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Public Act 099-0680 |
HB5948 Enrolled | LRB099 20560 SMS 45111 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Dental Practice Act is amended by |
changing Sections 4, 17, and 18.1 as follows:
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(225 ILCS 25/4)
(from Ch. 111, par. 2304)
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(Section scheduled to be repealed on January 1, 2026)
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Sec. 4. Definitions. As used in this Act:
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"Address of record" means the designated address recorded |
by the Department in the applicant's or licensee's application |
file or license file as maintained by the Department's |
licensure maintenance unit. It is the duty of the applicant or |
licensee to inform the Department of any change of address and |
those changes must be made either through the Department's |
website or by contacting the Department. |
"Department" means the Department of Financial and |
Professional Regulation.
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"Secretary" means the Secretary of Financial and |
Professional Regulation.
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"Board" means the Board of Dentistry.
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"Dentist" means a person who has received a general license |
pursuant
to paragraph (a) of Section 11 of this Act and who may |
perform any intraoral
and extraoral procedure required in the |
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practice of dentistry and to whom is
reserved the |
responsibilities specified in Section 17.
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"Dental hygienist" means a person who holds a license under |
this Act to
perform dental services as authorized by Section |
18.
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"Dental assistant" means an appropriately trained person
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who, under the supervision of a dentist, provides dental |
services
as authorized by Section 17.
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"Dental laboratory" means a person, firm or corporation |
which:
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(i) engages in making, providing, repairing or |
altering dental
prosthetic appliances and other artificial |
materials and devices which are
returned to a dentist for |
insertion into the human oral cavity or which
come in |
contact with its adjacent structures and tissues; and
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(ii) utilizes or employs a dental technician to provide |
such services; and
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(iii) performs such functions only for a dentist or |
dentists.
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"Supervision" means supervision of a dental hygienist or a |
dental
assistant requiring that a dentist authorize the |
procedure, remain in the
dental facility while the procedure is |
performed, and approve the work
performed by the dental |
hygienist or dental assistant before dismissal of
the patient, |
but does not mean that the dentist must be present at all
times |
in the treatment room.
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"General supervision" means supervision of a dental |
hygienist
requiring that the patient be a patient of record,
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that the dentist
examine the patient in accordance with Section |
18 prior to treatment by the
dental hygienist, and that the
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dentist authorize the procedures which
are being carried
out by |
a notation in the patient's record, but not requiring that a |
dentist
be present when the authorized
procedures are being |
performed. The
issuance of a prescription to a dental |
laboratory by a
dentist does not constitute general |
supervision.
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"Public member" means a person who is not a health |
professional.
For purposes of board membership, any person with |
a significant financial
interest in a health service or |
profession is not a public member.
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"Dentistry" means the healing art which is concerned with |
the
examination, diagnosis, treatment planning and care of |
conditions within
the human oral cavity and its adjacent |
tissues and structures, as further
specified in Section 17.
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"Branches of dentistry" means the various specialties of |
dentistry
which, for purposes of this Act, shall be limited to |
the following:
endodontics, oral and maxillofacial surgery, |
orthodontics and dentofacial
orthopedics, pediatric dentistry,
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periodontics, prosthodontics, and oral and maxillofacial
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radiology.
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"Specialist" means a dentist who has received a specialty |
license
pursuant to Section 11(b).
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"Dental technician" means a person who owns, operates or is
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employed by a dental laboratory and engages in making, |
providing, repairing
or altering dental prosthetic appliances |
and other artificial materials and
devices which are returned |
to a dentist for insertion into the human oral
cavity or which |
come in contact with its adjacent structures and tissues.
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"Impaired dentist" or "impaired dental hygienist" means a |
dentist
or dental hygienist who is unable to practice with
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reasonable skill and safety because of a physical or mental |
disability as
evidenced by a written determination or written |
consent based on clinical
evidence, including deterioration |
through the aging process, loss of motor
skills, abuse of drugs |
or alcohol, or a psychiatric disorder, of sufficient
degree to |
diminish the person's ability to deliver competent patient |
care.
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"Nurse" means a registered professional nurse, a certified |
registered
nurse anesthetist licensed as an advanced practice
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nurse, or a licensed practical nurse licensed under the Nurse |
Practice Act.
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"Patient of record" means a patient for whom the patient's |
most recent
dentist has obtained
a
relevant medical and dental |
history and on whom the dentist has performed an
examination |
and evaluated the condition to be treated.
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"Dental responder" means a dentist or dental hygienist who |
is appropriately certified in disaster preparedness, |
immunizations, and dental humanitarian medical response |
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consistent with the Society of Disaster Medicine and Public |
Health and training certified by the National Incident |
Management System or the National Disaster Life Support |
Foundation.
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"Mobile dental van or portable dental unit" means any |
self-contained or portable dental unit in which dentistry is |
practiced that can be moved, towed, or transported from one |
location to another in order to establish a location where |
dental services can be provided. |
"Public health dental hygienist" means a hygienist who |
holds a valid license to practice in the State, has 2 years of |
full-time clinical experience or an equivalent of 4,000 hours |
of clinical experience and has completed at least 42 clock 72 |
hours of additional structured courses in dental education |
approved by rule by the Department course work in advanced |
areas specific to public health dentistry, including, but not |
limited to, emergency procedures for medically compromised |
patients, pharmacology, medical recordkeeping procedures, |
geriatric dentistry, pediatric dentistry, and pathology, and |
other areas of study as determined by the Department, and works |
in a public health setting pursuant to a written public health |
supervision agreement as defined by rule by the Department with |
a dentist working in or contracted with a local or State |
government agency or institution or who is providing services |
as part of a certified school-based program or school-based |
oral health program. |
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"Public health setting" means a federally qualified health |
center; a federal, State, or local public health facility; Head |
Start; a special supplemental nutrition program for Women, |
Infants, and Children (WIC) facility; or a certified |
school-based health center or school-based oral health |
program. |
"Public health supervision" means the supervision of a |
public health dental hygienist by a licensed dentist who has a |
written public health supervision agreement with that public |
health dental hygienist while working in an approved facility |
or program that allows the public health dental hygienist to |
treat patients, without a dentist first examining the patient |
and being present in the facility during treatment, (1) who are |
eligible for Medicaid or (2) who are uninsured and whose |
household income is not greater than 200% of the federal |
poverty level. |
(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15.)
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(225 ILCS 25/17) (from Ch. 111, par. 2317)
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(Section scheduled to be repealed on January 1, 2026)
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Sec. 17. Acts constituting the practice of dentistry. A |
person
practices dentistry, within the meaning of this Act:
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(1) Who represents himself or herself as being able to |
diagnose or diagnoses,
treats, prescribes, or operates for |
any disease, pain, deformity, deficiency,
injury, or |
physical condition of the human tooth, teeth, alveolar |
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process,
gums or jaw; or
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(2) Who is a manager, proprietor, operator or conductor |
of a
business where
dental operations are performed; or
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(3) Who performs dental operations of any kind; or
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(4) Who uses an X-Ray machine or X-Ray films for
dental |
diagnostic purposes; or
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(5) Who extracts a human tooth or teeth, or corrects or |
attempts to
correct
malpositions of the human teeth or |
jaws; or
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(6) Who offers or undertakes, by any means or method, |
to diagnose, treat
or remove stains, calculus, and bonding |
materials from human teeth or jaws; or
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(7) Who uses or administers local or general |
anesthetics in the treatment
of dental or oral diseases or |
in any preparation incident to a dental operation
of any |
kind or character; or
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(8) Who takes impressions of the human tooth, teeth, or |
jaws or performs
any phase of any operation incident to the |
replacement of a part of a tooth,
a tooth, teeth or |
associated tissues by means of a filling, crown, a bridge,
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a denture or other appliance; or
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(9) Who offers to furnish, supply, construct, |
reproduce or repair, or
who furnishes, supplies, |
constructs, reproduces or repairs, prosthetic
dentures, |
bridges or other substitutes for natural teeth, to the user |
or
prospective user thereof; or
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(10) Who instructs students on clinical matters or |
performs any clinical
operation included in the curricula |
of recognized dental schools and colleges; or
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(11) Who takes impressions of human teeth or places his |
or her hands in the mouth of any person for the purpose of |
applying teeth whitening materials, or who takes |
impressions of human teeth or places his or her hands in |
the mouth of any person for the purpose of assisting in the |
application of teeth whitening materials. A person does not |
practice dentistry when he or she discloses to the consumer |
that he or she is not licensed as a dentist under this Act |
and (i) discusses the use of teeth whitening materials with |
a consumer purchasing these materials; (ii) provides |
instruction on the use of teeth whitening materials with a |
consumer purchasing these materials; or (iii) provides |
appropriate equipment on-site to the consumer for the |
consumer to self-apply teeth whitening materials. |
The fact that any person engages in or performs, or offers |
to engage in
or perform, any of the practices, acts, or |
operations set forth in this
Section, shall be prima facie |
evidence that such person is engaged in the
practice of |
dentistry.
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The following practices, acts, and operations, however, |
are exempt from
the operation of this Act:
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(a) The rendering of dental relief in emergency cases |
in the practice
of his or her profession by a physician or |
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surgeon, licensed as such
under the laws of this State, |
unless he or she undertakes to reproduce or reproduces
lost |
parts of the human teeth in the mouth or to restore or |
replace lost
or missing teeth in the mouth; or
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(b) The practice of dentistry in the discharge of their |
official duties
by dentists in any branch of the Armed |
Services of the United States, the
United States Public |
Health Service, or the United States Veterans
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Administration; or
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(c) The practice of dentistry by students in their |
course of study
in dental schools or colleges approved by |
the Department, when acting under the
direction and |
supervision of dentists acting as instructors; or
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(d) The practice of dentistry by clinical instructors |
in the course of
their teaching duties in dental schools or |
colleges approved by the
Department:
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(i) when acting under the direction and |
supervision of dentists,
provided that such clinical |
instructors have instructed continuously in
this State |
since January 1, 1986; or
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(ii) when holding the rank of full professor at |
such approved dental
school or college and possessing a |
current valid license or authorization
to practice |
dentistry in another country; or
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(e) The practice of dentistry by licensed dentists of |
other states or
countries at meetings of the Illinois State |
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Dental Society or component
parts thereof, alumni meetings |
of dental colleges, or any other like dental
organizations, |
while appearing as clinicians; or
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(f) The use of X-Ray machines for exposing X-Ray films |
of dental or oral
tissues by dental hygienists or dental |
assistants; or
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(g) The performance of any dental service by a dental |
assistant, if such
service is performed under the |
supervision and full responsibility of a
dentist.
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For purposes of this paragraph (g), "dental service" is |
defined to mean
any intraoral procedure or act which shall |
be prescribed by rule or
regulation of the Department. |
Dental service, however, shall not include:
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(1) Any and all diagnosis of or prescription for |
treatment of disease,
pain, deformity, deficiency, |
injury or physical condition of the human teeth
or |
jaws, or adjacent structures.
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(2) Removal of, or restoration of, or addition
to |
the hard or soft tissues of the oral cavity, except for |
the placing, carving, and finishing of amalgam |
restorations by dental assistants who have had |
additional formal education and certification as |
determined by the Department. A dentist utilizing |
dental assistants shall not supervise more than 4 |
dental assistants at any one time for placing, carving, |
and finishing of amalgam restorations.
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(3) Any and all correction of malformation of teeth |
or of the jaws.
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(4) Administration of anesthetics, except for |
monitoring of
nitrous oxide, conscious sedation, deep |
sedation, and general anesthetic as provided in |
Section 8.1 of this Act, that may be performed only |
after successful completion of a training
program |
approved by the Department. A dentist utilizing dental |
assistants shall not supervise more than 4 dental |
assistants at any one time for the monitoring of |
nitrous oxide.
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(5) Removal of calculus from human teeth.
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(6) Taking of impressions for the fabrication of |
prosthetic
appliances,
crowns,
bridges, inlays, |
onlays, or other restorative or replacement
dentistry.
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(7) The operative procedure of dental hygiene |
consisting of oral
prophylactic procedures, except for |
coronal polishing and pit and fissure sealants,
which |
may be
performed by a
dental assistant who has |
successfully completed a training program approved by
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the Department. Dental assistants may perform coronal |
polishing under the
following circumstances: (i) the |
coronal polishing shall be limited to
polishing the
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clinical crown of the tooth and existing restorations, |
supragingivally; (ii)
the
dental assistant performing |
the coronal polishing shall be limited to the use
of
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rotary instruments using a rubber cup or brush |
polishing method (air polishing
is
not permitted); and |
(iii) the supervising dentist shall not supervise more
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than 4
dental assistants at any one time for the task |
of coronal polishing or pit and fissure sealants.
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In addition to coronal polishing and pit and |
fissure sealants as described in this item (7), a |
dental assistant who has at least 2,000 hours of direct |
clinical patient care experience and who has |
successfully completed a structured training program |
provided by (1) an educational institution such as a |
dental school or dental hygiene or dental assistant |
program, or (2) by a statewide dental or dental |
hygienist association, approved by the Department on |
or before the effective date of this amendatory Act of |
the 99th General Assembly, that has developed and |
conducted a training program for expanded functions |
for dental assistants or hygienists approved by rule by |
the Department may perform: (A) coronal scaling above |
the gum line, supragingivally, on the clinical crown of |
the tooth only on patients 12 years of age or younger |
who have an absence of periodontal disease and who are |
not medically compromised or individuals with special |
needs and (B) intracoronal temporization of a tooth. |
The training program approved by the Department must: |
(I) include a minimum of 16 hours of instruction in |
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both didactic and clinical manikin or human subject |
instruction; all training programs shall include areas |
of study courses in dental anatomy, public health |
dentistry, medical history, dental emergencies, and |
managing the pediatric patient; (II) include an |
outcome assessment examination that demonstrates |
competency; (III) require the supervising dentist to |
observe and approve the completion of 6 full mouth |
supragingival scaling procedures; and (IV) issue a |
certificate of completion of the training program, |
which must be kept on file at the dental office and be |
made available to the Department upon request . A dental |
assistant must have successfully completed an approved |
coronal polishing course prior to taking the coronal |
scaling course. A dental assistant performing these |
functions shall be limited to the use of hand |
instruments only. In addition, coronal scaling as |
described in this paragraph shall only be utilized on |
patients who are eligible for Medicaid or who are |
uninsured and whose household income is not greater |
than 200% of the federal poverty level. A dentist may |
not supervise more than 2 dental assistants at any one |
time for the task of coronal scaling. This paragraph is |
inoperative on and after January 1, 2021. |
The limitations on the number of dental assistants a |
dentist may supervise contained in items (2), (4), and (7) |
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of this paragraph (g) mean a limit of 4 total dental |
assistants or dental hygienists doing expanded functions |
covered by these Sections being supervised by one dentist. |
(h) The practice of dentistry by an individual who:
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(i) has applied in writing to the Department, in |
form and substance
satisfactory to the Department, for |
a general dental license and has
complied with all |
provisions of Section 9 of this Act, except for the
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passage of the examination specified in subsection (e) |
of Section 9 of this
Act; or
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(ii) has applied in writing to the Department, in |
form and substance
satisfactory to the Department, for |
a temporary dental license and has
complied with all |
provisions of subsection (c) of Section 11 of this Act; |
and
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(iii) has been accepted or appointed for specialty |
or residency training
by a hospital situated in this |
State; or
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(iv) has been accepted or appointed for specialty |
training in an
approved dental program situated in this |
State; or
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(v) has been accepted or appointed for specialty |
training in a dental
public health agency situated in |
this State.
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The applicant shall be permitted to practice dentistry |
for a period of 3
months from the starting date of the |
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program, unless authorized in writing
by the Department to |
continue such practice for a period specified in
writing by |
the Department.
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The applicant shall only be entitled to perform such |
acts as may be
prescribed by and incidental to his or her |
program of residency or specialty
training and shall not |
otherwise engage in the practice of dentistry in this
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State.
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The authority to practice shall terminate immediately |
upon:
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(1) the decision of the Department that the |
applicant has failed the
examination; or
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(2) denial of licensure by the Department; or
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(3) withdrawal of the application.
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(Source: P.A. 98-147, eff. 1-1-14; 98-463, eff. 8-16-13; |
98-756, eff. 7-16-14; 99-492, eff. 12-31-15.)
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(225 ILCS 25/18.1) |
(Section scheduled to be repealed on January 1, 2021) |
Sec. 18.1. Public health dental supervision |
responsibilities. |
(a) When working together in a public health supervision |
relationship, dentists and public health dental hygienists |
shall enter into a public health supervision agreement. The |
dentist providing public health supervision must: |
(1) be available to provide an appropriate level of |
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contact, communication, collaboration, and consultation |
with the public health dental hygienist and must meet |
in-person with the public health dental hygienist at least |
quarterly for review and consultation; |
(2) have specific standing orders or policy guidelines |
for procedures that are to be carried out for each location |
or program, although the dentist need not be present when |
the procedures are being performed; |
(3) provide for the patient's additional necessary |
care in consultation with the public health dental |
hygienist; |
(4) file agreements and notifications as required; and |
(5) include procedures for creating and maintaining |
dental records, including protocols for transmission of |
all records between the public health dental hygienist and |
the dentist following each treatment, which shall include a |
notation regarding procedures authorized by the dentist |
and performed by the public health dental hygienist and the |
location where those records are to be kept. |
Each dentist and hygienist who enters into a public health |
supervision agreement must document and maintain a copy of any |
change or termination of that agreement. |
Dental records shall be owned and maintained by the |
supervising dentist for all patients treated under public |
health supervision, unless the supervising dentist is an |
employee of a public health clinic or federally qualified |
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health center, in which case the public health clinic or |
federally qualified health center shall maintain the records. |
If a dentist ceases to be employed or contracted by the |
facility, the dentist shall notify the facility administrator |
that the public health supervision agreement is no longer in |
effect. A new public health supervision agreement is required |
for the public health dental hygienist to continue treating |
patients under public health supervision. |
A dentist entering into an agreement under this Section may |
supervise and enter into agreements for public health |
supervision with 2 public health dental hygienists. This shall |
be in addition to the limit of 4 dental hygienists per dentist |
set forth in subsection (g) of Section 18 of this Act. |
(b) A public health dental hygienist providing services |
under public health supervision may perform only those duties |
within the accepted scope of practice of dental hygiene, as |
follows: |
(1) the operative procedures of dental hygiene, |
consisting of oral prophylactic procedures, including |
prophylactic cleanings, application of fluoride, and |
placement of sealants; |
(2) the exposure and processing of x-ray films of the |
teeth and surrounding structures; and |
(3) such other procedures and acts as shall be |
prescribed by rule of the Department. |
Any patient treated under this subsection (b) must be |
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examined by a dentist before additional services can be |
provided by a public health dental hygienist. However, if the |
supervising dentist, after consultation with the public health |
hygienist, determines that time is needed to complete an |
approved treatment plan on a patient eligible under this |
Section, then the dentist may instruct the hygienist to |
complete the remaining services prior to an oral examination by |
the dentist. Such instruction by the dentist to the hygienist |
shall be noted in the patient's records. Any services performed |
under this exception must be scheduled in a timely manner and |
shall not occur more than 30 days after the first appointment |
date. |
(c) A public health dental hygienist providing services |
under public health supervision must: |
(1) provide to the patient, parent, or guardian a |
written plan for referral or an agreement for follow-up |
that records all conditions observed that should be called |
to the attention of a dentist for proper diagnosis; |
(2) have each patient sign a permission slip or consent |
form that informs them that the service to be received does |
not take the place of regular dental checkups at a dental |
office and is meant for people who otherwise would not have |
access to the service; |
(3) inform each patient who may require further dental |
services of that need; |
(4) maintain an appropriate level of contact and |
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communication with the dentist providing public health |
supervision; and |
(5) complete an additional 4 hours of continuing |
education in areas specific to public health dentistry |
yearly. |
(d) Each public health dental hygienist who has rendered |
services under subsections (c), (d), and (e) of this Section |
must complete a summary report at the completion of a program |
or, in the case of an ongoing program, at least annually. The |
report must be completed in the manner specified by the |
Division of Oral Health in the Department of Public Health |
including information about each location where the public |
health dental hygienist has rendered these services. The public |
health dental hygienist must submit the form to the dentist |
providing supervision for his or her signature before sending |
it to the Division. |
(e) Public health dental hygienists providing services |
under public health supervision may be compensated for their |
work by salary, honoraria, and other mechanisms by the |
employing or sponsoring entity. Nothing in this Act shall |
preclude the entity that employs or sponsors a public health |
dental hygienist from seeking payment, reimbursement, or other |
source of funding for the services provided. |
(f) This Section is repealed on January 1, 2021.
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(Source: P.A. 99-492, eff. 12-31-15 .)
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