(225 ILCS 25/18)

(from Ch. 111, par. 2318)

(Text of Section before amendment by P.A. 103-431)

(Section scheduled to be repealed on January 1, 2026)

Sec. 18.

Acts constituting the practice of dental hygiene;
limitations.

(a) A person practices dental hygiene within the meaning of this Act when
he or she performs the following acts under the supervision of a dentist:

(i) the operative procedure of dental hygiene, consisting of oral prophylactic

procedures;

(ii) the exposure and processing of X-Ray films of the teeth and
surrounding structures;

(iii) the application to the surfaces of the teeth or gums of chemical compounds

designed to be desensitizing agents or effective agents in the prevention of dental caries or periodontal disease;

(iv) all services which may be performed by a dental assistant as specified by rule

pursuant to Section 17, and a dental hygienist may engage in the placing, carving, and finishing of amalgam restorations only after obtaining formal education and certification as determined by the Department;

(v) administration and monitoring of nitrous oxide upon successful completion of a

training program approved by the Department;

(vi) administration of local anesthetics upon successful completion of a training

program approved by the Department; and

(vii) such other procedures and acts as shall be prescribed by rule or regulation of the

Department.

(b) A dental hygienist may be employed or engaged only:

(1) by a dentist;

(2) by a federal, State, county, or municipal agency or institution;

(3) by a public or private school; or

(4) by a public clinic operating under the direction of a hospital or federal, State,

county, municipal, or other public agency or institution.

(c) When employed or engaged in the office of a dentist, a dental hygienist
may
perform, under general supervision, those procedures found in items (i) through
(iv) of
subsection (a) of this Section, provided the patient has been examined by the
dentist
within one year of the provision of dental hygiene services, the dentist has
approved the
dental hygiene services by a notation in the patient's record and the patient
has been
notified that the dentist may be out of the office during the provision of
dental hygiene
services.

(d) If a patient of record is unable to travel to a dental office because of
illness,
infirmity, or
imprisonment, a dental hygienist may perform, under the general supervision of
a dentist,
those procedures found in items (i) through (iv) of subsection (a) of this
Section,
provided the patient is located in a long-term care facility licensed by the
State of Illinois,
a mental health or developmental disability facility, or a State or federal
prison.  The dentist
shall either personally examine and diagnose the patient or utilize approved teledentistry communication methods and determine which
services are necessary to be performed, which shall be contained in an order to the hygienist and a notation in the patient's record.
Such order must be implemented within 45 days
of its issuance, and an updated medical history and observation of oral
conditions

must be performed by the hygienist immediately prior to beginning the
procedures to ensure that the patient's health has not changed in any
manner to warrant a reexamination by the dentist.

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

(f) Without the supervision of a dentist, a dental hygienist
may perform
dental health education functions, including instruction in proper oral health care and dental hygiene in either a school setting or long-term care facility. In addition, a dental hygienist may record care histories and oral conditions observed at any time prior to a clinical exam by a dentist.

(g) The number of dental hygienists practicing in a dental office shall
not
exceed, at any one time, 4 times the number of dentists practicing in the
office at the time.

(h) A dental hygienist who is certified as a public health dental hygienist may provide services to patients: (1) who are eligible for Medicaid or (2) who are uninsured and whose household income is not greater than 300% of the federal poverty level. A public health dental hygienist may perform oral assessments, perform screenings, and provide educational and preventative services as provided in subsection (b) of Section 18.1 of this Act.  The public health dental hygienist may not administer local anesthesia or nitrous oxide, or place, carve, or finish amalgam restorations or provide periodontal therapy under this exception.  Each patient must sign a consent form that acknowledges that the care received does not take the place of a regular dental examination.  The public health dental hygienist must provide the patient or guardian a written referral to a dentist for assessment of the need for further dental care at the time of treatment. Any indication or observation of a condition that could warrant the need for urgent attention must be reported immediately to the supervising dentist for appropriate assessment and treatment.

This subsection (h) is inoperative on and after January 1, 2026.

(i)   A dental hygienist performing procedures listed in paragraphs (1) through (4) of subsection (a) of Section 17.1 must be under the supervision of a dentist, requiring the dentist authorizes the procedure, remains in the dental facility while the procedure is performed, and approves the work performed by the dental hygienist before dismissal of the patient, but the dentist is not required to be present at all times in the treatment room.

(j)   A dental hygienist may perform actions described in paragraph (5) of subsection (a) of Section 17.1 under the general supervision of a dentist as described in this Section.

(Source: P.A. 101-162, eff. 7-26-19; 102-936, eff. 1-1-23.)

(Text of Section after amendment by P.A. 103-431)
(Section scheduled to be repealed on January 1, 2026)