Illinois General Assembly - Full Text of SB2631
Illinois General Assembly

Previous General Assemblies

Full Text of SB2631  100th General Assembly


Sen. Emil Jones, III

Filed: 4/6/2018





10000SB2631sam002LRB100 16398 XWW 38147 a


2    AMENDMENT NO. ______. Amend Senate Bill 2631, AS AMENDED,
3in the introductory clause of Section 5, by changing "changing
4Section 11" with "changing Sections 11, 17, and 17.1"; and
5in Section 5, immediately below Sec. 11, by inserting the
7    "(225 ILCS 25/17)  (from Ch. 111, par. 2317)
8    (Section scheduled to be repealed on January 1, 2026)
9    Sec. 17. Acts constituting the practice of dentistry. A
10person practices dentistry, within the meaning of this Act:
11        (1) Who represents himself or herself as being able to
12    diagnose or diagnoses, treats, prescribes, or operates for
13    any disease, pain, deformity, deficiency, injury, or
14    physical condition of the human tooth, teeth, alveolar
15    process, gums or jaw; or
16        (2) Who is a manager, proprietor, operator or conductor



10000SB2631sam002- 2 -LRB100 16398 XWW 38147 a

1    of a business where dental operations are performed; or
2        (3) Who performs dental operations of any kind; or
3        (4) Who uses an X-Ray machine or X-Ray films for dental
4    diagnostic purposes; or
5        (5) Who extracts a human tooth or teeth, or corrects or
6    attempts to correct malpositions of the human teeth or
7    jaws; or
8        (6) Who offers or undertakes, by any means or method,
9    to diagnose, treat or remove stains, calculus, and bonding
10    materials from human teeth or jaws; or
11        (7) Who uses or administers local or general
12    anesthetics in the treatment of dental or oral diseases or
13    in any preparation incident to a dental operation of any
14    kind or character; or
15        (8) Who takes material or digital scans for final
16    impressions of the human tooth, teeth, or jaws or performs
17    any phase of any operation incident to the replacement of a
18    part of a tooth, a tooth, teeth or associated tissues by
19    means of a filling, crown, a bridge, a denture or other
20    appliance; or
21        (9) Who offers to furnish, supply, construct,
22    reproduce or repair, or who furnishes, supplies,
23    constructs, reproduces or repairs, prosthetic dentures,
24    bridges or other substitutes for natural teeth, to the user
25    or prospective user thereof; or
26        (10) Who instructs students on clinical matters or



10000SB2631sam002- 3 -LRB100 16398 XWW 38147 a

1    performs any clinical operation included in the curricula
2    of recognized dental schools and colleges; or
3        (11) Who takes material or digital scans for final
4    impressions of human teeth or places his or her hands in
5    the mouth of any person for the purpose of applying teeth
6    whitening materials, or who takes impressions of human
7    teeth or places his or her hands in the mouth of any person
8    for the purpose of assisting in the application of teeth
9    whitening materials. A person does not practice dentistry
10    when he or she discloses to the consumer that he or she is
11    not licensed as a dentist under this Act and (i) discusses
12    the use of teeth whitening materials with a consumer
13    purchasing these materials; (ii) provides instruction on
14    the use of teeth whitening materials with a consumer
15    purchasing these materials; or (iii) provides appropriate
16    equipment on-site to the consumer for the consumer to
17    self-apply teeth whitening materials.
18    The fact that any person engages in or performs, or offers
19to engage in or perform, any of the practices, acts, or
20operations set forth in this Section, shall be prima facie
21evidence that such person is engaged in the practice of
23    The following practices, acts, and operations, however,
24are exempt from the operation of this Act:
25        (a) The rendering of dental relief in emergency cases
26    in the practice of his or her profession by a physician or



10000SB2631sam002- 4 -LRB100 16398 XWW 38147 a

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



10000SB2631sam002- 5 -LRB100 16398 XWW 38147 a

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



10000SB2631sam002- 6 -LRB100 16398 XWW 38147 a

1        had additional formal education and certification as
2        determined by the Department.
3            A dental assistant may place, carve, and finish
4        amalgam restorations and place, pack, and finish
5        composite restorations if he or she has at least 4,000
6        hours of direct clinical patient care experience and
7        has successfully completed a structured training
8        program provided by: (A) an educational institution
9        accredited by the Commission on Dental Accreditation,
10        such as a dental school or dental hygiene or dental
11        assistant program, or (B) a statewide dental
12        association, approved by the Department to provide
13        continuing education, that has developed and conducted
14        training programs for expanded functions for dental
15        assistants or hygienists. The training program must:
16        (i) include a minimum of 16 hours of didactic study and
17        12 hours of clinical manikin instruction; all training
18        programs shall include areas of study in nomenclature,
19        caries classifications, oral anatomy, periodontium,
20        basic occlusion, instrumentations, pulp protection
21        liners and bases, dental materials, matrix and wedge
22        techniques, amalgam placement and carving, rubber dam
23        clamp placement, and rubber dam placement and removal;
24        (ii) include an outcome assessment examination that
25        demonstrates competency; (iii) require the supervising
26        dentist to observe and approve the completion of 8



10000SB2631sam002- 7 -LRB100 16398 XWW 38147 a

1        amalgam or composite restorations; and (iv) issue a
2        certificate of completion of the training program,
3        which must be kept on file at the dental office and be
4        made available to the Department upon request. A dental
5        assistant must have successfully completed an approved
6        coronal polishing and dental sealant course prior to
7        taking the amalgam and composite restoration course.
8            A dentist utilizing dental assistants shall not
9        supervise more than 4 dental assistants at any one time
10        for placing, carving, and finishing of amalgam
11        restorations or for placing, packing, and finishing
12        composite restorations.
13            (3) Any and all correction of malformation of teeth
14        or of the jaws.
15            (4) Administration of anesthetics, except for
16        monitoring of nitrous oxide, conscious sedation, deep
17        sedation, and general anesthetic as provided in
18        Section 8.1 of this Act, that may be performed only
19        after successful completion of a training program
20        approved by the Department. A dentist utilizing dental
21        assistants shall not supervise more than 4 dental
22        assistants at any one time for the monitoring of
23        nitrous oxide.
24            (5) Removal of calculus from human teeth.
25            (6) Taking of material or digital scans for final
26        impressions for the fabrication of prosthetic



10000SB2631sam002- 8 -LRB100 16398 XWW 38147 a

1        appliances, crowns, bridges, inlays, onlays, or other
2        restorative or replacement dentistry.
3            (7) The operative procedure of dental hygiene
4        consisting of oral prophylactic procedures, except for
5        coronal polishing and pit and fissure sealants, which
6        may be performed by a dental assistant who has
7        successfully completed a training program approved by
8        the Department. Dental assistants may perform coronal
9        polishing under the following circumstances: (i) the
10        coronal polishing shall be limited to polishing the
11        clinical crown of the tooth and existing restorations,
12        supragingivally; (ii) the dental assistant performing
13        the coronal polishing shall be limited to the use of
14        rotary instruments using a rubber cup or brush
15        polishing method (air polishing is not permitted); and
16        (iii) the supervising dentist shall not supervise more
17        than 4 dental assistants at any one time for the task
18        of coronal polishing or pit and fissure sealants.
19            In addition to coronal polishing and pit and
20        fissure sealants as described in this item (7), a
21        dental assistant who has at least 2,000 hours of direct
22        clinical patient care experience and who has
23        successfully completed a structured training program
24        provided by (1) an educational institution such as a
25        dental school or dental hygiene or dental assistant
26        program, or (2) by a statewide dental or dental



10000SB2631sam002- 9 -LRB100 16398 XWW 38147 a

1        hygienist association, approved by the Department on
2        or before the effective date of this amendatory Act of
3        the 99th General Assembly, that has developed and
4        conducted a training program for expanded functions
5        for dental assistants or hygienists may perform: (A)
6        coronal scaling above the gum line, supragingivally,
7        on the clinical crown of the tooth only on patients 12
8        years of age or younger who have an absence of
9        periodontal disease and who are not medically
10        compromised or individuals with special needs and (B)
11        intracoronal temporization of a tooth. The training
12        program must: (I) include a minimum of 16 hours of
13        instruction in both didactic and clinical manikin or
14        human subject instruction; all training programs shall
15        include areas of study in dental anatomy, public health
16        dentistry, medical history, dental emergencies, and
17        managing the pediatric patient; (II) include an
18        outcome assessment examination that demonstrates
19        competency; (III) require the supervising dentist to
20        observe and approve the completion of 6 full mouth
21        supragingival scaling procedures; and (IV) issue a
22        certificate of completion of the training program,
23        which must be kept on file at the dental office and be
24        made available to the Department upon request. A dental
25        assistant must have successfully completed an approved
26        coronal polishing course prior to taking the coronal



10000SB2631sam002- 10 -LRB100 16398 XWW 38147 a

1        scaling course. A dental assistant performing these
2        functions shall be limited to the use of hand
3        instruments only. In addition, coronal scaling as
4        described in this paragraph shall only be utilized on
5        patients who are eligible for Medicaid or who are
6        uninsured and whose household income is not greater
7        than 200% of the federal poverty level. A dentist may
8        not supervise more than 2 dental assistants at any one
9        time for the task of coronal scaling. This paragraph is
10        inoperative on and after January 1, 2021.
11        The limitations on the number of dental assistants a
12    dentist may supervise contained in items (2), (4), and (7)
13    of this paragraph (g) mean a limit of 4 total dental
14    assistants or dental hygienists doing expanded functions
15    covered by these Sections being supervised by one dentist.
16        (h) The practice of dentistry by an individual who:
17            (i) has applied in writing to the Department, in
18        form and substance satisfactory to the Department, for
19        a general dental license and has complied with all
20        provisions of Section 9 of this Act, except for the
21        passage of the examination specified in subsection (e)
22        of Section 9 of this Act; or
23            (ii) has applied in writing to the Department, in
24        form and substance satisfactory to the Department, for
25        a temporary dental license and has complied with all
26        provisions of subsection (c) of Section 11 of this Act;



10000SB2631sam002- 11 -LRB100 16398 XWW 38147 a

1        and
2            (iii) has been accepted or appointed for specialty
3        or residency training by a hospital situated in this
4        State; or
5            (iv) has been accepted or appointed for specialty
6        training in an approved dental program situated in this
7        State; or
8            (v) has been accepted or appointed for specialty
9        training in a dental public health agency situated in
10        this State.
11        The applicant shall be permitted to practice dentistry
12    for a period of 3 months from the starting date of the
13    program, unless authorized in writing by the Department to
14    continue such practice for a period specified in writing by
15    the Department.
16        The applicant shall only be entitled to perform such
17    acts as may be prescribed by and incidental to his or her
18    program of residency or specialty training and shall not
19    otherwise engage in the practice of dentistry in this
20    State.
21        The authority to practice shall terminate immediately
22    upon:
23            (1) the decision of the Department that the
24        applicant has failed the examination; or
25            (2) denial of licensure by the Department; or
26            (3) withdrawal of the application.



10000SB2631sam002- 12 -LRB100 16398 XWW 38147 a

1(Source: P.A. 99-492, eff. 12-31-15; 99-680, eff. 1-1-17;
2100-215, eff. 1-1-18.)
3    (225 ILCS 25/17.1)
4    (Section scheduled to be repealed on January 1, 2026)
5    Sec. 17.1. Expanded function dental assistants.
6    (a) A dental assistant who has completed training as
7provided in subsection (b) of this Section in all of the
8following areas may hold himself or herself out as an expanded
9function dental assistant:
10        (1) Taking material or digital scans for final
11    impressions after completing a training program that
12    includes either didactic objectives or clinical skills and
13    functions that demonstrate competency.
14        (2) Performing pulp vitality test after completing a
15    training program that includes either didactic objectives
16    or clinical skills and functions that demonstrate
17    competency.
18        (3) Placing, carving, and finishing of amalgam
19    restorations and placing, packing, and finishing composite
20    restorations as allowed under Section 17.
21        (4) Starting the flow of oxygen and monitoring of
22    nitrous oxide-oxygen analgesia as allowed under Section
23    17.
24        (5) Coronal polishing and pit and fissure sealants, as
25    currently allowed under Section 17 by law.



10000SB2631sam002- 13 -LRB100 16398 XWW 38147 a

1    All procedures listed in paragraphs (1) through (5) for
2dental assistants must be performed under the supervision of a
3dentist, requiring the dentist authorizes the procedure,
4remains in the dental facility while the procedure is
5performed, and approves the work performed by the dental
6assistant before dismissal of the patient, but the dentist is
7not required to be present at all times in the treatment room.
8    After the completion of training as provided in subsection
9(b) of this Section, an expanded function dental assistant may
10perform any of the services listed in this subsection (a)
11pursuant to the limitations of this Act.
12    (b) Certification and training as an expanded function
13dental assistant must be obtained from one of the following
14sources: (i) an approved continuing education sponsor; (ii) a
15dental assistant training program approved by the Commission on
16Dental Accreditation of the American Dental Association; or
17(iii) a training program approved by the Department.
18    Training required under this subsection (b) must also
19include Basic Life Support certification, as described in
20Section 16 of this Act. Proof of current certification shall be
21kept on file with the supervising dentist.
22    (c) Any procedures listed in subsection (a) that are
23performed by an expanded function dental assistant must be
24approved by the supervising dentist and examined prior to
25dismissal of the patient. The supervising dentist shall be
26responsible for all dental services or procedures performed by



10000SB2631sam002- 14 -LRB100 16398 XWW 38147 a

1the dental assistant.
2    (d) Nothing in this Section shall be construed to alter the
3number of dental assistants that a dentist may supervise under
4paragraph (g) of Section 17 of this Act.
5    (e) Nothing in this Act shall: (1) require a dental
6assistant to be certified as an expanded function dental
7assistant or (2) prevent a dentist from training dental
8assistants in accordance with the provisions of Section 17 of
9this Act or rules pertaining to dental assistant duties.
10(Source: P.A. 100-215, eff. 1-1-18.)
11    (225 ILCS 25/18)   (from Ch. 111, par. 2318)
12    (Section scheduled to be repealed on January 1, 2026)
13    Sec. 18. Acts constituting the practice of dental hygiene;
15    (a) A person practices dental hygiene within the meaning of
16this Act when he or she performs the following acts under the
17supervision of a dentist:
18            (i) the operative procedure of dental hygiene,
19        consisting of oral prophylactic procedures;
20            (ii) the exposure and processing of X-Ray films of
21        the teeth and surrounding structures;
22            (iii) the application to the surfaces of the teeth
23        or gums of chemical compounds designed to be
24        desensitizing agents or effective agents in the
25        prevention of dental caries or periodontal disease;



10000SB2631sam002- 15 -LRB100 16398 XWW 38147 a

1            (iv) all services which may be performed by a
2        dental assistant as specified by rule pursuant to
3        Section 17, and a dental hygienist may engage in the
4        placing, carving, and finishing of amalgam
5        restorations only after obtaining formal education and
6        certification as determined by the Department;
7            (v) administration and monitoring of nitrous oxide
8        upon successful completion of a training program
9        approved by the Department;
10            (vi) administration of local anesthetics upon
11        successful completion of a training program approved
12        by the Department; and
13            (vii) such other procedures and acts as shall be
14        prescribed by rule or regulation of the Department.
15    (b) A dental hygienist may be employed or engaged only:
16        (1) by a dentist;
17        (2) by a federal, State, county, or municipal agency or
18    institution;
19        (3) by a public or private school; or
20        (4) by a public clinic operating under the direction of
21    a hospital or federal, State, county, municipal, or other
22    public agency or institution.
23    (c) When employed or engaged in the office of a dentist, a
24dental hygienist may perform, under general supervision, those
25procedures found in items (i) through (iv) of subsection (a) of
26this Section, provided the patient has been examined by the



10000SB2631sam002- 16 -LRB100 16398 XWW 38147 a

1dentist within one year of the provision of dental hygiene
2services, the dentist has approved the dental hygiene services
3by a notation in the patient's record and the patient has been
4notified that the dentist may be out of the office during the
5provision of dental hygiene services.
6    (d) If a patient of record is unable to travel to a dental
7office because of illness, infirmity, or imprisonment, a dental
8hygienist may perform, under the general supervision of a
9dentist, those procedures found in items (i) through (iv) of
10subsection (a) of this Section, provided the patient is located
11in a long-term care facility licensed by the State of Illinois,
12a mental health or developmental disability facility, or a
13State or federal prison. The dentist shall personally examine
14and diagnose the patient and determine which services are
15necessary to be performed, which shall be contained in an order
16to the hygienist and a notation in the patient's record. Such
17order must be implemented within 120 days of its issuance, and
18an updated medical history and observation of oral conditions
19must be performed by the hygienist immediately prior to
20beginning the procedures to ensure that the patient's health
21has not changed in any manner to warrant a reexamination by the
23    (e) School-based oral health care, consisting of and
24limited to oral prophylactic procedures, sealants, and
25fluoride treatments, may be provided by a dental hygienist
26under the general supervision of a dentist. A dental hygienist



10000SB2631sam002- 17 -LRB100 16398 XWW 38147 a

1may not provide other dental hygiene treatment in a
2school-based setting, including but not limited to
3administration or monitoring of nitrous oxide or
4administration of local anesthetics. The school-based
5procedures may be performed provided the patient is located at
6a public or private school and the program is being conducted
7by a State, county or local public health department initiative
8or in conjunction with a dental school or dental hygiene
9program. The dentist shall personally examine and diagnose the
10patient and determine which services are necessary to be
11performed, which shall be contained in an order to the
12hygienist and a notation in the patient's record. Any such
13order for sealants must be implemented within 120 days after
14its issuance. Any such order for oral prophylactic procedures
15or fluoride treatments must be implemented within 180 days
16after its issuance. An updated medical history and observation
17of oral conditions must be performed by the hygienist
18immediately prior to beginning the procedures to ensure that
19the patient's health has not changed in any manner to warrant a
20reexamination by the dentist.
21    (f) Without the supervision of a dentist, a dental
22hygienist may perform dental health education functions and may
23record case histories and oral conditions observed.
24    (g) The number of dental hygienists practicing in a dental
25office shall not exceed, at any one time, 4 times the number of
26dentists practicing in the office at the time.



10000SB2631sam002- 18 -LRB100 16398 XWW 38147 a

1    (h) A dental hygienist who is certified as a public health
2dental hygienist may provide services to patients: (1) who are
3eligible for Medicaid or (2) who are uninsured and whose
4household income is not greater than 200% of the federal
5poverty level. A public health dental hygienist may perform
6oral assessments, perform screenings, and provide educational
7and preventative services as provided in subsection (b) of
8Section 18.1 of this Act. The public health dental hygienist
9may not administer local anesthesia or nitrous oxide, or place,
10carve, or finish amalgam restorations or provide periodontal
11therapy under this exception. Each patient must sign a consent
12form that acknowledges that the care received does not take the
13place of a regular dental examination. The public health dental
14hygienist must provide the patient or guardian a written
15referral to a dentist for assessment of the need for further
16dental care at the time of treatment. Any indication or
17observation of a condition that could warrant the need for
18urgent attention must be reported immediately to the
19supervising dentist for appropriate assessment and treatment.
20    This subsection (h) is inoperative on and after January 1,
22    (i) A dental hygienist performing procedures listed in
23paragraphs (1) through (4) of subsection (a) of Section 17.1
24must be under the supervision of a dentist, requiring the
25dentist authorizes the procedure, remains in the dental
26facility while the procedure is performed, and approves the



10000SB2631sam002- 19 -LRB100 16398 XWW 38147 a

1work performed by the dental hygienist before dismissal of the
2patient, but the dentist is not required to be present at all
3times in the treatment room.
4    (j) A dental hygienist may perform actions described in
5paragraph (5) of subsection (a) of Section 17.1 under the
6general supervision of a dentist as described in this Section.
7(Source: P.A. 99-492, eff. 12-31-15.)".