Public Act 099-0680
 
HB5948 EnrolledLRB099 20560 SMS 45111 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Dental Practice Act is amended by
changing Sections 4, 17, and 18.1 as follows:
 
    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
    (Section scheduled to be repealed on January 1, 2026)
    Sec. 4. Definitions. As used in this Act:
    "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.
    "Secretary" means the Secretary of Financial and
Professional Regulation.
    "Board" means the Board of Dentistry.
    "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
practice of dentistry and to whom is reserved the
responsibilities specified in Section 17.
    "Dental hygienist" means a person who holds a license under
this Act to perform dental services as authorized by Section
18.
    "Dental assistant" means an appropriately trained person
who, under the supervision of a dentist, provides dental
services as authorized by Section 17.
    "Dental laboratory" means a person, firm or corporation
which:
        (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
        (ii) utilizes or employs a dental technician to provide
    such services; and
        (iii) performs such functions only for a dentist or
    dentists.
    "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.
    "General supervision" means supervision of a dental
hygienist requiring that the patient be a patient of record,
that the dentist examine the patient in accordance with Section
18 prior to treatment by the dental hygienist, and that the
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.
    "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.
    "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.
    "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,
periodontics, prosthodontics, and oral and maxillofacial
radiology.
    "Specialist" means a dentist who has received a specialty
license pursuant to Section 11(b).
    "Dental technician" means a person who owns, operates or is
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.
    "Impaired dentist" or "impaired dental hygienist" means a
dentist or dental hygienist who is unable to practice with
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.
    "Nurse" means a registered professional nurse, a certified
registered nurse anesthetist licensed as an advanced practice
nurse, or a licensed practical nurse licensed under the Nurse
Practice Act.
    "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.
    "Dental responder" means a dentist or dental hygienist who
is appropriately certified in disaster preparedness,
immunizations, and dental humanitarian medical response
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.
    "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.
    "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.)
 
    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
    (Section scheduled to be repealed on January 1, 2026)
    Sec. 17. Acts constituting the practice of dentistry. A
person practices dentistry, within the meaning of this Act:
        (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
    process, gums or jaw; or
        (2) Who is a manager, proprietor, operator or conductor
    of a business where dental operations are performed; or
        (3) Who performs dental operations of any kind; or
        (4) Who uses an X-Ray machine or X-Ray films for dental
    diagnostic purposes; or
        (5) Who extracts a human tooth or teeth, or corrects or
    attempts to correct malpositions of the human teeth or
    jaws; or
        (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
        (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
        (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,
    a denture or other appliance; or
        (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
        (10) Who instructs students on clinical matters or
    performs any clinical operation included in the curricula
    of recognized dental schools and colleges; or
        (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.
    The following practices, acts, and operations, however,
are exempt from the operation of this Act:
        (a) The rendering of dental relief in emergency cases
    in the practice of his or her profession by a physician or
    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
        (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
    Administration; or
        (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
        (d) The practice of dentistry by clinical instructors
    in the course of their teaching duties in dental schools or
    colleges approved by the Department:
            (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
            (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
        (e) The practice of dentistry by licensed dentists of
    other states or countries at meetings of the Illinois State
    Dental Society or component parts thereof, alumni meetings
    of dental colleges, or any other like dental organizations,
    while appearing as clinicians; or
        (f) The use of X-Ray machines for exposing X-Ray films
    of dental or oral tissues by dental hygienists or dental
    assistants; or
        (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.
        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:
            (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.
            (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.
            (3) Any and all correction of malformation of teeth
        or of the jaws.
            (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.
            (5) Removal of calculus from human teeth.
            (6) Taking of impressions for the fabrication of
        prosthetic appliances, crowns, bridges, inlays,
        onlays, or other restorative or replacement dentistry.
            (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
        the Department. Dental assistants may perform coronal
        polishing under the following circumstances: (i) the
        coronal polishing shall be limited to polishing the
        clinical crown of the tooth and existing restorations,
        supragingivally; (ii) the dental assistant performing
        the coronal polishing shall be limited to the use of
        rotary instruments using a rubber cup or brush
        polishing method (air polishing is not permitted); and
        (iii) the supervising dentist shall not supervise more
        than 4 dental assistants at any one time for the task
        of coronal polishing or pit and fissure sealants.
            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
        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)
    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:
            (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
        passage of the examination specified in subsection (e)
        of Section 9 of this Act; or
            (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
            (iii) has been accepted or appointed for specialty
        or residency training by a hospital situated in this
        State; or
            (iv) has been accepted or appointed for specialty
        training in an approved dental program situated in this
        State; or
            (v) has been accepted or appointed for specialty
        training in a dental public health agency situated in
        this State.
        The applicant shall be permitted to practice dentistry
    for a period of 3 months from the starting date of the
    program, unless authorized in writing by the Department to
    continue such practice for a period specified in writing by
    the Department.
        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
    State.
        The authority to practice shall terminate immediately
    upon:
            (1) the decision of the Department that the
        applicant has failed the examination; or
            (2) denial of licensure by the Department; or
            (3) withdrawal of the application.
(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.)
 
    (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
    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
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
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
    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.
(Source: P.A. 99-492, eff. 12-31-15.)