics, oral and maxillofacial surgery,
25orthodontics and dentofacial orthopedics, pediatric dentistry,
26periodontics, prosthodontics, and oral and maxillofacial

 

 

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1radiology, and dental anesthesiology.
2    "Specialist" means a dentist who has received a specialty
3license pursuant to Section 11(b).
4    "Dental technician" means a person who owns, operates or
5is employed by a dental laboratory and engages in making,
6providing, repairing or altering dental prosthetic appliances
7and other artificial materials and devices which are returned
8to a dentist for insertion into the human oral cavity or which
9come in contact with its adjacent structures and tissues.
10    "Impaired dentist" or "impaired dental hygienist" means a
11dentist or dental hygienist who is unable to practice with
12reasonable skill and safety because of a physical or mental
13disability as evidenced by a written determination or written
14consent based on clinical evidence, including deterioration
15through the aging process, loss of motor skills, abuse of
16drugs or alcohol, or a psychiatric disorder, of sufficient
17degree to diminish the person's ability to deliver competent
18patient care.
19    "Nurse" means a registered professional nurse, a certified
20registered nurse anesthetist licensed as an advanced practice
21registered nurse, or a licensed practical nurse licensed under
22the Nurse Practice Act.
23    "Patient of record" means a patient for whom the patient's
24most recent dentist has obtained a relevant medical and dental
25history and on whom the dentist has performed an examination
26and evaluated the condition to be treated.

 

 

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1    "Dental responder" means a dentist or dental hygienist who
2is appropriately certified in disaster preparedness,
3immunizations, and dental humanitarian medical response
4consistent with the Society of Disaster Medicine and Public
5Health and training certified by the National Incident
6Management System or the National Disaster Life Support
7Foundation.
8    "Mobile dental van or portable dental unit" means any
9self-contained or portable dental unit in which dentistry is
10practiced that can be moved, towed, or transported from one
11location to another in order to establish a location where
12dental services can be provided.
13    "Public health dental hygienist" means a hygienist who
14holds a valid license to practice in the State, has 2 years of
15full-time clinical experience or an equivalent of 4,000 hours
16of clinical experience and has completed at least 42 clock
17hours of additional structured courses in dental education in
18advanced areas specific to public health dentistry.
19    "Public health setting" means a federally qualified health
20center; a federal, State, or local public health facility;
21Head Start; a special supplemental nutrition program for
22Women, Infants, and Children (WIC) facility; or a certified
23school-based health center or school-based oral health
24program.
25    "Public health supervision" means the supervision of a
26public health dental hygienist by a licensed dentist who has a

 

 

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1written public health supervision agreement with that public
2health dental hygienist while working in an approved facility
3or program that allows the public health dental hygienist to
4treat patients, without a dentist first examining the patient
5and being present in the facility during treatment, (1) who
6are eligible for Medicaid or (2) who are uninsured and whose
7household income is not greater than 200% of the federal
8poverty level.
9    "Teledentistry" means the use of telehealth systems and
10methodologies in dentistry and includes limited patient
11diagnosis, treatment planning, care and education delivery
12using synchronous and asynchronous communications under an
13Illinois licensed a dentist's authority as provided under this
14Act.
15(Source: P.A. 100-215, eff. 1-1-18; 100-513, eff. 1-1-18;
16100-863, eff. 8-14-18; 101-64, eff. 7-12-19; 101-162, eff.
177-26-19; revised 9-27-19.)
 
18    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
19    (Section scheduled to be repealed on January 1, 2026)
20    Sec. 17. Acts constituting the practice of dentistry. A
21person practices dentistry, within the meaning of this Act:
22        (1) Who represents himself or herself as being able to
23    diagnose or diagnoses, treats, prescribes, or operates for
24    any disease, pain, deformity, deficiency, injury, or
25    physical condition of the human tooth, teeth, alveolar

 

 

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1    process, gums or jaw; or
2        (2) Who is a manager, proprietor, operator or
3    conductor of a business where dental operations are
4    performed; or
5        (3) Who performs dental operations of any kind; or
6        (4) Who uses an X-Ray machine or X-Ray films for
7    dental diagnostic purposes; or
8        (5) Who extracts a human tooth or teeth, or corrects
9    or attempts to correct malpositions of the human teeth or
10    jaws; or
11        (6) Who offers or undertakes, by any means or method,
12    to diagnose, treat or remove stains, calculus, and bonding
13    materials from human teeth or jaws; or
14        (7) Who uses or administers local or general
15    anesthetics in the treatment of dental or oral diseases or
16    in any preparation incident to a dental operation of any
17    kind or character; or
18        (8) Who takes material or digital scans for final
19    impressions of the human tooth, teeth, or jaws or performs
20    any phase of any operation incident to the replacement of
21    a part of a tooth, a tooth, teeth or associated tissues by
22    means of a filling, crown, a bridge, a denture or other
23    appliance; or
24        (9) Who offers to furnish, supply, construct,
25    reproduce or repair, or who furnishes, supplies,
26    constructs, reproduces or repairs, prosthetic dentures,

 

 

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1    bridges or other substitutes for natural teeth, to the
2    user or prospective user thereof; or
3        (10) Who instructs students on clinical matters or
4    performs any clinical operation included in the curricula
5    of recognized dental schools and colleges; or
6        (11) Who takes material or digital scans for final
7    impressions of human teeth or places his or her hands in
8    the mouth of any person for the purpose of applying teeth
9    whitening materials, or who takes impressions of human
10    teeth or places his or her hands in the mouth of any person
11    for the purpose of assisting in the application of teeth
12    whitening materials. A person does not practice dentistry
13    when he or she discloses to the consumer that he or she is
14    not licensed as a dentist under this Act and (i) discusses
15    the use of teeth whitening materials with a consumer
16    purchasing these materials; (ii) provides instruction on
17    the use of teeth whitening materials with a consumer
18    purchasing these materials; or (iii) provides appropriate
19    equipment on-site to the consumer for the consumer to
20    self-apply teeth whitening materials; or .
21        (12) Who uses teledentistry. A dentist may not
22    delegate teledentistry services unless authorized in this
23    Act.
24    The fact that any person engages in or performs, or offers
25to engage in or perform, any of the practices, acts, or
26operations set forth in this Section, shall be prima facie

 

 

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1evidence that such person is engaged in the practice of
2dentistry.
3    The following practices, acts, and operations, however,
4are exempt from the operation of this Act:
5        (a) The rendering of dental relief in emergency cases
6    in the practice of his or her profession by a physician or
7    surgeon, licensed as such under the laws of this State,
8    unless he or she undertakes to reproduce or reproduces
9    lost parts of the human teeth in the mouth or to restore or
10    replace lost or missing teeth in the mouth; or
11        (b) The practice of dentistry in the discharge of
12    their official duties by dentists in any branch of the
13    Armed Services of the United States, the United States
14    Public Health Service, or the United States Veterans
15    Administration; or
16        (c) The practice of dentistry by students in their
17    course of study in dental schools or colleges approved by
18    the Department, when acting under the direction and
19    supervision of dentists acting as instructors; or
20        (d) The practice of dentistry by clinical instructors
21    in the course of their teaching duties in dental schools
22    or colleges approved by the Department:
23            (i) when acting under the direction and
24        supervision of dentists, provided that such clinical
25        instructors have instructed continuously in this State
26        since January 1, 1986; or

 

 

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1            (ii) when holding the rank of full professor at
2        such approved dental school or college and possessing
3        a current valid license or authorization to practice
4        dentistry in another country; or
5        (e) The practice of dentistry by licensed dentists of
6    other states or countries at meetings of the Illinois
7    State Dental Society or component parts thereof, alumni
8    meetings of dental colleges, or any other like dental
9    organizations, while appearing as clinicians; or
10        (f) The use of X-Ray machines for exposing X-Ray films
11    of dental or oral tissues by dental hygienists or dental
12    assistants; or
13        (g) The performance of any dental service by a dental
14    assistant, if such service is performed under the
15    supervision and full responsibility of a dentist. In
16    addition, after being authorized by a dentist, a dental
17    assistant may, for the purpose of eliminating pain or
18    discomfort, remove loose, broken, or irritating
19    orthodontic appliances on a patient of record.
20        For purposes of this paragraph (g), "dental service"
21    is defined to mean any intraoral procedure or act which
22    shall be prescribed by rule or regulation of the
23    Department. Dental service, however, shall not include:
24            (1) Any and all diagnosis of or prescription for
25        treatment of disease, pain, deformity, deficiency,
26        injury or physical condition of the human teeth or

 

 

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1        jaws, or adjacent structures.
2            (2) Removal of, or restoration of, or addition to
3        the hard or soft tissues of the oral cavity, except for
4        the placing, carving, and finishing of amalgam
5        restorations and placing, packing, and finishing
6        composite restorations by dental assistants who have
7        had additional formal education and certification.
8            A dental assistant may place, carve, and finish
9        amalgam restorations, place, pack, and finish
10        composite restorations, and place interim restorations
11        if he or she (A) has successfully completed a
12        structured training program as described in item (2)
13        of subsection (g) provided by an educational
14        institution accredited by the Commission on Dental
15        Accreditation, such as a dental school or dental
16        hygiene or dental assistant program, or (B) has at
17        least 4,000 hours of direct clinical patient care
18        experience and has successfully completed a structured
19        training program as described in item (2) of
20        subsection (g) provided by a statewide dental
21        association, approved by the Department to provide
22        continuing education, that has developed and conducted
23        training programs for expanded functions for dental
24        assistants or hygienists. The training program must:
25        (i) include a minimum of 16 hours of didactic study and
26        14 hours of clinical manikin instruction; all training

 

 

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1        programs shall include areas of study in nomenclature,
2        caries classifications, oral anatomy, periodontium,
3        basic occlusion, instrumentations, pulp protection
4        liners and bases, dental materials, matrix and wedge
5        techniques, amalgam placement and carving, rubber dam
6        clamp placement, and rubber dam placement and removal;
7        (ii) include an outcome assessment examination that
8        demonstrates competency; (iii) require the supervising
9        dentist to observe and approve the completion of 8
10        amalgam or composite restorations; and (iv) issue a
11        certificate of completion of the training program,
12        which must be kept on file at the dental office and be
13        made available to the Department upon request. A
14        dental assistant must have successfully completed an
15        approved coronal polishing and dental sealant course
16        prior to taking the amalgam and composite restoration
17        course.
18            A dentist utilizing dental assistants shall not
19        supervise more than 4 dental assistants at any one
20        time for placing, carving, and finishing of amalgam
21        restorations or for placing, packing, and finishing
22        composite restorations.
23            (3) Any and all correction of malformation of
24        teeth or of the jaws.
25            (4) Administration of anesthetics, except for
26        monitoring of nitrous oxide, conscious sedation, deep

 

 

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1        sedation, and general anesthetic as provided in
2        Section 8.1 of this Act, that may be performed only
3        after successful completion of a training program
4        approved by the Department. A dentist utilizing dental
5        assistants shall not supervise more than 4 dental
6        assistants at any one time for the monitoring of
7        nitrous oxide.
8            (5) Removal of calculus from human teeth.
9            (6) Taking of material or digital scans for final
10        impressions for the fabrication of prosthetic
11        appliances, crowns, bridges, inlays, onlays, or other
12        restorative or replacement dentistry.
13            (7) The operative procedure of dental hygiene
14        consisting of oral prophylactic procedures, except for
15        coronal polishing and pit and fissure sealants, which
16        may be performed by a dental assistant who has
17        successfully completed a training program approved by
18        the Department. Dental assistants may perform coronal
19        polishing under the following circumstances: (i) the
20        coronal polishing shall be limited to polishing the
21        clinical crown of the tooth and existing restorations,
22        supragingivally; (ii) the dental assistant performing
23        the coronal polishing shall be limited to the use of
24        rotary instruments using a rubber cup or brush
25        polishing method (air polishing is not permitted); and
26        (iii) the supervising dentist shall not supervise more

 

 

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1        than 4 dental assistants at any one time for the task
2        of coronal polishing or pit and fissure sealants.
3            In addition to coronal polishing and pit and
4        fissure sealants as described in this item (7), a
5        dental assistant who has at least 2,000 hours of
6        direct clinical patient care experience and who has
7        successfully completed a structured training program
8        provided by (1) an educational institution such as a
9        dental school or dental hygiene or dental assistant
10        program, or (2) by a statewide dental or dental
11        hygienist association, approved by the Department on
12        or before January 1, 2017 (the effective date of
13        Public Act 99-680) this amendatory Act of the 99th
14        General Assembly, that has developed and conducted a
15        training program for expanded functions for dental
16        assistants or hygienists may perform: (A) coronal
17        scaling above the gum line, supragingivally, on the
18        clinical crown of the tooth only on patients 12 years
19        of age or younger who have an absence of periodontal
20        disease and who are not medically compromised or
21        individuals with special needs and (B) intracoronal
22        temporization of a tooth. The training program must:
23        (I) include a minimum of 16 hours of instruction in
24        both didactic and clinical manikin or human subject
25        instruction; all training programs shall include areas
26        of study in dental anatomy, public health dentistry,

 

 

SB0335- 15 -LRB102 10201 SPS 15524 b

1        medical history, dental emergencies, and managing the
2        pediatric patient; (II) include an outcome assessment
3        examination that demonstrates competency; (III)
4        require the supervising dentist to observe and approve
5        the completion of 6 full mouth supragingival scaling
6        procedures; and (IV) issue a certificate of completion
7        of the training program, which must be kept on file at
8        the dental office and be made available to the
9        Department upon request. A dental assistant must have
10        successfully completed an approved coronal polishing
11        course prior to taking the coronal scaling course. A
12        dental assistant performing these functions shall be
13        limited to the use of hand instruments only. In
14        addition, coronal scaling as described in this
15        paragraph shall only be utilized on patients who are
16        eligible for Medicaid or who are uninsured and whose
17        household income is not greater than 200% of the
18        federal poverty level. A dentist may not supervise
19        more than 2 dental assistants at any one time for the
20        task of coronal scaling. This paragraph is inoperative
21        on and after January 1, 2026.
22        The limitations on the number of dental assistants a
23    dentist may supervise contained in items (2), (4), and (7)
24    of this paragraph (g) mean a limit of 4 total dental
25    assistants or dental hygienists doing expanded functions
26    covered by these Sections being supervised by one dentist;

 

 

SB0335- 16 -LRB102 10201 SPS 15524 b

1    or .
2        (h) The practice of dentistry by an individual who:
3            (i) has applied in writing to the Department, in
4        form and substance satisfactory to the Department, for
5        a general dental license and has complied with all
6        provisions of Section 9 of this Act, except for the
7        passage of the examination specified in subsection (e)
8        of Section 9 of this Act; or
9            (ii) has applied in writing to the Department, in
10        form and substance satisfactory to the Department, for
11        a temporary dental license and has complied with all
12        provisions of subsection (c) of Section 11 of this
13        Act; and
14            (iii) has been accepted or appointed for specialty
15        or residency training by a hospital situated in this
16        State; or
17            (iv) has been accepted or appointed for specialty
18        training in an approved dental program situated in
19        this State; or
20            (v) has been accepted or appointed for specialty
21        training in a dental public health agency situated in
22        this State.
23        The applicant shall be permitted to practice dentistry
24    for a period of 3 months from the starting date of the
25    program, unless authorized in writing by the Department to
26    continue such practice for a period specified in writing

 

 

SB0335- 17 -LRB102 10201 SPS 15524 b

1    by the Department.
2        The applicant shall only be entitled to perform such
3    acts as may be prescribed by and incidental to his or her
4    program of residency or specialty training and shall not
5    otherwise engage in the practice of dentistry in this
6    State.
7        The authority to practice shall terminate immediately
8    upon:
9            (1) the decision of the Department that the
10        applicant has failed the examination; or
11            (2) denial of licensure by the Department; or
12            (3) withdrawal of the application.
13(Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19;
14101-162, eff. 7-26-19; revised 9-19-19.)