103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1509

 

Introduced 2/7/2023, by Sen. Bill Cunningham

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 25/4  from Ch. 111, par. 2304
225 ILCS 25/17  from Ch. 111, par. 2317
225 ILCS 25/26  from Ch. 111, par. 2326
225 ILCS 25/46.5 new

    Amends the Illinois Dental Practice Act. Provides that a person who provides teledentistry is considered to practice dentistry under the Act. Provides that a dentist practicing teledentistry is subject to the same standard of care as if those services were being delivered in a clinic or office setting. Provides that a patient receiving dental services through teledentistry shall be provided with the name, direct telephone number, and physical practice address of the treating dentist who will be involved in the teledentistry services. Provides that the Department of Financial and Professional Regulation may adopt rules to implement the provisions of the use of teledentistry services. Provides that it shall be a violation of the Act for a provider of dental services utilizing care through teledentistry to require a patient to sign an agreement that limits in any way the patient's ability to write a review of services received or file a complaint with the Department or other regulatory agency. Provides that a person may not sell a clear aligner to a patient unless the person has received written or electronic confirmation from a dentist licensed in this State that the patient has received an intraoral or extraoral dental examination and has had a review of new or recently conducted x-rays, panoramic x-rays, computed tomography, bone imaging scans, or other appropriate diagnostic imaging sufficient to allow the dentist to detect conditions in the patient that would preclude or contraindicate the provision of safe orthodontic treatment. Provides that a person who sells a clear aligner to a patient shall maintain any documents for not less than 7 years after the date of sale. Defines "informed consent" and "clear aligner". Changes the definitions of "patient of record" and "teledentistry".


LRB103 26930 AMQ 53294 b

 

 

A BILL FOR

 

SB1509LRB103 26930 AMQ 53294 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4, 17, and 26 and by adding Section 46.5 as
6follows:
 
7    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
8    (Section scheduled to be repealed on January 1, 2026)
9    Sec. 4. Definitions. As used in this Act:
10    "Address of record" means the designated address recorded
11by the Department in the applicant's or licensee's application
12file or license file as maintained by the Department's
13licensure maintenance unit. It is the duty of the applicant or
14licensee to inform the Department of any change of address and
15those changes must be made either through the Department's
16website or by contacting the Department.
17    "Department" means the Department of Financial and
18Professional Regulation.
19    "Secretary" means the Secretary of Financial and
20Professional Regulation.
21    "Board" means the Board of Dentistry.
22    "Dentist" means a person who has received a general
23license pursuant to paragraph (a) of Section 11 of this Act and

 

 

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1who may perform any intraoral and extraoral procedure required
2in the practice of dentistry and to whom is reserved the
3responsibilities specified in Section 17.
4    "Dental hygienist" means a person who holds a license
5under this Act to perform dental services as authorized by
6Section 18.
7    "Dental assistant" means an appropriately trained person
8who, under the supervision of a dentist, provides dental
9services as authorized by Section 17.
10    "Expanded function dental assistant" means a dental
11assistant who has completed the training required by Section
1217.1 of this Act.
13    "Dental laboratory" means a person, firm or corporation
14which:
15        (i) engages in making, providing, repairing or
16    altering dental prosthetic appliances and other artificial
17    materials and devices which are returned to a dentist for
18    insertion into the human oral cavity or which come in
19    contact with its adjacent structures and tissues; and
20        (ii) utilizes or employs a dental technician to
21    provide such services; and
22        (iii) performs such functions only for a dentist or
23    dentists.
24    "Supervision" means supervision of a dental hygienist or a
25dental assistant requiring that a dentist authorize the
26procedure, remain in the dental facility while the procedure

 

 

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1is performed, and approve the work performed by the dental
2hygienist or dental assistant before dismissal of the patient,
3but does not mean that the dentist must be present at all times
4in the treatment room.
5    "General supervision" means supervision of a dental
6hygienist requiring that the patient be a patient of record,
7that the dentist examine the patient in accordance with
8Section 18 prior to treatment by the dental hygienist, and
9that the dentist authorize the procedures which are being
10carried out by a notation in the patient's record, but not
11requiring that a dentist be present when the authorized
12procedures are being performed. The issuance of a prescription
13to a dental laboratory by a dentist does not constitute
14general supervision.
15    "Public member" means a person who is not a health
16professional. For purposes of board membership, any person
17with a significant financial interest in a health service or
18profession is not a public member.
19    "Dentistry" means the healing art which is concerned with
20the examination, diagnosis, treatment planning and care of
21conditions within the human oral cavity and its adjacent
22tissues and structures, as further specified in Section 17.
23    "Branches of dentistry" means the various specialties of
24dentistry which, for purposes of this Act, shall be limited to
25the following: endodontics, oral and maxillofacial surgery,
26orthodontics and dentofacial orthopedics, pediatric dentistry,

 

 

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

 

 

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1registered nurse, or a licensed practical nurse licensed under
2the Nurse Practice Act.
3    "Patient of record" means a patient for whom the patient's
4most recent dentist has obtained a relevant medical and dental
5history and on whom the dentist has performed an a physical
6examination within the last year and evaluated the condition
7to be treated, including a review of the patient's most recent
8x-rays.
9    "Dental responder" means a dentist or dental hygienist who
10is appropriately certified in disaster preparedness,
11immunizations, and dental humanitarian medical response
12consistent with the Society of Disaster Medicine and Public
13Health and training certified by the National Incident
14Management System or the National Disaster Life Support
15Foundation.
16    "Mobile dental van or portable dental unit" means any
17self-contained or portable dental unit in which dentistry is
18practiced that can be moved, towed, or transported from one
19location to another in order to establish a location where
20dental services can be provided.
21    "Public health dental hygienist" means a hygienist who
22holds a valid license to practice in the State, has 2 years of
23full-time clinical experience or an equivalent of 4,000 hours
24of clinical experience, and has completed at least 42 clock
25hours of additional structured courses in dental education in
26advanced areas specific to public health dentistry.

 

 

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1    "Public health setting" means a federally qualified health
2center; a federal, State, or local public health facility;
3Head Start; a special supplemental nutrition program for
4Women, Infants, and Children (WIC) facility; a certified
5school-based health center or school-based oral health
6program; a prison; or a long-term care facility.
7    "Public health supervision" means the supervision of a
8public health dental hygienist by a licensed dentist who has a
9written public health supervision agreement with that public
10health dental hygienist while working in an approved facility
11or program that allows the public health dental hygienist to
12treat patients, without a dentist first examining the patient
13and being present in the facility during treatment, (1) who
14are eligible for Medicaid or (2) who are uninsured and whose
15household income is not greater than 200% of the federal
16poverty level.
17    "Teledentistry" means the use of telehealth systems and
18methodologies in dentistry and includes patient diagnosis,
19treatment planning, care, and education delivery for a patient
20of record using synchronous and asynchronous communications
21under an Illinois licensed a dentist's authority as provided
22under this Act.
23    "Clear aligner" means a medical device, excluding a
24retainer used to keep teeth in a fixed position, that is used
25in orthodontic treatment to gradually move a patient's teeth
26or jaw and correct misalignment and manufactured to address

 

 

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1the patient's unique orthodontic needs.
2(Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19;
3102-93, eff. 1-1-22; 102-588, eff. 8-20-21; 102-936, eff.
41-1-23.)
 
5    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
6    (Section scheduled to be repealed on January 1, 2026)
7    Sec. 17. Acts constituting the practice of dentistry. A
8person practices dentistry, within the meaning of this Act:
9        (1) Who represents himself or herself as being able to
10    diagnose or diagnoses, treats, prescribes, or operates for
11    any disease, pain, deformity, deficiency, injury, or
12    physical condition of the human tooth, teeth, alveolar
13    process, gums, or jaw; or
14        (2) Who is a manager, proprietor, operator, or
15    conductor of a business where dental operations are
16    performed; or
17        (3) Who performs dental operations of any kind; or
18        (4) Who uses an X-Ray machine or X-Ray films for
19    dental diagnostic purposes; or
20        (5) Who extracts a human tooth or teeth, or corrects
21    or attempts to correct malpositions of the human teeth or
22    jaws; or
23        (6) Who offers or undertakes, by any means or method,
24    to diagnose, treat, or remove stains, calculus, and
25    bonding materials from human teeth or jaws; or

 

 

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1        (7) Who uses or administers local or general
2    anesthetics in the treatment of dental or oral diseases or
3    in any preparation incident to a dental operation of any
4    kind or character; or
5        (8) Who takes material or digital scans for final
6    impressions of the human tooth, teeth, or jaws or performs
7    any phase of any operation incident to the replacement of
8    a part of a tooth, a tooth, teeth, or associated tissues by
9    means of a filling, crown, a bridge, a denture, or other
10    appliance; or
11        (9) Who offers to furnish, supply, construct,
12    reproduce, or repair, or who furnishes, supplies,
13    constructs, reproduces, or repairs, prosthetic dentures,
14    bridges, or other substitutes for natural teeth, to the
15    user or prospective user thereof; or
16        (10) Who instructs students on clinical matters or
17    performs any clinical operation included in the curricula
18    of recognized dental schools and colleges; or
19        (11) Who takes material or digital scans for final
20    impressions of human teeth or places his or her hands in
21    the mouth of any person for the purpose of applying teeth
22    whitening materials, or who takes impressions of human
23    teeth or places his or her hands in the mouth of any person
24    for the purpose of assisting in the application of teeth
25    whitening materials. A person does not practice dentistry
26    when he or she discloses to the consumer that he or she is

 

 

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1    not licensed as a dentist under this Act and (i) discusses
2    the use of teeth whitening materials with a consumer
3    purchasing these materials; (ii) provides instruction on
4    the use of teeth whitening materials with a consumer
5    purchasing these materials; or (iii) provides appropriate
6    equipment on-site to the consumer for the consumer to
7    self-apply teeth whitening materials; or .
8        (12) Who provides teledentistry. A dentist may provide
9    and delegate dental services using telehealth only under
10    the supervision requirements as specified in this Act for
11    in-person care. A dentist practicing dentistry through
12    teledentistry is subject to the same standard of care as
13    if those services were being delivered in a clinic or
14    office setting. A patient receiving dental services
15    through teledentistry shall be provided with the name,
16    direct telephone number, and physical practice address of
17    the treating dentist who will be involved in the
18    teledentistry services. The information shall be provided
19    to the patient prior to the provision of services. The
20    Department may adopt rules to implement this paragraph.
21    The fact that any person engages in or performs, or offers
22to engage in or perform, any of the practices, acts, or
23operations set forth in this Section, shall be prima facie
24evidence that such person is engaged in the practice of
25dentistry.
26    The following practices, acts, and operations, however,

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1        fissure sealants as described in this item (7), a
2        dental assistant who has at least 2,000 hours of
3        direct clinical patient care experience and who has
4        successfully completed a structured training program
5        provided by (1) an educational institution including,
6        but not limited to, a dental school or dental hygiene
7        or dental assistant program, or (2) a continuing
8        education provider approved by the Department, or (3)
9        a statewide dental or dental hygienist association,
10        approved by the Department on or before January 1,
11        2017 (the effective date of Public Act 99-680), that
12        has developed and conducted a training program for
13        expanded functions for dental assistants or hygienists
14        may perform: (A) coronal scaling above the gum line,
15        supragingivally, on the clinical crown of the tooth
16        only on patients 17 years of age or younger who have an
17        absence of periodontal disease and who are not
18        medically compromised or individuals with special
19        needs and (B) intracoronal temporization of a tooth.
20        The training program must: (I) include a minimum of 32
21        hours of instruction in both didactic and clinical
22        manikin or human subject instruction; all training
23        programs shall include areas of study in dental
24        anatomy, public health dentistry, medical history,
25        dental emergencies, and managing the pediatric
26        patient; (II) include an outcome assessment

 

 

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1        examination that demonstrates competency; (III)
2        require the supervising dentist to observe and approve
3        the completion of 6 full mouth supragingival scaling
4        procedures unless the training was received as part of
5        a Commission on Dental Accreditation approved dental
6        assistant program; and (IV) issue a certificate of
7        completion of the training program, which must be kept
8        on file at the dental office and be made available to
9        the Department upon request. A dental assistant must
10        have successfully completed an approved coronal
11        polishing course prior to taking the coronal scaling
12        course. A dental assistant performing these functions
13        shall be limited to the use of hand instruments only.
14        In addition, coronal scaling as described in this
15        paragraph shall only be utilized on patients who are
16        eligible for Medicaid, who are uninsured, or whose
17        household income is not greater than 300% of the
18        federal poverty level. A dentist may not supervise
19        more than 2 dental assistants at any one time for the
20        task of coronal scaling. This paragraph is inoperative
21        on and after January 1, 2026.
22        The limitations on the number of dental assistants a
23    dentist may supervise contained in items (2), (4), and (7)
24    of this paragraph (g) mean a limit of 4 total dental
25    assistants or dental hygienists doing expanded functions
26    covered by these Sections being supervised by one dentist;

 

 

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1    or
2        (h) The practice of dentistry by an individual who:
3            (i) has applied in writing to the Department, in
4        form and substance satisfactory to the Department, for
5        a general dental license and has complied with all
6        provisions of Section 9 of this Act, except for the
7        passage of the examination specified in subsection (e)
8        of Section 9 of this Act; or
9            (ii) has applied in writing to the Department, in
10        form and substance satisfactory to the Department, for
11        a temporary dental license and has complied with all
12        provisions of subsection (c) of Section 11 of this
13        Act; and
14            (iii) has been accepted or appointed for specialty
15        or residency training by a hospital situated in this
16        State; or
17            (iv) has been accepted or appointed for specialty
18        training in an approved dental program situated in
19        this State; or
20            (v) has been accepted or appointed for specialty
21        training in a dental public health agency situated in
22        this State.
23        The applicant shall be permitted to practice dentistry
24    for a period of 3 months from the starting date of the
25    program, unless authorized in writing by the Department to
26    continue such practice for a period specified in writing

 

 

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1    by the Department.
2        The applicant shall only be entitled to perform such
3    acts as may be prescribed by and incidental to his or her
4    program of residency or specialty training and shall not
5    otherwise engage in the practice of dentistry in this
6    State.
7        The authority to practice shall terminate immediately
8    upon:
9            (1) the decision of the Department that the
10        applicant has failed the examination; or
11            (2) denial of licensure by the Department; or
12            (3) withdrawal of the application.
13(Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21;
14102-936, eff. 1-1-23.)
 
15    (225 ILCS 25/26)  (from Ch. 111, par. 2326)
16    (Section scheduled to be repealed on January 1, 2026)
17    Sec. 26. Disciplinary actions.
18    (a) In case the respondent, after receiving notice, fails
19to file an answer, his or her license may, in the discretion of
20the Secretary, having first received the recommendation of the
21Board, be suspended, revoked, placed on probationary status,
22or the Secretary may take whatever disciplinary or
23non-disciplinary action he or she may deem proper, including
24limiting the scope, nature, or extent of the person's practice
25or the imposition of a fine, without a hearing, if the act or

 

 

SB1509- 19 -LRB103 26930 AMQ 53294 b

1acts charged constitute sufficient grounds for such action
2under this Act.
3    (b) The Secretary may temporarily suspend the license of a
4dentist or dental hygienist without a hearing, simultaneous to
5the institution of proceedings for a hearing under this Act,
6if the Secretary finds that evidence in his or her possession
7indicates that a dentist's or dental hygienist's continuation
8in practice would constitute an immediate danger to the
9public. In the event that the Secretary temporarily suspends
10the license of a dentist or a dental hygienist without a
11hearing, a hearing by the Board must be held within 15 days
12after such suspension has occurred.
13    (c) The entry of a judgment by any circuit court
14establishing that any person holding a license under this Act
15is a person subject to involuntary admission under the Mental
16Health and Developmental Disabilities Code shall operate as a
17suspension of that license. That person may resume his or her
18practice only upon a finding by the Board that he or she has
19been determined to be no longer subject to involuntary
20admission by the court and upon the Board's recommendation to
21the Secretary that he or she be permitted to resume his or her
22practice.
23    (d) It shall be a violation of this Act for a provider of
24dental services utilizing care through teledentistry to
25require a patient to sign an agreement that limits in any way
26the patient's ability to write a review of services received

 

 

SB1509- 20 -LRB103 26930 AMQ 53294 b

1or file a complaint with the Department or other regulatory
2agency.
3(Source: P.A. 99-492, eff. 12-31-15.)
 
4    (225 ILCS 25/46.5 new)
5    Sec. 46.5. Prohibition on sale of clear aligners to the
6public.
7    (a) A person may not sell a clear aligner to a patient
8unless the person has received written or electronic
9confirmation from a dentist licensed in this State that the
10patient has received an intraoral or extraoral dental
11examination and has had a review of new or recently conducted
12x-rays, panoramic x-rays, computed tomography, bone imaging
13scans, or other appropriate diagnostic imaging sufficient to
14allow the dentist to detect conditions in the patient that
15would preclude or contraindicate the provision of safe
16orthodontic treatment.
17    (b) A person who sells a clear aligner to a patient shall
18maintain any documents received under subsection (a) for not
19less than 7 years after the date of sale.