SB3265 - 104th General Assembly
| ||||||||||||||||||||||
| ||||||||||||||||||||||
| ||||||||||||||||||||||
| 1 | AN ACT concerning regulation. | |||||||||||||||||||||
| 2 | Be it enacted by the People of the State of Illinois, | |||||||||||||||||||||
| 3 | represented in the General Assembly: | |||||||||||||||||||||
| 4 | Section 5. The Illinois Dental Practice Act is amended by | |||||||||||||||||||||
| 5 | changing Sections 4 and 18 as follows: | |||||||||||||||||||||
| 6 | (225 ILCS 25/4) | |||||||||||||||||||||
| 7 | (Section scheduled to be repealed on January 1, 2031) | |||||||||||||||||||||
| 8 | Sec. 4. Definitions. As used in this Act: | |||||||||||||||||||||
| 9 | "Address of record" means the designated address recorded | |||||||||||||||||||||
| 10 | by the Department in the applicant's or licensee's application | |||||||||||||||||||||
| 11 | file or license file as maintained by the Department's | |||||||||||||||||||||
| 12 | licensure maintenance unit. It is the duty of the applicant or | |||||||||||||||||||||
| 13 | licensee to inform the Department of any change of address and | |||||||||||||||||||||
| 14 | those changes must be made either through the Department's | |||||||||||||||||||||
| 15 | website or by contacting the Department. | |||||||||||||||||||||
| 16 | "Email address of record" means the designated email | |||||||||||||||||||||
| 17 | address recorded by the Department in the applicant's | |||||||||||||||||||||
| 18 | application file or the licensee's license file, as maintained | |||||||||||||||||||||
| 19 | by the Department's licensure maintenance unit. | |||||||||||||||||||||
| 20 | "Department" means the Department of Financial and | |||||||||||||||||||||
| 21 | Professional Regulation. | |||||||||||||||||||||
| 22 | "Secretary" means the Secretary of Financial and | |||||||||||||||||||||
| 23 | Professional Regulation. | |||||||||||||||||||||
| |||||||
| |||||||
| 1 | "Board" means the Board of Dentistry. | ||||||
| 2 | "Community health center" means a migrant health center, | ||||||
| 3 | community health center, health care program for the homeless | ||||||
| 4 | or for residents of public housing supported under Section 330 | ||||||
| 5 | of the federal Public Health Service Act, or FQHC, including | ||||||
| 6 | an FQHC Look-Alike, as designated by the U.S. Department of | ||||||
| 7 | Health and Human Services, that operates at least one | ||||||
| 8 | federally designated primary health care delivery site in | ||||||
| 9 | Illinois. | ||||||
| 10 | "Dentist" means a person who has received a general | ||||||
| 11 | license pursuant to subsection (a) of Section 11 of this Act, | ||||||
| 12 | and who may perform any intraoral and extraoral procedure | ||||||
| 13 | required in the practice of dentistry, and to whom is reserved | ||||||
| 14 | the responsibilities specified in Section 17. | ||||||
| 15 | "Dental hygienist" means a person who holds a license | ||||||
| 16 | under this Act to perform dental services as authorized by | ||||||
| 17 | Section 18. | ||||||
| 18 | "Dental assistant" means an appropriately trained person | ||||||
| 19 | who, under the supervision of a dentist, provides dental | ||||||
| 20 | services as authorized by Section 17. | ||||||
| 21 | "Expanded function dental assistant" means a dental | ||||||
| 22 | assistant who has completed the training required by Section | ||||||
| 23 | 17.1 of this Act. | ||||||
| 24 | "Dental laboratory" means a person, firm, or corporation | ||||||
| 25 | which: | ||||||
| 26 | (i) engages in making, providing, repairing, or | ||||||
| |||||||
| |||||||
| 1 | altering dental prosthetic appliances and other artificial | ||||||
| 2 | materials and devices which are returned to a dentist for | ||||||
| 3 | insertion into the human oral cavity or which come in | ||||||
| 4 | contact with its adjacent structures and tissues; and | ||||||
| 5 | (ii) utilizes or employs a dental technician to | ||||||
| 6 | provide such services; and | ||||||
| 7 | (iii) performs such functions only for a dentist or | ||||||
| 8 | dentists. | ||||||
| 9 | "Supervision" means supervision of a dental hygienist or a | ||||||
| 10 | dental assistant requiring that a dentist authorize the | ||||||
| 11 | procedure, remain in the dental facility while the procedure | ||||||
| 12 | is performed, and approve the work performed by the dental | ||||||
| 13 | hygienist or dental assistant before dismissal of the patient, | ||||||
| 14 | but does not mean that the dentist must be present at all times | ||||||
| 15 | in the treatment room. | ||||||
| 16 | "General supervision" means supervision of a dental | ||||||
| 17 | hygienist requiring that the patient be a patient of record, | ||||||
| 18 | that the dentist examine the patient in accordance with | ||||||
| 19 | Section 18 prior to treatment by the dental hygienist, and | ||||||
| 20 | that the dentist authorize the procedures which are being | ||||||
| 21 | carried out by a notation in the patient's record, but not | ||||||
| 22 | requiring that a dentist be present when the authorized | ||||||
| 23 | procedures are being performed. The issuance of a prescription | ||||||
| 24 | to a dental laboratory by a dentist does not constitute | ||||||
| 25 | general supervision. | ||||||
| 26 | "Physician" means a person licensed under the Medical | ||||||
| |||||||
| |||||||
| 1 | Practice Act of 1987 to practice medicine in all of its | ||||||
| 2 | branches. "Physician" does not include a chiropractic | ||||||
| 3 | physician. | ||||||
| 4 | "Public member" means a person who is not a health | ||||||
| 5 | professional. For purposes of board membership, any person | ||||||
| 6 | with a significant financial interest in a health service or | ||||||
| 7 | profession is not a public member. | ||||||
| 8 | "Dentistry" means the healing art which is concerned with | ||||||
| 9 | the examination, diagnosis, treatment planning, and care of | ||||||
| 10 | conditions within the human oral cavity and its adjacent | ||||||
| 11 | tissues and structures, as further specified in Section 17. | ||||||
| 12 | "Branches of dentistry" means the various specialties of | ||||||
| 13 | dentistry which, for purposes of this Act, shall be limited to | ||||||
| 14 | the following: endodontics, oral and maxillofacial surgery, | ||||||
| 15 | orthodontics and dentofacial orthopedics, pediatric dentistry, | ||||||
| 16 | periodontics, prosthodontics, oral and maxillofacial | ||||||
| 17 | radiology, dental anesthesiology, oral and maxillofacial | ||||||
| 18 | pathology, dental public health, oral medicine, and orofacial | ||||||
| 19 | pain. | ||||||
| 20 | "Specialist" means a dentist who has received a specialty | ||||||
| 21 | license pursuant to subsection (b) of Section 11. | ||||||
| 22 | "Dental technician" means a person who owns, operates, or | ||||||
| 23 | is employed by a dental laboratory and engages in making, | ||||||
| 24 | providing, repairing, or altering dental prosthetic appliances | ||||||
| 25 | and other artificial materials and devices which are returned | ||||||
| 26 | to a dentist for insertion into the human oral cavity or which | ||||||
| |||||||
| |||||||
| 1 | come in contact with its adjacent structures and tissues. | ||||||
| 2 | "Informed consent" means legally valid consent that is | ||||||
| 3 | given by a patient or legal guardian, that is recorded in | ||||||
| 4 | writing or digitally, that authorizes intervention or | ||||||
| 5 | treatment services from the treating dentist, and that | ||||||
| 6 | documents agreement to participate in those services and | ||||||
| 7 | knowledge of the risks, benefits, and alternatives, including | ||||||
| 8 | the decision to withdraw from or decline treatment. | ||||||
| 9 | "Impaired dentist" or "impaired dental hygienist" means a | ||||||
| 10 | dentist or dental hygienist who is unable to practice with | ||||||
| 11 | reasonable skill and safety because of a physical or mental | ||||||
| 12 | disability as evidenced by a written determination or written | ||||||
| 13 | consent based on clinical evidence, including deterioration | ||||||
| 14 | through the aging process, loss of motor skills, abuse of | ||||||
| 15 | drugs or alcohol, or a psychiatric disorder, of sufficient | ||||||
| 16 | degree to diminish the person's ability to deliver competent | ||||||
| 17 | patient care. | ||||||
| 18 | "Nurse" means a registered professional nurse, a certified | ||||||
| 19 | registered nurse anesthetist licensed as an advanced practice | ||||||
| 20 | registered nurse, or a licensed practical nurse licensed under | ||||||
| 21 | the Nurse Practice Act. | ||||||
| 22 | "Patient of record", except as provided in Section 17.2, | ||||||
| 23 | means a patient for whom the patient's most recent dentist has | ||||||
| 24 | obtained a relevant medical and dental history and on whom the | ||||||
| 25 | dentist has performed a physical examination within the last | ||||||
| 26 | year and evaluated the condition to be treated, including a | ||||||
| |||||||
| |||||||
| 1 | review of the patient's most recent x-rays. | ||||||
| 2 | "Dental responder" means a dentist or dental hygienist who | ||||||
| 3 | is appropriately certified in disaster preparedness, | ||||||
| 4 | immunizations, and dental humanitarian medical response | ||||||
| 5 | consistent with the Society of Disaster Medicine and Public | ||||||
| 6 | Health and training certified by the National Incident | ||||||
| 7 | Management System or the National Disaster Life Support | ||||||
| 8 | Foundation. | ||||||
| 9 | "Mobile dental van or portable dental unit" means any | ||||||
| 10 | self-contained or portable dental unit in which dentistry is | ||||||
| 11 | practiced that can be moved, towed, or transported from one | ||||||
| 12 | location to another in order to establish a location where | ||||||
| 13 | dental services can be provided. | ||||||
| 14 | "Public health dental hygienist" means a hygienist who | ||||||
| 15 | holds a valid license to practice in the State, has 2 years of | ||||||
| 16 | full-time clinical experience or an equivalent of 4,000 hours | ||||||
| 17 | of clinical experience, and has completed at least 42 clock | ||||||
| 18 | hours of additional structured courses in dental education in | ||||||
| 19 | advanced areas specific to public health dentistry. | ||||||
| 20 | "Public health setting" means a federally qualified health | ||||||
| 21 | center; a federal, State, or local public health facility; | ||||||
| 22 | Head Start; a special supplemental nutrition program for | ||||||
| 23 | Women, Infants, and Children (WIC) facility; a certified | ||||||
| 24 | school-based health center or school-based oral health | ||||||
| 25 | program; a prison; or a long-term care facility. | ||||||
| 26 | "Public health supervision" means the supervision of a | ||||||
| |||||||
| |||||||
| 1 | public health dental hygienist by a licensed dentist who has a | ||||||
| 2 | written public health supervision agreement with that public | ||||||
| 3 | health dental hygienist while working in an approved facility | ||||||
| 4 | or program that allows the public health dental hygienist to | ||||||
| 5 | treat patients, without a dentist first examining the patient | ||||||
| 6 | and being present in the facility during treatment, (1) who | ||||||
| 7 | are eligible for Medicaid or (2) who are uninsured or whose | ||||||
| 8 | household income is not greater than 300% of the federal | ||||||
| 9 | poverty level. | ||||||
| 10 | "Teledentistry" means the use of telehealth systems and | ||||||
| 11 | methodologies in dentistry and includes patient diagnosis, | ||||||
| 12 | treatment planning, care, and education delivery for a patient | ||||||
| 13 | of record using synchronous and asynchronous communications | ||||||
| 14 | under an Illinois licensed dentist's authority as provided | ||||||
| 15 | under this Act. | ||||||
| 16 | "Moderate sedation" means a drug-induced depression of | ||||||
| 17 | consciousness during which: (1) patients respond purposefully | ||||||
| 18 | to verbal commands, either alone or accompanied by light | ||||||
| 19 | tactile stimulation; (2) no interventions are required to | ||||||
| 20 | maintain a patient's airway and spontaneous ventilation is | ||||||
| 21 | adequate; and (3) cardiovascular function is usually | ||||||
| 22 | maintained. | ||||||
| 23 | "Deep sedation" means a drug-induced depression of | ||||||
| 24 | consciousness during which: (1) patients cannot be easily | ||||||
| 25 | aroused, but respond purposefully following repeated or | ||||||
| 26 | painful stimulation; (2) the ability to independently maintain | ||||||
| |||||||
| |||||||
| 1 | ventilatory function may be impaired; (3) patients may require | ||||||
| 2 | assistance in maintaining airways and spontaneous ventilation | ||||||
| 3 | may be inadequate; and (4) cardiovascular function is usually | ||||||
| 4 | maintained. | ||||||
| 5 | "General anesthesia" means a drug-induced loss of | ||||||
| 6 | consciousness during which: (1) patients are not arousable, | ||||||
| 7 | even by painful stimulation; (2) the ability to independently | ||||||
| 8 | maintain ventilatory function is often impaired; (3) patients | ||||||
| 9 | often require assistance in maintaining airways and positive | ||||||
| 10 | pressure ventilation may be required because of depressed | ||||||
| 11 | spontaneous ventilation or drug-induced depression of | ||||||
| 12 | neuromuscular function; and (4) cardiovascular function may be | ||||||
| 13 | impaired. | ||||||
| 14 | "Venipuncture" means the puncture of a vein as part of a | ||||||
| 15 | medical procedure, typically to withdraw a blood sample or for | ||||||
| 16 | an intravenous catheter for the administration of medication | ||||||
| 17 | or fluids. | ||||||
| 18 | "Enteral route of administration" means administration of | ||||||
| 19 | a drug that is absorbed through the gastrointestinal tract or | ||||||
| 20 | through oral, rectal, or sublingual mucosa. | ||||||
| 21 | "Parenteral route of administration" means administration | ||||||
| 22 | of a drug by which the drug bypasses the gastrointestinal | ||||||
| 23 | tract through intramuscular, intravenous, intranasal, | ||||||
| 24 | submucosal, subcutaneous, or intraosseous methods. | ||||||
| 25 | (Source: P.A. 103-425, eff. 1-1-24; 103-431, eff. 1-1-24; | ||||||
| 26 | 103-605, eff. 7-1-24; 103-628, eff. 7-1-24; 103-902, eff. | ||||||
| |||||||
| |||||||
| 1 | 8-9-24; 104-103, eff. 8-1-25; 104-151, eff. 1-1-26; 104-417, | ||||||
| 2 | eff. 8-15-25; revised 9-15-25.) | ||||||
| 3 | (225 ILCS 25/18) | ||||||
| 4 | (Section scheduled to be repealed on January 1, 2031) | ||||||
| 5 | Sec. 18. Acts constituting the practice of dental hygiene; | ||||||
| 6 | limitations. | ||||||
| 7 | (a) A person practices dental hygiene within the meaning | ||||||
| 8 | of this Act when the person performs the following acts under | ||||||
| 9 | the supervision of a dentist: | ||||||
| 10 | (i) the operative procedure of dental hygiene, | ||||||
| 11 | consisting of oral prophylactic procedures; | ||||||
| 12 | (ii) the exposure and processing of X-Ray films of the | ||||||
| 13 | teeth and surrounding structures; | ||||||
| 14 | (iii) the application to the surfaces of the teeth or | ||||||
| 15 | gums of chemical compounds designed to be desensitizing | ||||||
| 16 | agents or effective agents in the prevention of dental | ||||||
| 17 | caries or periodontal disease; | ||||||
| 18 | (iv) all services which may be performed by a dental | ||||||
| 19 | assistant as specified by rule pursuant to Section 17, and | ||||||
| 20 | a dental hygienist may engage in the placing, carving, and | ||||||
| 21 | finishing of amalgam restorations only after obtaining | ||||||
| 22 | formal education and certification as determined by the | ||||||
| 23 | Department; | ||||||
| 24 | (v) administration and monitoring of nitrous oxide | ||||||
| 25 | upon successful completion of a training program approved | ||||||
| |||||||
| |||||||
| 1 | by the Department; | ||||||
| 2 | (vi) administration of local anesthetics upon | ||||||
| 3 | successful completion of a training program approved by | ||||||
| 4 | the Department; and | ||||||
| 5 | (vii) such other procedures and acts as shall be | ||||||
| 6 | prescribed by rule or regulation of the Department. | ||||||
| 7 | (b) A dental hygienist may be employed or engaged only: | ||||||
| 8 | (1) by a dentist; | ||||||
| 9 | (2) by a federal, State, county, or municipal agency | ||||||
| 10 | or institution; | ||||||
| 11 | (3) by a public or private school; or | ||||||
| 12 | (4) by a public clinic operating under the direction | ||||||
| 13 | of a hospital or federal, State, county, municipal, or | ||||||
| 14 | other public agency or institution. | ||||||
| 15 | (c) When employed or engaged in the office of a dentist, a | ||||||
| 16 | dental hygienist may perform, under general supervision, those | ||||||
| 17 | procedures found in items (i) through (iv) of subsection (a) | ||||||
| 18 | of this Section, provided the patient has been examined by the | ||||||
| 19 | dentist within one year of the provision of dental hygiene | ||||||
| 20 | services, the dentist has approved the dental hygiene services | ||||||
| 21 | by a notation in the patient's record and the patient has been | ||||||
| 22 | notified that the dentist may be out of the office during the | ||||||
| 23 | provision of dental hygiene services. | ||||||
| 24 | (d) If a patient of record is unable to travel to a dental | ||||||
| 25 | office because of illness, infirmity, or imprisonment, a | ||||||
| 26 | dental hygienist may perform, under the general supervision of | ||||||
| |||||||
| |||||||
| 1 | a dentist, those procedures found in items (i) through (iv) of | ||||||
| 2 | subsection (a) of this Section, provided the patient is | ||||||
| 3 | located in a long-term care facility licensed by the State of | ||||||
| 4 | Illinois, a mental health or developmental disability | ||||||
| 5 | facility, or a State or federal prison. The dentist shall | ||||||
| 6 | either personally examine and diagnose the patient or utilize | ||||||
| 7 | approved teledentistry communication methods and determine | ||||||
| 8 | which services are necessary to be performed, which shall be | ||||||
| 9 | contained in an order to the hygienist and a notation in the | ||||||
| 10 | patient's record. Such order must be implemented within 45 | ||||||
| 11 | days of its issuance; except when a patient is located within a | ||||||
| 12 | State or federal prison, then the order must be implemented | ||||||
| 13 | within 180 days of its issuance, and an updated medical | ||||||
| 14 | history and observation of oral conditions must be performed | ||||||
| 15 | by the hygienist immediately prior to beginning the procedures | ||||||
| 16 | to ensure that the patient's health has not changed in any | ||||||
| 17 | manner to warrant a reexamination by the dentist. | ||||||
| 18 | (e) School-based oral health care, consisting of and | ||||||
| 19 | limited to oral prophylactic procedures, sealants, and | ||||||
| 20 | fluoride treatments, may be provided by a dental hygienist | ||||||
| 21 | under the general supervision of a dentist. A dental hygienist | ||||||
| 22 | may not provide other dental hygiene treatment in a | ||||||
| 23 | school-based setting, including, but not limited to, | ||||||
| 24 | administration or monitoring of nitrous oxide or | ||||||
| 25 | administration of local anesthetics. The school-based | ||||||
| 26 | procedures may be performed provided the patient is located at | ||||||
| |||||||
| |||||||
| 1 | a public or private school and the program is being conducted | ||||||
| 2 | by a State, county, or local public health department | ||||||
| 3 | initiative or in conjunction with a dental school or dental | ||||||
| 4 | hygiene program. The dentist shall personally examine and | ||||||
| 5 | diagnose the patient and determine which services are | ||||||
| 6 | necessary to be performed, which shall be contained in an | ||||||
| 7 | order to the hygienist and a notation in the patient's record. | ||||||
| 8 | Any such order for sealants must be implemented within 120 | ||||||
| 9 | days after its issuance. Any such order for oral prophylactic | ||||||
| 10 | procedures or fluoride treatments must be implemented within | ||||||
| 11 | 180 days after its issuance. An updated medical history and | ||||||
| 12 | observation of oral conditions must be performed by the | ||||||
| 13 | hygienist immediately prior to beginning the procedures to | ||||||
| 14 | ensure that the patient's health has not changed in any manner | ||||||
| 15 | to warrant a reexamination by the dentist. | ||||||
| 16 | (f) Without the supervision of a dentist, a dental | ||||||
| 17 | hygienist may perform dental health education functions, | ||||||
| 18 | including instruction in proper oral health care and dental | ||||||
| 19 | hygiene in, for example, a school setting, a long-term care | ||||||
| 20 | facility, and a health fair. In addition, a dental hygienist | ||||||
| 21 | may record case histories and oral conditions observed at any | ||||||
| 22 | time prior to a clinical exam by a dentist. | ||||||
| 23 | (g) The number of dental hygienists practicing in a dental | ||||||
| 24 | office shall not exceed, at any one time, 4 times the number of | ||||||
| 25 | dentists practicing in the office at the time. | ||||||
| 26 | (h) A dental hygienist who is certified as a public health | ||||||
| |||||||
| |||||||
| 1 | dental hygienist may provide services to patients: (1) who are | ||||||
| 2 | eligible for Medicaid or (2) who are uninsured and whose | ||||||
| 3 | household income is not greater than 300% of the federal | ||||||
| 4 | poverty level. A public health dental hygienist may perform | ||||||
| 5 | oral assessments, perform screenings, and provide educational | ||||||
| 6 | and preventative services as provided in subsection (b) of | ||||||
| 7 | Section 18.1 of this Act. The public health dental hygienist | ||||||
| 8 | may not administer local anesthesia or nitrous oxide, or | ||||||
| 9 | place, carve, or finish amalgam restorations, or provide | ||||||
| 10 | periodontal therapy under this exception. A public health | ||||||
| 11 | dental hygienist may not administer local anesthesia except as | ||||||
| 12 | provided in subsection (k) of this Section. Each patient must | ||||||
| 13 | sign a consent form that acknowledges that the care received | ||||||
| 14 | does not take the place of a regular dental examination. The | ||||||
| 15 | public health dental hygienist must provide the patient or | ||||||
| 16 | guardian a written referral to a dentist for assessment of the | ||||||
| 17 | need for further dental care at the time of treatment. Any | ||||||
| 18 | indication or observation of a condition that could warrant | ||||||
| 19 | the need for urgent attention must be reported immediately to | ||||||
| 20 | the supervising dentist for appropriate assessment and | ||||||
| 21 | treatment. | ||||||
| 22 | (i) A dental hygienist performing procedures listed in | ||||||
| 23 | paragraphs (1) through (4) of subsection (a) of Section 17.1 | ||||||
| 24 | must be under the supervision of a dentist, requiring the | ||||||
| 25 | dentist authorizes the procedure, remains in the dental | ||||||
| 26 | facility while the procedure is performed, and approves the | ||||||
| |||||||
| |||||||
| 1 | work performed by the dental hygienist before dismissal of the | ||||||
| 2 | patient, but the dentist is not required to be present at all | ||||||
| 3 | times in the treatment room. | ||||||
| 4 | (j) A dental hygienist may perform actions described in | ||||||
| 5 | paragraph (5) of subsection (a) of Section 17.1 under the | ||||||
| 6 | general supervision of a dentist as described in this Section. | ||||||
| 7 | (k) A dental hygienist practicing in a community health | ||||||
| 8 | center may administer local anesthetics upon the successful | ||||||
| 9 | completion of a training program approved by the Department | ||||||
| 10 | and under the general supervision of a dentist as long as the | ||||||
| 11 | community health center: | ||||||
| 12 | (1) has adopted written policies and procedures | ||||||
| 13 | establishing supervision by a dentist or physician at the | ||||||
| 14 | time the local anesthetics are administered; and | ||||||
| 15 | (2) ensures that a dentist or physician is physically | ||||||
| 16 | present in the clinic at the time the local anesthetics | ||||||
| 17 | are administered. | ||||||
| 18 | (Source: P.A. 103-431, eff. 1-1-24; 104-103, eff. 8-1-25; | ||||||
| 19 | 104-151, eff. 1-1-26; revised 11-21-25.) | ||||||
