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| | HB5948 Engrossed | | LRB099 20560 SMS 45111 b |
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1 | | AN ACT concerning regulation.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Dental Practice Act is amended by |
5 | | changing Sections 4, 17, and 18.1 as follows:
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6 | | (225 ILCS 25/4)
(from Ch. 111, par. 2304)
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7 | | (Section scheduled to be repealed on January 1, 2026)
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8 | | Sec. 4. Definitions. As used in this Act:
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9 | | "Address of record" means the designated address recorded |
10 | | by the Department in the applicant's or licensee's application |
11 | | file or license file as maintained by the Department's |
12 | | licensure maintenance unit. It is the duty of the applicant or |
13 | | licensee to inform the Department of any change of address and |
14 | | those changes must be made either through the Department's |
15 | | website or by contacting the Department. |
16 | | "Department" means the Department of Financial and |
17 | | Professional Regulation.
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18 | | "Secretary" means the Secretary of Financial and |
19 | | Professional Regulation.
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20 | | "Board" means the Board of Dentistry.
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21 | | "Dentist" means a person who has received a general license |
22 | | pursuant
to paragraph (a) of Section 11 of this Act and who may |
23 | | perform any intraoral
and extraoral procedure required in the |
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1 | | practice of dentistry and to whom is
reserved the |
2 | | responsibilities specified in Section 17.
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3 | | "Dental hygienist" means a person who holds a license under |
4 | | this Act to
perform dental services as authorized by Section |
5 | | 18.
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6 | | "Dental assistant" means an appropriately trained person
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7 | | who, under the supervision of a dentist, provides dental |
8 | | services
as authorized by Section 17.
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9 | | "Dental laboratory" means a person, firm or corporation |
10 | | which:
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11 | | (i) engages in making, providing, repairing or |
12 | | altering dental
prosthetic appliances and other artificial |
13 | | materials and devices which are
returned to a dentist for |
14 | | insertion into the human oral cavity or which
come in |
15 | | contact with its adjacent structures and tissues; and
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16 | | (ii) utilizes or employs a dental technician to provide |
17 | | such services; and
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18 | | (iii) performs such functions only for a dentist or |
19 | | dentists.
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20 | | "Supervision" means supervision of a dental hygienist or a |
21 | | dental
assistant requiring that a dentist authorize the |
22 | | procedure, remain in the
dental facility while the procedure is |
23 | | performed, and approve the work
performed by the dental |
24 | | hygienist or dental assistant before dismissal of
the patient, |
25 | | but does not mean that the dentist must be present at all
times |
26 | | in the treatment room.
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1 | | "General supervision" means supervision of a dental |
2 | | hygienist
requiring that the patient be a patient of record,
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3 | | that the dentist
examine the patient in accordance with Section |
4 | | 18 prior to treatment by the
dental hygienist, and that the
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5 | | dentist authorize the procedures which
are being carried
out by |
6 | | a notation in the patient's record, but not requiring that a |
7 | | dentist
be present when the authorized
procedures are being |
8 | | performed. The
issuance of a prescription to a dental |
9 | | laboratory by a
dentist does not constitute general |
10 | | supervision.
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11 | | "Public member" means a person who is not a health |
12 | | professional.
For purposes of board membership, any person with |
13 | | a significant financial
interest in a health service or |
14 | | profession is not a public member.
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15 | | "Dentistry" means the healing art which is concerned with |
16 | | the
examination, diagnosis, treatment planning and care of |
17 | | conditions within
the human oral cavity and its adjacent |
18 | | tissues and structures, as further
specified in Section 17.
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19 | | "Branches of dentistry" means the various specialties of |
20 | | dentistry
which, for purposes of this Act, shall be limited to |
21 | | the following:
endodontics, oral and maxillofacial surgery, |
22 | | orthodontics and dentofacial
orthopedics, pediatric dentistry,
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23 | | periodontics, prosthodontics, and oral and maxillofacial
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24 | | radiology.
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25 | | "Specialist" means a dentist who has received a specialty |
26 | | license
pursuant to Section 11(b).
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1 | | "Dental technician" means a person who owns, operates or is
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2 | | employed by a dental laboratory and engages in making, |
3 | | providing, repairing
or altering dental prosthetic appliances |
4 | | and other artificial materials and
devices which are returned |
5 | | to a dentist for insertion into the human oral
cavity or which |
6 | | come in contact with its adjacent structures and tissues.
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7 | | "Impaired dentist" or "impaired dental hygienist" means a |
8 | | dentist
or dental hygienist who is unable to practice with
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9 | | reasonable skill and safety because of a physical or mental |
10 | | disability as
evidenced by a written determination or written |
11 | | consent based on clinical
evidence, including deterioration |
12 | | through the aging process, loss of motor
skills, abuse of drugs |
13 | | or alcohol, or a psychiatric disorder, of sufficient
degree to |
14 | | diminish the person's ability to deliver competent patient |
15 | | care.
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16 | | "Nurse" means a registered professional nurse, a certified |
17 | | registered
nurse anesthetist licensed as an advanced practice
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18 | | nurse, or a licensed practical nurse licensed under the Nurse |
19 | | Practice Act.
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20 | | "Patient of record" means a patient for whom the patient's |
21 | | most recent
dentist has obtained
a
relevant medical and dental |
22 | | history and on whom the dentist has performed an
examination |
23 | | and evaluated the condition to be treated.
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24 | | "Dental responder" means a dentist or dental hygienist who |
25 | | is appropriately certified in disaster preparedness, |
26 | | immunizations, and dental humanitarian medical response |
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1 | | consistent with the Society of Disaster Medicine and Public |
2 | | Health and training certified by the National Incident |
3 | | Management System or the National Disaster Life Support |
4 | | Foundation.
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5 | | "Mobile dental van or portable dental unit" means any |
6 | | self-contained or portable dental unit in which dentistry is |
7 | | practiced that can be moved, towed, or transported from one |
8 | | location to another in order to establish a location where |
9 | | dental services can be provided. |
10 | | "Public health dental hygienist" means a hygienist who |
11 | | holds a valid license to practice in the State, has 2 years of |
12 | | full-time clinical experience or an equivalent of 4,000 hours |
13 | | of clinical experience and has completed 42 clock 72 hours of |
14 | | additional course work in areas specific to public health |
15 | | dentistry, including, but not limited to, emergency procedures |
16 | | for medically compromised patients, pharmacology, medical |
17 | | recordkeeping procedures, geriatric dentistry, pediatric |
18 | | dentistry, and pathology, and works in a public health setting |
19 | | pursuant to a written public health supervision agreement as |
20 | | defined by rule by the Department with a dentist working in or |
21 | | contracted with a local or State government agency or |
22 | | institution or who is providing services as part of a certified |
23 | | school-based program or school-based oral health program. |
24 | | "Public health setting" means a federally qualified health |
25 | | center; a federal, State, or local public health facility; Head |
26 | | Start; a special supplemental nutrition program for Women, |
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1 | | Infants, and Children (WIC) facility; or a certified |
2 | | school-based health center or school-based oral health |
3 | | program. |
4 | | "Public health supervision" means the supervision of a |
5 | | public health dental hygienist by a licensed dentist who has a |
6 | | written public health supervision agreement with that public |
7 | | health dental hygienist while working in an approved facility |
8 | | or program that allows the public health dental hygienist to |
9 | | treat patients, without a dentist first examining the patient |
10 | | and being present in the facility during treatment, (1) who are |
11 | | eligible for Medicaid or (2) who are uninsured and whose |
12 | | household income is not greater than 200% of the federal |
13 | | poverty level. |
14 | | (Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15.)
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15 | | (225 ILCS 25/17) (from Ch. 111, par. 2317)
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16 | | (Section scheduled to be repealed on January 1, 2026)
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17 | | Sec. 17. Acts constituting the practice of dentistry. A |
18 | | person
practices dentistry, within the meaning of this Act:
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19 | | (1) Who represents himself or herself as being able to |
20 | | diagnose or diagnoses,
treats, prescribes, or operates for |
21 | | any disease, pain, deformity, deficiency,
injury, or |
22 | | physical condition of the human tooth, teeth, alveolar |
23 | | process,
gums or jaw; or
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24 | | (2) Who is a manager, proprietor, operator or conductor |
25 | | of a
business where
dental operations are performed; or
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1 | | (3) Who performs dental operations of any kind; or
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2 | | (4) Who uses an X-Ray machine or X-Ray films for
dental |
3 | | diagnostic purposes; or
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4 | | (5) Who extracts a human tooth or teeth, or corrects or |
5 | | attempts to
correct
malpositions of the human teeth or |
6 | | jaws; or
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7 | | (6) Who offers or undertakes, by any means or method, |
8 | | to diagnose, treat
or remove stains, calculus, and bonding |
9 | | materials from human teeth or jaws; or
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10 | | (7) Who uses or administers local or general |
11 | | anesthetics in the treatment
of dental or oral diseases or |
12 | | in any preparation incident to a dental operation
of any |
13 | | kind or character; or
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14 | | (8) Who takes impressions of the human tooth, teeth, or |
15 | | jaws or performs
any phase of any operation incident to the |
16 | | replacement of a part of a tooth,
a tooth, teeth or |
17 | | associated tissues by means of a filling, crown, a bridge,
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18 | | a denture or other appliance; or
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19 | | (9) Who offers to furnish, supply, construct, |
20 | | reproduce or repair, or
who furnishes, supplies, |
21 | | constructs, reproduces or repairs, prosthetic
dentures, |
22 | | bridges or other substitutes for natural teeth, to the user |
23 | | or
prospective user thereof; or
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24 | | (10) Who instructs students on clinical matters or |
25 | | performs any clinical
operation included in the curricula |
26 | | of recognized dental schools and colleges; or
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1 | | (11) Who takes impressions of human teeth or places his |
2 | | or her hands in the mouth of any person for the purpose of |
3 | | applying teeth whitening materials, or who takes |
4 | | impressions of human teeth or places his or her hands in |
5 | | the mouth of any person for the purpose of assisting in the |
6 | | application of teeth whitening materials. A person does not |
7 | | practice dentistry when he or she discloses to the consumer |
8 | | that he or she is not licensed as a dentist under this Act |
9 | | and (i) discusses the use of teeth whitening materials with |
10 | | a consumer purchasing these materials; (ii) provides |
11 | | instruction on the use of teeth whitening materials with a |
12 | | consumer purchasing these materials; or (iii) provides |
13 | | appropriate equipment on-site to the consumer for the |
14 | | consumer to self-apply teeth whitening materials. |
15 | | The fact that any person engages in or performs, or offers |
16 | | to engage in
or perform, any of the practices, acts, or |
17 | | operations set forth in this
Section, shall be prima facie |
18 | | evidence that such person is engaged in the
practice of |
19 | | dentistry.
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20 | | The following practices, acts, and operations, however, |
21 | | are exempt from
the operation of this Act:
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22 | | (a) The rendering of dental relief in emergency cases |
23 | | in the practice
of his or her profession by a physician or |
24 | | surgeon, licensed as such
under the laws of this State, |
25 | | unless he or she undertakes to reproduce or reproduces
lost |
26 | | parts of the human teeth in the mouth or to restore or |
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1 | | replace lost
or missing teeth in the mouth; or
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2 | | (b) The practice of dentistry in the discharge of their |
3 | | official duties
by dentists in any branch of the Armed |
4 | | Services of the United States, the
United States Public |
5 | | Health Service, or the United States Veterans
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6 | | Administration; or
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7 | | (c) The practice of dentistry by students in their |
8 | | course of study
in dental schools or colleges approved by |
9 | | the Department, when acting under the
direction and |
10 | | supervision of dentists acting as instructors; or
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11 | | (d) The practice of dentistry by clinical instructors |
12 | | in the course of
their teaching duties in dental schools or |
13 | | colleges approved by the
Department:
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14 | | (i) when acting under the direction and |
15 | | supervision of dentists,
provided that such clinical |
16 | | instructors have instructed continuously in
this State |
17 | | since January 1, 1986; or
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18 | | (ii) when holding the rank of full professor at |
19 | | such approved dental
school or college and possessing a |
20 | | current valid license or authorization
to practice |
21 | | dentistry in another country; or
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22 | | (e) The practice of dentistry by licensed dentists of |
23 | | other states or
countries at meetings of the Illinois State |
24 | | Dental Society or component
parts thereof, alumni meetings |
25 | | of dental colleges, or any other like dental
organizations, |
26 | | while appearing as clinicians; or
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1 | | (f) The use of X-Ray machines for exposing X-Ray films |
2 | | of dental or oral
tissues by dental hygienists or dental |
3 | | assistants; or
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4 | | (g) The performance of any dental service by a dental |
5 | | assistant, if such
service is performed under the |
6 | | supervision and full responsibility of a
dentist.
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7 | | For purposes of this paragraph (g), "dental service" is |
8 | | defined to mean
any intraoral procedure or act which shall |
9 | | be prescribed by rule or
regulation of the Department. |
10 | | Dental service, however, shall not include:
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11 | | (1) Any and all diagnosis of or prescription for |
12 | | treatment of disease,
pain, deformity, deficiency, |
13 | | injury or physical condition of the human teeth
or |
14 | | jaws, or adjacent structures.
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15 | | (2) Removal of, or restoration of, or addition
to |
16 | | the hard or soft tissues of the oral cavity, except for |
17 | | the placing, carving, and finishing of amalgam |
18 | | restorations by dental assistants who have had |
19 | | additional formal education and certification as |
20 | | determined by the Department. A dentist utilizing |
21 | | dental assistants shall not supervise more than 4 |
22 | | dental assistants at any one time for placing, carving, |
23 | | and finishing of amalgam restorations.
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24 | | (3) Any and all correction of malformation of teeth |
25 | | or of the jaws.
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26 | | (4) Administration of anesthetics, except for |
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1 | | monitoring of
nitrous oxide, conscious sedation, deep |
2 | | sedation, and general anesthetic as provided in |
3 | | Section 8.1 of this Act, that may be performed only |
4 | | after successful completion of a training
program |
5 | | approved by the Department. A dentist utilizing dental |
6 | | assistants shall not supervise more than 4 dental |
7 | | assistants at any one time for the monitoring of |
8 | | nitrous oxide.
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9 | | (5) Removal of calculus from human teeth.
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10 | | (6) Taking of impressions for the fabrication of |
11 | | prosthetic
appliances,
crowns,
bridges, inlays, |
12 | | onlays, or other restorative or replacement
dentistry.
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13 | | (7) The operative procedure of dental hygiene |
14 | | consisting of oral
prophylactic procedures, except for |
15 | | coronal polishing and pit and fissure sealants,
which |
16 | | may be
performed by a
dental assistant who has |
17 | | successfully completed a training program approved by
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18 | | the Department. Dental assistants may perform coronal |
19 | | polishing under the
following circumstances: (i) the |
20 | | coronal polishing shall be limited to
polishing the
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21 | | clinical crown of the tooth and existing restorations, |
22 | | supragingivally; (ii)
the
dental assistant performing |
23 | | the coronal polishing shall be limited to the use
of
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24 | | rotary instruments using a rubber cup or brush |
25 | | polishing method (air polishing
is
not permitted); and |
26 | | (iii) the supervising dentist shall not supervise more
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1 | | than 4
dental assistants at any one time for the task |
2 | | of coronal polishing or pit and fissure sealants.
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3 | | In addition to coronal polishing and pit and |
4 | | fissure sealants as described in this item (7), a |
5 | | dental assistant who has at least 2,000 hours of direct |
6 | | clinical patient care experience and who has |
7 | | successfully completed a training program approved by |
8 | | rule by the Department may perform: (A) coronal scaling |
9 | | above the gum line, supragingivally, on the clinical |
10 | | crown of the tooth only on patients 12 years of age or |
11 | | younger who have an absence of periodontal disease and |
12 | | who are not medically compromised or individuals with |
13 | | special needs and (B) intracoronal temporization of a |
14 | | tooth. The training program approved by the Department |
15 | | must: (I) include a minimum of 16 hours of instruction |
16 | | in both didactic and clinical manikin or human subject |
17 | | instruction; all training programs shall include |
18 | | courses in dental anatomy, public health dentistry, |
19 | | medical history, dental emergencies, and managing the |
20 | | pediatric patient; (II) include an outcome assessment |
21 | | examination that demonstrates competency; (III) |
22 | | require the supervising dentist to observe and approve |
23 | | the completion of 6 full mouth supragingival scaling |
24 | | procedures; and (IV) issue a certificate of completion |
25 | | of the training program, which must be kept on file at |
26 | | the dental office. A dental assistant must have |
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1 | | successfully completed an approved coronal polishing |
2 | | course prior to taking the coronal scaling course. A |
3 | | dental assistant performing these functions shall be |
4 | | limited to the use of hand instruments only. In |
5 | | addition, coronal scaling as described in this |
6 | | paragraph shall only be utilized on patients who are |
7 | | eligible for Medicaid or who are uninsured and whose |
8 | | household income is not greater than 200% of the |
9 | | federal poverty level. A dentist may not supervise more |
10 | | than 2 dental assistants at any one time for the task |
11 | | of coronal scaling. This paragraph is inoperative on |
12 | | and after January 1, 2021. |
13 | | The limitations on the number of dental assistants a |
14 | | dentist may supervise contained in items (2), (4), and (7) |
15 | | of this paragraph (g) mean a limit of 4 total dental |
16 | | assistants or dental hygienists doing expanded functions |
17 | | covered by these Sections being supervised by one dentist. |
18 | | (h) The practice of dentistry by an individual who:
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19 | | (i) has applied in writing to the Department, in |
20 | | form and substance
satisfactory to the Department, for |
21 | | a general dental license and has
complied with all |
22 | | provisions of Section 9 of this Act, except for the
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23 | | passage of the examination specified in subsection (e) |
24 | | of Section 9 of this
Act; or
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25 | | (ii) has applied in writing to the Department, in |
26 | | form and substance
satisfactory to the Department, for |
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1 | | a temporary dental license and has
complied with all |
2 | | provisions of subsection (c) of Section 11 of this Act; |
3 | | and
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4 | | (iii) has been accepted or appointed for specialty |
5 | | or residency training
by a hospital situated in this |
6 | | State; or
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7 | | (iv) has been accepted or appointed for specialty |
8 | | training in an
approved dental program situated in this |
9 | | State; or
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10 | | (v) has been accepted or appointed for specialty |
11 | | training in a dental
public health agency situated in |
12 | | this State.
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13 | | The applicant shall be permitted to practice dentistry |
14 | | for a period of 3
months from the starting date of the |
15 | | program, unless authorized in writing
by the Department to |
16 | | continue such practice for a period specified in
writing by |
17 | | the Department.
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18 | | The applicant shall only be entitled to perform such |
19 | | acts as may be
prescribed by and incidental to his or her |
20 | | program of residency or specialty
training and shall not |
21 | | otherwise engage in the practice of dentistry in this
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22 | | State.
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23 | | The authority to practice shall terminate immediately |
24 | | upon:
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25 | | (1) the decision of the Department that the |
26 | | applicant has failed the
examination; or
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1 | | (2) denial of licensure by the Department; or
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2 | | (3) withdrawal of the application.
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3 | | (Source: P.A. 98-147, eff. 1-1-14; 98-463, eff. 8-16-13; |
4 | | 98-756, eff. 7-16-14; 99-492, eff. 12-31-15.)
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5 | | (225 ILCS 25/18.1) |
6 | | (Section scheduled to be repealed on January 1, 2021) |
7 | | Sec. 18.1. Public health dental supervision |
8 | | responsibilities. |
9 | | (a) When working together in a public health supervision |
10 | | relationship, dentists and public health dental hygienists |
11 | | shall enter into a public health supervision agreement. The |
12 | | dentist providing public health supervision must: |
13 | | (1) be available to provide an appropriate level of |
14 | | contact, communication, collaboration, and consultation |
15 | | with the public health dental hygienist and must meet |
16 | | in-person with the public health dental hygienist at least |
17 | | quarterly for review and consultation; |
18 | | (2) have specific standing orders or policy guidelines |
19 | | for procedures that are to be carried out for each location |
20 | | or program, although the dentist need not be present when |
21 | | the procedures are being performed; |
22 | | (3) provide for the patient's additional necessary |
23 | | care in consultation with the public health dental |
24 | | hygienist; |
25 | | (4) file agreements and notifications as required; and |
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1 | | (5) include procedures for creating and maintaining |
2 | | dental records, including protocols for transmission of |
3 | | all records between the public health dental hygienist and |
4 | | the dentist following each treatment, which shall include a |
5 | | notation regarding procedures authorized by the dentist |
6 | | and performed by the public health dental hygienist and the |
7 | | location where those records are to be kept. |
8 | | Each dentist and hygienist who enters into a public health |
9 | | supervision agreement must document and maintain a copy of any |
10 | | change or termination of that agreement. |
11 | | Dental records shall be owned and maintained by the |
12 | | supervising dentist for all patients treated under public |
13 | | health supervision, unless the supervising dentist is an |
14 | | employee of a public health clinic or federally qualified |
15 | | health center, in which case the public health clinic or |
16 | | federally qualified health center shall maintain the records. |
17 | | If a dentist ceases to be employed or contracted by the |
18 | | facility, the dentist shall notify the facility administrator |
19 | | that the public health supervision agreement is no longer in |
20 | | effect. A new public health supervision agreement is required |
21 | | for the public health dental hygienist to continue treating |
22 | | patients under public health supervision. |
23 | | A dentist entering into an agreement under this Section may |
24 | | supervise and enter into agreements for public health |
25 | | supervision with 2 public health dental hygienists. This shall |
26 | | be in addition to the limit of 4 dental hygienists per dentist |
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1 | | set forth in subsection (g) of Section 18 of this Act. |
2 | | (b) A public health dental hygienist providing services |
3 | | under public health supervision may perform only those duties |
4 | | within the accepted scope of practice of dental hygiene, as |
5 | | follows: |
6 | | (1) the operative procedures of dental hygiene, |
7 | | consisting of oral prophylactic procedures, including |
8 | | prophylactic cleanings, application of fluoride, and |
9 | | placement of sealants; |
10 | | (2) the exposure and processing of x-ray films of the |
11 | | teeth and surrounding structures; and |
12 | | (3) such other procedures and acts as shall be |
13 | | prescribed by rule of the Department. |
14 | | Any patient treated under this subsection (b) must be |
15 | | examined by a dentist before additional services can be |
16 | | provided by a public health dental hygienist. However, if the |
17 | | supervising dentist, after consultation with the public health |
18 | | hygienist, determines that time is needed to complete an |
19 | | approved treatment plan on a patient eligible under this |
20 | | Section, then the dentist may instruct the hygienist to |
21 | | complete the remaining services prior to an oral examination by |
22 | | the dentist. Such instruction by the dentist to the hygienist |
23 | | shall be noted in the patient's records. Any services performed |
24 | | under this exception must be scheduled in a timely manner and |
25 | | shall not occur more than 30 days after the first appointment |
26 | | date. |
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1 | | (c) A public health dental hygienist providing services |
2 | | under public health supervision must: |
3 | | (1) provide to the patient, parent, or guardian a |
4 | | written plan for referral or an agreement for follow-up |
5 | | that records all conditions observed that should be called |
6 | | to the attention of a dentist for proper diagnosis; |
7 | | (2) have each patient sign a permission slip or consent |
8 | | form that informs them that the service to be received does |
9 | | not take the place of regular dental checkups at a dental |
10 | | office and is meant for people who otherwise would not have |
11 | | access to the service; |
12 | | (3) inform each patient who may require further dental |
13 | | services of that need; |
14 | | (4) maintain an appropriate level of contact and |
15 | | communication with the dentist providing public health |
16 | | supervision; and |
17 | | (5) complete an additional 4 hours of continuing |
18 | | education in areas specific to public health dentistry |
19 | | yearly. |
20 | | (d) Each public health dental hygienist who has rendered |
21 | | services under subsections (c), (d), and (e) of this Section |
22 | | must complete a summary report at the completion of a program |
23 | | or, in the case of an ongoing program, at least annually. The |
24 | | report must be completed in the manner specified by the |
25 | | Division of Oral Health in the Department of Public Health |
26 | | including information about each location where the public |
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1 | | health dental hygienist has rendered these services. The public |
2 | | health dental hygienist must submit the form to the dentist |
3 | | providing supervision for his or her signature before sending |
4 | | it to the Division. |
5 | | (e) Public health dental hygienists providing services |
6 | | under public health supervision may be compensated for their |
7 | | work by salary, honoraria, and other mechanisms by the |
8 | | employing or sponsoring entity. Nothing in this Act shall |
9 | | preclude the entity that employs or sponsors a public health |
10 | | dental hygienist from seeking payment, reimbursement, or other |
11 | | source of funding for the services provided. |
12 | | (f) This Section is repealed on January 1, 2021.
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13 | | (Source: P.A. 99-492, eff. 12-31-15 .) |