|
| | 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 |
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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).
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| | A BILL FOR |
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| | SB0335 | | LRB102 10201 SPS 15524 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Dental Practice Act is amended by |
5 | | changing Sections 4 and 17 as follows:
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6 | | (225 ILCS 25/4)
(from Ch. 111, par. 2304)
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7 | | (Section scheduled to be repealed on January 1, 2026)
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8 | | Sec. 4. Definitions. As used in this Act:
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9 | | "Address of record" means the designated address recorded |
10 | | by the Department in the applicant's or licensee's application |
11 | | file or license file as maintained by the Department's |
12 | | licensure maintenance unit. It is the duty of the applicant or |
13 | | licensee to inform the Department of any change of address and |
14 | | those changes must be made either through the Department's |
15 | | website or by contacting the Department. |
16 | | "Department" means the Department of Financial and |
17 | | Professional Regulation.
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18 | | "Secretary" means the Secretary of Financial and |
19 | | Professional Regulation.
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20 | | "Board" means the Board of Dentistry.
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21 | | "Dentist" means a person who has received a general |
22 | | license pursuant
to paragraph (a) of Section 11 of this Act and |
23 | | who may perform any intraoral
and extraoral procedure required |
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1 | | in the practice of dentistry and to whom is
reserved the |
2 | | responsibilities specified in Section 17.
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3 | | "Dental hygienist" means a person who holds a license |
4 | | under this Act to
perform dental services as authorized by |
5 | | Section 18.
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6 | | "Dental assistant" means an appropriately trained person
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7 | | who, under the supervision of a dentist, provides dental |
8 | | services
as authorized by Section 17.
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9 | | "Expanded function dental assistant" means a dental |
10 | | assistant who has completed the training required by Section |
11 | | 17.1 of this Act. |
12 | | "Dental laboratory" means a person, firm or corporation |
13 | | which:
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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
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19 | | (ii) utilizes or employs a dental technician to |
20 | | provide such services; and
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21 | | (iii) performs such functions only for a dentist or |
22 | | dentists.
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23 | | "Supervision" means supervision of a dental hygienist or a |
24 | | dental
assistant requiring that a dentist authorize the |
25 | | procedure, remain in the
dental facility while the procedure |
26 | | is performed, and approve the work
performed by the dental |
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1 | | hygienist or dental assistant before dismissal of
the patient, |
2 | | but does not mean that the dentist must be present at all
times |
3 | | in the treatment room.
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4 | | "General supervision" means supervision of a dental |
5 | | hygienist
requiring that the patient be a patient of record,
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6 | | that the dentist
examine the patient in accordance with |
7 | | Section 18 prior to treatment by the
dental hygienist, and |
8 | | that the
dentist authorize the procedures which
are being |
9 | | carried
out by a notation in the patient's record, but not |
10 | | requiring that a dentist
be present when the authorized
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11 | | procedures are being performed. The
issuance of a prescription |
12 | | to a dental laboratory by a
dentist does not constitute |
13 | | general supervision.
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14 | | "Public member" means a person who is not a health |
15 | | professional.
For purposes of board membership, any person |
16 | | with a significant financial
interest in a health service or |
17 | | profession is not a public member.
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18 | | "Dentistry" means the healing art which is concerned with |
19 | | the
examination, diagnosis, treatment planning and care of |
20 | | conditions within
the human oral cavity and its adjacent |
21 | | tissues and structures, as further
specified in Section 17.
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22 | | "Branches of dentistry" means the various specialties of |
23 | | dentistry
which, for purposes of this Act, shall be limited to |
24 | | the following:
endodontics, oral and maxillofacial surgery, |
25 | | orthodontics and dentofacial
orthopedics, pediatric dentistry,
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26 | | periodontics, prosthodontics, and oral and maxillofacial
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1 | | radiology , and dental anesthesiology .
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2 | | "Specialist" means a dentist who has received a specialty |
3 | | license
pursuant to Section 11(b).
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4 | | "Dental technician" means a person who owns, operates or |
5 | | is
employed by a dental laboratory and engages in making, |
6 | | providing, repairing
or altering dental prosthetic appliances |
7 | | and other artificial materials and
devices which are returned |
8 | | to a dentist for insertion into the human oral
cavity or which |
9 | | come in contact with its adjacent structures and tissues.
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10 | | "Impaired dentist" or "impaired dental hygienist" means a |
11 | | dentist
or dental hygienist who is unable to practice with
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12 | | reasonable skill and safety because of a physical or mental |
13 | | disability as
evidenced by a written determination or written |
14 | | consent based on clinical
evidence, including deterioration |
15 | | through the aging process, loss of motor
skills, abuse of |
16 | | drugs or alcohol, or a psychiatric disorder, of sufficient
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17 | | degree to diminish the person's ability to deliver competent |
18 | | patient care.
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19 | | "Nurse" means a registered professional nurse, a certified |
20 | | registered
nurse anesthetist licensed as an advanced practice
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21 | | registered nurse, or a licensed practical nurse licensed under |
22 | | the Nurse Practice Act.
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23 | | "Patient of record" means a patient for whom the patient's |
24 | | most recent
dentist has obtained
a
relevant medical and dental |
25 | | history and on whom the dentist has performed an
examination |
26 | | and evaluated the condition to be treated.
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1 | | "Dental responder" means a dentist or dental hygienist who |
2 | | is appropriately certified in disaster preparedness, |
3 | | immunizations, and dental humanitarian medical response |
4 | | consistent with the Society of Disaster Medicine and Public |
5 | | Health and training certified by the National Incident |
6 | | Management System or the National Disaster Life Support |
7 | | Foundation.
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8 | | "Mobile dental van or portable dental unit" means any |
9 | | self-contained or portable dental unit in which dentistry is |
10 | | practiced that can be moved, towed, or transported from one |
11 | | location to another in order to establish a location where |
12 | | dental services can be provided. |
13 | | "Public health dental hygienist" means a hygienist who |
14 | | holds a valid license to practice in the State, has 2 years of |
15 | | full-time clinical experience or an equivalent of 4,000 hours |
16 | | of clinical experience and has completed at least 42 clock |
17 | | hours of additional structured courses in dental education in |
18 | | advanced areas specific to public health dentistry. |
19 | | "Public health setting" means a federally qualified health |
20 | | center; a federal, State, or local public health facility; |
21 | | Head Start; a special supplemental nutrition program for |
22 | | Women, Infants, and Children (WIC) facility; or a certified |
23 | | school-based health center or school-based oral health |
24 | | program. |
25 | | "Public health supervision" means the supervision of a |
26 | | public health dental hygienist by a licensed dentist who has a |
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1 | | written public health supervision agreement with that public |
2 | | health dental hygienist while working in an approved facility |
3 | | or program that allows the public health dental hygienist to |
4 | | treat patients, without a dentist first examining the patient |
5 | | and being present in the facility during treatment, (1) who |
6 | | are eligible for Medicaid or (2) who are uninsured and whose |
7 | | household income is not greater than 200% of the federal |
8 | | poverty level. |
9 | | "Teledentistry" means the use of telehealth systems and |
10 | | methodologies in dentistry and includes limited patient |
11 | | diagnosis, treatment planning, care and education delivery |
12 | | using synchronous and asynchronous communications under an |
13 | | Illinois licensed a dentist's authority as provided under this |
14 | | Act. |
15 | | (Source: P.A. 100-215, eff. 1-1-18; 100-513, eff. 1-1-18; |
16 | | 100-863, eff. 8-14-18; 101-64, eff. 7-12-19; 101-162, eff. |
17 | | 7-26-19; revised 9-27-19.)
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18 | | (225 ILCS 25/17) (from Ch. 111, par. 2317)
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19 | | (Section scheduled to be repealed on January 1, 2026)
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20 | | Sec. 17. Acts constituting the practice of dentistry. A |
21 | | person
practices dentistry, within the meaning of this Act:
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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
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2 | | (2) Who is a manager, proprietor, operator or |
3 | | conductor of a
business where
dental operations are |
4 | | performed; or
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5 | | (3) Who performs dental operations of any kind; or
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6 | | (4) Who uses an X-Ray machine or X-Ray films for
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7 | | dental diagnostic purposes; or
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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
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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
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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
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18 | | (8) Who takes material or digital scans for final |
19 | | impressions of the human tooth, teeth, or jaws or performs
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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
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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
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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
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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 |
25 | | to engage in
or perform, any of the practices, acts, or |
26 | | operations set forth in this
Section, shall be prima facie |
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1 | | evidence that such person is engaged in the
practice of |
2 | | dentistry.
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3 | | The following practices, acts, and operations, however, |
4 | | are exempt from
the operation of this Act:
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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
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9 | | lost parts of the human teeth in the mouth or to restore or |
10 | | replace lost
or missing teeth in the mouth; or
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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
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15 | | Administration; or
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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
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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:
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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
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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
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9 | | organizations, while appearing as clinicians; or
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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
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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.
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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:
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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.
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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.
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23 | | (3) Any and all correction of malformation of |
24 | | teeth or of the jaws.
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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.
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8 | | (5) Removal of calculus from human teeth.
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9 | | (6) Taking of material or digital scans for final |
10 | | impressions for the fabrication of prosthetic
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11 | | appliances,
crowns,
bridges, inlays, onlays, or other |
12 | | restorative or replacement
dentistry.
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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
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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
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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
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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.
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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, |
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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 ; |
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1 | | or . |
2 | | (h) The practice of dentistry by an individual who:
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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
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7 | | passage of the examination specified in subsection (e) |
8 | | of Section 9 of this
Act; or
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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
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14 | | (iii) has been accepted or appointed for specialty |
15 | | or residency training
by a hospital situated in this |
16 | | State; or
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17 | | (iv) has been accepted or appointed for specialty |
18 | | training in an
approved dental program situated in |
19 | | this State; or
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20 | | (v) has been accepted or appointed for specialty |
21 | | training in a dental
public health agency situated in |
22 | | this State.
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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 |
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1 | | by the Department.
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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
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6 | | State.
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7 | | The authority to practice shall terminate immediately |
8 | | upon:
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9 | | (1) the decision of the Department that the |
10 | | applicant has failed the
examination; or
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11 | | (2) denial of licensure by the Department; or
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12 | | (3) withdrawal of the application.
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13 | | (Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19; |
14 | | 101-162, eff. 7-26-19; revised 9-19-19.)
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