Bill Text: IL SB0589 | 2017-2018 | 100th General Assembly | Chaptered


Bill Title: Amends the Illinois Dental Practice Act. Allows a dental assistant, after being authorized by a dentist, to remove loose, broken, or irritating orthodontic appliances on a patient of record for the purpose of eliminating pain or discomfort. Provides that dental assistants who have undergone certain training may hold themselves out as expanded function dental assistants. Sets forth the training requirements for expanded function dental assistants and the services that may be provided. Provides that any procedure completed by an expanded function dental assistant must be approved by the supervising dentist and examined prior to dismissal of the patient. Sets forth certain limits on expanded function dental assistants.

Spectrum: Moderate Partisan Bill (Republican 4-1)

Status: (Passed) 2017-08-18 - Public Act . . . . . . . . . 100-0215 [SB0589 Detail]

Download: Illinois-2017-SB0589-Chaptered.html



Public Act 100-0215
SB0589 EnrolledLRB100 05381 SMS 15392 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, 9, and 17 and by adding Section 17.1 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(Section scheduled to be repealed on January 1, 2026)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.
"Expanded function dental assistant" means a dental
assistant who has completed the training required by Section
17.1 of this Act.
"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
hours of additional structured courses in dental education
approved by rule by the Department 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, 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;
99-680, eff. 1-1-17.)
(225 ILCS 25/9) (from Ch. 111, par. 2309)
(Section scheduled to be repealed on January 1, 2026)
Sec. 9. Qualifications of applicants for dental licenses.
The Department shall require that each applicant for a license
to practice dentistry shall:
(a) (Blank).
(b) Be at least 21 years of age and of good moral
character.
(c) (1) Present satisfactory evidence of completion of
dental education by graduation from a dental college or
school in the United States or Canada approved by the
Department. The Department shall not approve any dental
college or school which does not require at least (A) 60
semester hours of collegiate credit or the equivalent in
acceptable subjects from a college or university before
admission, and (B) completion of at least 4 academic years
of instruction or the equivalent in an approved dental
college or school that is accredited by the Commission on
Dental Accreditation of the American Dental Association;
or
(2) Present satisfactory evidence of completion of
dental education by graduation from a dental college or
school outside the United States or Canada and provide
satisfactory evidence that the applicant has: (A)
completed a minimum of 2 academic years of general dental
clinical training and obtained a doctorate of dental
surgery (DDS) or doctorate of dental medicine (DMD) at a
dental college or school in the United States or Canada
approved by the Department; or (B) met the program
requirements approved by rule by the Department.
Nothing in this Act shall be construed to prevent
either the Department or any dental college or school from
establishing higher standards than specified in this Act.
(d) (Blank).
(e) Present satisfactory evidence that the applicant
has passed both parts of the National Board Dental
Examination administered by the Joint Commission on
National Dental Examinations and has successfully
completed an examination conducted by one of the following
regional testing services: the Central Regional Dental
Testing Service, Inc. (CRDTS), the Southern Regional
Testing Agency, Inc. (SRTA), the Western Regional
Examining Board (WREB), the North East Regional Board
(NERB), or the Council of Interstate Testing Agencies
(CITA). For purposes of this Section, successful
completion shall mean that the applicant has achieved a
minimum passing score as determined by the applicable
regional testing service. The Secretary may suspend a
regional testing service under this subsection (e) if,
after proper notice and hearing, it is established that (i)
the integrity of the examination has been breached so as to
make future test results unreliable or (ii) the test is
fundamentally deficient in testing clinical competency.
In determining professional capacity under this Section,
any individual who has not been actively engaged in the
practice of dentistry, has not been a dental student, or has
not been engaged in a formal program of dental education during
the 5 years immediately preceding the filing of an application
may be required to complete such additional testing, training,
or remedial education as the Board may deem necessary in order
to establish the applicant's present capacity to practice
dentistry with reasonable judgment, skill, and safety.
(Source: P.A. 99-366, eff. 1-1-16.)
(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. In
addition, after being authorized by a dentist, a dental
assistant may, for the purpose of eliminating pain or
discomfort, remove loose, broken, or irritating
orthodontic appliances on a patient of record.
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 and placing, packing, and finishing
composite 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 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 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 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; 99-680, eff.
1-1-17.)
(225 ILCS 25/17.1 new)
Sec. 17.1. Expanded function dental assistants.
(a) A dental assistant who has completed training as
provided in subsection (b) of this Section in all of the
following areas may hold himself or herself out as an expanded
function dental assistant:
(1) Taking material or digital final impressions.
(2) Performing pulp vitality test.
(3) Placing, carving, and finishing of amalgam
restorations and placing, packing, and finishing composite
restorations.
(4) Starting the flow of oxygen and monitoring of
nitrous oxide-oxygen analgesia.
(5) Coronal polishing and pit and fissure sealants, as
currently allowed by law.
After the completion of training as provided in subsection
(b) of this Section, an expanded function dental assistant may
perform any of the services listed in this subsection (a)
pursuant to the limitations of this Act.
(b) Certification as an expanded function dental assistant
must be obtained from one of the following sources: (i) an
approved continuing education sponsor; (ii) a dental assistant
training program approved by the Commission on Dental
Accreditation of the American Dental Association; or (iii) a
training program approved by the Department.
Training required under this subsection (b) must also
include Basic Life Support certification, as described in
Section 16 of this Act. Proof of current certification shall be
kept on file with the supervising dentist.
(c) Any procedures listed in subsection (a) that are
performed by an expanded function dental assistant must be
approved by the supervising dentist and examined prior to
dismissal of the patient. The supervising dentist shall be
responsible for all dental services or procedures performed by
the dental assistant.
(d) Nothing in this Section shall be construed to alter the
number of dental assistants that a dentist may supervise under
paragraph (g) of Section 17 of this Act.
(e) Nothing in this Act shall: (1) require a dental
assistant to be certified as an expanded function dental
assistant or (2) prevent a dentist from training dental
assistants in accordance with the provisions of Section 17 of
this Act or rules pertaining to dental assistant duties.
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