Illinois General Assembly - Full Text of SB0589
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Full Text of SB0589  100th General Assembly




State of Illinois
2017 and 2018


Introduced 1/24/2017, by Sen. Neil Anderson


225 ILCS 25/4  from Ch. 111, par. 2304
225 ILCS 25/17  from Ch. 111, par. 2317
225 ILCS 25/17.1 new

    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.

LRB100 05381 SMS 15392 b





SB0589LRB100 05381 SMS 15392 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 and 17 and by adding Section 17.1 as
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8    (Section scheduled to be repealed on January 1, 2026)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 license
23pursuant to paragraph (a) of Section 11 of this Act and who may



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1perform any intraoral and extraoral procedure required in the
2practice of dentistry and to whom is reserved the
3responsibilities specified in Section 17.
4    "Dental hygienist" means a person who holds a license under
5this Act to perform dental services as authorized by Section
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
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 provide
21    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 is



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1performed, 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 Section
818 prior to treatment by the dental hygienist, and that the
9dentist authorize the procedures which are being carried out by
10a notation in the patient's record, but not requiring that a
11dentist be present when the authorized procedures are being
12performed. The issuance of a prescription to a dental
13laboratory by a dentist does not constitute general
15    "Public member" means a person who is not a health
16professional. For purposes of board membership, any person with
17a 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, and oral and maxillofacial
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 is
6employed 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    "Impaired dentist" or "impaired dental hygienist" means a
12dentist or dental hygienist who is unable to practice with
13reasonable skill and safety because of a physical or mental
14disability as evidenced by a written determination or written
15consent based on clinical evidence, including deterioration
16through the aging process, loss of motor skills, abuse of drugs
17or alcohol, or a psychiatric disorder, of sufficient degree to
18diminish the person's ability to deliver competent patient
20    "Nurse" means a registered professional nurse, a certified
21registered nurse anesthetist licensed as an advanced practice
22nurse, or a licensed practical nurse licensed under the Nurse
23Practice Act.
24    "Patient of record" means a patient for whom the patient's
25most recent dentist has obtained a relevant medical and dental
26history and on whom the dentist has performed an examination



SB0589- 5 -LRB100 05381 SMS 15392 b

1and evaluated the condition to be treated.
2    "Dental responder" means a dentist or dental hygienist who
3is appropriately certified in disaster preparedness,
4immunizations, and dental humanitarian medical response
5consistent with the Society of Disaster Medicine and Public
6Health and training certified by the National Incident
7Management System or the National Disaster Life Support
9    "Mobile dental van or portable dental unit" means any
10self-contained or portable dental unit in which dentistry is
11practiced that can be moved, towed, or transported from one
12location to another in order to establish a location where
13dental services can be provided.
14    "Public health dental hygienist" means a hygienist who
15holds a valid license to practice in the State, has 2 years of
16full-time clinical experience or an equivalent of 4,000 hours
17of clinical experience and has completed at least 42 clock
18hours of additional structured courses in dental education
19approved by rule by the Department in advanced areas specific
20to public health dentistry, including, but not limited to,
21emergency procedures for medically compromised patients,
22pharmacology, medical recordkeeping procedures, geriatric
23dentistry, pediatric dentistry, pathology, and other areas of
24study as determined by the Department, and works in a public
25health setting pursuant to a written public health supervision
26agreement as defined by rule by the Department with a dentist



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1working in or contracted with a local or State government
2agency or institution or who is providing services as part of a
3certified school-based program or school-based oral health
5    "Public health setting" means a federally qualified health
6center; a federal, State, or local public health facility; Head
7Start; a special supplemental nutrition program for Women,
8Infants, and Children (WIC) facility; or a certified
9school-based health center or school-based oral health
11    "Public health supervision" means the supervision of a
12public health dental hygienist by a licensed dentist who has a
13written public health supervision agreement with that public
14health dental hygienist while working in an approved facility
15or program that allows the public health dental hygienist to
16treat patients, without a dentist first examining the patient
17and being present in the facility during treatment, (1) who are
18eligible for Medicaid or (2) who are uninsured and whose
19household income is not greater than 200% of the federal
20poverty level.
21(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15;
2299-680, eff. 1-1-17.)
23    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
24    (Section scheduled to be repealed on January 1, 2026)
25    Sec. 17. Acts constituting the practice of dentistry. A



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1person practices dentistry, within the meaning of this Act:
2        (1) Who represents himself or herself as being able to
3    diagnose or diagnoses, treats, prescribes, or operates for
4    any disease, pain, deformity, deficiency, injury, or
5    physical condition of the human tooth, teeth, alveolar
6    process, gums or jaw; or
7        (2) Who is a manager, proprietor, operator or conductor
8    of a business where dental operations are performed; or
9        (3) Who performs dental operations of any kind; or
10        (4) Who uses an X-Ray machine or X-Ray films for dental
11    diagnostic purposes; or
12        (5) Who extracts a human tooth or teeth, or corrects or
13    attempts to correct malpositions of the human teeth or
14    jaws; or
15        (6) Who offers or undertakes, by any means or method,
16    to diagnose, treat or remove stains, calculus, and bonding
17    materials from human teeth or jaws; or
18        (7) Who uses or administers local or general
19    anesthetics in the treatment of dental or oral diseases or
20    in any preparation incident to a dental operation of any
21    kind or character; or
22        (8) Who takes impressions of the human tooth, teeth, or
23    jaws or performs any phase of any operation incident to the
24    replacement of a part of a tooth, a tooth, teeth or
25    associated tissues by means of a filling, crown, a bridge,
26    a denture or other appliance; or



SB0589- 8 -LRB100 05381 SMS 15392 b

1        (9) Who offers to furnish, supply, construct,
2    reproduce or repair, or who furnishes, supplies,
3    constructs, reproduces or repairs, prosthetic dentures,
4    bridges or other substitutes for natural teeth, to the user
5    or prospective user thereof; or
6        (10) Who instructs students on clinical matters or
7    performs any clinical operation included in the curricula
8    of recognized dental schools and colleges; or
9        (11) Who takes impressions of human teeth or places his
10    or her hands in the mouth of any person for the purpose of
11    applying teeth whitening materials, or who takes
12    impressions of human teeth or places his or her hands in
13    the mouth of any person for the purpose of assisting in the
14    application of teeth whitening materials. A person does not
15    practice dentistry when he or she discloses to the consumer
16    that he or she is not licensed as a dentist under this Act
17    and (i) discusses the use of teeth whitening materials with
18    a consumer purchasing these materials; (ii) provides
19    instruction on the use of teeth whitening materials with a
20    consumer purchasing these materials; or (iii) provides
21    appropriate equipment on-site to the consumer for the
22    consumer to self-apply teeth whitening materials.
23    The fact that any person engages in or performs, or offers
24to engage in or perform, any of the practices, acts, or
25operations set forth in this Section, shall be prima facie
26evidence that such person is engaged in the practice of



SB0589- 9 -LRB100 05381 SMS 15392 b

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



SB0589- 10 -LRB100 05381 SMS 15392 b

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



SB0589- 11 -LRB100 05381 SMS 15392 b

1            (2) Removal of, or restoration of, or addition to
2        the hard or soft tissues of the oral cavity, except for
3        the placing, carving, and finishing of amalgam
4        restorations and placing, packing, and finishing
5        composite restorations by dental assistants who have
6        had additional formal education and certification as
7        determined by the Department. A dentist utilizing
8        dental assistants shall not supervise more than 4
9        dental assistants at any one time for placing, carving,
10        and finishing of amalgam restorations.
11            (3) Any and all correction of malformation of teeth
12        or of the jaws.
13            (4) Administration of anesthetics, except for
14        monitoring of nitrous oxide, conscious sedation, deep
15        sedation, and general anesthetic as provided in
16        Section 8.1 of this Act, that may be performed only
17        after successful completion of a training program
18        approved by the Department. A dentist utilizing dental
19        assistants shall not supervise more than 4 dental
20        assistants at any one time for the monitoring of
21        nitrous oxide.
22            (5) Removal of calculus from human teeth.
23            (6) Taking of impressions for the fabrication of
24        prosthetic appliances, crowns, bridges, inlays,
25        onlays, or other restorative or replacement dentistry.
26            (7) The operative procedure of dental hygiene



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1        consisting of oral prophylactic procedures, except for
2        coronal polishing and pit and fissure sealants, which
3        may be performed by a dental assistant who has
4        successfully completed a training program approved by
5        the Department. Dental assistants may perform coronal
6        polishing under the following circumstances: (i) the
7        coronal polishing shall be limited to polishing the
8        clinical crown of the tooth and existing restorations,
9        supragingivally; (ii) the dental assistant performing
10        the coronal polishing shall be limited to the use of
11        rotary instruments using a rubber cup or brush
12        polishing method (air polishing is not permitted); and
13        (iii) the supervising dentist shall not supervise more
14        than 4 dental assistants at any one time for the task
15        of coronal polishing or pit and fissure sealants.
16            In addition to coronal polishing and pit and
17        fissure sealants as described in this item (7), a
18        dental assistant who has at least 2,000 hours of direct
19        clinical patient care experience and who has
20        successfully completed a structured training program
21        provided by (1) an educational institution such as a
22        dental school or dental hygiene or dental assistant
23        program, or (2) by a statewide dental or dental
24        hygienist association, approved by the Department on
25        or before the effective date of this amendatory Act of
26        the 99th General Assembly, that has developed and



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



SB0589- 14 -LRB100 05381 SMS 15392 b

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



SB0589- 15 -LRB100 05381 SMS 15392 b

1        State; or
2            (iv) has been accepted or appointed for specialty
3        training in an approved dental program situated in this
4        State; or
5            (v) has been accepted or appointed for specialty
6        training in a dental public health agency situated in
7        this State.
8        The applicant shall be permitted to practice dentistry
9    for a period of 3 months from the starting date of the
10    program, unless authorized in writing by the Department to
11    continue such practice for a period specified in writing by
12    the Department.
13        The applicant shall only be entitled to perform such
14    acts as may be prescribed by and incidental to his or her
15    program of residency or specialty training and shall not
16    otherwise engage in the practice of dentistry in this
17    State.
18        The authority to practice shall terminate immediately
19    upon:
20            (1) the decision of the Department that the
21        applicant has failed the examination; or
22            (2) denial of licensure by the Department; or
23            (3) withdrawal of the application.
24(Source: P.A. 98-147, eff. 1-1-14; 98-463, eff. 8-16-13;
2598-756, eff. 7-16-14; 99-492, eff. 12-31-15; 99-680, eff.



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1    (225 ILCS 25/17.1 new)
2    Sec. 17.1. Expanded function dental assistants.
3    (a) A dental assistant who has completed training as
4provided in subsection (b) of this Section in all of the
5following areas may hold himself or herself out as an expanded
6function dental assistant:
7        (1) Taking material or digital final impressions.
8        (2) Performing pulp vitality test.
9        (3) Placing, carving, and finishing of amalgam
10    restorations and placing packing and finishing composite
11    restorations.
12        (4) Starting the flow of oxygen and monitoring of
13    nitrous oxide-oxygen analgesia.
14        (5) Coronal polishing and pit and fissure sealants, as
15    currently allowed by law.
16    After the completion of training as provided in subsection
17(b) of this Section, an expanded function dental assistant may
18perform any of the services listed in this subsection (a)
19pursuant to the limitations of this Act.
20    (b) Certification as an expanded functions dental
21assistant must be obtained from one of the following sources:
22(i) an approved continuing education sponsor; (ii) a dental
23assistant training program approved by the Commission on Dental
24Accreditation of the American Dental Association; or (iii) a
25training program approved by the Department.



SB0589- 17 -LRB100 05381 SMS 15392 b

1    (c) Any procedures listed in subsection (a) that are
2performed by an expanded function dental assistant must be
3approved by the supervising dentist and examined prior to
4dismissal of the patient.
5    (d) Nothing in this Section shall be construed to alter the
6number of dental assistants that a dentist may supervise under
7paragraph (g) of Section 17 of this Act.
8    (e) Nothing in this Act shall: (1) require a dental
9assistant to be certified as an expanded function dental
10assistant or (2) prevent a dentist from training dental
11assistants in accordance with the provisions of Section 17 of
12this Act or rules pertaining to dental assistant duties.