101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
SB0167

 

Introduced 1/30/2019, by Sen. Neil Anderson and Dale Fowler

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Illinois Dental Practice Act. Defines "teledentistry". Makes changes concerning the requirements that must be met by a dental assistant before the dental assistant may replace, carve, and finish amalgam restorations, place, pack, and finish composite restorations, and place interim restorations. In provisions concerning the qualifications for a permit to administer anesthesia and sedation, requires the Department to ensure that the dentist has completed and maintains certification in advanced cardiac life support or pediatric advanced life support. In provisions concerning death or incapacitation of a dentist, provides that specified personnel may contract with another dentist or dentists to continue the operations of the deceased or incapacitated dentist's practice for a period of one year (rather than no more than one year) from the time of death or incapacitation or the dentist or until the practice is sold, whichever occurs first. Provides that if the practice is not sold within the initial one-year period, the contract may be extended for additional 12-month periods by the Department, but the extension shall not exceed 3 additional 12-month periods. Sets forth specified requirements for extension. Changes repeal and operative dates for various provisions of the Act. Makes other changes. Effective immediately.


LRB101 04886 JRG 49895 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB0167LRB101 04886 JRG 49895 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, 8.1, 17, 17.1, 18, 18.1, 38.2, and 54.3 as
6follows:
 
7    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
8    (Section scheduled to be repealed on January 1, 2026)
9    Sec. 4. Definitions. As used in this Act:
10    "Address of record" means the designated address recorded
11by the Department in the applicant's or licensee's application
12file or license file as maintained by the Department's
13licensure maintenance unit. It is the duty of the applicant or
14licensee to inform the Department of any change of address and
15those changes must be made either through the Department's
16website or by contacting the Department.
17    "Department" means the Department of Financial and
18Professional Regulation.
19    "Secretary" means the Secretary of Financial and
20Professional Regulation.
21    "Board" means the Board of Dentistry.
22    "Dentist" means a person who has received a general license
23pursuant to paragraph (a) of Section 11 of this Act and who may

 

 

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1perform any intraoral and extraoral procedure required in the
2practice of dentistry and to whom is reserved the
3responsibilities specified in Section 17.
4    "Dental hygienist" means a person who holds a license under
5this Act to perform dental services as authorized by Section
618.
7    "Dental assistant" means an appropriately trained person
8who, under the supervision of a dentist, provides dental
9services as authorized by Section 17.
10    "Expanded function dental assistant" means a dental
11assistant who has completed the training required by Section
1217.1 of this Act.
13    "Dental laboratory" means a person, firm or corporation
14which:
15        (i) engages in making, providing, repairing or
16    altering dental prosthetic appliances and other artificial
17    materials and devices which are returned to a dentist for
18    insertion into the human oral cavity or which come in
19    contact with its adjacent structures and tissues; and
20        (ii) utilizes or employs a dental technician to provide
21    such services; and
22        (iii) performs such functions only for a dentist or
23    dentists.
24    "Supervision" means supervision of a dental hygienist or a
25dental assistant requiring that a dentist authorize the
26procedure, remain in the dental facility while the procedure is

 

 

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

 

 

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

 

 

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1and evaluated the condition to be treated.
2    "Dental responder" means a dentist or dental hygienist who
3is appropriately certified in disaster preparedness,
4immunizations, and dental humanitarian medical response
5consistent with the Society of Disaster Medicine and Public
6Health and training certified by the National Incident
7Management System or the National Disaster Life Support
8Foundation.
9    "Mobile dental van or portable dental unit" means any
10self-contained or portable dental unit in which dentistry is
11practiced that can be moved, towed, or transported from one
12location to another in order to establish a location where
13dental services can be provided.
14    "Public health dental hygienist" means a hygienist who
15holds a valid license to practice in the State, has 2 years of
16full-time clinical experience or an equivalent of 4,000 hours
17of clinical experience and has completed at least 42 clock
18hours of additional structured courses in dental education
19approved by rule by the Department in advanced areas specific
20to public health dentistry, including, but not limited to,
21emergency procedures for medically compromised patients,
22pharmacology, medical recordkeeping procedures, geriatric
23dentistry, pediatric dentistry, pathology, and other areas of
24study as determined by the Department, and works in a public
25health setting pursuant to a written public health supervision
26agreement as defined by rule by the Department with a dentist

 

 

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1working in or contracted with a local or State government
2agency or institution or who is providing services as part of a
3certified school-based program or school-based oral health
4program.
5    "Public health setting" means a federally qualified health
6center; a federal, State, or local public health facility; Head
7Start; a special supplemental nutrition program for Women,
8Infants, and Children (WIC) facility; or a certified
9school-based health center or school-based oral health
10program.
11    "Public health supervision" means the supervision of a
12public health dental hygienist by a licensed dentist who has a
13written public health supervision agreement with that public
14health dental hygienist while working in an approved facility
15or program that allows the public health dental hygienist to
16treat patients, without a dentist first examining the patient
17and being present in the facility during treatment, (1) who are
18eligible for Medicaid or (2) who are uninsured and whose
19household income is not greater than 200% of the federal
20poverty level.
21    "Teledentistry" means the use of telehealth systems and
22methodologies in dentistry and includes patient care and
23education delivery using synchronous and asynchronous
24communications under a dentist's authority as provided under
25this Act.
26(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15;

 

 

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199-680, eff. 1-1-17; 100-215, eff. 1-1-18; 100-513, eff.
21-1-18; 100-863, eff. 8-14-18.)
 
3    (225 ILCS 25/8.1)  (from Ch. 111, par. 2308.1)
4    (Section scheduled to be repealed on January 1, 2026)
5    Sec. 8.1. Permit for the administration of anesthesia and
6sedation.
7    (a) No licensed dentist shall administer general
8anesthesia, deep sedation, or conscious sedation without first
9applying for and obtaining a permit for such purpose from the
10Department. The Department shall issue such permit only after
11ascertaining that the applicant possesses the minimum
12qualifications necessary to protect public safety. A person
13with a dental degree who administers anesthesia, deep sedation,
14or conscious sedation in an approved hospital training program
15under the supervision of either a licensed dentist holding such
16permit or a physician licensed to practice medicine in all its
17branches shall not be required to obtain such permit.
18    (b) In determining the minimum permit qualifications that
19are necessary to protect public safety, the Department, by
20rule, shall:
21        (1) establish the minimum educational and training
22    requirements necessary for a dentist to be issued an
23    appropriate permit;
24        (2) establish the standards for properly equipped
25    dental facilities (other than licensed hospitals and

 

 

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1    ambulatory surgical treatment centers) in which general
2    anesthesia, deep sedation, or conscious sedation is
3    administered, as necessary to protect public safety;
4        (3) establish minimum requirements for all persons who
5    assist the dentist in the administration of general
6    anesthesia, deep sedation, or conscious sedation,
7    including minimum training requirements for each member of
8    the dental team, monitoring requirements, recordkeeping
9    requirements, and emergency procedures;
10        (4) ensure that the dentist has completed and maintains
11    current certification in advanced cardiac life support or
12    pediatric advanced life support and all persons assisting
13    the dentist or monitoring the administration of general
14    anesthesia, deep sedation, or conscious sedation maintain
15    current certification in Basic Life Support (BLS); and
16        (5) establish continuing education requirements in
17    sedation techniques and airway management for dentists who
18    possess a permit under this Section.
19    When establishing requirements under this Section, the
20Department shall consider the current American Dental
21Association guidelines on sedation and general anesthesia, the
22current "Guidelines for Monitoring and Management of Pediatric
23Patients During and After Sedation for Diagnostic and
24Therapeutic Procedures" established by the American Academy of
25Pediatrics and the American Academy of Pediatric Dentistry, and
26the current parameters of care and Office Anesthesia Evaluation

 

 

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1(OAE) Manual established by the American Association of Oral
2and Maxillofacial Surgeons.
3    (c) A licensed dentist must hold an appropriate permit
4issued under this Section in order to perform dentistry while a
5nurse anesthetist administers conscious sedation, and a valid
6written collaborative agreement must exist between the dentist
7and the nurse anesthetist, in accordance with the Nurse
8Practice Act.
9    A licensed dentist must hold an appropriate permit issued
10under this Section in order to perform dentistry while a nurse
11anesthetist administers deep sedation or general anesthesia,
12and a valid written collaborative agreement must exist between
13the dentist and the nurse anesthetist, in accordance with the
14Nurse Practice Act.
15    For the purposes of this subsection (c), "nurse
16anesthetist" means a licensed certified registered nurse
17anesthetist who holds a license as an advanced practice
18registered nurse.
19(Source: P.A. 100-201, eff. 8-18-17; 100-513, eff. 1-1-18.)
 
20    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
21    (Section scheduled to be repealed on January 1, 2026)
22    Sec. 17. Acts constituting the practice of dentistry. A
23person practices dentistry, within the meaning of this Act:
24        (1) Who represents himself or herself as being able to
25    diagnose or diagnoses, treats, prescribes, or operates for

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1        classifications, oral anatomy, periodontium, basic
2        occlusion, instrumentations, pulp protection liners
3        and bases, dental materials, matrix and wedge
4        techniques, amalgam placement and carving, rubber dam
5        clamp placement, and rubber dam placement and removal;
6        (ii) include an outcome assessment examination that
7        demonstrates competency; (iii) require the supervising
8        dentist to observe and approve the completion of 8
9        amalgam or composite restorations; and (iv) issue a
10        certificate of completion of the training program,
11        which must be kept on file at the dental office and be
12        made available to the Department upon request. A dental
13        assistant must have successfully completed an approved
14        coronal polishing and dental sealant course prior to
15        taking the amalgam and composite restoration course.
16            A dentist utilizing dental assistants shall not
17        supervise more than 4 dental assistants at any one time
18        for placing, carving, and finishing of amalgam
19        restorations or for placing, packing, and finishing
20        composite restorations.
21            (3) Any and all correction of malformation of teeth
22        or of the jaws.
23            (4) Administration of anesthetics, except for
24        monitoring of nitrous oxide, conscious sedation, deep
25        sedation, and general anesthetic as provided in
26        Section 8.1 of this Act, that may be performed only

 

 

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

 

 

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

 

 

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1        competency; (III) require the supervising dentist to
2        observe and approve the completion of 6 full mouth
3        supragingival scaling procedures; and (IV) issue a
4        certificate of completion of the training program,
5        which must be kept on file at the dental office and be
6        made available to the Department upon request. A dental
7        assistant must have successfully completed an approved
8        coronal polishing course prior to taking the coronal
9        scaling course. A dental assistant performing these
10        functions shall be limited to the use of hand
11        instruments only. In addition, coronal scaling as
12        described in this paragraph shall only be utilized on
13        patients who are eligible for Medicaid or who are
14        uninsured and whose household income is not greater
15        than 200% of the federal poverty level. A dentist may
16        not supervise more than 2 dental assistants at any one
17        time for the task of coronal scaling. This paragraph is
18        inoperative on and after January 1, 2026 2021.
19        The limitations on the number of dental assistants a
20    dentist may supervise contained in items (2), (4), and (7)
21    of this paragraph (g) mean a limit of 4 total dental
22    assistants or dental hygienists doing expanded functions
23    covered by these Sections being supervised by one dentist.
24        (h) The practice of dentistry by an individual who:
25            (i) has applied in writing to the Department, in
26        form and substance satisfactory to the Department, for

 

 

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1        a general dental license and has complied with all
2        provisions of Section 9 of this Act, except for the
3        passage of the examination specified in subsection (e)
4        of Section 9 of this Act; or
5            (ii) has applied in writing to the Department, in
6        form and substance satisfactory to the Department, for
7        a temporary dental license and has complied with all
8        provisions of subsection (c) of Section 11 of this Act;
9        and
10            (iii) has been accepted or appointed for specialty
11        or residency training by a hospital situated in this
12        State; or
13            (iv) has been accepted or appointed for specialty
14        training in an approved dental program situated in this
15        State; or
16            (v) has been accepted or appointed for specialty
17        training in a dental public health agency situated in
18        this State.
19        The applicant shall be permitted to practice dentistry
20    for a period of 3 months from the starting date of the
21    program, unless authorized in writing by the Department to
22    continue such practice for a period specified in writing by
23    the Department.
24        The applicant shall only be entitled to perform such
25    acts as may be prescribed by and incidental to his or her
26    program of residency or specialty training and shall not

 

 

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1    otherwise engage in the practice of dentistry in this
2    State.
3        The authority to practice shall terminate immediately
4    upon:
5            (1) the decision of the Department that the
6        applicant has failed the examination; or
7            (2) denial of licensure by the Department; or
8            (3) withdrawal of the application.
9(Source: P.A. 99-492, eff. 12-31-15; 99-680, eff. 1-1-17;
10100-215, eff. 1-1-18; 100-976, eff. 1-1-19.)
 
11    (225 ILCS 25/17.1)
12    (Section scheduled to be repealed on January 1, 2026)
13    Sec. 17.1. Expanded function dental assistants.
14    (a) A dental assistant who has completed training as
15provided in subsection (b) of this Section in all of the
16following areas may hold himself or herself out as an expanded
17function dental assistant:
18        (1) Taking material or digital scans for final
19    impressions after completing a training program that
20    includes either didactic objectives or clinical skills and
21    functions that demonstrate competency.
22        (2) Performing pulp vitality test after completing a
23    training program that includes either didactic objectives
24    or clinical skills and functions that demonstrate
25    competency.

 

 

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1        (3) Placing, carving, and finishing of amalgam
2    restorations and placing, packing, and finishing composite
3    restorations as allowed under Section 17.
4        (4) Starting the flow of oxygen and monitoring of
5    nitrous oxide-oxygen analgesia as allowed under Section
6    17.
7        (5) Coronal polishing and pit and fissure sealants as
8    allowed under Section 17.
9    All procedures listed in paragraphs (1) through (5) for
10dental assistants must be performed under the supervision of a
11dentist, requiring the dentist authorizes the procedure,
12remains in the dental facility while the procedure is
13performed, and approves the work performed by the dental
14assistant before dismissal of the patient, but the dentist is
15not required to be present at all times in the treatment room.
16    After the completion of training as provided in subsection
17(b) of this Section, an expanded function dental assistant may
18perform any of the services listed in this subsection (a)
19pursuant to the limitations of this Act.
20    (b) Certification and training as an expanded function
21dental assistant must be obtained from one of the following
22sources: (i) an approved continuing education sponsor; (ii) a
23dental assistant training program approved by the Commission on
24Dental Accreditation of the American Dental Association; or
25(iii) a training program approved by the Department.
26    Training required under this subsection (b) must also

 

 

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1include Basic Life Support certification, as described in
2Section 16 of this Act. Proof of current certification shall be
3kept on file with the supervising dentist.
4    (c) Any procedures listed in subsection (a) that are
5performed by an expanded function dental assistant must be
6approved by the supervising dentist and examined prior to
7dismissal of the patient. The supervising dentist shall be
8responsible for all dental services or procedures performed by
9the dental assistant.
10    (d) Nothing in this Section shall be construed to alter the
11number of dental assistants that a dentist may supervise under
12paragraph (g) of Section 17 of this Act.
13    (e) Nothing in this Act shall: (1) require a dental
14assistant to be certified as an expanded function dental
15assistant or (2) prevent a dentist from training dental
16assistants in accordance with the provisions of Section 17 or
1717.1 of this Act or rules pertaining to dental assistant
18duties.
19(Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19.)
 
20    (225 ILCS 25/18)   (from Ch. 111, par. 2318)
21    (Section scheduled to be repealed on January 1, 2026)
22    Sec. 18. Acts constituting the practice of dental hygiene;
23limitations.
24    (a) A person practices dental hygiene within the meaning of
25this Act when he or she performs the following acts under the

 

 

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1supervision of a dentist:
2        (i) the operative procedure of dental hygiene,
3    consisting of oral prophylactic procedures;
4        (ii) the exposure and processing of X-Ray films of the
5    teeth and surrounding structures;
6        (iii) the application to the surfaces of the teeth or
7    gums of chemical compounds designed to be desensitizing
8    agents or effective agents in the prevention of dental
9    caries or periodontal disease;
10        (iv) all services which may be performed by a dental
11    assistant as specified by rule pursuant to Section 17, and
12    a dental hygienist may engage in the placing, carving, and
13    finishing of amalgam restorations only after obtaining
14    formal education and certification as determined by the
15    Department;
16        (v) administration and monitoring of nitrous oxide
17    upon successful completion of a training program approved
18    by the Department;
19        (vi) administration of local anesthetics upon
20    successful completion of a training program approved by the
21    Department; and
22        (vii) such other procedures and acts as shall be
23    prescribed by rule or regulation of the Department.
24    (b) A dental hygienist may be employed or engaged only:
25        (1) by a dentist;
26        (2) by a federal, State, county, or municipal agency or

 

 

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1    institution;
2        (3) by a public or private school; or
3        (4) by a public clinic operating under the direction of
4    a hospital or federal, State, county, municipal, or other
5    public agency or institution.
6    (c) When employed or engaged in the office of a dentist, a
7dental hygienist may perform, under general supervision, those
8procedures found in items (i) through (iv) of subsection (a) of
9this Section, provided the patient has been examined by the
10dentist within one year of the provision of dental hygiene
11services, the dentist has approved the dental hygiene services
12by a notation in the patient's record and the patient has been
13notified that the dentist may be out of the office during the
14provision of dental hygiene services.
15    (d) If a patient of record is unable to travel to a dental
16office because of illness, infirmity, or imprisonment, a dental
17hygienist may perform, under the general supervision of a
18dentist, those procedures found in items (i) through (iv) of
19subsection (a) of this Section, provided the patient is located
20in a long-term care facility licensed by the State of Illinois,
21a mental health or developmental disability facility, or a
22State or federal prison. The dentist shall personally examine
23and diagnose the patient and determine which services are
24necessary to be performed, which shall be contained in an order
25to the hygienist and a notation in the patient's record. Such
26order must be implemented within 120 days of its issuance, and

 

 

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1an updated medical history and observation of oral conditions
2must be performed by the hygienist immediately prior to
3beginning the procedures to ensure that the patient's health
4has not changed in any manner to warrant a reexamination by the
5dentist.
6    (e) School-based oral health care, consisting of and
7limited to oral prophylactic procedures, sealants, and
8fluoride treatments, may be provided by a dental hygienist
9under the general supervision of a dentist. A dental hygienist
10may not provide other dental hygiene treatment in a
11school-based setting, including but not limited to
12administration or monitoring of nitrous oxide or
13administration of local anesthetics. The school-based
14procedures may be performed provided the patient is located at
15a public or private school and the program is being conducted
16by a State, county or local public health department initiative
17or in conjunction with a dental school or dental hygiene
18program. The dentist shall personally examine and diagnose the
19patient and determine which services are necessary to be
20performed, which shall be contained in an order to the
21hygienist and a notation in the patient's record. Any such
22order for sealants must be implemented within 120 days after
23its issuance. Any such order for oral prophylactic procedures
24or fluoride treatments must be implemented within 180 days
25after its issuance. An updated medical history and observation
26of oral conditions must be performed by the hygienist

 

 

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1immediately prior to beginning the procedures to ensure that
2the patient's health has not changed in any manner to warrant a
3reexamination by the dentist.
4    (f) Without the supervision of a dentist, a dental
5hygienist may perform dental health education functions and may
6record case histories and oral conditions observed.
7    (g) The number of dental hygienists practicing in a dental
8office shall not exceed, at any one time, 4 times the number of
9dentists practicing in the office at the time.
10    (h) A dental hygienist who is certified as a public health
11dental hygienist may provide services to patients: (1) who are
12eligible for Medicaid or (2) who are uninsured and whose
13household income is not greater than 200% of the federal
14poverty level. A public health dental hygienist may perform
15oral assessments, perform screenings, and provide educational
16and preventative services as provided in subsection (b) of
17Section 18.1 of this Act. The public health dental hygienist
18may not administer local anesthesia or nitrous oxide, or place,
19carve, or finish amalgam restorations or provide periodontal
20therapy under this exception. Each patient must sign a consent
21form that acknowledges that the care received does not take the
22place of a regular dental examination. The public health dental
23hygienist must provide the patient or guardian a written
24referral to a dentist for assessment of the need for further
25dental care at the time of treatment. Any indication or
26observation of a condition that could warrant the need for

 

 

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1urgent attention must be reported immediately to the
2supervising dentist for appropriate assessment and treatment.
3    This subsection (h) is inoperative on and after January 1,
42026 2021.
5    (i) A dental hygienist performing procedures listed in
6paragraphs (1) through (4) of subsection (a) of Section 17.1
7must be under the supervision of a dentist, requiring the
8dentist authorizes the procedure, remains in the dental
9facility while the procedure is performed, and approves the
10work performed by the dental hygienist before dismissal of the
11patient, but the dentist is not required to be present at all
12times in the treatment room.
13    (j) A dental hygienist may perform actions described in
14paragraph (5) of subsection (a) of Section 17.1 under the
15general supervision of a dentist as described in this Section.
16(Source: P.A. 99-492, eff. 12-31-15; 100-976, eff. 1-1-19.)
 
17    (225 ILCS 25/18.1)
18    (Section scheduled to be repealed on January 1, 2021)
19    Sec. 18.1. Public health dental supervision
20responsibilities.
21    (a) When working together in a public health supervision
22relationship, dentists and public health dental hygienists
23shall enter into a public health supervision agreement. The
24dentist providing public health supervision must:
25        (1) be available to provide an appropriate level of

 

 

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1    contact, communication, collaboration, and consultation
2    with the public health dental hygienist and must meet
3    in-person with the public health dental hygienist at least
4    quarterly for review and consultation;
5        (2) have specific standing orders or policy guidelines
6    for procedures that are to be carried out for each location
7    or program, although the dentist need not be present when
8    the procedures are being performed;
9        (3) provide for the patient's additional necessary
10    care in consultation with the public health dental
11    hygienist;
12        (4) file agreements and notifications as required; and
13        (5) include procedures for creating and maintaining
14    dental records, including protocols for transmission of
15    all records between the public health dental hygienist and
16    the dentist following each treatment, which shall include a
17    notation regarding procedures authorized by the dentist
18    and performed by the public health dental hygienist and the
19    location where those records are to be kept.
20    Each dentist and hygienist who enters into a public health
21supervision agreement must document and maintain a copy of any
22change or termination of that agreement.
23    Dental records shall be owned and maintained by the
24supervising dentist for all patients treated under public
25health supervision, unless the supervising dentist is an
26employee of a public health clinic or federally qualified

 

 

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1health center, in which case the public health clinic or
2federally qualified health center shall maintain the records.
3    If a dentist ceases to be employed or contracted by the
4facility, the dentist shall notify the facility administrator
5that the public health supervision agreement is no longer in
6effect. A new public health supervision agreement is required
7for the public health dental hygienist to continue treating
8patients under public health supervision.
9    A dentist entering into an agreement under this Section may
10supervise and enter into agreements for public health
11supervision with 2 public health dental hygienists. This shall
12be in addition to the limit of 4 dental hygienists per dentist
13set forth in subsection (g) of Section 18 of this Act.
14    (b) A public health dental hygienist providing services
15under public health supervision may perform only those duties
16within the accepted scope of practice of dental hygiene, as
17follows:
18        (1) the operative procedures of dental hygiene,
19    consisting of oral prophylactic procedures, including
20    prophylactic cleanings, application of fluoride, and
21    placement of sealants;
22        (2) the exposure and processing of x-ray films of the
23    teeth and surrounding structures; and
24        (3) such other procedures and acts as shall be
25    prescribed by rule of the Department.
26    Any patient treated under this subsection (b) must be

 

 

SB0167- 30 -LRB101 04886 JRG 49895 b

1examined by a dentist before additional services can be
2provided by a public health dental hygienist. However, if the
3supervising dentist, after consultation with the public health
4hygienist, determines that time is needed to complete an
5approved treatment plan on a patient eligible under this
6Section, then the dentist may instruct the hygienist to
7complete the remaining services prior to an oral examination by
8the dentist. Such instruction by the dentist to the hygienist
9shall be noted in the patient's records. Any services performed
10under this exception must be scheduled in a timely manner and
11shall not occur more than 30 days after the first appointment
12date.
13    (c) A public health dental hygienist providing services
14under public health supervision must:
15        (1) provide to the patient, parent, or guardian a
16    written plan for referral or an agreement for follow-up
17    that records all conditions observed that should be called
18    to the attention of a dentist for proper diagnosis;
19        (2) have each patient sign a permission slip or consent
20    form that informs them that the service to be received does
21    not take the place of regular dental checkups at a dental
22    office and is meant for people who otherwise would not have
23    access to the service;
24        (3) inform each patient who may require further dental
25    services of that need;
26        (4) maintain an appropriate level of contact and

 

 

SB0167- 31 -LRB101 04886 JRG 49895 b

1    communication with the dentist providing public health
2    supervision; and
3        (5) complete an additional 4 hours of continuing
4    education in areas specific to public health dentistry
5    yearly.
6    (d) Each public health dental hygienist who has rendered
7services under subsections (c), (d), and (e) of this Section
8must complete a summary report at the completion of a program
9or, in the case of an ongoing program, at least annually. The
10report must be completed in the manner specified by the
11Division of Oral Health in the Department of Public Health
12including information about each location where the public
13health dental hygienist has rendered these services. The public
14health dental hygienist must submit the form to the dentist
15providing supervision for his or her signature before sending
16it to the Division.
17    (e) Public health dental hygienists providing services
18under public health supervision may be compensated for their
19work by salary, honoraria, and other mechanisms by the
20employing or sponsoring entity. Nothing in this Act shall
21preclude the entity that employs or sponsors a public health
22dental hygienist from seeking payment, reimbursement, or other
23source of funding for the services provided.
24    (f) This Section is repealed on January 1, 2026 2021.
25(Source: P.A. 99-492, eff. 12-31-15; 99-680, eff. 1-1-17.)
 

 

 

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1    (225 ILCS 25/38.2)
2    (Section scheduled to be repealed on January 1, 2026)
3    Sec. 38.2. Death or incapacitation of dentist.
4    (a) The executor or administrator of a dentist's estate or
5the legal guardian or authorized representative of a dentist
6who has become incapacitated may contract with another dentist
7or dentists to continue the operations of the deceased or
8incapacitated dentist's practice (if the practice of the
9deceased or incapacitated dentist is a sole proprietorship, a
10corporation where the deceased or incapacitated dentist is the
11sole shareholder, or a limited liability company where the
12deceased or incapacitated dentist is the sole member) for a
13period of no more than one year from the time of death or
14incapacitation of the dentist or until the practice is sold,
15whichever occurs first, if all the following conditions are
16met:
17        (1) The executor, administrator, guardian, or
18    authorized representative executes and files with the
19    Department a notification of death or incapacitation on a
20    form provided by the Department, which notification shall
21    include the following:
22            (A) the name and license number of the deceased or
23        incapacitated dentist;
24            (B) the name and address of the dental practice;
25            (C) the name, address, and tax identification
26        number of the estate;

 

 

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1            (D) the name and license number of each dentist who
2        will operate the dental practice; and
3            (E) an affirmation, under penalty of perjury, that
4        the information provided is true and correct and that
5        the executor, administrator, guardian, or authorized
6        representative understands that any interference by
7        the executor, administrator, guardian, or authorized
8        representative or any agent or assignee of the
9        executor, administrator, guardian, or authorized
10        representative with the contracting dentist's or
11        dentists' practice of dentistry or professional
12        judgment or any other violation of this Section is
13        grounds for an immediate termination of the operations
14        of the dental practice.
15        (2) Within 30 days after the death or incapacitation of
16    a dentist, the executor, administrator, guardian, or
17    authorized representative shall send notification of the
18    death or incapacitation by mail to the last known address
19    of each patient of record that has seen the deceased or
20    incapacitated dentist within the previous 12 months, with
21    an explanation of how copies of the practitioner's records
22    may be obtained. This notice may also contain any other
23    relevant information concerning the continuation of the
24    dental practice.
25    Continuation of the operations of the dental practice of a
26deceased or incapacitated dentist shall not begin until the

 

 

SB0167- 34 -LRB101 04886 JRG 49895 b

1provisions of this subsection (a) have been met.
2    If the practice is not sold within the initial one-year
3period, the provision described in subsection (a) may be
4extended for additional 12-month periods by the Department.
5However, if the extension is approved, the extension shall not
6exceed 3 additional 12-month periods. Each extension must be
7granted prior to the expiration date of the prior extension and
8must be accompanied by a petition detailing the reasons for the
9extension that must be kept on file by the Department.
10    (b) The Secretary may terminate the operations of a dental
11practice operating pursuant to this Section if the Department
12has evidence of a violation of this Section or Section 23 or 24
13of this Act. The Secretary must conduct a hearing before
14terminating the operations of a dental practice operating
15pursuant to this Section. At least 15 days before the hearing
16date, the Department (i) must notify, in writing, the executor,
17administrator, guardian, or authorized representative at the
18address provided, pursuant to item (C) of subdivision (1) of
19subsection (a) of this Section, and to the contracting dentist
20or dentists at the address of the dental practice provided
21pursuant to item (B) of subdivision (1) of subsection (a) of
22this Section, of any charges made and of the time and place of
23the hearing on the charges before the Secretary or hearing
24officer, as provided in Section 30 of this Act, (ii) direct the
25executor, administrator, guardian, or authorized
26representative to file his or her written answer to such

 

 

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1charges with the Secretary under oath within 10 days after the
2service on the executor, administrator, guardian, or
3authorized representative of the notice, and (iii) inform the
4executor, administrator, guardian, or authorized
5representative that if he or she fails to file such answer, a
6default judgment will be entered against him or her and the
7operations of the dental practice shall be terminated.
8    (c) If the Secretary finds that evidence in his or her
9possession indicates that a violation of this Section or
10Section 23 or 24 of this Act constitutes an immediate threat to
11the public health, safety, or welfare, the Secretary may
12immediately terminate the operations of the dental practice
13without a hearing. Upon service by certified mail to the
14executor, administrator, guardian, or authorized
15representative, at the address provided pursuant to item (C) of
16subdivision (1) of subsection (a) of this Section, and the
17contracting dentist or dentists, at the address of the dental
18practice provided pursuant to item (B) of subdivision (1) of
19subsection (a) of this Section, of notice of an order
20immediately terminating the operations of the dental practice,
21the executor, administrator, guardian, or authorized
22representative may petition the Department within 30 days for a
23hearing to take place within 30 days after the petition is
24filed.
25    (d) The Department may require, by rule, the submission to
26the Department of any additional information necessary for the

 

 

SB0167- 36 -LRB101 04886 JRG 49895 b

1administration of this Section.
2(Source: P.A. 94-1028, eff. 1-1-07.)
 
3    (225 ILCS 25/54.3)
4    (Section scheduled to be repealed on January 1, 2020)
5    Sec. 54.3. Vaccinations.
6    (a) Notwithstanding Section 54.2 of this Act, a dentist may
7administer vaccinations upon completion of appropriate
8training set forth by rule and approved by the Department on
9appropriate vaccine storage, proper administration, and
10addressing contraindications and adverse reactions.
11Vaccinations shall be limited to patients 18 years of age and
12older pursuant to a valid prescription or standing order by a
13physician licensed to practice medicine in all its branches
14who, in the course of professional practice, administers
15vaccines to patients. Methods of communication shall be
16established for consultation with the physician in person or by
17telecommunications.
18    (b) Vaccinations administered by a dentist shall be limited
19to influenza (inactivated influenza vaccine and live
20attenuated influenza intranasal vaccine). Vaccines shall only
21be administered by the dentist and shall not be delegated to an
22assistant or any other person. Vaccination of a patient by a
23dentist shall be documented in the patient's dental record and
24the record shall be retained in accordance with current dental
25recordkeeping standards. The dentist shall notify the

 

 

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1patient's primary care physician of each dose of vaccine
2administered to the patient and shall enter all patient level
3data or update the patient's current record. The dentist may
4provide this notice to the patient's physician electronically.
5In addition, the dentist shall enter all patient level data on
6vaccines administered in the immunization data registry
7maintained by the Department of Public Health.
8    (c) A dentist shall only provide vaccinations under this
9Section if contracted with and credentialed by the patient's
10health insurance, health maintenance organization, or other
11health plan to specifically provide the vaccinations allowed
12under this Section. Persons enrolled in Medicare or Medicaid
13may only receive the vaccinations allowed for under this
14Section from dentists who are authorized to do so by the
15federal Centers for Medicare and Medicaid Services or the
16Department of Healthcare and Family Services.
17    (d) The Department shall adopt any rules necessary to
18implement this Section.
19    (e) This Section is repealed on January 1, 2026 2020.
20(Source: P.A. 98-665, eff. 6-23-14.)
 
21    Section 99. Effective date. This Act takes effect upon
22becoming law.

 

 

SB0167- 38 -LRB101 04886 JRG 49895 b

1 INDEX
2 Statutes amended in order of appearance
3    225 ILCS 25/4from Ch. 111, par. 2304
4    225 ILCS 25/8.1from Ch. 111, par. 2308.1
5    225 ILCS 25/17from Ch. 111, par. 2317
6    225 ILCS 25/17.1
7    225 ILCS 25/18from Ch. 111, par. 2318
8    225 ILCS 25/18.1
9    225 ILCS 25/38.2
10    225 ILCS 25/54.3