TELEDENTISTRY/RDH ADMIN. LOCAL ANESTHETIC.

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View NCGA Bill Details2021
Senate Bill 146 (Public) Filed Wednesday, February 24, 2021
AN ACT TO ESTABLISH STANDARDS FOR THE PRACTICE OF TELEDENTISTRY, TO AUTHORIZE PROPERLY TRAINED DENTAL HYGIENISTS TO ADMINISTER LOCAL DENTAL ANESTHETICS UNDER DIRECT SUPERVISION OF A LICENSED DENTIST, TO ALLOW CERTAIN DENTAL HYGIENISTS GREATER FLEXIBILITY TO PRACTICE WITHOUT SUPERVISION OF A LICENSED DENTIST, TO ALLOW LICENSURE BY CREDENTIAL FOR CERTAIN INSTRUCTORS, AND TO ENABLE REPRESENTATIVES OF THE ECU SCHOOL OF DENTAL MEDICINE TO SERVE ON THE NC CARING DENTAL PROFESSIONALS BOARD.
Intro. by Perry.

Status: Ch. SL 2021-95 (Jul 23 2021)

SOG comments (2):

Long title change

Senate committee substitute to the 1st edition changed the long title. Original long title was AN ACT TO ESTABLISH STANDARDS FOR THE PRACTICE OF TELEDENTISTRY AND TO AUTHORIZE PROPERLY TRAINED DENTAL HYGIENISTS TO ADMINISTER LOCAL DENTAL ANESTHETICS UNDER DIRECT SUPERVISION OF A LICENSED DENTIST.

Long Title Change

The House committee substitute to the 2nd edition changes the act's long title. The previous long title was: AN ACT TO ESTABLISH STANDARDS FOR THE PRACTICE OF TELEDENTISTRY, TO AUTHORIZE PROPERLY TRAINED DENTAL HYGIENISTS TO ADMINISTER LOCAL DENTAL ANESTHETICS UNDER DIRECT SUPERVISION OF A LICENSED DENTIST, AND TO PERMIT CERTAIN DENTAL HYGIENISTS TO PRACTICE DENTAL HYGIENE AT SCHOOLS WITHOUT A LICENSED DENTIST BEING PHYSICALLY PRESENT.

Bill History:

S 146/S.L. 2021-95

Bill Summaries:

  • Summary date: Jul 26 2021 - View Summary

    AN ACT TO ESTABLISH STANDARDS FOR THE PRACTICE OF TELEDENTISTRY, TO AUTHORIZE PROPERLY TRAINED DENTAL HYGIENISTS TO ADMINISTER LOCAL DENTAL ANESTHETICS UNDER DIRECT SUPERVISION OF A LICENSED DENTIST, TO ALLOW CERTAIN DENTAL HYGIENISTS GREATER FLEXIBILITY TO PRACTICE WITHOUT SUPERVISION OF A LICENSED DENTIST, TO ALLOW LICENSURE BY CREDENTIAL FOR CERTAIN INSTRUCTORS, AND TO ENABLE REPRESENTATIVES OF THE ECU SCHOOL OF DENTAL MEDICINE TO SERVE ON THE NC CARING DENTAL PROFESSIONALS BOARD. SL 2021-95. Enacted July 23, 2021. Section 2 is effective Oct. 1, 2021. The remainder is effective July 23, 2021.


  • Summary date: Jul 14 2021 - View Summary

    House committee substitute amends the 2nd edition as follows.

    Makes technical corrections to proposed GS 90-225.2 to now refer to the UNC Adams School of Dentistry (was, the UNC School of Dentistry) and the Commission on Dental Accreditation (was, the Council on Dental Accreditation). 

    Further amends GS 90-233, which governs the practice of dental hygiene, as follows. Specifies that the provision allowing a dental hygienist to practice only under the supervision of one or more licensed dentists is deemed to be complied with when a dental hygienist is employed by or under contract with a federally qualified health center and trained as a public health hygienist, while performing their duties for the persons officially served by the federally qualified health center under the direction of a duly licensed dentist employed by that program or by the Oral Health Section of the Department of Health and Human Services. Replaces all references to the Dental Heath Section with the Oral Health Section. Expands the conditions in which certain described dental hygienists meeting specified experience requirements can perform dental hygiene functions without a licensed dentist physically present, to require that the dental hygiene functions performed be under the direction of a dentist based on a written standing order, rather than an in-person evaluation by the dentist. Also amends some of the conditions that must be met in order for such hygienists to perform dental hygienist functions without a licensed dentist being physically present, as follows: (1) requires that the dental hygiene functions directed to be performed be conducted within 270 days of the dentist's standing order (was, within 120 days of the dentist's evaluation); (2) requires that the services be performed in a federally qualified health center (or in one of the seven categories of already identified facilities); (3) requires a licensed dentist be available to provide appropriate follow-up care as necessary; and (4) removes the requirement that the licensed dentist have personally conducted an evaluation of the patient including specified actions including a specific written treatment plan. Allows dental hygienists performing procedures without a licensed dentist physically present to supervise a Dental Assistant who assists the hygienist in clinical procedures and is classified as a Dental Assistant II or permitted to perform functions as a Dental Assistant II. Makes further technical corrections. 

    Adds the following content.

    Amends GS 90-36 to require the North Carolina State Board of Dental Examiners to issue a license by credential to any dentist who applies for a such a license, and possesses good moral character and who (1) holds a current Instructor's License or (2) has graduated with a general dental degree from any school or college and has graduated from an advanced dental education program with either a certificate or a degree from a school or college accredited by the Commission on Dental Accreditation of the American Dental Association and approved by the Board. Sets out additional requirements that must be met for applicants who are applying based on the educational requirements in (2). 

    Amends GS 90-48.2, which allows the State Board of Dental Examiners to enter into agreements with special impaired dentist peer review organizations formed by the North Carolina Dental Society. Amends the organizations included to now refer to the UNC Adams School of Dentistry (was, the Dental School of UNC) and to add the East Carolina University School of Dental Medicine. Makes the same changes to the organizations that make up special impaired dentist peer review organizations' statewide supervisory committee.

    Makes conforming organizational changes.

    Amends the act's long title.


  • Summary date: Mar 17 2021 - View Summary

    Senate committee substitute amends the 1st edition as follows.

    Makes technical changes to a statutory cross-reference in proposed GS 90-30.2.

    Adds a new section amending GS 90-233, which governs the practice of dental hygiene. Expands the conditions in which certain described dental hygienists meeting specified experience requirements can perform dental hygiene functions without a licensed dentist physically present, to include performing dental hygiene services in schools. Makes conforming changes to the act's long title. 


  • Summary date: Feb 24 2021 - View Summary

    Identical to H 144, filed 2/24/21.

    Section 1

    Amends GS 90-29 to exclude registered dental hygienists qualified to administer local anesthetics from the practice of dentistry. Expands the practice of dentistry to include individuals who, by use of electronic or digital means, own, manage, supervise, control or conduct any enterprise wherein any act otherwise defined as the practice of dentistry is done, attempted to be done, or represented.

    Enacts GS 90-30.2 authorizing teledentistry services to be delivered by a licensed dentist or licensed dental hygienist who is under the supervision of a licensed dentist. Requires informed consent of the patient or authorized person to be obtained prior to rendering teledentistry services and to be reflected in the patient's records, as specified. Allows for the transmission of data, electronic images, and related information appropriate to provide teledentistry services. Provides guidelines for patient care and explicitly authorizes evaluations to be conducted by a licensed dentist using teledentistry modalities. Details the determination of the encounter location for services provided. Mandates confidentiality consistent with HIPPA and other confidentiality laws and regulations regarding medical records. Additionally, requires patient records to be kept in the same manner as in-person dental records, as specified. Requires licensed dentists prescribing medication, lab services or dental lab services through teledentistry to adhere to applicable law and current standards of care, including appropriate documentation. Requires compliance with the NC Controlled Substance Reporting System, as appropriate. 

    Expands grounds for disciplinary action by the State Board of Dental Examiners (Board) authorized by GS 90-41 to include (1) allowing fee-splitting for the use of teledentistry services, and (2) limiting a patient's right or ability to raise grievances or file complaints with any appropriate oversight body.

    Section 2

    Expands the definition given for dental hygiene in GS 90-221 to include the administration of local anesthetics by infiltration and block techniques by certified dental hygienists under the direct supervision of a licensed dentist. Adds direct supervision to the defined terms used in Article 16, the Dental Hygiene Act. 

    Enacts GS 90-225.2 to establish clinical instruction requirements for licensed dental hygienists to qualify to administer local anesthetics. Requires instruction by lecture and lab or clinical formats at UNC School of Dentistry, ECU School of Dental Medicine, or a program accredited by the Council on Dental Accreditation (CODA), or similar federally approved organization. Requires at least a 30-hour session composed of 16 didactic hours and 14 clinical hours, with instruction by a dentist with a DDS or DMD degree. Sets standards for class ratios and scoring. Requires awarding a certificate upon successful completion.

    Enacts GS 90-225.3 to establish requirements for the Board to approve licensed dental hygienists to administer local anesthetics, including completing the required education and training, and practicing under the supervision of a licensed dentist for the preceding two years. Requires two hours of continuing education annually, as specified. Details further authorities of the Board regarding additional education and training when applicants cannot satisfy the specified requirements. 

    Applies to licenses granted or renewed on or after October 1, 2021. 

    Authorizes the Board to adopt temporary implementing rules.