Full Text of HB2267 103rd General Assembly
HB2267eng 103RD GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Dental Practice Act is amended by | 5 | | changing Sections 4, 17, 18, and 18.1 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| 7 | | (Section scheduled to be repealed on January 1, 2026)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 | 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.
| 18 | | "Secretary" means the Secretary of Financial and | 19 | | Professional Regulation.
| 20 | | "Board" means the Board of Dentistry.
| 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.
| 3 | | "Dental hygienist" means a person who holds a license | 4 | | under this Act to
perform dental services as authorized by | 5 | | Section 18.
| 6 | | "Dental assistant" means an appropriately trained person
| 7 | | who, under the supervision of a dentist, provides dental | 8 | | services
as authorized by Section 17.
| 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:
| 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 | 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.
| 4 | | "General supervision" means supervision of a dental | 5 | | hygienist
requiring that the patient be a patient of record,
| 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
| 11 | | procedures are being performed. The
issuance of a prescription | 12 | | to a dental laboratory by a
dentist does not constitute | 13 | | general supervision.
| 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.
| 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.
| 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,
| 26 | | periodontics, prosthodontics, oral and maxillofacial
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| 1 | | radiology, and dental anesthesiology.
| 2 | | "Specialist" means a dentist who has received a specialty | 3 | | license
pursuant to Section 11(b).
| 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.
| 10 | | "Impaired dentist" or "impaired dental hygienist" means a | 11 | | dentist
or dental hygienist who is unable to practice with
| 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
| 17 | | degree to diminish the person's ability to deliver competent | 18 | | patient care.
| 19 | | "Nurse" means a registered professional nurse, a certified | 20 | | registered
nurse anesthetist licensed as an advanced practice
| 21 | | registered nurse, or a licensed practical nurse licensed under | 22 | | the Nurse Practice Act.
| 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.
| 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; a certified | 23 | | school-based health center or school-based oral health | 24 | | program; a prison; or a long-term care facility. | 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 or and whose | 7 | | household income is not greater than 300% 200% of the federal | 8 | | poverty level. | 9 | | "Teledentistry" means the use of telehealth systems and | 10 | | methodologies in dentistry and includes patient care and | 11 | | education delivery using synchronous and asynchronous | 12 | | communications under a dentist's authority as provided under | 13 | | this Act. | 14 | | (Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19; | 15 | | 102-93, eff. 1-1-22; 102-588, eff. 8-20-21; 102-936, eff. | 16 | | 1-1-23 .)
| 17 | | (225 ILCS 25/17) (from Ch. 111, par. 2317)
| 18 | | (Section scheduled to be repealed on January 1, 2026)
| 19 | | Sec. 17. Acts constituting the practice of dentistry. A | 20 | | person
practices dentistry, within the meaning of this Act:
| 21 | | (1) Who represents himself or herself as being able to | 22 | | diagnose or diagnoses,
treats, prescribes, or operates for | 23 | | any disease, pain, deformity, deficiency,
injury, or | 24 | | physical condition of the human tooth, teeth, alveolar | 25 | | process,
gums or jaw; or
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| 1 | | (2) Who is a manager, proprietor, operator or | 2 | | conductor of a
business where
dental operations are | 3 | | performed; or
| 4 | | (3) Who performs dental operations of any kind; or
| 5 | | (4) Who uses an X-Ray machine or X-Ray films for
| 6 | | dental diagnostic purposes; or
| 7 | | (5) Who extracts a human tooth or teeth, or corrects | 8 | | or attempts to
correct
malpositions of the human teeth or | 9 | | jaws; or
| 10 | | (6) Who offers or undertakes, by any means or method, | 11 | | to diagnose, treat
or remove stains, calculus, and bonding | 12 | | materials from human teeth or jaws; or
| 13 | | (7) Who uses or administers local or general | 14 | | anesthetics in the treatment
of dental or oral diseases or | 15 | | in any preparation incident to a dental operation
of any | 16 | | kind or character; or
| 17 | | (8) Who takes material or digital scans for final | 18 | | impressions of the human tooth, teeth, or jaws or performs
| 19 | | any phase of any operation incident to the replacement of | 20 | | a part of a tooth,
a tooth, teeth or associated tissues by | 21 | | means of a filling, crown, a bridge,
a denture or other | 22 | | appliance; or
| 23 | | (9) Who offers to furnish, supply, construct, | 24 | | reproduce or repair, or
who furnishes, supplies, | 25 | | constructs, reproduces or repairs, prosthetic
dentures, | 26 | | bridges or other substitutes for natural teeth, to the |
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| 1 | | user or
prospective user thereof; or
| 2 | | (10) Who instructs students on clinical matters or | 3 | | performs any clinical
operation included in the curricula | 4 | | of recognized dental schools and colleges; or
| 5 | | (11) Who takes material or digital scans for final | 6 | | impressions of human teeth or places his or her hands in | 7 | | the mouth of any person for the purpose of applying teeth | 8 | | whitening materials, or who takes impressions of human | 9 | | teeth or places his or her hands in the mouth of any person | 10 | | for the purpose of assisting in the application of teeth | 11 | | whitening materials. A person does not practice dentistry | 12 | | when he or she discloses to the consumer that he or she is | 13 | | not licensed as a dentist under this Act and (i) discusses | 14 | | the use of teeth whitening materials with a consumer | 15 | | purchasing these materials; (ii) provides instruction on | 16 | | the use of teeth whitening materials with a consumer | 17 | | purchasing these materials; or (iii) provides appropriate | 18 | | equipment on-site to the consumer for the consumer to | 19 | | self-apply teeth whitening materials. | 20 | | The fact that any person engages in or performs, or offers | 21 | | to engage in
or perform, any of the practices, acts, or | 22 | | operations set forth in this
Section, shall be prima facie | 23 | | evidence that such person is engaged in the
practice of | 24 | | dentistry.
| 25 | | The following practices, acts, and operations, however, | 26 | | are exempt from
the operation of this Act:
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| 1 | | (a) The rendering of dental relief in emergency cases | 2 | | in the practice
of his or her profession by a physician or | 3 | | surgeon, licensed as such
under the laws of this State, | 4 | | unless he or she undertakes to reproduce or reproduces
| 5 | | lost parts of the human teeth in the mouth or to restore or | 6 | | replace lost
or missing teeth in the mouth; or
| 7 | | (b) The practice of dentistry in the discharge of | 8 | | their official duties
by dentists in any branch of the | 9 | | Armed Services of the United States, the
United States | 10 | | Public Health Service, or the United States Veterans
| 11 | | Administration; or
| 12 | | (c) The practice of dentistry by students in their | 13 | | course of study
in dental schools or colleges approved by | 14 | | the Department, when acting under the
direction and | 15 | | supervision of dentists acting as instructors; or
| 16 | | (d) The practice of dentistry by clinical instructors | 17 | | in the course of
their teaching duties in dental schools | 18 | | or colleges approved by the
Department:
| 19 | | (i) when acting under the direction and | 20 | | supervision of dentists,
provided that such clinical | 21 | | instructors have instructed continuously in
this State | 22 | | since January 1, 1986; or
| 23 | | (ii) when holding the rank of full professor at | 24 | | such approved dental
school or college and possessing | 25 | | a current valid license or authorization
to practice | 26 | | dentistry in another country; or
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| 1 | | (e) The practice of dentistry by licensed dentists of | 2 | | other states or
countries at meetings of the Illinois | 3 | | State Dental Society or component
parts thereof, alumni | 4 | | meetings of dental colleges, or any other like dental
| 5 | | organizations, while appearing as clinicians; or
| 6 | | (f) The use of X-Ray machines for exposing X-Ray films | 7 | | of dental or oral
tissues by dental hygienists or dental | 8 | | assistants; or
| 9 | | (g) The performance of any dental service by a dental | 10 | | assistant, if such
service is performed under the | 11 | | supervision and full responsibility of a
dentist. In | 12 | | addition, after being authorized by a dentist, a dental | 13 | | assistant may, for the purpose of eliminating pain or | 14 | | discomfort, remove loose, broken, or irritating | 15 | | orthodontic appliances on a patient of record.
| 16 | | For purposes of this paragraph (g), "dental service" | 17 | | is defined to mean
any intraoral procedure or act which | 18 | | shall be prescribed by rule or
regulation of the | 19 | | Department. Dental service, however, shall not include:
| 20 | | (1) Any and all diagnosis of or prescription for | 21 | | treatment of disease,
pain, deformity, deficiency, | 22 | | injury or physical condition of the human teeth
or | 23 | | jaws, or adjacent structures.
| 24 | | (2) Removal of, or restoration of, or addition
to | 25 | | the hard or soft tissues of the oral cavity, except for | 26 | | the placing, carving, and finishing of amalgam |
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| 1 | | restorations and placing, packing, and finishing | 2 | | composite restorations by dental assistants who have | 3 | | had additional formal education and certification. | 4 | | A dental assistant may place, carve, and finish | 5 | | amalgam restorations, place, pack, and finish | 6 | | composite restorations, and place interim restorations | 7 | | if he or she (A) has successfully completed a | 8 | | structured training program as described in item (2) | 9 | | of subsection (g) provided by an educational | 10 | | institution accredited by the Commission on Dental | 11 | | Accreditation, such as a dental school or dental | 12 | | hygiene or dental assistant program, or (B) has at | 13 | | least 4,000 hours of direct clinical patient care | 14 | | experience and has successfully completed a structured | 15 | | training program as described in item (2) of | 16 | | subsection (g) provided by a statewide dental | 17 | | association, approved by the Department to provide | 18 | | continuing education, that has developed and conducted | 19 | | training programs for expanded functions for dental | 20 | | assistants or hygienists. The training program must: | 21 | | (i) include a minimum of 16 hours of didactic study and | 22 | | 14 hours of clinical manikin instruction; all training | 23 | | programs shall include areas of study in nomenclature, | 24 | | caries classifications, oral anatomy, periodontium, | 25 | | basic occlusion, instrumentations, pulp protection | 26 | | liners and bases, dental materials, matrix and wedge |
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| 1 | | techniques, amalgam placement and carving, rubber dam | 2 | | clamp placement, and rubber dam placement and removal; | 3 | | (ii) include an outcome assessment examination that | 4 | | demonstrates competency; (iii) require the supervising | 5 | | dentist to observe and approve the completion of 8 | 6 | | amalgam or composite restorations; and (iv) issue a | 7 | | certificate of completion of the training program, | 8 | | which must be kept on file at the dental office and be | 9 | | made available to the Department upon request. A | 10 | | dental assistant must have successfully completed an | 11 | | approved coronal polishing and dental sealant course | 12 | | prior to taking the amalgam and composite restoration | 13 | | course. | 14 | | A dentist utilizing dental assistants shall not | 15 | | supervise more than 4 dental assistants at any one | 16 | | time for placing, carving, and finishing of amalgam | 17 | | restorations or for placing, packing, and finishing | 18 | | composite restorations.
| 19 | | (3) Any and all correction of malformation of | 20 | | teeth or of the jaws.
| 21 | | (4) Administration of anesthetics, except for | 22 | | monitoring of
nitrous oxide, conscious sedation, deep | 23 | | sedation, and general anesthetic as provided in | 24 | | Section 8.1 of this Act, that may be performed only | 25 | | after successful completion of a training
program | 26 | | approved by the Department. A dentist utilizing dental |
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| 1 | | assistants shall not supervise more than 4 dental | 2 | | assistants at any one time for the monitoring of | 3 | | nitrous oxide.
| 4 | | (5) Removal of calculus from human teeth.
| 5 | | (6) Taking of material or digital scans for final | 6 | | impressions for the fabrication of prosthetic
| 7 | | appliances,
crowns,
bridges, inlays, onlays, or other | 8 | | restorative or replacement
dentistry.
| 9 | | (7) The operative procedure of dental hygiene | 10 | | consisting of oral
prophylactic procedures, except for | 11 | | coronal polishing and pit and fissure sealants,
which | 12 | | may be
performed by a
dental assistant who has | 13 | | successfully completed a training program approved by
| 14 | | the Department. Dental assistants may perform coronal | 15 | | polishing under the
following circumstances: (i) the | 16 | | coronal polishing shall be limited to
polishing the
| 17 | | clinical crown of the tooth and existing restorations, | 18 | | supragingivally; (ii)
the
dental assistant performing | 19 | | the coronal polishing shall be limited to the use
of
| 20 | | rotary instruments using a rubber cup or brush | 21 | | polishing method (air polishing
is
not permitted); and | 22 | | (iii) the supervising dentist shall not supervise more
| 23 | | than 4
dental assistants at any one time for the task | 24 | | of coronal polishing or pit and fissure sealants.
| 25 | | In addition to coronal polishing and pit and | 26 | | fissure sealants as described in this item (7), a |
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| 1 | | dental assistant who has at least 2,000 hours of | 2 | | direct clinical patient care experience and who has | 3 | | successfully completed a structured training program | 4 | | provided by (1) an educational institution including, | 5 | | but not limited to, a dental school or dental hygiene | 6 | | or dental assistant program, or (2) a continuing | 7 | | education provider approved by the Department, or (3) | 8 | | a statewide dental or dental hygienist association, | 9 | | approved by the Department on or before January 1, | 10 | | 2017 (the effective date of Public Act 99-680) , that | 11 | | has developed and conducted a training program for | 12 | | expanded functions for dental assistants or hygienists | 13 | | may perform: (A) coronal scaling above the gum line, | 14 | | supragingivally, on the clinical crown of the tooth | 15 | | only on patients 17 years of age or younger who have an | 16 | | absence of periodontal disease and who are not | 17 | | medically compromised or individuals with special | 18 | | needs and (B) intracoronal temporization of a tooth. | 19 | | The training program must: (I) include a minimum of 32 | 20 | | hours of instruction in both didactic and clinical | 21 | | manikin or human subject instruction; all training | 22 | | programs shall include areas of study in dental | 23 | | anatomy, public health dentistry, medical history, | 24 | | dental emergencies, and managing the pediatric | 25 | | patient; (II) include an outcome assessment | 26 | | examination that demonstrates competency; (III) |
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| 1 | | require the supervising dentist to observe and approve | 2 | | the completion of 6 full mouth supragingival scaling | 3 | | procedures unless the training was received as part of | 4 | | a Commission on Dental Accreditation approved dental | 5 | | assistant program; and (IV) issue a certificate of | 6 | | completion of the training program, which must be kept | 7 | | on file at the dental office and be made available to | 8 | | the Department upon request. A dental assistant must | 9 | | have successfully completed an approved coronal | 10 | | polishing course prior to taking the coronal scaling | 11 | | course. A dental assistant performing these functions | 12 | | shall be limited to the use of hand instruments only. | 13 | | In addition, coronal scaling as described in this | 14 | | paragraph shall only be utilized on patients who are | 15 | | eligible for Medicaid, who are uninsured, or whose | 16 | | household income is not greater than 300% of the | 17 | | federal poverty level. A dentist may not supervise | 18 | | more than 2 dental assistants at any one time for the | 19 | | task of coronal scaling. This paragraph is inoperative | 20 | | on and after January 1, 2026. | 21 | | The limitations on the number of dental assistants a | 22 | | dentist may supervise contained in items (2), (4), and (7) | 23 | | of this paragraph (g) mean a limit of 4 total dental | 24 | | assistants or dental hygienists doing expanded functions | 25 | | covered by these Sections being supervised by one dentist; | 26 | | or |
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| 1 | | (h) The practice of dentistry by an individual who:
| 2 | | (i) has applied in writing to the Department, in | 3 | | form and substance
satisfactory to the Department, for | 4 | | a general dental license and has
complied with all | 5 | | provisions of Section 9 of this Act, except for the
| 6 | | passage of the examination specified in subsection (e) | 7 | | of Section 9 of this
Act; or
| 8 | | (ii) has applied in writing to the Department, in | 9 | | form and substance
satisfactory to the Department, for | 10 | | a temporary dental license and has
complied with all | 11 | | provisions of subsection (c) of Section 11 of this | 12 | | Act; and
| 13 | | (iii) has been accepted or appointed for specialty | 14 | | or residency training
by a hospital situated in this | 15 | | State; or
| 16 | | (iv) has been accepted or appointed for specialty | 17 | | training in an
approved dental program situated in | 18 | | this State; or
| 19 | | (v) has been accepted or appointed for specialty | 20 | | training in a dental
public health agency situated in | 21 | | this State.
| 22 | | The applicant shall be permitted to practice dentistry | 23 | | for a period of 3
months from the starting date of the | 24 | | program, unless authorized in writing
by the Department to | 25 | | continue such practice for a period specified in
writing | 26 | | by the Department.
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| 1 | | The applicant shall only be entitled to perform such | 2 | | acts as may be
prescribed by and incidental to his or her | 3 | | program of residency or specialty
training and shall not | 4 | | otherwise engage in the practice of dentistry in this
| 5 | | State.
| 6 | | The authority to practice shall terminate immediately | 7 | | upon:
| 8 | | (1) the decision of the Department that the | 9 | | applicant has failed the
examination; or
| 10 | | (2) denial of licensure by the Department; or
| 11 | | (3) withdrawal of the application.
| 12 | | (Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21; | 13 | | 102-936, eff. 1-1-23 .)
| 14 | | (225 ILCS 25/18)
(from Ch. 111, par. 2318)
| 15 | | (Section scheduled to be repealed on January 1, 2026)
| 16 | | Sec. 18. Acts constituting the practice of dental hygiene;
| 17 | | limitations. | 18 | | (a) A person practices dental hygiene within the meaning | 19 | | of this Act when
he or she performs the following acts under | 20 | | the supervision of a dentist:
| 21 | | (i) the operative procedure of dental hygiene, | 22 | | consisting of oral
prophylactic procedures;
| 23 | | (ii) the exposure and processing of X-Ray films of the | 24 | | teeth and
surrounding structures;
| 25 | | (iii) the application to the surfaces of the teeth or |
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| 1 | | gums of chemical
compounds designed to be desensitizing | 2 | | agents or effective agents in the
prevention of dental | 3 | | caries or periodontal disease;
| 4 | | (iv) all services which may be performed by a
dental | 5 | | assistant as specified by rule pursuant to Section 17, and | 6 | | a dental hygienist may engage in the placing, carving, and | 7 | | finishing of amalgam restorations only after obtaining | 8 | | formal education and certification as determined by the | 9 | | Department;
| 10 | | (v) administration and monitoring of nitrous oxide | 11 | | upon successful
completion of a
training program approved | 12 | | by the Department;
| 13 | | (vi) administration of local anesthetics upon | 14 | | successful completion of
a
training program approved by | 15 | | the Department; and
| 16 | | (vii) such other procedures and acts as shall be | 17 | | prescribed
by
rule or regulation of the Department.
| 18 | | (b) A dental hygienist may be employed or engaged only:
| 19 | | (1) by a dentist;
| 20 | | (2) by a federal, State, county, or municipal agency | 21 | | or institution;
| 22 | | (3) by a public or private school; or
| 23 | | (4) by a public clinic operating under the direction | 24 | | of a hospital or
federal,
State, county, municipal, or | 25 | | other public agency or institution.
| 26 | | (c) When employed or engaged in the office of a dentist, a |
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| 1 | | dental hygienist
may
perform, under general supervision, those | 2 | | procedures found in items (i) through
(iv) of
subsection (a) | 3 | | of this Section, provided the patient has been examined by the
| 4 | | dentist
within one year of the provision of dental hygiene | 5 | | services, the dentist has
approved the
dental hygiene services | 6 | | by a notation in the patient's record and the patient
has been
| 7 | | notified that the dentist may be out of the office during the | 8 | | provision of
dental hygiene
services.
| 9 | | (d) If a patient of record is unable to travel to a dental | 10 | | office because of
illness,
infirmity, or
imprisonment, a | 11 | | dental hygienist may perform, under the general supervision of
| 12 | | a dentist,
those procedures found in items (i) through (iv) of | 13 | | subsection (a) of this
Section,
provided the patient is | 14 | | located in a long-term care facility licensed by the
State of | 15 | | Illinois,
a mental health or developmental disability | 16 | | facility, or a State or federal
prison. The dentist
shall | 17 | | either personally examine and diagnose the patient or utilize | 18 | | approved teledentistry communication methods and determine | 19 | | which
services are necessary to be performed, which shall be | 20 | | contained in an order to the hygienist and a notation in the | 21 | | patient's record.
Such order must be implemented within 45 | 22 | | days
of its issuance, and an updated medical history and | 23 | | observation of oral
conditions
must be performed by the | 24 | | hygienist immediately prior to beginning the
procedures to | 25 | | ensure that the patient's health has not changed in any
manner | 26 | | to warrant a reexamination by the dentist.
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| 1 | | (e) School-based oral health care,
consisting of and | 2 | | limited to oral prophylactic
procedures, sealants, and | 3 | | fluoride treatments,
may be provided by a dental hygienist
| 4 | | under the general supervision of a dentist. A dental hygienist | 5 | | may not provide
other dental hygiene treatment in a | 6 | | school-based setting, including but not
limited to | 7 | | administration or monitoring of nitrous oxide or | 8 | | administration of
local anesthetics. The school-based | 9 | | procedures may be performed provided the
patient is located at | 10 | | a public or private school and the program is being
conducted | 11 | | by a State, county or local public health department | 12 | | initiative or in
conjunction with a dental school or dental | 13 | | hygiene program.
The dentist shall personally examine and | 14 | | diagnose the patient and
determine
which services are | 15 | | necessary to be performed, which shall be contained in an
| 16 | | order to the
hygienist and a notation in the patient's record. | 17 | | Any such order for sealants must be implemented within 120 | 18 | | days after its issuance. Any such order for oral prophylactic | 19 | | procedures or fluoride treatments must be implemented within | 20 | | 180 days after its issuance. An updated medical history and | 21 | | observation of
oral conditions
must be
performed by the | 22 | | hygienist immediately prior to beginning the procedures to
| 23 | | ensure that
the patient's health has not changed in any manner | 24 | | to warrant a reexamination
by the
dentist.
| 25 | | (f) Without the supervision of a dentist, a dental | 26 | | hygienist
may perform
dental health education functions, |
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| 1 | | including instruction in proper oral health care and dental | 2 | | hygiene in , for example, either a school setting , a or | 3 | | long-term care facility , and a health fair . In addition, a | 4 | | dental hygienist may record case care histories and oral | 5 | | conditions observed at any time prior to a clinical exam by a | 6 | | dentist.
| 7 | | (g) The number of dental hygienists practicing in a dental | 8 | | office shall
not
exceed, at any one time, 4 times the number of | 9 | | dentists practicing in the
office at the time.
| 10 | | (h) A dental hygienist who is certified as a public health | 11 | | dental hygienist may provide services to patients: (1) who are | 12 | | eligible for Medicaid or (2) who are uninsured and whose | 13 | | household income is not greater than 300% of the federal | 14 | | poverty level. A public health dental hygienist may perform | 15 | | oral assessments, perform screenings, and provide educational | 16 | | and preventative services as provided in subsection (b) of | 17 | | Section 18.1 of this Act. The public health dental hygienist | 18 | | may not administer local anesthesia or nitrous oxide, or | 19 | | place, carve, or finish amalgam restorations or provide | 20 | | periodontal therapy under this exception. Each patient must | 21 | | sign a consent form that acknowledges that the care received | 22 | | does not take the place of a regular dental examination. The | 23 | | public health dental hygienist must provide the patient or | 24 | | guardian a written referral to a dentist for assessment of the | 25 | | need for further dental care at the time of treatment. Any | 26 | | indication or observation of a condition that could warrant |
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| 1 | | the need for urgent attention must be reported immediately to | 2 | | the supervising dentist for appropriate assessment and | 3 | | treatment. | 4 | | This subsection (h) is inoperative on and after January 1, | 5 | | 2026. | 6 | | (i) A dental hygienist performing procedures listed in | 7 | | paragraphs (1) through (4) of subsection (a) of Section 17.1 | 8 | | must be under the supervision of a dentist, requiring the | 9 | | dentist authorizes the procedure, remains in the dental | 10 | | facility while the procedure is performed, and approves the | 11 | | work performed by the dental hygienist before dismissal of the | 12 | | patient, but the dentist is not required to be present at all | 13 | | times in the treatment room. | 14 | | (j) A dental hygienist may perform actions described in | 15 | | paragraph (5) of subsection (a) of Section 17.1 under the | 16 | | general supervision of a dentist as described in this Section. | 17 | | (Source: P.A. 101-162, eff. 7-26-19; 102-936, eff. 1-1-23 .)
| 18 | | (225 ILCS 25/18.1) | 19 | | (Section scheduled to be repealed on January 1, 2026) | 20 | | Sec. 18.1. Public health dental supervision | 21 | | responsibilities. | 22 | | (a) When working together in a public health supervision | 23 | | relationship, dentists and public health dental hygienists | 24 | | shall enter into a public health supervision agreement. The | 25 | | dentist providing public health supervision must: |
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| 1 | | (1) be available to provide an appropriate level of | 2 | | contact, communication, collaboration, and consultation | 3 | | with the public health dental hygienist and must meet | 4 | | in-person with the public health dental hygienist at least | 5 | | quarterly for review and consultation; | 6 | | (2) have specific standing orders or policy guidelines | 7 | | for procedures that are to be carried out for each | 8 | | location or program, although the dentist need not be | 9 | | present when the procedures are being performed; | 10 | | (3) provide for the patient's additional necessary | 11 | | care in consultation with the public health dental | 12 | | hygienist; | 13 | | (4) file agreements and notifications as required; and | 14 | | (5) include procedures for creating and maintaining | 15 | | dental records, including protocols for transmission of | 16 | | all records between the public health dental hygienist and | 17 | | the dentist following each treatment, which shall include | 18 | | a notation regarding procedures authorized by the dentist | 19 | | and performed by the public health dental hygienist and | 20 | | the location where those records are to be kept. | 21 | | Each dentist and hygienist who enters into a public health | 22 | | supervision agreement must document and maintain a copy of any | 23 | | change or termination of that agreement. | 24 | | Dental records shall be owned and maintained by the | 25 | | supervising dentist for all patients treated under public | 26 | | health supervision, unless the supervising dentist is an |
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| 1 | | employee of a public health clinic or federally qualified | 2 | | health center, in which case the public health clinic or | 3 | | federally qualified health center shall maintain the records. | 4 | | If a dentist ceases to be employed or contracted by the | 5 | | facility, the dentist shall notify the facility administrator | 6 | | that the public health supervision agreement is no longer in | 7 | | effect. A new public health supervision agreement is required | 8 | | for the public health dental hygienist to continue treating | 9 | | patients under public health supervision. | 10 | | A dentist entering into an agreement under this Section | 11 | | may supervise and enter into agreements for public health | 12 | | supervision with 4 2 public health dental hygienists. This | 13 | | shall be in addition to the limit of 4 dental hygienists per | 14 | | dentist set forth in subsection (g) of Section 18 of this Act. | 15 | | (b) A public health dental hygienist providing services | 16 | | under public health supervision may perform only those duties | 17 | | within the accepted scope of practice of dental hygiene, as | 18 | | follows: | 19 | | (1) the operative procedures of dental hygiene, | 20 | | consisting of oral prophylactic procedures, including | 21 | | prophylactic cleanings, application of fluoride, and | 22 | | placement of sealants; | 23 | | (2) the exposure and processing of x-ray films of the | 24 | | teeth and surrounding structures; and | 25 | | (3) such other procedures and acts as shall be | 26 | | prescribed by rule of the Department. |
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| 1 | | Any patient treated under this subsection (b) must be | 2 | | examined by a dentist before additional services can be | 3 | | provided by a public health dental hygienist. However, if the | 4 | | supervising dentist, after consultation with the public health | 5 | | hygienist, determines that time is needed to complete an | 6 | | approved treatment plan on a patient eligible under this | 7 | | Section, then the dentist may instruct the hygienist to | 8 | | complete the remaining services prior to an oral examination | 9 | | by the dentist. Such instruction by the dentist to the | 10 | | hygienist shall be noted in the patient's records. Any | 11 | | services performed under this exception must be scheduled in a | 12 | | timely manner and shall not occur more than 30 days after the | 13 | | first appointment date. | 14 | | (c) A public health dental hygienist providing services | 15 | | under public health supervision must: | 16 | | (1) provide to the patient, parent, or guardian a | 17 | | written plan for referral or an agreement for follow-up | 18 | | that records all conditions observed that should be called | 19 | | to the attention of a dentist for proper diagnosis; | 20 | | (2) have each patient sign a permission slip or | 21 | | consent form that informs them that the service to be | 22 | | received does not take the place of regular dental | 23 | | checkups at a dental office and is meant for people who | 24 | | otherwise would not have access to the service; | 25 | | (3) inform each patient who may require further dental | 26 | | services of that need; |
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| 1 | | (4) maintain an appropriate level of contact and | 2 | | communication with the dentist providing public health | 3 | | supervision; and | 4 | | (5) complete an additional 4 hours of continuing | 5 | | education in areas specific to public health dentistry | 6 | | yearly. | 7 | | (d) Each public health dental hygienist who has rendered | 8 | | services under subsections (c), (d), and (e) of this Section | 9 | | must complete a summary report at the completion of a program | 10 | | or, in the case of an ongoing program, at least annually. The | 11 | | report must be completed in the manner specified by the | 12 | | Division of Oral Health in the Department of Public Health | 13 | | Oral Health Section including information about each location | 14 | | where the public health dental hygienist has rendered these | 15 | | services. The public health dental hygienist must submit the | 16 | | form to the dentist providing supervision for his or her | 17 | | signature before sending it to the Division. The Department of | 18 | | Public Health Oral Health Section shall compile and publicize | 19 | | public health dental hygienist service data annually. | 20 | | (e) Public health dental hygienists providing services | 21 | | under public health supervision may be compensated for their | 22 | | work by salary, honoraria, and other mechanisms by the | 23 | | employing or sponsoring entity. Nothing in this Act shall | 24 | | preclude the entity that employs or sponsors a public health | 25 | | dental hygienist from seeking payment, reimbursement, or other | 26 | | source of funding for the services provided. |
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| 1 | | (f) This Section is repealed on January 1, 2026.
| 2 | | (Source: P.A. 101-162, eff. 7-26-19.)
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