ADMINISTRATIVE CODE

TITLE 68: PROFESSIONS AND OCCUPATIONS
CHAPTER VII: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
SUBCHAPTER b: PROFESSIONS AND OCCUPATIONS
PART 1220 ILLINOIS DENTAL PRACTICE ACT

SUBPART A: DENTIST

Section 1220.10 Definitions

Section 1220.100 Application for Licensure

Section 1220.110 Application for Examination (Repealed)

Section 1220.120 Dental Examinations

Section 1220.130 System of Retaking the Clinical Sections of the Examination (Repealed)

Section 1220.140 Minimum Standards for an Approved Program in Dentistry

Section 1220.150 Licensure (Repealed)

Section 1220.155 Restricted Faculty Licenses

Section 1220.156 Temporary Training License

Section 1220.157 Temporary Permit for Free Dental Care

Section 1220.160 Restoration

Section 1220.170 Renewal

SUBPART B: DENTAL HYGIENIST

Section 1220.200 Application for Licensure

Section 1220.210 Application for Examination (Repealed)

Section 1220.220 Dental Hygiene Examination

Section 1220.230 System of Grading (Repealed)

Section 1220.231 System of Retaking the Clinical Examination (Repealed)

Section 1220.240 Prescribed Duties of Dental Hygienists

Section 1220.245 Prescribed Duties of Dental Assistants

Section 1220.250 Approved Programs of Dental Hygiene

Section 1220.260 Restoration

Section 1220.270 Renewal

SUBPART C: DENTAL SPECIALIST

Section 1220.310 Applications

Section 1220.320 Examination (Repealed)

Section 1220.330 System of Grading (Repealed)

Section 1220.335 American Board Diplomates (Repealed)

Section 1220.340 Specialty Listing (Repealed)

Section 1220.350 Restoration

Section 1220.360 Renewal

SUBPART D: GENERAL

Section 1220.380 Definitions

Section 1220.400 Reportable Diseases and Conditions

Section 1220.403 Dentists Administering Flu Vaccines

Section 1220.405 Reporting of Adverse Occurrences

Section 1220.406 Impaired Dentist and Dental Hygienist Program of Care, Counseling or Treatment

Section 1220.407 Death or Incapacitation of Dentist

Section 1220.410 Endorsement

Section 1220.415 Fees

Section 1220.421 Advertising

Section 1220.425 Referral Services

Section 1220.431 Employment by Corporation (Repealed)

Section 1220.435 Renewals (Repealed)

Section 1220.440 Continuing Education

Section 1220.441 Granting Variances

SUBPART E: ANESTHESIA PERMITS

Section 1220.500 Definitions

Section 1220.505 Minimal Sedation in the Dental Office Setting

Section 1220.510 Moderate Sedation (Conscious Sedation) in the Dental Office Setting

Section 1220.520 Deep Sedation and General Anesthesia in the Dental Office Setting

Section 1220.525 Renewal

Section 1220.530 Anesthesia Review Panel

Section 1220.540 Approved Programs in Anesthesiology (Repealed)

Section 1220.550 Reporting of Adverse Occurrences (Repealed)

Section 1220.560 Restoration of Permits

Section 1220.APPENDIX A Pre-clinical Restorative Dentistry Sub-section (Repealed)

Section 1220.APPENDIX B Dental Assistant Permitted Procedures (Repealed)

Section 1220.APPENDIX C Dental Hygienist Permitted Procedures (Repealed)

Section 1220.APPENDIX D Characteristics of Levels of Anesthesia*

SUBPART A: DENTIST

TITLE 68: PROFESSIONS AND OCCUPATIONS
CHAPTER VII: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
SUBCHAPTER b: PROFESSIONS AND OCCUPATIONS
PART 1220 ILLINOIS DENTAL PRACTICE ACT
SECTION 1220.10 DEFINITIONS

Section 1220.10 Definitions

"AAOMS" means the American Association of Oral and Maxillofacial Surgeons.

"ACLS" means Advanced Cardiac Life Support.

"Act" means the Illinois Dental Practice Act [225 ILCS 25].

"AMP Exam" means the national Anatomy, Morphology, and Physiology exam administered by DANB.

"BLS" means current basic life support certification intended for healthcare providers that includes evaluation of hands-on skills and a written exam.

"Board" means the Board of Dentistry authorized by Section 6 of the Act.

“CDCA-WREB” means the Commission on Dental Competency Assessments and Western Regional Examining Board.

"CE" means continuing education.

"CITA" means the Counsel of Interstate Testing Agencies, Inc.

"CODA" means Commission on Dental Accreditation of the American Dental Association.

"CRDTS" means the Central Regional Dental Testing Service.

"DANB" means Dental Assisting National Board, Inc.

"Department" means the Department of Financial and Professional Regulation.

"Director" means the Director of the Division of Professional Regulation with the authority delegated by the Secretary.

"Division" means the Department of Financial and Professional Regulation-Division of Professional Regulation with the authority delegated by the Secretary.

"IS Exam" means the national exam on oral cavity isolation techniques administered by DANB.

"JCNDE" or "Joint Commission" means the Joint Commission on National Dental Examinations.

"LLC" means limited liability company, as defined in Section 1-5 of the Limited Liability Company Act [805 ILCS 180].

"NERB" means the North East Regional Board.

"PALS" means Pediatric Advanced Life Support.

"RF Exam" means the national Restorative Functions exam administered by DANB.

"Secretary" means the Secretary of the Department of Financial and Professional Regulation.

"SRTA" means the Southern Regional Testing Agency, Inc.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.100 Application for Licensure

An applicant for a license to practice dentistry in Illinois shall file an application on forms supplied by the Division that shall include:

a) For graduates from a dental college or school in the United States or Canada, certification of successful completion of 60 semester hours or its equivalent of college pre-dental education, and graduation from a dental program specified in Section 1220.140.

b) For graduates from a dental college or school outside of the United States or Canada:

1) Certification of graduation from a dental college or school; and

2) Clinical Training

A) Certification from an approved dental college or school in the United States or Canada that the applicant has completed a minimum of 2 years of general dental clinical training at the school in which the applicant met the same level of scientific knowledge and clinical competence as all graduates from that school or college. The 2 years of general dental clinical training shall consist of:

i) 2850 clock hours completed in 2 academic years for full-time applicants; or

ii) 2850 clock hours completed in 4 years with a minimum of 700 hours per year for part-time applicants; or

B) In the alternative, certification, from the program director of an accredited advanced dental education program approved by the Division, of completion of no less than 2 academic years may be substituted for the 2 academic years of general dental clinical training. The accredited advanced dental education program must have sufficient clinical and didactic training. An advanced dental education clinical program in Prosthodontics, pediatric dentistry, periodontics, endodontics, orthodontics, and oral and maxillofacial surgery is acceptable under this Part;

c) The required fee set forth in Section 1220.415(a)(1).

d) Proof of successful completion of the Theoretical examination given by JCNDE. The passing score shall be determined by JCNDE. The National Board Certificate must be mailed to the Division by JCNDE.

e) Proof of successful completion of an examination set forth in Section 1220.120(a).

f) Certification, on forms provided by the Division, from the state in which an applicant was originally licensed and is currently licensed, if applicable, stating:

1) The time during which the applicant was licensed in that state, including the date of the original issuance of the license; and

2) Whether the file on the applicant contains any record of disciplinary actions taken or pending.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.110 Application for Examination (Repealed)

(Source: Repealed at 26 Ill. Reg. 18286, effective December 13, 2002)

Section 1220.120 Dental Examinations

a) The Division shall accept the following examinations for licensure if administered and passed in their entirety (which includes passage of the restorative, periodontal, prosthodontic and endodontic portions of the examination):

1) CDCA-WREB-CITA Examination, with a passing score established by the testing entity;

2) CRDTS Examination, with a passing score established by the testing entity; or

3) SRTA Examination, with a passing score established by the testing entity.

b) Retake requirements shall be that of the testing entity.

c) The applicant shall have the examination scores submitted to the Division directly from the reporting entity.

d) The Division will accept only examinations that have been completed in the 5 years prior to submission of the application, if never licensed in another jurisdiction.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.130 System of Retaking the Clinical Sections of the Examination (Repealed)

(Source: Repealed at 26 Ill. Reg. 18286, effective December 13, 2002)

Section 1220.140 Minimum Standards for an Approved Program in Dentistry

A dental program shall meet the following requirements:

a) The curriculum must include at least 4 academic years of instruction or its equivalent.

b) Biomedical, Behavioral, and Clinical Science instruction must be integrated and of sufficient depth, scope, timeliness, quality and emphasis to ensure achievement of the curriculum's defined competencies.

c) The stated goals of the dental education program must include the preparation of graduates who possess the knowledge and values to begin the practice of general dentistry.

d) A graduate shall be competent in:

1) Providing oral health care within the scope of general dentistry for all age groups, as well as the medically compromised patient.

2) Functioning in the community and practice environment.

e) The curriculum must include the following areas of instruction:

Ethics

Critical thinking

Professional and community involvement

Patient management

History and examination

Diagnosis

Treatment planning

Emergency care

Prevention and maintenance

Oral medicine

Therapeutics/pharmacology

Periodontal therapy

Endodontic therapy

Surgical therapy

Occlusal therapy

Orthodontic therapy

Restorative/prosthodontic therapy

Office management

Personnel management

f) Graduates must be competent in providing appropriate life support measures for medical emergencies that may be encountered in dental practice.

g) In determining whether a program should be approved, the Division shall take into consideration but not be bound by accreditation by the Commission on Dental Accreditation of the American Dental Association.

h) The Division, upon the recommendation of the Board, has determined that all of the dental programs accredited by the Commission on Dental Accreditation of the American Dental Association as of July 2006 meet the minimum curriculum criteria set forth in this Section and are, therefore, approved.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.150 Licensure (Repealed)

(Source: Repealed at 13 Ill. Reg. 4191, effective March 16, 1989)

Section 1220.155 Restricted Faculty Licenses

a) Pursuant to Section 11(d) of the Act, the Division shall issue a Restricted Faculty License to an individual who is currently licensed in another jurisdiction as a dentist and who files an application, on forms provided by the Division, that includes:

1) Certification of licensure from the jurisdiction of original licensure and current licensure;

A) The time during which the applicant was licensed in that jurisdiction, including the date of the original license; and

B) Whether the files of the jurisdiction contain any record of disciplinary action taken or pending;

2) A certification, on forms provided by the Division, signed by the Dean of the school or hospital administrator, indicating:

A) The name and address of the dental school or hospital;

B) The beginning and ending date of the appointment; and

C) The nature of and the need for the educational service that will be provided by the applicant;

3) The required fee set forth in Section 1220.415(a)(8).

b) The restricted faculty license shall be valid for 3 years from the date of issuance and may be renewed in accordance with subsection (e).

c) The holder of a restricted faculty license may perform acts as may be required by the teaching of dentistry and may practice general dentistry or in the holder's area of specialty, including ordering, prescribing and administering controlled substances, but only in a hospital clinic or office affiliated with the dental school. A restricted faculty license holder may apply for and obtain a controlled substances license.

d) Any restricted faculty license and controlled substances license issued to a faculty member shall be terminated immediately and automatically without any further action by the Division if the holder ceases to be a faculty member at an approved dental school or hospital in this State.

e) Renewal

1) Beginning with the September 30, 2021 renewal, every restricted faculty license issued under the Act shall expire on September 30 every 3 years. The holder of a license may renew the license during the month preceding the expiration date thereof by paying the fee required in Section 1220.415(b) and providing the following:

A) Certification from the Dean of a dental program or the administrator of the hospital indicating the term of the renewal contract, not to exceed 3 years from the date of the original expiration date; and

B) Certification from the jurisdiction of current licensure indicating the current status of the license.

2) Failure to renew a restricted faculty license at least 30 days prior to its expiration shall result in the license expiring. A new application must be submitted.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.156 Temporary Training License

a) A person seeking a Temporary Training License in Illinois pursuant to Section 11(c) of the Act shall file an application, on forms provided by the Division, that includes:

1) Certification of graduation and/or transcripts from a dental school or program;

2) Certification signed by the Dean/hospital administrator of the specialty or residency program indicating the name of the specialty/residency program, the name and address of the dental school/hospital/institution in which the applicant will be located and the beginning and ending dates of the training;

3) Certification of licensure in another jurisdiction in which the applicant is currently licensed, stating, if applicable:

A) The time during which the applicant was licensed in that jurisdiction, including the date of original issuance of the license;

B) A description of the licensure examination in that jurisdiction;

C) Whether the file on the applicant contains a record of any disciplinary actions taken or pending;

4) The required fee set forth in Section 1220.415(a)(8).

b) The Temporary Training License will be issued for the duration of the residency or specialty training and may be extended as set forth in subsection (c).

c) The holder of a Temporary Training License may request in writing an extension of a temporary license and pay a $20 processing fee that covers the cost of printing a new temporary license. The Temporary Training License may be extended in the following circumstances:

1) Proof of continuance of a residency/specialty training program;

2) Serving full-time in the Armed Forces; or

3) An incapacitating illness as documented by a currently licensed physician.

d) A Temporary Training License may be transferred from one program to another only upon the return of the temporary license and receipt by the Division of a new application that contains a certificate of acceptance that the resident will be accepted or appointed to a specialty/residency position and the temporary license fee.

e) The holder of a Temporary Training License may only perform such acts as may be prescribed and incidental to the training in the designated facility and may not engage in the practice of dentistry in Illinois.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.157 Temporary Permit for Free Dental Care

a) A person seeking a Temporary Permit for Free Dental Care pursuant to Section 19.2 of the Act shall file an application on forms provided by the Division, that includes:

1) Certification of licensure in the original jurisdiction and from any jurisdiction where the applicant has been practicing for at least one year, stating:

A) The time during which the applicant was licensed in that jurisdiction, including the date of the original issuance of the license; and

B) Whether the files of the jurisdiction contain any record of any disciplinary action taken or pending;

2) Certification of graduation from a course of instruction in a dental school that meets the minimum education standards of the Division specified in Section 1220.140;

3) Certification of licensure in another jurisdiction in which the applicant is currently licensed, stating, if applicable:

A) The time during which the applicant was licensed in that jurisdiction, including the date of original issuance of the license;

B) A description of the licensure examination in that jurisdiction; and

C) Whether the file on the applicant contains a record of any disciplinary actions taken or pending;

4) Certification of a collaborative agreement with an Illinois licensed dentist, including the name and license number of the Illinois licensed collaborating dentist;

5) Certification of formal invitation to perform dental care by a charitable organization or a formal invitation to study or receive training on specific dental or clinical subjects or techniques by a licensed CE sponsor approved by the Department; and

6) The fee as required under Section 1220.415.

b) A continuing education sponsor seeking a license to provide live patient continuing education clinical training courses pursuant to Section 19.2(a-5) of the Act shall file an application on forms provided by the Division, that includes:

1) Proof of a valid Illinois CE Sponsor License in good standing;

2) Proof that the continuing education course provides services, without compensation, that will improve the welfare of Illinois residents who are eligible for Medicaid or who are uninsured and whose household income is not greater than 200% of the federal poverty level;

3) A plan of follow-up care and training models;

4) Any and all documentation to be signed by the patients, including but not limited to waivers, consent forms, and releases;

5) Information related to the facilities being utilized, staffing plans, and emergency plans;

6) The process by which patients will be contacted before, during, and after treatment;

7) The intended population that will be receiving treatment in the specific continuing education course;

8) Proof of valid malpractice insurance for the approved continuing education sponsor that extends coverage to clinical staff, trainees, and out-of-state permit holders;

9) A valid written collaborative agreement between the temporary visiting dentists holding a permit pursuant to Section 19.2 of the Act and the Illinois licensed dentist co-treating patients under this Section; and

10) A fee as required under 1220.415.

c) The written collaborative agreement shall be made available upon request. The application to the Department shall include the name and Illinois license number of the collaborating dentist, as well as the name, license number, and licensure jurisdiction of the visiting dentist. The Department may disapprove a collaborating dentist if the Department believes a collaborating dentist is not appropriate based on previous disciplinary history or inability to properly serve as a collaborating dentist.

d) The Temporary Training License will be valid for no longer than 5 consecutive clinical days within 6 months from the date of issuance and may be restored no more than one time within 5 years of the initial license’s issuance.

(Source: Added at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.160 Restoration

a) A licensee seeking restoration of a dental license after it has expired or has been placed on inactive status for less than 5 years shall have the license restored by submitting proof of 48 hours of continuing education in accordance with Section 1220.440 completed within 3 years prior to the restoration application and payment of $20 plus all lapsed renewal fees. Individuals restoring a license from inactive status shall only be required to pay the current renewal fee.

b) A licensee seeking restoration of a dental license after it has expired or has been placed on inactive status for 5 years or more shall file an application, on forms supplied by the Division, together with proof of 48 hours of CE in accordance with Section 1220.440 completed within 3 years prior to the restoration application and the fees required by Section 21 of the Act. Individuals restoring a license from inactive status shall only be required to pay the current renewal fee.

1) The licensee shall also submit either:

A) Certification of lawful active practice in another jurisdiction for 3 of the last 5 years. That certification shall include a statement from the appropriate board or licensing authority in the other jurisdiction that the licensee was authorized to practice during the term of the active practice; or

B) An affidavit attesting to military service as provided in Section 16 of the Act. If an applicant applies for restoration of a license within 2 years after termination of military service, the applicant shall have the license restored without paying any lapsed renewal or restoration fees.

2) A current certification in BLS by an organization that has adopted the American Heart Association's or American Red Cross' guidelines on BLS or a statement provided by the dentist's licensed physician indicating that the applicant is physically disabled and unable to obtain certification.

c) If neither subsection (b)(1) or (b)(2) applies to the licensee, then the licensee shall be required to take and pass an examination set forth in Section 1220.120.

d) A licensee who has been granted restoration, whose license has not been active for less than 5 years due to discipline, and whose license expired during the period of discipline, must comply with the requirements of subsection (a). If the licensee has not had an active license for 5 years or more due to discipline, the licensee must pass an examination set forth in Section 1220.120 or shall be required to complete such additional testing, training, or remedial education as the Board may deem necessary in order to establish the licensee’s present capacity to practice dentistry with reasonable judgment, skill, and safety.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.170 Renewal

a) Beginning with the September 30, 2006 renewal, every dental license issued under the Act shall expire on September 30 every 3 years. The holder of a license may renew the license during the month preceding the expiration date thereof by paying the fee required in Section 21 of the Act and certifying to fulfillment of 48 hours of continuing education pursuant to Section 1220.440.

b) A renewal applicant must provide proof of current certification in BLS by an organization that has adopted the American Heart Association's or American Red Cross' guidelines on BLS or a statement provided by the dentist's licensed physician indicating that the applicant is physically disabled and unable to obtain certification;

c) It is the responsibility of each licensee to notify the Division of any change of address. Failure to receive a renewal form from the Division shall not constitute an excuse for failure to pay the renewal fee or to renew one's license.

d) Practicing or offering to practice on a license that has expired shall be considered unlicensed activity and shall be grounds for discipline pursuant to Section 23 of the Act.

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)

SUBPART B: DENTAL HYGIENIST

Section 1220.200 Application for Licensure

An applicant for licensure as a dental hygienist shall file an application, on forms supplied by the Division, that shall include:

a) Certification of successful completion of 2 academic years of credit from a dental hygiene program approved by the Commission on Dental Accreditation of the American Dental Association;

b) Proof that the applicant has passed the National Dental Hygienist Board Examination, with a passing score as established by the testing entity given by JCNDE and has been issued a National Board Certificate, mailed to the Division by the JCNDF;

c) Proof of successful completion of an examination pursuant to Section 1220.220(a) received directly from the testing entity;

d) A current certification in BLS from the American Red Cross, the American Heart Association, or the American Safety and Health Institute or a statement from a licensed physician indicating that the applicant is physically disabled and unable to obtain certification;

e) Certification, on forms provided by the Division, from the state in which an applicant was originally licensed and is currently licensed, if applicable, stating:

1) The time during which the applicant was licensed in that state, including the date of the original issuance of the license; and

2) Whether the file on the applicant contains any record of disciplinary actions taken or pending;

f) The required fee set forth in Section 1220.415(a)(3).

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.210 Application for Examination (Repealed)

(Source: Repealed at 26 Ill. Reg. 18286, effective December 13, 2002)

Section 1220.220 Dental Hygiene Examination

a) The Division shall accept the following examinations for licensure if administered and passed in their entirety:

1) CDCA-WREB-CITA Examination, with a passing score established by the testing entity;

2) CRDTS Examination, with a passing score established by the testing entity; or

3) SRTA Examination, with a passing score established by the testing entity.

b) Retake requirements shall be that of the testing entity.

c) The applicant shall have examination scores submitted to the Division directly from the reporting entity.

d) The Division will only accept examinations that have been completed in the 5 years prior to submission of the application, if never licensed in another jurisdiction.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.230 System of Grading (Repealed)

(Source: Repealed at 19 Ill. Reg. 6606, effective May 2, 1995)

Section 1220.231 System of Retaking the Clinical Examination (Repealed)

(Source: Repealed at 26 Ill. Reg. 18286, effective December 13, 2002)

Section 1220.240 Prescribed Duties of Dental Hygienists

a) Dental hygienists may perform the operative procedure of dental hygiene, consisting of oral prophylaxis procedures.

b) Dental hygienists may perform dental health education functions and may record case histories and oral conditions observed.

c) Dental hygienists may perform all procedures that may be performed by an appropriately trained dental assistant.

d) Dental hygienists shall not perform those procedures that constitute the practice of dentistry as described in the Act. Hygienists may not perform procedures that require the professional judgment and skill of a dentist. Such prohibited procedures include, but shall not be limited to, the following:

1) Making denture adjustments.

2) Placing and finishing composite restorations.

3) Taking final impressions for the fabrication of prosthetic appliances, crowns, bridges, inlays, onlays or other restorative or replacement dentistry.

4) Permanently cementing permanent crowns or bridges.

5) Permanently re-cementing permanent crowns or bridges that have come loose.

6) Inter-oral use of a high-speed hand piece.

7) Use of a laser to remove tissue.

8) Placement or removal of implant prosthetic components and prostheses, including but not limited to the placement or removal of healing abutments, implant supported provisionals, components used in final impression procedures, and final prostheses, which include abutment, crowns, fixed and fixed detachable prostheses and fixed detachable prostheses during recare appointments.

e) Dental hygienists may administer and monitor nitrous oxide under the following conditions:

1) The dental hygienist functions under the supervision of the dentist who must remain in the facility;

2) The dental hygienist may administer (start the flow of) nitrous oxide to the patient and control the induction of the gas, so that the patient is at a level of analgesia not anesthesia;

3) The dental hygienist may remove the patient from nitrous oxide when the hygiene procedures have been completed;

4) Proof of Completion

A) The dental hygienist is responsible for obtaining proof of certification, validating completion of a 12 hour course relative to nitrous oxide analgesia and submitting certification to the dentist of valid completion of the required course. The course shall have been completed no earlier than December 31, 1994.

B) A dental hygienist who completed the 12 hour course shall complete an additional 2 hour course in nitrous oxide analgesia administration. The course shall be completed by September 30, 2011. A dental hygienist who has not completed the 12 hour course shall complete an approved course of 14 hours relative to the administration and monitoring of nitrous oxide analgesia and submit certification of successful completion to the dentist. The course shall have been completed no earlier than January 1, 1998.

C) An individual who graduated from an approved dental hygiene program after January 1, 1998 that contained nitrous oxide analgesia administration and monitoring in the curriculum shall not be required to complete the 14 hour course upon proof to the dentist of the required curriculum.

D) A dental hygienist who has not completed the 12 or 14 hour course shall complete an approved 6 hour course relative to the administration and monitoring of nitrous oxide analgesia and submit certification of successful completion to the dentist.

E) Proof of nitrous oxide analgesia education shall be made available to the Division upon request. The required hours shall include both didactic and clinical components and be given by a continuing education sponsor approved pursuant to Section 1220.440 or a dental hygiene program approved by the Division pursuant to Section 1220.250;

5) The dental hygienist must maintain BLS certification or its equivalent, which will be in addition to the required courses. Certification or its equivalent shall be completed by September 30, 2011.

f) Dental hygienists may assist in the provision of moderate sedation (conscious sedation), deep sedation, and general anesthesia, as defined in Section 1220.500, under the following conditions:

1) The dental hygienist functions under the supervision of the dentist who must remain in the facility. When the hygienist is the treatment provider while the patient is under moderate sedation (conscious sedation), deep sedation, or general anesthesia, the anesthesia permit holder must remain in the treatment room;

2) The dental hygienist is responsible for obtaining proof of certification validating completion of a course or courses totaling 12 hours or more, including 6 hours of didactic education and 6 hours of clinical training. The didactic education may be completed online, and online instruction may be used to guide the hands-on clinical training.

A) The didactic course work shall include the areas of anatomy, physiology, pharmacology, monitoring, including nitrous oxide monitoring, and emergency procedures with an emphasis on airway management.

B) The clinical components may be conducted by the CE sponsor approved pursuant to Section 1220.440, a dental hygiene program approved by the Division pursuant to Section 1220.250 or a licensed dentist having a permit A or B who employs the dental hygienist.

i) The courses described in this subsection (f)(2)(B) must be approved by the Division prior to initial offering. Dental hygienists who completed a 12 hour course that met course requirements in place for monitoring sedation prior to adoption of the current rules will not be required to recertify. Proof shall be provided to the Division upon request.

ii) If the clinical training is delivered by the supervising dentist, that dentist must attest, in writing, to the CE sponsor that the training has been completed. This attestation must be received by the CE sponsor in order for the sponsor to issue a certification of course completion. The supervising dentist must attest that the dental hygienist has been thoroughly trained and has demonstrated in-office proficiency in the skills required by this subsection (f)(2)(B)(ii). The dentist's attestation, signed by both the dentist and the dental hygienist, shall be maintained by the dentist. The copy sent to the CE sponsor shall be maintained by that sponsor as part of the official course record.

iii) The clinical component must include practical training on airway management. Other skills that must be demonstrated include manual blood pressure and pulse determination, operation of supplemental oxygen equipment, monitoring operations, including EKG, pulse oximeter and capnograph, and completion of the anesthesia record.

3) If the dental hygienist has complied with the provisions set forth in subsection (e)(4), the dental hygienist may complete an additional course or courses totaling 6 hours or more on advanced airway management and monitoring equipment in lieu of the 12 hour course required by subsection (f)(2). The course must comply with the elements set forth in subsection (f)(2), other than coursework related only to administration and monitoring of nitrous oxide. The courses described in this subsection (f)(3) must be approved by the Division prior to their initial offering. Proof of course completion shall be made available to the Division upon request;

4) The dental hygienist must maintain BLS certification or its equivalent, which will be in addition to the required courses.

g) Dental hygienists may administer local anesthetics under the following conditions:

1) The dental hygienist functions under the supervision of the dentist who remains in the facility.

2) The dental hygienist is responsible for obtaining proof of certification, indicating successful completion of a 32 hour course that contains 24 hours of lecture and 8 hours of clinical training relative to the administration of local anesthetics and submitting certification to the dentist. An individual who graduated from an approved dental hygiene program after January 1, 1999 that contained administration of local anesthetics in the curriculum shall not be required to complete the 32 hour course upon proof to the dentist of the required curriculum. Proof of completion of education shall be made available to the Division upon request. The required hours shall include both didactic and clinical components and be given by a continuing education sponsor approved pursuant to Section 1220.440 or a dental or a dental hygiene program approved by the Division pursuant to Section 1220.250. The course shall contain at a minimum the following topics:

A) Patient preevaluation, which includes dental and medical health history (e.g., drug interactions/anxiety/pain and a physical evaluation);

B) Pharmacology (e.g., drugs/types, vasoconstrictors, dosages, toxicity);

C) Recordkeeping;

D) Anatomy/Neuroanatomy/Physiology;

E) Armamentarium;

F) Techniques that include adjunctive use of topical anesthetics, mandibular block and infiltration;

G) Complications;

H) Post-operative instructions; and

I) Clinical experience that includes combining techniques for quadrant anesthesia and practical use of different techniques in all areas of oral cavity.

3) A dental hygienist who was licensed in another state and was authorized to administer local anesthesia in that jurisdiction will not be required to complete an additional course. Proof shall be submitted to the dentist and shall be made available to the Division upon request.

h) Dental hygienists may place, carve and finish amalgam restorations under the following conditions:

1) The dental hygienist functions under the direct supervision of a dentist who remains in the facility and examines the work done by the hygienist prior to the dismissal of the patient.

2) The dental hygienist is responsible for obtaining proof of certification, indicating successful completion of a 40 hour course, pre-approved by the Board, that contains lecture, laboratory and manikin training relative to the placing, carving and finishing of amalgam restorations and submitting certification to the dentist. Proof of completion of education shall be made available to the Division upon request. The required hours shall include both didactic and clinical components and be given by a continuing education sponsor approved by the Division and taught in an institution that is CODA approved, such as a dental school, hygiene program or assistant program. The course shall contain, at a minimum, the following preclinical, didactic and clinical instruction:

A) nomenclature;

B) caries classification;

C) oral anatomy;

D) dental morphology;

E) periodontium;

F) histology;

G) basic occlusion;

H) ergonomics;

I) instrumentation;

J) pulp protection liners and bases;

K) dental materials;

L) the medical history conditions and their implication for dental treatment and office emergencies;

M) matrix and wedge techniques;

N) amalgam placement and carving;

O) polishing amalgams;

P) rubber dam clamp placement;

Q) rubber dam placement and removal;

R) amalgam class I, II, IV and V. Class II cannot involve cusp replacement or pins.

3) Pass a pre-examination on basic dental procedures and techniques, as well as the basic fundamentals of dentistry.

4) Pass DANB's AMP Exam, IS Exam and RF Exam or equivalent exams administered by DANB or DANB's successor organization, or pass another written and clinical exam that is psychometrically sound and approved by the Board.

5) A supervising dentist must attend a required orientation class with the applicant and sign an agreement that he or she will follow the required guidelines regarding supervision and clinical application of specific techniques being taught.

i) The licensed dentist need not be present in the facility for a dental hygienist to perform the procedures set forth in this Section (except for the administration and monitoring of nitrous oxide, minimal sedation, assisting in the provision of moderate sedation (conscious sedation), deep sedation, and general anesthesia, as defined in Section 1220.500, and the administration of injectable local anesthetics, which must be done under the direct supervision of a dentist as outlined in subsection (e)(1)) on persons who reside in a long-term care facility licensed by the State of Illinois or a mental health or developmental disability facility operated by the Department of Human Services hospital or other similar institution and are unable to travel to a dental office because of illness or infirmity. The dentist shall personally examine and diagnose the patient and determine which services are necessary to be performed, which shall be contained in a written order to the hygienist. The order must be implemented within 90 days after its issuance and an updated medical history and oral inspection must be performed by the hygienist immediately prior to beginning the procedures to ensure that the patient's health has not changed in any manner to warrant a re-examination by the dentist.

j) All intraoral procedures performed by a dental hygienist, except those provided for in subsections (b), (h) and (i), must be examined by the supervising dentist prior to the dismissal of the patient from the facility that day.

(Source: Amended at 40 Ill. Reg. 12553, effective September 2, 2016)

Section 1220.245 Prescribed Duties of Dental Assistants

a) "Dental Assistant" means an appropriately trained person who, under the supervision of a dentist, provides dental services or procedures as authorized by Section 17 of the Act or as prescribed by this Part. "Appropriately trained" means a person who:

1) Has completed formal training as a condition for administering a specific service or procedure as required by the Act or this Part; and

2) Is considered, for all other authorized or prescribed services or procedures, by the supervising dentist to be competent to render such service or procedure as a result of on-the-job training.

b) Provided that a dental assistant is appropriately trained pursuant to this Section and is acting under the supervision and full responsibility of a dentist, a dental assistant may perform any dental service or procedure except the following:

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, restoration of, or addition to the hard or soft tissues of the oral cavity. For purposes of this Section, coronal polishing and acid etching of a tooth surface are not considered removal of hard or soft tissues.

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 the Act.

5) Removal of calculus from teeth.

6) Taking of final impressions for the fabricating 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 as specified in this Section.

8) Making denture adjustments.

9) Placing and finishing composite restorations.

10) Permanently cementing permanent crowns or bridges.

11) Permanently re-cementing permanent crowns or bridges that have come loose.

12) Placement of any chemotherapeutic agent for the management of periodontal disease.

13) Applying cavity bases.

14) Cementing bands and/or bonding brackets.

15) Performing supragingival or subgingival scaling.

16) Performing pulp vitality tests.

17) Inter-oral use of a high-speed hand piece.

18) Use of a laser to remove tissue.

19) Placement or removal of implant prosthetic components and prostheses, including but not limited to the placement or removal of healing abutments, implant supported provisionals, components used in final impression procedures, and final prostheses, which include abutment, crowns, fixed and fixed detachable prostheses and fixed detachable prostheses during recare appointments.

c) A dental assistant, who is at least 18 years of age and has 1000 hours of clinical dental assisting experience or has graduated from a dental assistant program accredited by the CODA or is a currently certified dental assistant as designated by DANB may perform the following services and procedures, but only under the following terms and conditions:

1) Monitoring nitrous oxide, provided:

A) The dental assistant has completed an approved course of 12 hours relative to nitrous oxide analgesia and has submitted certification to the dentist of valid completion of the course. The course shall have been completed no earlier than January 1, 1998 nor later than June 1, 2014.

i) A dental assistant who has not completed the 12 hour course shall complete an approved course or courses totaling 6 hours or more relative to monitoring nitrous oxide analgesia and submit certification of successful completion to the dentist.

ii) Proof shall be made available to the Division upon request.

iii) The required hours shall include both didactic and clinical components and have been designed by an educational institution such as a dental school, dental hygiene or dental assistant program or by an approved CE sponsor. The course shall include areas of anatomy, physiology, monitoring, pharmacology and emergency procedures with an emphasis on airway management. Courses being offered by approved CE sponsors, as provided for in Section 1220.440(b)(2)(N) must be preapproved by the Division prior to their initial offering and must meet the requirements set forth in this subsection (c)(1);

B) The dental assistant is functioning under the supervision of the dentist who must remain in the facility;

C) Only a dentist or dental hygienist qualified pursuant to Section 1220.240(e) shall administer (start the flow of) nitrous oxide to the patient and control the induction of the gas so that the patient is at a level of analgesia, not anesthesia;

D) Only a dentist or dental hygienist qualified pursuant to Section 1220.240(e) shall remove the patient from nitrous oxide when the dentist or dental hygienist has completed the procedures on the patient;

E) If the dental assistant has completed a monitoring course or courses totaling 12 hours or more provided by AAOMS or a similar course preapproved by the Division, the dental assistant need not complete the course hours required in subsection (c)(1)(A). The course shall have been completed no earlier than December 31, 2002. Proof shall be made available to the Division upon request;

F) The dental assistant maintains BLS certification or its equivalent, which will be in addition to the required courses.

2) Monitoring minimal sedation, moderate sedation (conscious sedation), deep sedation, or general anesthesia, as defined in Section 1220.500, provided:

A) The dental assistant is responsible for obtaining proof of certification validating completion of a course or courses totaling 12 hours or more, including 6 hours of didactic education and 6 hours of clinical training.

i) The didactic education may be completed online, and online instruction may be used to guide the hands-on clinical training. The didactic course work shall include the areas of anatomy, physiology, pharmacology, monitoring, including nitrous oxide monitoring, and emergency procedures with an emphasis on airway management.

ii) The clinical components may be conducted by the CE sponsor approved pursuant to Section 1220.440, a dental hygiene program approved by the Division pursuant to Section 1220.250 or a licensed dentist having a permit A or B who employs the dental assistant.

• The courses described in this subsection (c)(2)(A) must be approved by the Division prior to initial offering. Dental assistants who completed a 12 hour course that met course requirements in place for monitoring sedation prior to adoption of the current rules will not be required to recertify. Proof shall be provided to the Division upon request.

• If the clinical training is delivered by the supervising dentist, that dentist must attest, in writing, to the CE sponsor that the training has been completed. This attestation must be received by the CE sponsor in order for the sponsor to issue a certification of course completion. The supervising dentist must attest that the dental assistant has been thoroughly trained and has demonstrated in-office proficiency in the skills required by this subsection (c)(2)(A)(ii). The dentist's attestation, signed by both the dentist and the dental assistant, shall be maintained by the dentist. The copy sent to the CE sponsor shall be maintained by the sponsor as part of the official course record.

• The clinical component must include practical training on airway management. Other skills that must be demonstrated include manual blood pressure and pulse determination, operation of supplemental oxygen equipment, monitoring operations, including EKG, pulse oximeter and capnograph, and completion of the anethesia record.

B) If the dental assistant has complied with the provisions set forth in subsection (c)(1)(A), the dental assistant shall complete an additional 6 hour course on advanced airway management and monitoring equipment in lieu of the 12 hour course required in subsection (c)(2)(A). The courses must comply with the elements set forth in subsection (c)(2)(A) other than coursework related only to monitoring of nitrous oxide. The courses described in this subsection (c)(2)(B) must be approved by the Division prior to their initial offering. Proof shall be made available to the Division upon request.

C) If the dental assistant has completed a monitoring course or courses totaling 12 hours or more provided by AAOMS or a similar course or courses pre-approved by the Division, the dental assistant need not complete the course hours required in subsection (c)(2)(A). The course shall have been completed no earlier than December 31, 2002. Proof shall be made available to the Division upon request.

D) The dental assistant is functioning under the supervision of the dentist who must remain in the facility.

E) The dental assistant maintains BLS certification or its equivalent, which will be in addition to the required courses.

3) Coronal polishing, provided:

A) The dental assistant has completed an approved course of 6 hours relative to coronal polishing and has submitted certification of successful completion to the dentist. The course shall have been completed no earlier than January 1, 1998. Proof shall be made available to the Division upon request. The required hours shall include a minimum of 4 hours of didactic study in areas of anatomy, physiology, pharmacology and dental emergencies and 2 hours of clinical instruction and have been provided by an educational institution such as a dental school, dental hygiene or dental assistant program or by an approved CE sponsor. Courses being offered by CE sponsors approved pursuant to Section 1220.440(b)(2)(N) must be pre-approved by the Division prior to their initial offering and must meet the requirements set forth in this subsection (c)(3). The assistant must pass an examination in the didactic portion of the course and the clinical portion must contain experience on human subjects;

B) Coronal polishing is limited to polishing the clinical crown of the tooth and existing restoration, supragingivally;

C) Coronal polishing is limited to the use of slow speed rotary instruments using a rubber cup and/or brush polishing method. The use of air polish by dental assistants is not permitted; and

D) A dentist shall be limited to supervising 4 dental assistants at any one time for the task of coronal polishing.

4) Pit and fissure sealant application, provided:

A) The dental assistant has completed a course of at least 2 hours of didactic study and 2 hours of clinical instruction;

B) Prior to being permitted to place sealants in accord with this Section, the supervising dentist has personally observed the dental assistant successfully placing 6 pit and fissure sealants;

C) The supervising dentist documents that the training has been completed; and

D) The supervising dentist is responsible for examining the patient prior to and following the placement of sealants by a dental assistant.

5) Placing, carving and finishing amalgam restorations, provided:

A) The dental assistant functions under the direct supervision of the dentist who remains in the facility and examines the work done by the assistant prior to the dismissal of the patient.

B) The dental assistant is at least 18 years of age and can show proof that he or she is a DANB Certified Dental Assistant or has been employed as a dental assistant with a minimum of 2 years continuous hands-on experience (4,000 hours).

C) The dental assistant is responsible for obtaining proof of certification, indicating successful completion of a 40 hour course that contains lecture, laboratory and manikin training relative to the placing, carving and finishing of amalgam restorations and submitting certification to the dentist. Proof of completion of education shall be made available to the Division upon request. The required hours shall include both didactic and clinical components and be given by a continuing education sponsor approved by the Division and taught in an institution that is CODA approved, such as a dental school, hygiene program or assistant program. The course shall contain, at a minimum, the following preclinical, didactic and clinical instruction:

i) nomenclature;

ii) caries classification;

iii) oral anatomy;

iv) dental morphology;

v) periodontium;

vi) histology;

vii) basic occlusion;

viii) ergonomics;

ix) instrumentation;

x) pulp protection liners and bases;

xi) dental materials;

xii) the medical history and conditions and their implication for dental treatment and office emergencies;

xiii) matrix and wedge techniques;

xiv) amalgam placement and carving;

xv) polishing amalgams;

xvi) rubber dam clamp placement;

xvii) rubber dam placement and removal;

xviii) amalgam class I, II, IV and V. Class II cannot involve cusp replacement or pins.

D) All applicants must take and pass a pre-examination on basic dental procedures and techniques, as well as the basic fundamentals of dentistry.

E) All applicants must pass DANB's AMP Exam, IS Exam, and RF Exam or equivalent exams administered by DANB or DANB's successor organization, or pass another written and clinical exam that is psychometrically sound and approved by the Board.

F) All applicants must maintain proof of BLS certification.

G) As a condition of acceptance into the program, a supervising dentist must attend a required orientation class with the applicant and sign an agreement that he or she will follow the required guidelines regarding supervision and clinical application of specific techniques being taught between scheduled classes.

d) An individual who graduated from an approved dental assisting program after January 1, 1999 that contained monitoring of nitrous oxide, coronal polishing, and sealant application in the curriculum shall not be required to complete an additional course or courses in these areas as prescribed in this Section upon proof to the dentist of having successfully completed the required curriculum.

e) All intraoral procedures performed by a dental assistant must be examined by the supervising dentist prior to the dismissal of the patient from the facility that day.

(Source: Amended at 40 Ill. Reg. 12553, effective September 2, 2016)

Section 1220.250 Approved Programs of Dental Hygiene

Approved dental hygiene programs are those programs accredited by the Commission on Dental Accreditation of the American Dental Association.

(Source: Amended at 26 Ill. Reg. 18286, effective December 13, 2002)

Section 1220.260 Restoration

a) A licensee seeking restoration of a dental hygienist license after it has expired or been placed on inactive status for less than 5 years shall have the license restored by submitting proof of 36 hours of continuing education pursuant to Section 1220.440 within 3 years prior to application for restoration, proof of certification in BLS by an organization that has adopted the American Heart Association's or American Red Cross' guidelines on BLS or a statement from a licensed physician indicating that the applicant is physically disabled and unable to obtain certification and payment of the fees required by Section 1220.415. Individuals restoring a license from inactive status shall only be required to pay the current renewal fee.

b) A licensee seeking restoration of a dental hygienist license after it has expired or been placed on inactive status for 5 years or more shall file an application, on forms supplied by the Division, together with the fees required by Section 1220.415, proof of 36 hours of continuing education pursuant to Section 1220.440 within 3 years prior to application for restoration and proof of certification in BLS by an organization that has adopted the American Heart Association's or American Red Cross' guidelines on BLS or a statement from a licensed physician indicating that the applicant is physically disabled and unable to obtain certification. Individuals restoring a license from inactive status shall only be required to pay the current renewal fee. The licensee shall also submit either:

1) Certification of lawful active practice in another jurisdiction for at least 3 of the last 5 years. The certification shall include a statement from the appropriate board or licensing authority in the other jurisdiction that the licensee was authorized to practice during the term of said active practice; or

2) An affidavit attesting to military service as provided in Section 16 of the Act. If an applicant applies for restoration of a license within 2 years after termination of the service, the applicant shall have the license restored without paying any lapsed renewal or restoration fees.

c) If neither subsection (b)(1) or (b)(2) applies to the licensee, then the licensee shall be required to take and pass the clinical examination as provided in Section 1220.220.

d) A licensee who has been granted restoration, whose license has not been active for less than 5 years due to discipline, and whose license expired during the period of discipline, must comply with the requirements of subsection (a). If the licensee has not had an active license for 5 years or more due to discipline, the licensee must pass an examination set forth in Section 1220.220 or shall be required to complete such additional testing, training, or remedial education as the Board may deem necessary in order to establish the licensee’s present capacity to practice dental hygiene with reasonable judgment, skill and safety.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.270 Renewal

a) Beginning with the September 30, 2006 renewal, every dental hygienist license issued under the Act shall expire on September 30 every 3 years. The holder of a license may renew the license during the month preceding the expiration date by:

1) certifying on the application to completion of 36 hours of continuing education pursuant to Section 1220.440;

2) certifying to current certification in Basic Life Support for Healthcare Providers or its equivalent or a statement from a licensed physician indicating that the applicant is physically disabled and unable to obtain certification; and

3) submitting the fee required in Section 1220.415.

b) It is the responsibility of each licensee to notify the Division of any change of address. Failure to receive a renewal form from the Division shall not constitute an excuse for failure to pay the renewal fee or to renew one's license.

c) Practicing or offering to practice on a license that has expired shall be considered unlicensed activity and shall be grounds for discipline pursuant to Section 23 of the Act.

(Source: Amended at 34 Ill. Reg. 7205, effective May 5, 2010)

SUBPART C: DENTAL SPECIALIST

Section 1220.310 Applications

a) An applicant for licensure as a dental specialist must be currently licensed as a dentist in Illinois and must file an application. The application shall include the following:

1) Certification of completion of dental specialty training in accordance with subsection (b);

2) The fee required in Section 1220.415(a)(2).

b) To qualify for licensure as a specialist in endodontics, pediatric dentistry, prosthodontics, oral and maxillofacial radiology, or orthodontics and dentofacial orthopedics, the applicant must submit, in addition to the requirements of subsection (a), records, certified by the director of the program, showing that the applicant has successfully completed a course of study of not less than 2 academic years in a program approved by the Division in the dental specialty he or she proposes to practice.

c) To further qualify for licensure as a specialist in oral and maxillofacial surgery, the applicant must submit, in addition to the requirements of subsection (a), the following:

1) The oral and maxillofacial surgery application must contain evidence that the applicant has successfully completed a 4-year (48 months) period of training in oral and maxillofacial surgery in a school and/or hospital approved by the Division. A minimum of 30 months shall be in clinical oral and maxillofacial surgery. The schedule shall include 24 months of full-time hospital training in an acceptable oral and maxillofacial surgery residency program. Not less than 4 months of this period must be devoted to training in anesthesiology.

2) Certified records are required from the Dean of the dental school or the head of the Oral and Maxillofacial Surgery Department of the hospital or clinic in which the oral and maxillofacial surgery training took place. The records must attest to the individual's successful completion of the program.

d) To further qualify for licensure as a specialist in dental anesthesiology, the applicant must submit, in addition to the requirements of subsection (a), the following:

1) The dental anesthesiology application must contain evidence that the applicant has successfully completed a 3-year (36 months) period of training in a CODA accredited dental anesthesiology program. An applicant who completed a dental anesthesiology program prior to July 1, 2018, must submit an application containing evidence of a two-year dental anesthesiology residency program. An applicant who completed a dental anesthesiology program prior to July 1, 1993, must submit an application containing evidence of completion of a one-year dental anesthesiology residency program.

2) Certified records are required from the Program Director of the associated residency training program in which the dental anesthesiology training took place. The records must attest to the individual's successful completion of the program.

e) After July 1, 1994, periodontic specialty programs shall be 3 consecutive academic years with a minimum of 30 months of instruction. At least 2 consecutive years of clinical education must take place in a single educational setting. Applicants who completed periodontic specialty training prior to July 1, 1994, shall have successfully completed a course of study of not less than 2 academic years in a program approved by the Division.

f) The Division shall accept those specialty education providers accredited, at the time the education was obtained, by CODA.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.320 Examination (Repealed)

(Source: Repealed at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.330 System of Grading (Repealed)

(Source: Repealed at 19 Ill. Reg. 6606, effective May 2, 1995)

Section 1220.335 American Board Diplomates (Repealed)

(Source: Repealed at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.340 Specialty Listing (Repealed)

(Source: Repealed at 13 Ill. Reg. 4191, effective March 16, 1989)

Section 1220.350 Restoration

a) A licensee seeking restoration of a specialty license after it has expired for less than 5 years shall have the license restored upon payment of $20 plus all lapsed renewal fees. Individuals restoring a license from inactive status shall not be required to pay lapsed renewal fees. In order to restore a specialty license the applicant shall have an active dental license.

b) A licensee seeking restoration of a license after it has expired or been placed on inactive status for 5 years or more shall file an application, on forms supplied by the Division, together with the fees required by Section 21 of the Act. Individuals reactivating a license from inactive status shall only be required to pay the current renewal fee. The registrant shall also submit either:

1) Certification of lawful active practice in another jurisdiction for 3 of the last 5 years. That certification shall include a statement from the appropriate board or licensing authority in the other jurisdiction that the licensee was authorized to practice during the term of said active practice; or

2) An affidavit attesting to military service as provided in Section 16 of the Act. If an applicant applies for restoration of their license within 2 years of termination of such service, the applicant shall have their license restored without paying any lapsed renewal or restoration fees.

c) If the licensee has not maintained an active practice in another jurisdiction for over 5 years, the licensee shall be required to complete such additional testing, training or remedial education as the Board may deem necessary in order to establish the licensee's present capacity to practice a specialty with reasonable judgment, skill and safety.

d) A licensee who has been granted restoration, whose license has not been active for less than 5 years due to discipline, and whose license expired during the period of discipline, must comply with the requirements of subsection (a). If the licensee has not had an active license for 5 years or more due to discipline, the licensee must show proof of training set forth in Section 1220.310 or shall be required to complete additional testing, training, or remedial education as the Board may deem necessary in order to establish the licensee’s present capacity to practice dentistry with reasonable judgment, skill and safety.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.360 Renewal

a) Beginning with the September 30, 2006 renewal, every dental specialty license issued under the Act shall expire on September 30 every 3 years. The holder of a license may renew the license during the month preceding the expiration date thereof by paying the required fee in Section 21 of the Act.

b) No specialty license shall be renewed if the dental license is expired, revoked, suspended or otherwise subject to discipline under Section 23 of the Act.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

SUBPART D: GENERAL

Section 1220.380 Definitions

"Act" means the Illinois Dental Practice Act.

"Board" means the State Board of Dentistry.

"Dentistry" means the evaluation, diagnosis, prevention and/or treatment (nonsurgical or surgical), or related procedures of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist, within the scope of his/her education, training and experience in accordance with the ethics of the profession and applicable laws.

"Department" means the Illinois Department of Financial and Professional Regulation.

"Director" means the Director of the Division of Professional Regulation with the authority delegated by the Secretary.

"Division" means the Department of Financial and Professional Regulation-Division of Professional Regulation.

"Secretary" means the Secretary of the Department of Financial and Professional Regulation.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.400 Reportable Diseases and Conditions

Whenever a dentist or dental hygienist becomes aware that a patient has or may have a contagious, infectious and communicable disease that is dangerous to the public health, such information shall be reported to the Illinios Department of Public Health in accordance with the rules of the Department of Public Health (77 Ill. Adm. Code 690). Whenever a dentist or dental hygienist continues the active practice of dentistry or dental hygiene while knowingly having an infectious, communicable, or contagious disease as defined in 77 Ill. Adm. Code 690, he or she may be subject to disciplinary action by the Division.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.403 Dentists Administering Flu Vaccines

A licensed dentist seeking to administer influenza (inactivated influenza vaccine and live attenuated influenza intranasal vaccine) shall be required to complete an additional training course and must comply with all provisions in this Section and Section 54.3 of the Act.

a) Vaccinations shall be limited to patients 18 years of age and older who consent to administration of the vaccine and shall be administered pursuant to a valid prescription or standing order by a physician who, in the course of professional practice, administers vaccines to patients.

b) Prior to being administered a vaccine, those receiving immunizations shall be provided with the relevant vaccine information statements (VIS) that are required to be disseminated by federal law, which may contain information on circumstances in which a vaccine should not be administered.

c) The additional training course shall be given by continuing education providers approved pursuant to Section 1220.440(b)(2).

d) Any course must contain, at a minimum, four hours of training and include:

1) The recognition of contraindications, as well as how to handle adverse reactions;

2) The appropriate methods of storage, handling and disposal of vaccines and all used supplies or contaminated equipment; and

3) Proper administration and maintenance of written policies and procedures that are required by this Section.

e) Reporting Requirements

1) Any adverse events are required to be reported to the Vaccine Adverse Events Reporting System (VAERS) and to the primary care provider named by the patient.

2) Any dentist who administers the influenza vaccine shall enter all patient level data on the vaccines in the immunization data registry (I-Care) maintained by the Department of Public Health.

3) Within 30 days after administration of a vaccine, the dentist must report to the patient's primary care provider that the vaccine has been administered.

4) Additional information, including precautions and contraindications for vaccination, is available from CDC's Vaccines and Immunization online site or by telephone at 800-CDC-INFO or (800-232-4636).

f) Patient records must include:

1) The date of administration and site of injection of the vaccine;

2) The name, dose, manufacturer, lot number and beyond use date of the vaccine;

3) The name and address of the patient's primary health care provider named by the patient;

4) A notation that the patient was presented with the appropriate vaccine information statement (VIS) prior to the administration of each vaccine; and

5) Any adverse event that followed vaccination.

g) Certification of completion of the required course on the administration of the influenza vaccines must be kept on file by the dentist for review by the Department upon request.

(Source: Added at 40 Ill. Reg. 12553, effective September 2, 2016)

Section 1220.405 Reporting of Adverse Occurrences

a) "Adverse occurrence" shall be defined for the purposes of this Section as:

1) The death of a patient within 24 hours after the administration of a dental procedure; or

2) The permanent organic brain dysfunction of a patient that first occurs within 24 hours after the administration of a dental procedure; or

3) The in-patient hospitalization of a patient for physical injury within 24 hours after the administration of a dental procedure.

b) A dentist shall report to the Division within 72 hours each adverse occurrence that involves the death of a patient.

c) A dentist shall report to the Division within 30 days each adverse occurrence that involves the permanent organic brain dysfunction or hospitalization of a patient.

d) The adverse occurrence report shall be in writing and shall include:

1) The dentist's name and license number;

2) The date and time of the occurrence;

3) The facility where the occurrence took place;

4) The name of the patient;

5) The dental procedure involved;

6) The type and dosage of sedation or anesthesia utilized in the procedure; and

7) The circumstances involved in such occurrence.

e) Upon receipt of any such report, the Division shall investigate pursuant to Section 25 of the Act and 68 Ill. Adm. Code 1110.

f) The adverse occurrence report is required by the Division to assist in its mission of protecting the public. The filing of such report by a dentist shall not constitute an admission by the dentist of any wrongdoing, malpractice, error or omission in treatment or even an admission that the death, organic brain dysfunction or hospitalization is related to the dental procedure or its administration. A dentist shall be responsible for filing an adverse occurrence report only for those adverse occurrences of which he/she has knowledge or should reasonably have been expected to have knowledge. In the event that a dentist does not have knowledge or cannot reasonably be expected to have knowledge, but subsequently obtains actual knowledge of an adverse occurrence, then such dentist shall file an adverse occurrence report within 72 hours after obtaining knowledge of the death of a patient or within 30 days after obtaining knowledge of the permanent organic brain dysfunction or hospitalization of a patient.

g) Failure to provide such a report to the Division shall be grounds for discipline. (See 225 ILCS 25/23.)

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.406 Impaired Dentist and Dental Hygienist Program of Care, Counseling or Treatment

a) Section 5.5 of the Act requires the Division to establish a program of care, counseling or treatment for impaired dentists.

b) Definitions

1) "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. (Section 4 of the Act). A dentist or dental hygienist may be determined to be impaired:

A) by signing a written consent with the Department declaring the nature of the impairment; or

B) upon the determination of a qualified health care professional; or

C) upon the determination of a qualified health care professional who has performed an examination of the dentist or dental hygienist pursuant to Section 23b of the Act.

2) "Program of care, counseling, or treatment" means a written schedule of organized treatment care, counseling, activities, or education satisfactory to the Board, designed for the purpose of restoring an impaired person to a condition whereby the impaired person can practice with reasonable skill and safety of sufficient degree to deliver competent patient care.

c) Program of Care, Counseling or Treatment

1) A dentist or dental hygienist who has been determined by a qualified health care professional to be impaired shall enter into an agreement with the Division in which the dentist or dental hygienist agrees to participate in a program designed to provide care, counseling and treatment specifically for health care professionals and that has been approved by the Division. The agreement may include, but not be limited to, the length of the program, the status of the licensee while in a treatment program, and a termination clause whereby both parties may, by separate agreement in writing, terminate the agreement at any time.

2) All progress reports of treatment and participation in a treatment program shall be sent to the Division every 60 days. A relapse or non-compliance with the treatment program shall be reported to the Division immediately. All reports shall be signed by a licensed physician, clinical psychologist, licensed clinical social worker, or licensed clinical professional counselor or other substance abuse professional approved by the Division.

3) An impaired dentist or dental hygienist shall continue in an after care program until he or she is released upon successful completion of the structured treatment program.

4) If a dentist or dental hygienist is being treated for alcohol or drug abuse:

A) The person shall submit progress reports from any sponsors in Narcotics Anonymous or Alcoholics Anonymous or other after care programs to the Division on a quarterly basis.

B) The person shall submit to random drug and alcohol screenings and the results shall be submitted to the Division by the treatment program. The impaired dentist or dental hygienist is responsible for the cost of the reports. The Division shall be notified immediately by the treatment program if the person fails to submit to the random drug and alcohol screenings.

d) All reports required shall be submitted to the Dental Coordinator, Division of Professional Regulation, Illinois Department of Financial and Professional Regulation, 100 West Randolph Street, Suite 9-300, Chicago, Illinois 60601.

e) The contents of any report shall be strictly confidential and shall be exempt from public disclosure. The reports shall be reviewed only by the following:

1) The Board of Dentistry.

2) Designated Department attorneys.

3) Administrative personnel assigned to open mail containing reports and to process and distribute the reports to authorized persons, and to communicate with senders of reports.

4) The individual who is the subject of the report, his/her attorney or his/her authorized representative.

5) The Division's Dental Coordinator.

f) The reports shall also be admissible as evidence at any hearing arising from any charge by the Division that the impaired individual failed to comply with any terms and conditions of any agreement with the Division or otherwise violated the Dental Practice Act during the period an agreement is in effect.

g) The reports may also be handled or processed by other designated persons in a limited manner necessary to implement reports required under the Act or this Section by computer, word processing equipment or other mechanical means. The data record shall be limited to the name and address of the originator of the report, the date the initial report was received, the date of the most recent report and the professional license number of the subject of the report.

h) Upon determination by the Board that a report on an impaired person is no longer required for review and consideration, the Board shall notify the maker of the reports to cease sending the reports. The Board's determination shall be based on, but not be limited to: the type of impairment and the type of rehabilitation program, length of supervision, occurrence of any relapses, and present status of the dentist's or dental hygienist's license.

(Source: Added at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.407 Death or Incapacitation of Dentist

a) The executor or administrator of a dentist's estate or the legal guardian or authorized representative of a dentist who has become incapacitated may contract with another dentist or dentists to continue the operations of the deceased or incapacitated dentist's practice for a period of no more than one year from the time of death or incapacitation of the dentist or until the practice is sold, whichever occurs first. [225 ILCS 25/38.2(a)]

b) An executor, administrator, guardian or authorized representative seeking authorization to contract with another dentist or dentists to continue a practice as referenced in subsection (a), shall file an application with the Division, on forms provided by the Division, that shall include:

1) The name and license number of the deceased or incapacitated dentist;

2) A signed affidavit certifying that the executor, administrator, guardian, or authorized representative understands that any interference by the executor, administrator, guardian, or authorized representative or any agent or assignee of the executor, administrator, guardian, or authorized representative with the contracting dentist's or dentists' practice of dentistry or professional judgment or any other violation of this Section is grounds for an immediate termination of the operations of the dental practice [225 ILCS 25/38.2(a)(1)(E)];

3) The required fee set forth in Section 1220.415;

4) The name and address of the dental practice;

5) The name, address and tax identification number of the estate;

6) The name and license number of each dentist who will operate the dental practice; and

7) A copy of the death certificate of the dentist, if applicable, or a copy of a physician's statement detailing the dentist's incapacitating condition as set forth in subsection (e).

c) A dental practice seeking to continue operations of a deceased or incapacitated dentist shall not begin until the provisions of subsection (b) have been met.

d) Within 30 days after the death or incapacitation of a dentist, the executor, administrator, guardian, or authorized representative shall send notification of the death or incapacitation by mail to the last known address of each patient of record that has seen the deceased or incapacitated dentist within the previous 12 months, with an explanation of how copies of the practitioner's records may be obtained. This notice may also contain any other relevant information concerning the continuation of the dental practice. [225 ILCS 38.2(a)(2)]

e) A licensed dentist shall be considered incapacitated if:

1) a physician licensed to practice medicine in all its branches has examined the licensee and has determined that the licensee lacks decision making capacity in order to competently and safely practice dentistry and that the incapacity is expected to continue for a minimum of 6 months;

2) that physician has made a written record of this determination and has signed the written record within 90 days after the examination; and

3) the written record has been delivered to the Department.

f) A declaration of incapacity or a determination of incapacity shall not be a bar to Department action pursuant to Section 23 of the Act.

g) After review for compliance with the standards set forth in this Section, the Division shall place the licensee's dental license in inactive or deceased status as appropriate.

h) Prior to the Division restoring a license that has been placed in inactive status due to an incapacitating illness or condition, the licensee shall:

1) request restoration in writing on forms supplied by the Department; and

2) provide a statement from a physician licensed to practice medicine in all its branches that the physician has examined the licensee and has determined that the licensee is no longer under the incapacitating illness or condition as stated in subsection (e) and that the licensee is not subject to any other incapacitating illness or condition that would affect the licensee's ability to competently and safely practice dentistry.

(Source: Added at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.410 Endorsement

a) A person seeking licensure in Illinois as a dentist, a dental specialist or a dental hygienist who is so licensed in another state or territory and has been lawfully practicing for at least 3 of the last 5 years prior to application in Illinois, may be granted licensure in Illinois upon proof that the requirements for licensure in the other jurisdiction are at least equal to the requirements in Illinois.

b) An applicant for a dental license shall file an application for licensure on forms provided by the Division, that shall include:

1) Certification of licensure in the original jurisdiction and from any jurisdiction where the applicant has been practicing within the last 5 years, stating:

A) The time during which the applicant was licensed in that jurisdiction, including the date of the original issuance of the license;

B) Whether the files of the jurisdiction contain any record of any disciplinary action taken or pending;

2) The applicant's National Board of Dentistry Examination scores, which must be forwarded to the Division from the Joint Commission on National Dental Examinations;

3) Certification of successful completion of 60 semester hours or its equivalent of college level pre-dental education and graduation from a course of instruction in a dental school that meets the minimum education standards of the Division specified in Section 1220.140;

4) After May 21, 1993, for dental applicants who graduated from a dental college or school outside of the United States or Canada:

A) Certification of graduation from a dental college or school;

B) Certification that the applicant was authorized to practice in the jurisdiction in which the applicant attended dental school; and

C) Certification from an approved dental college or school in the United States or Canada that the applicant has completed a minimum of 2 years of clinical training at the school in which the applicant met the same level of scientific knowledge and clinical competence as all graduates from that school or college. The 2 years of clinical training shall consist of:

i) 2850 clock hours completed in 2 academic years for full-time applicants; or

ii) 2850 clock hours completed in 4 years with a minimum of 700 hours per year for part-time applicants;

5) Verification of employment;

6) The fee required under Section 1220.415.

c) An applicant for a dental hygienist license shall file an application for licensure on forms provided by the Division, that shall include:

1) Certification of licensure in the original jurisdiction and from any jurisdiction where the applicant has been practicing within the last 5 years, stating:

A) The time during which the applicant was licensed in that jurisdiction, including the date of the original issuance of the license;

B) Whether the files of the jurisdiction contain any record of any disciplinary action taken or pending;

2) The applicant's National Dental Hygienist Board Examination scores, which must be forwarded to the Division from JCNDE;

3) Certification of 2 academic years of credit in an approved school of dental hygiene that meets the minimum education standards of the Division specified in Section 1220.250;

4) Verification of employment;

5) The fee required under Section 1220.415.

d) Applicants who have not actively practiced in 3 of the last 5 years may be required to complete additional testing, training, or remedial education as the Board may deem necessary in order to establish the applicant's present capacity to practice dentistry.

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.415 Fees

The following fees shall be paid to the Department and are not refundable:

a) Application Fees

1) The fee for application for initial license as a dentist is $250.

2) The fee for application as a dental specialist is $300.

3) The fee for application as a dental hygienist is $100.

4) Applicants for any examination shall be required to pay, either to the Department or to the designated testing service, a fee covering the cost of determining an applicant's eligibility and providing the examination. Failure to appear for the examination on the scheduled date, at the time and place specified, after the applicant's application for examination has been received and acknowledged by the Division or the designated testing service, shall result in the forfeiture of the examination fee.

5) The fee for application for a dentist licensed under the laws of another jurisdiction is $750.

6) The fee for application for a dental hygienist licensed under the laws of another jurisdiction is $300.

7) The fee for application for a dental sedation permit is $300.

8) The fee for application for a restricted faculty license is $250.

9) The fee for application for a temporary training license is $150.

10) The fee for application as a continuing education sponsor is $1,000.

11) The fee for application for a temporary visiting dentist is $100.

12) The fee for application for live patient clinical training is $100.

b) Renewal Fees

1) The fee for the renewal of a license as a dentist is $300 ($100 per year), pursuant to Section 21 of the Act.

2) The fee for the renewal of a license as a dental specialist is $300 ($100 per year), pursuant to Section 21 of the Act.

3) The fee for the renewal of a license as a dental hygienist is $150 ($50 per year), pursuant to Section 21 of the Act.

4) The fee for the renewal of a sedation permit is $300 ($100 per year).

5) The fee for the renewal of a license as a continuing education sponsor is $700.

6) The fee for the renewal of a restricted faculty license is $150.

c) General Fees

1) The fee for the restoration of a license other than from inactive status is $50 plus payment of all lapsed renewal fees.

2) The fee for the issuance of a duplicate license, for the issuance of a replacement license, for a license that has been lost or destroyed or for the issuance of a license with a change of name or address other than during the renewal period is $20. No fee is required for name and address changes on Division records when no duplicate license is issued.

3) The fee for a certification of a licensee's record for any purpose is $20.

4) The fee to have the scoring of an examination administered by the Division reviewed and verified is $20 plus any fees charged by the applicable testing service.

5) The fee for a roster of persons licensed in this State under the Act shall be the actual cost of producing the roster.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.421 Advertising

a) Persons licensed to practice dentistry in the State of Illinois may advertise in any medium or other form of public communication in a manner that is truthful, and that is not fraudulent, deceptive, inherently misleading or proven to be misleading in practice. The advertising shall contain all information necessary to make the communication not misleading and shall not contain any false or misleading statement or otherwise operate to deceive.

b) Information that may be contained in the advertising includes:

1) Dentist's name, address, office hours and telephone number;

2) Schools attended;

3) Announcement of the opening of, change of, or return to practice;

4) Announcement of additions to or deletions from professional dental staff (Section 45 of the Act);

5) Dentist's hospital affiliations;

6) Any specialty licenses held, Board certification, professional society memberships and any limitations or concentrations of practice;

7) Credit arrangements and/or acceptance of Medicare/Medicaid patients;

8) Foreign language ability;

9) Usual and customary fees for routine professional services that must include a statement that fees may be adjusted due to complications or unforeseen circumstances unless the fees do not vary under any circumstances;

10) Description of offices in which dentist practices, e.g., accessibility to the handicapped, laboratory facilities on the premises, convenience of parking; and

11) Other information about the dentist, the dentist's practice, or the types of practice in which the dentist will accept employment, which a reasonable person might regard as relevant in determining whether to seek the dentist's services. (Section 45 of the Act)

c) If an advertisement is communicated to the public over television, radio or the Internet, it shall be prerecorded and approved for broadcast by the dentist, and a recording of the actual transmission, including videotape, shall be retained by the dentist for a period of at least 3 years. Upon a written request from the Division, a dentist shall provide the Division with a copy of any such advertisement within 7 working days after receipt of the request (e.g., upon initiation of any investigation, receipt of a complaint, inquiry from the public, etc.).

d) Information that may be untruthful, fraudulent, deceptive, inherently misleading, or that has proven to be misleading in practice includes that which:

1) Contains a misrepresentation of fact or omits a material fact required to prevent deception;

2) Guarantees favorable results or creates false or unjustified expectations of favorable results;

3) Takes advantage of the potential client's fears, anxieties, vanities, or other emotions;

4) Contains exaggerations pertaining to the quality of dental care;

5) Describes as available products or services that are not permitted by the laws of this State and/or applicable Federal laws; and

6) Advertises professional services that the dentist is not licensed to render.

e) A dentist may incorporate as a professional service corporation or other business entity permitted to provide dental services under a fictitious or an assumed name; however, all advertisements for dental services to be performed by members or employees of the corporation or other business entity must comply with the following conditions:

1) A dentist licensed and practicing in Illinois shall be designated at each practice location for the corporation or other business entity who shall assume responsibility for all advertising in Illinois.

2) The name, office address and office phone number of the designated dentists shall appear in all advertising for the corporation or other business entity.

3) The names of the owners of the corporation or other business entity, if other than the designated dentists, shall appear in all advertising for the corporation or other business entity.

4) A list of all dentists employed by the corporation or other business entity who perform dental services shall be prominently displayed at the location where they practice.

5) If the corporation or other business entity offers to practice both general dentistry and any licensed specialty, all advertising for the specialty shall include the name of the licensed dental specialists who performs the specialty services.

f) When words relating to specialty practice are used in an advertisement, the advertisement must not imply that the dentist offering those services is licensed as a specialist unless he holds a specialty license issued by the Division. Words that cannot be used by a dentist unless licensed in that specialty are Endodontist, Pedodontist, Pediatric Dentist, Periodontist, Prosthodontist, Orthodontist, Dentist Anesthesiologist, Oral and Maxillofacial Radiologist, or Oral and Maxillofacial Surgeon. Terms such as "Specialist", "Practice Limited To" or "Limited To Specialty Of", with the name of the branch of dentistry practiced as a specialty, (endodontics, pedodontics (pediatric dentistry), periodontics, prosthodontics, orthodontics, oral and maxillofacial radiology, oral and maxillofacial surgery, and dental anesthesiology) shall be prima facie evidence that such dentist is holding himself out to the public as a specialist. A general dentist who advertises, in any media, using words or phrases customarily used by a specialist, except those prohibited above, but who does not hold a specialty license, shall include in the advertisement a prominent disclaimer that he or she is licensed only as a general dentist.

g) Any advertisements offering the availability of those recognized dental specialties specified in Section 1220.310, or offering the availability of some other "specialty" practice not specifically recognized by the Division shall contain a prominent disclaimer in the form of a statement setting forth the specialties in which the dentist is licensed in Illinois and/or a statement that the dentist is licensed to practice as a general dentist in Illinois.

h) Advertising shall not use language suggesting a dental specialty that is not specified in Section 1220.310 unless it contains the disclaimer required in subsection (g). Examples of language requiring disclaimer: family dentistry, cosmetic dentistry, restorative dentistry, preventive dentistry, hospital dentistry, implant dentistry, TMJ, cranio mandibular dentistry.

(Source: Amended at 48 Ill. Reg. 14138, effective September 10, 2024)

Section 1220.425 Referral Services

a) The practice of dentistry in the State of Illinois affects the public health, safety and welfare, and consequently regulation and control of the various aspects of dental practice is in the public interest. The offering to refer dental patients and the operation of a dental referral service is considered to be a matter of public interest.

b) If a dental referral service receives compensation or anything of value from dentists in exchange for making referrals, it must disclose in its advertisements and communications to the public that it is compensated. Failure to disclose in accordance with this Section shall be considered fee-splitting in violation of Section 23 of the Dental Practice Act.

c) If a person requesting a referral is expected to pay the referral service, there must be full disclosure of such fees at the time of the initial inquiry to the person using the service.

d) A referral service may only make referrals to licensed dentists or dental specialists who have consented in writing to accept referrals from that referral service.

e) A referral service shall not represent that it is able to practice dentistry as defined in Section 17 of the Dental Practice Act or practice dentistry, furnish dental advice or services, diagnose or treat conditions of the teeth, gums, or jaw, remove stains or calculus from teeth, or furnish, construct or repair dentures, bridges or other appliances or substitutes for natural teeth unless the referral service is operated by a licensed dentist. Any referral service operated by a licensed dentist that refers services to that dentist's own dental practice or a dental practice that he is in any way affiliated with shall disclose these facts at the time of such referral. Failure to comply with this provision shall be considered a violation of Section 8 of the Dental Practice Act.

f) This Section shall not apply to dentists who refer a patient for treatment or consultation to another dentist or dental specialist in the course of their dental practice.

(Source: Amended at 30 Ill. Reg. 19656, effective December 18, 2006)

Section 1220.431 Employment by Corporation (Repealed)

(Source: Repealed at 13 Ill. Reg. 4191, effective March 16, 1989)

Section 1220.435 Renewals (Repealed)

(Source: Repealed at 17 Ill. Reg. 1559, effective January 25, 1993)

Section 1220.440 Continuing Education

a) Continuing Education Hours Requirements

1) Each person who applies for renewal of a license as a dentist shall have completed 48 hours of continuing education (CE) relevant to the practice of dentistry during the prerenewal period.

2) Each person who applies for renewal of a license as a dental hygienist shall have completed 36 hours of CE relevant to the practice of dental hygiene during the prerenewal period.

3) A prerenewal period is the 36 months preceding September 30 of the year of the renewal.

4) A renewal applicant is not required to comply with CE requirements for the first renewal following the original issuance of a dental or dental hygienist license.

5) Continuing education is not required to renew a dental specialty license. The holder of a dental specialty license is, however, required to complete 48 hours to renew the dental license.

6) Dentists or dental hygienist licensed in Illinois but residing in other states shall comply with the CE requirements set forth in this Section.

7) Continuing education credit for hours used to satisfy the CE requirements of another state may be applied to fulfillment of the CE requirements of the State of Illinois.

b) Approved Continuing Education/Continuing Education Sponsors

1) All CE courses shall be relevant to the treatment and care of patients and shall be:

A) Clinical courses in dentistry and dental hygiene; or

B) Nonclinical subjects that relate to the skills necessary to provide dental or dental hygiene services and are supportive of clinical services (i.e., patient management, legal and ethical responsibilities, stress management). Courses not acceptable for the purpose of this definition include, but are not limited to, estate planning, financial planning, investments and personal health.

2) CE credit may be earned for verifiable attendance at or participation in any courses that meet the requirements of subsection (b)(1) given by one of the following sponsors:

A) American Dental Association and National Dental Association, its constituent and component/branch associations and the American Dental Association Continuing Education Recognition Programs;

B) American Dental Hygienist's Association and National Dental Hygienist's Association, its constituent and component/branch associations;

C) Dental programs approved by the Division as meeting minimum standards for an approved curriculum in dentistry under Section 1220.140 and dental hygiene programs approved under Section 1220.250;

D) Organizations of specialties recognized by the American Dental Association and its constituent and component/branch associations, which are:

i) Oral and maxillofacial surgery;

ii) Endodontics;

iii) Pediatric dentistry;

iv) Prosthodontics;

v) Orthodontics;

vi) Periodontology;

vii) Oral and maxillofacial radiology;

E) Academy of General Dentistry, its constituent and component/branch associations and approved sponsors;

F) American Dental Society of Anesthesiology and its constituent and component/branch associations;

G) Community colleges with an approved dental hygiene program if offered under the auspices of the dental hygiene program;

H) A college or university accredited by an agency approved by the U.S. Office of Education or a community college approved by the Illinois Community College Board;

I) A hospital that has been accredited by the Joint Commission on Accreditation of Healthcare Organizations;

J) The American Heart Association and the American Cancer Society;

K) A medical school that is accredited by the American Medical Association's Liaison Committee for Medical Education;

L) American Medical Association (AMA), specialty medical associations/organizations, the Accreditation Council on Continuing Medical Education;

M) Federal and State government agencies (i.e., dental division, military dental division, Veterans' Administration, etc.);

N) A sponsor whose course is approved by the National Board for Certification in Dental Laboratory Technology; or

O) A person, firm or association approved by the Division in accordance with subsection (c).

3) CE credit may be earned for completion of an individual study course (correspondence, audio or video course) sponsored by an approved sponsor. The courses shall include a test that the licensee must pass to obtain credit. No more than 50% of the required CE credit hours during a prerenewal period may be acquired through correspondence courses.

4) CE credit may be earned from teleconferencing courses with a moderator present given by an Illinois approved sponsor.

5) CE credit may be earned from courses leading to an advanced degree or specialty in dental or dental hygiene. The courses shall be allotted CE credit at the rate of 15 CE hours for each semester hour and 10 CE hours for each quarter hour of school credit awarded.

6) CE credit may be earned as an instructor of continuing education courses given by approved sponsors. Credit will be applied for every hour taught and only for the first presentation of the program (i.e., credit shall not be allowed for repetitious presentations). No more than 50% of the required CE credit hours during a prerenewal period may be acquired through teaching continuing education courses.

7) CE credit may be earned for presenting volunteer community oral health education programs. Credit will be applied for each hour of presentation documented by the program director. No more than 2 hours of the required CE credit hours during a prerenewal period may be acquired through presentation of volunteer community oral health education programs.

8) Continuing education hours required by a disciplinary order shall not be used to satisfy the continuing education requirements for license renewal.

9) If a renewal applicant will be earning or has earned CE hours in another jurisdiction, but is not licensed in that jurisdiction and the course is not presented by an Illinois approved sponsor, the applicant shall submit an individual program approval request form, along with a $20 processing fee, to have the program reviewed. The Board shall review and recommend approval or disapproval of the program using the criteria set forth in subsection (b)(1). Applicants may seek individual program approval prior to participation in the course or program. All individual program approval requests shall be submitted prior to the expiration date of the license.

c) Sponsor Application Pursuant to Subsection (b)(2)(O)

1) Entities seeking approval as CE sponsors pursuant to subsection (b)(2)(O) shall file an application, on forms supplied by the Division, along with the fee set forth in Section 1220.415(a)(9). The applicant shall certify on the application the following:

A) That all programs offered by the sponsor for CE credit will comply with the criteria in subsection (b)(1) and all other criteria in this Section;

B) That the sponsor will be responsible for providing a certificate of attendance and will maintain attendance records for at least 5 years. The certificate of attendance shall contain:

i) The name and address of the sponsor;

ii) The name, address and license number of the participant;

iii) A brief statement of the subject matter;

iv) The number of hours attended in each program;

v) An indication of whether the program fulfills CE requirements for dentist, dental hygienist or both;

vi) The date and place of the program; and

vii) The signature of the sponsor;

C) That, upon request by the Division, the sponsor will submit evidence (e.g., certificate of attendance or course materials) as is necessary to establish compliance with this Section. Evidence shall be required when the Division has reason to believe that there is not full compliance with this Part and that the information is necessary to ensure compliance.

2) To maintain approval as a sponsor, each sponsor shall submit to the Division by September 30 of each even-numbered year a renewal application, the fee set forth in Section 1220.415(b)(5) and a list of courses and programs offered within the last 24 months. The list shall include a brief description, location, date and time of each course given.

3) The sponsor shall be responsible for ensuring that any dentist or dental hygienist who will be performing some type of procedure as a part of a continuing education course shall have a current license in Illinois or another jurisdiction.

d) Certification of Compliance with CE Requirements

1) Each renewal applicant shall certify, on the renewal application, to full compliance with the CE requirements set forth in subsection (a).

2) The Division may require additional evidence (e.g., certificate of attendance, transcripts and proof of registration) demonstrating compliance with the CE requirements. It is the responsibility of each renewal applicant to retain or otherwise produce evidence of the compliance. The evidence shall be retained for at least 5 years following the renewal period in which the CE was taken.

3) The Division may conduct random audits to verify compliance with CE requirements.

4) When there is evidence of a lack of compliance with CE requirements, an applicant shall be notified in writing and may request a hearing before the Board. The Division may recommend that steps be taken to begin the formal disciplinary proceedings as required by Section 10-65 of the Illinois Administrative Procedure Act [5 ILCS 100/10-65].

e) Waiver of CE Requirements

1) Any renewal applicant seeking renewal of the license or certificate without having fully complied with these CE requirements shall file with the Division a renewal application, a statement setting forth the facts concerning the noncompliance, a request for waiver of the CE requirements on the basis of the facts and, if desired, a request for an interview before the Board. If the Division finds, from the statement or any other evidence submitted, that good cause has been shown for granting a waiver of the CE requirements, or any part thereof, the Division shall waive enforcement of those requirements for the renewal period for which the applicant has applied.

2) Good cause shall be defined as an inability to devote sufficient hours to fulfilling the CE requirements during the applicable prerenewal period because of:

A) Full-time service in the armed forces of the United States of America during a substantial part of that period;

B) A temporary incapacitating illness documented by a licensed physician. A second, consecutive request for a CE waiver pursuant to this subsection (e)(2)(B) shall be prima facie proof that the renewal applicant has a physical or mental illness, including, but not limited to, deterioration through the aging process, or loss of motor skills that results in the dentist's inability to practice dentistry with reasonable judgment, skill or safety, in violation of Section 23(24) of the Act, and shall be grounds for denial of the renewal or other discipline;

C) Temporary undue hardship (e.g., prolonged hospitalization, being disabled and unable to practice dentistry or dental hygiene on a temporary basis).

3) If an interview is requested at the time the request for waiver is filed with the Division, the renewal applicant shall be given at least 20 days written notice of the date, time and place of the interview by certified mail, return receipt requested.

(Source: Amended at 40 Ill. Reg. 12553, effective September 2, 2016)

Section 1220.441 Granting Variances

The Director may grant variances from this Part in individual cases when the Director finds that:

a) the provision from which the variance is granted is not statutorily mandated;

b) no party will be injured by the granting of the variance; and

c) the rule from which the variance is granted would, in the particular case, be unreasonable or unnecessarily burdensome.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

SUBPART E: ANESTHESIA PERMITS

Section 1220.500 Definitions

"Anesthesia Case" means a situation in which the permit holder is responsible for anesthesia care on a live patient.

"Deep Sedation" means a pharmacologically induced depressed state of consciousness, accompanied by partial loss of protective reflexes, including the inability to respond purposefully to oral commands. The purposeful response to painful stimulation is maintained.

"General Anesthesia" means a pharmacologically induced state of unconsciousness accompanied by a partial or complete loss of protective reflexes, including the inability to independently maintain an airway and respond purposefully to painful stimulation or oral commands.

"Minimal Sedation" means a minimally depressed level of consciousness, produced by a pharmacological method, that retains the patient's ability to independently and continually maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected.

"Moderate Sedation" or "Conscious Sedation" means a pharmacologically induced depressed state of consciousness (altered consciousness; signs of sleep) under which an individual retains the ability to independently and continuously maintain an airway and respond appropriately to light tactile stimulation and oral commands.

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.505 Minimal Sedation in the Dental Office Setting

a) Minimal sedation includes the prescription or administration of a pharmacologic anxiolitic either with or without concomitant use of nitrous oxide dental analgesia. The drugs and/or techniques used must carry a margin of safety wide enough to prevent a depressed level of consciousness.

b) No permit is required beyond the D.D.S. or D.M.D. degrees.

c) Minimal monitoring of the patient is to be by clinical observation and appropriately documented in the patient's record.

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)

Section 1220.510 Moderate Sedation (Conscious Sedation) in the Dental Office Setting

a) Moderate sedation (conscious sedation) includes the prescription or administration of pharmacologic agents to be used for the purposes of moderate sedation. Moderate sedation (conscious sedation) must be administered by an individual qualified under this Section. (See Appendix D for characteristics of levels of anesthesia.) The drugs and/or techniques used must carry a margin of safety wide enough to render unintended loss of consciousness unlikely.

b) A licensed dentist seeking a Permit A for moderate sedation (conscious sedation) administration privileges shall file an application with the Division, on forms provided by the Division, that shall include:

1) Certification of completion of an anesthesiology training program that meets the following requirements:

A) Include a minimum of 75 hours of didactic and clinical study that includes training in moderate sedation (conscious sedation), physical evaluation, venipuncture, advanced airway management, technical administration, recognition and management of complications and emergencies, and monitoring with additionally supervised experience in providing moderate sedation to 20 or more patients; and

B) Be an organized sequence of study operated by one entity and completed in less than one calendar year;

2) A signed affidavit certifying that:

A) the dentist will practice in a facility properly equipped in accordance with subsection (g) for the administration of moderate sedation (conscious sedation);

B) the facility will be staffed with a team, supervised by the applicant, that will remain in the treatment room. For each patient, the anesthesia team will consist of at least:

i) the dentist who holds the Permit A;

ii) one dental hygienist or dental assistant who has completed the training prescribed in Section 1220.240(f) or 1220.245(c)(2) and is capable of assisting with procedures, problems and emergencies incident to the administration of sedation; and

iii) one additional hygienist or dental assistant;

C) the dentist permit holder will remain immediately available to the patient after being treated under moderate sedation. A dental hygienist or dental assistant trained to monitor a patient under moderate sedation will remain with the sedated patient until the patient is no longer sedated;

D) all members of the anesthesia team are capable of assisting with procedures, problems and emergencies incident to the administration of sedation and will maintain current certification in BLS; and

E) for the dentist permit holder, the BLS certification is in addition to the required 9 sedation technique CE hours (see subsection (k)) required per renewal cycle;

3) Proof of current ACLS certification or PALS certification; and

4) The required fee set forth in Section 1220.415.

c) Dentists who have a current valid permit for moderate sedation (conscious sedation) issued by the Division shall be permitted to administer without additional application.

d) In accordance with the standards set forth in this Section, the Division will:

1) Issue a moderate sedation (conscious sedation) permit (Permit A).

2) Re-issue a moderate sedation (conscious sedation) permit to Permit A holders who attest to completing continuing education.

e) Licensees qualified to administer deep sedation (Permit B) pursuant to Section 1220.520 may administer moderate sedation (conscious sedation) without a Permit A.

f) If the accuracy, relevance or sufficiency of any submitted documentation is questioned by the Division or the Board, because of discrepancies or conflicts in information, needing further clarification, and/or missing information, additional documentation may be required and/or an on-site evaluation of the facilities, equipment and personnel may be conducted by the Division or a member of the Board's Anesthesia Review Panel.

g) A properly equipped facility for the administration of moderation sedation (conscious sedation) shall include at minimum:

1) Sphygmomanometer and stethoscope;

2) An oxygen delivery system with full face masks and connectors appropriate to the patient population being served that is capable of delivering oxygen to the patient under positive pressure, with an emergency backup system;

3) Emergency drugs and equipment appropriate to the medications administered;

4) Suction equipment, including an emergency backup suction system;

5) An emergency backup lighting system that will permit the completion of any operation underway;

6) A pulse oximeter;

7) Laryngoscope complete with selection of blades and spare batteries and bulbs in sizes appropriate to the patient population being served;

8) Advanced airway devices that would isolate the trachea and facilitate positive pressure oxygen administration in sizes appropriate for the patient population being served (e.g., endotracheal tubes or laryngeal mask airway);

9) Tonsillar or pharyngeal suction tips adaptable to all office outlets;

10) Nasal and oral airways in sizes appropriate to the patient population being served;

11) Defibrillator (an automated external defibrillator is an acceptable defibrillator);

12) Equipment for the establishment of an intravenous infusion;

13) An operating table or an operating chair that permits appropriate access to the patient and provides a firm platform for the management of cardiopulmonary resuscitation; and

14) A recovery area that has available oxygen, lighting, suction and electrical outlets. The Permit A holder shall remain with the patient until the patient retains the ability to independently and consciously maintain an airway and respond appropriately to physical stimulation and oral commands. The recovery area may be the operating theatre.

h) The following records shall be kept during the administration of moderate sedation (conscious sedation):

1) Medical history of the patient and consent for administration of anesthesia prior to the performance of any procedure;

2) Preoperative, intraoperative and pre-discharge monitoring of blood pressure, pulse, respiration and oxygen saturation. A time based record shall be entered into the patient's chart;

3) Drugs and dosages of these drugs used during the operative procedure, including the identification of the person administering drugs and times of their administration over the course of the procedure.

i) The dentist who holds the Permit A shall report adverse occurrences to the Division and the Board as required by Section 1220.405.

j) A licensed dentist shall hold Permit A in order to perform dentistry while a licensed certified nurse anesthetist administers moderate sedation (conscious sedation). A nurse anesthetist for purposes of this Section is a licensed certified nurse anesthetist who holds a license as an advanced practice nurse under the Nurse Practice Act [225 ILCS 65]. The dentist shall enter into a written collaborative agreement with the nurse anesthetist consisting of the requirements of this section as follows: A certified registered nurse anesthetist who provides anesthesia services in a dental office shall enter into a written collaborative agreement with the operating dentist performing the procedure. The agreement shall describe the working relationship of the nurse anesthetist and the operating dentist and shall authorize the categories of care, treatment, or procedures to be performed by the nurse anesthetist. In a collaborating dentist office, the nurse anesthetist may only provide those services that the operating dentist with the appropriate permit is authorized to provide as found in 68 Ill. Adm. Code 1220.510 and 1220.520. For anesthesia services, the operating dentist shall approve the anesthesia plan prepared by the nurse anesthetist and shall remain physically present and be available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions. The nurse anesthetist may select, order, and administer medications, including controlled substances, and apply appropriate medical devices for delivery of anesthesia services under the anesthesia plan agreed with by the operating dentist.

k) Proof of 9 hours of continuing education per renewal cycle in sedation techniques, including medications and recognition and management of complications and emergencies, is required for renewal of Permit A.

l) A treating dentist does not need to hold Permit A to perform dentistry when another dentist, who holds Permit A or Permit B, or a physician or dental anesthesiologist assists the treating dentist by administering moderate sedation (conscious sedation). Physician for purposes of this Section means a physician who is licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 [225 ILCS 60] and is authorized to provide anesthesia services in a licensed hospital or licensed ambulatory surgical treatment center or is a Board-certified anesthesiologist.

1) The treating dentist shall be prepared to provide affidavits to the following if requested by the Division:

A) That the facility used for sedation meets the criteria of subsection (g) of this Section;

B) That the dentist shall staff the facility with a team, supervised by the permit holder or physician, that includes a minimum of 3 individuals per patient. The team shall be composed of either:

i) One dental hygienist or dental assistant; the treating dentist; and the dentist who holds a Permit A or B providing the anesthesia services; or

ii) One dental hygienist or dental assistant; the treating dentist; and a dental anesthesiologist or physician performing the anesthesia services.

C) That the permit holder or physician will remain immediately available to the patient after being treated under moderate sedation. A dental hygienist or dental assistant trained to monitor a patient under moderate sedation will remain with the sedated patient until the patient is no longer sedated.

2) All members of the team, including the treating dentist (non-permit holder) must maintain current BLS certification or its equivalent.

3) In addition, the dentist (non-permit holder) shall report adverse occurrences to the Division as set forth in Section 1220.405 and accept the responsibility to verify the certification and licensure of any licensed provider present during the moderate sedation (conscious sedation) of a patient who is receiving dental care.

m) A dentist holding a Permit A shall maintain current ACLS or PALS certification. ACLS or PALS certification shall be in addition to the required 9 hours of anesthesia CE per renewal cycle.

n) A dentist holding a Permit A shall maintain a logbook indicating the sedation cases performed. The log shall include the patient name, date, route of sedation administration, drug name and dosage, and the names of anesthesia team members assisting. This information shall be supplied to the Division upon request.

o) A dentist holding a Permit A must also hold an active Illinois Controlled Substances License and current federal Drug Enforcement Administration registration.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.520 Deep Sedation and General Anesthesia in the Dental Office Setting

Deep sedation and general anesthesia must be administered by an individual qualified under this Section. (See Appendix D for characteristics of levels of anesthesia.)

a) A licensed dentist seeking a permit to administer deep sedation or general anesthesia shall make application to the Division, on forms provided by the Division, that shall include:

1) Certification of meeting one or more of the following:

A) Completion of a minimum of 2 years of advanced training in anesthesiology beyond the pre-doctoral level, in a training program approved by the American Dental Association, Commission on Dental Education, as outlined in Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students, published by the American Dental Association, Commission on Dental Education (October 2012).

B) Be a diplomate of the American Board of Oral and Maxillofacial Surgery.

C) Have an active, approved application with the American Board of Oral and Maxillofacial Surgery to obtain diplomat status.

D) Have a specialty license in oral and maxillofacial surgery issued by the Division;

2) A signed affidavit certifying that:

A) the dentist will practice in a facility properly equipped in accordance with subsection (d) for the administration of deep sedation and general anesthesia;

B) the facility will be staffed with an anesthesia team, supervised by the applicant, that will remain in the treatment room during the procedure on the patient. For each patient, the anesthesia team will consist of at least:

i) the dentist who holds the permit B;

iii) one additional hygienist or dental assistant;

C) the dentist permit holder will remain immediately available to the patient after being treated under deep sedation or general anesthesia. A dental hygienist or dental assistant trained to monitor a patient under deep sedation or general anesthesia will remain with the sedated patient until the patient is no longer sedated;

D) all members of the anesthesia team are capable of assisting with procedures, problems and emergencies incident to the administration of sedation and will maintain current certification in BLS or its equivalent; and

E) for the dentist permit holder, the BLS certification is in addition to the required 9 sedation technique CE hours (see subsection (h)) required per renewal cycle;

3) Proof of current ACLS or PALS certification; and

4) The required fee set forth in Section 1220.415.

b) In accordance with the standards set forth in this Section, the Division will issue a deep sedation or general anesthesia permit (Permit B).

c) If the accuracy, relevance or sufficiency of any submitted documentation is questioned by the Division or the Board because of discrepancies or conflicts in information needing further clarification, and/or missing information, additional documentation may be required and/or an on-site evaluation of the facilities, equipment and personnel may be conducted by the Division or a member of the Board's Anesthesia Review Panel.

d) A properly equipped facility for the administration of deep sedation or general anesthesia shall include, at a minimum:

1) Sphygmomanometer and stethoscope;

3) Emergency drugs and equipment appropriate to the medications administered;

4) Suction equipment, including an emergency backup suction system;

5) An emergency backup lighting system that will permit the completion of any operation underway;

6) Laryngoscope complete with selection of blades and spare batteries and bulbs in sizes appropriate to the patient population being served;

7) Endotracheal tubes and connectors in sizes appropriate for the patient population being served;

8) Tonsillar or pharyngeal suction tips adaptable to all office outlets;

9) Nasal and oral airways in sizes appropriate to the patient population being served;

10) Device for monitoring temperature (e.g., temperature strips, thermometer);

11) Electrocardioscope and defibrillator (an automated external defibrillator is an acceptable defibrillator);

12) Pulse oximeter;

13) Equipment for the establishment of an intravenous infusion;

14) An operating table or an operating chair that permits appropriate access to the patient and provides a firm platform for the management of cardiopulmonary resuscitation; and

15) A recovery area that has available oxygen, lighting, suction and electrical outlets. The Permit B holder shall remain with the patient until the patient retains the ability to independently and consciously maintain an airway and respond appropriately to physical stimulation and oral commands. The recovery area may be the operating theatre.

e) The following records shall be kept when administering deep sedation and general anesthesia:

1) Medical history and patient evaluation prior to the performance of any procedure;

2) Preoperative, intraoperative, and pre-discharge monitoring of blood pressure, pulse, respiration and oxygen saturation. A time based record shall be entered into the patient's chart;

3) EKG monitoring during the entire procedure;

4) Drugs and dosages of agents used during the operative procedure, including nitrous oxide and oxygen, and including identification of the person administering drugs and times of their administration over the course of the procedure. Documentation of the anesthetic encounter will be consistent with currently accepted standards of anesthetic practice.

f) The dentist who holds the Permit B shall report adverse occurrences to the Division and the Board as required by Section 1220.405.

g) A licensed dentist shall hold a Permit B in order to perform dentistry while a licensed certified nurse anesthetist administers deep sedation or general anesthesia. A nurse anesthetist for purposes of this Section is a licensed certified nurse anesthetist who holds a license as an advanced practice nurse under the Nurse Practice Act. The dentist shall enter into a written collaborative agreement with the nurse anesthetist in accordance with the following:

1) A certified registered nurse anesthetist who provides anesthesia services in a dental office shall enter into a written collaborative agreement with the operating dentist performing the procedure. The agreement shall describe the working relationship of the nurse anesthetist and the operating dentist and shall authorize the categories of care, treatment, or procedures to be performed by the nurse anesthetist. In a collaborating dentist office, the nurse anesthetist may only provide those services that the operating dentist with the appropriate permit is authorized to provide as found in 68 Ill. Adm. Code 1220.510 and 1220.520.

2) For anesthesia services, the operating dentist shall approve the anesthesia plan prepared by the nurse anesthetist and shall remain physically present and be available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions. The nurse anesthetist may select, order, and administer medications, including controlled substances, and apply appropriate medical devices for delivery of anesthesia services under the anesthesia plan agreed with by the operating dentist.

h) Proof of 9 hours of continuing education per renewal cycle in sedation techniques, including medications and recognition and management of complications and emergencies, is required for renewal of Permit B.

i) A treating dentist does not need to hold Permit B to perform dentistry when another dentist, who holds Permit B, or a physician or dental anesthesiologist assists the treating dentist by administering deep sedation or general anesthesia. Physician for purposes of this Section means a physician who is licensed to practice medicine in all of its branches under the Medical Practice Act of 1987 and is authorized to provide anesthesia services in a licensed hospital or licensed ambulatory surgical treatment center or is a Board-certified anesthesiologist.

1) The treating dentist shall be prepared to provide affidavits attesting to the following if requested by the Division:

A) That the facility used is equipped as specified in subsection (d);

B) That the dentist shall staff the facility with a team, supervised by the Permit B holder or physician, that includes a minimum of 3 individuals per patient. The team shall be composed of either:

i) One dental hygienist or dental assistant who has completed the training prescribed in Section 1220.240(f) or 1220.245(c)(2) capable of assisting with procedures, problems and emergencies incident to the administration of the sedation; the treating dentist; and the dentist who holds a Permit B providing the anesthesia services;

ii) One dental hygienist or dental assistant; the treating dentist; and a physician providing the anesthesia services; or

iii) One dental hygienist or dental assistant; the treating dentist; and a dental anesthesiologist providing the anesthesia services.

C) That the Permit B holder will remain with the patient until the patient retains the ability to independently and consciously maintain an airway and respond appropriately to physical stimulation and oral commands. The recovery area may be the operating theatre.

2) All members of the anesthesia team, including the treating dentist (non-Permit B holder) must maintain certification in BLS or its equivalent.

3) In addition, the dentist shall report severe adverse occurrences to the Division as set forth in Section 1220.405 and accept the responsibility for verifying certification and licensure of any licensed provider present during the deep sedation or general anesthesia of a patient receiving dental care.

j) A dentist holding a Permit B shall maintain current ACLS or PALS certification. ACLS or PALS certification shall be in addition to the required 9 hours of anesthesia CE per renewal cycle.

k) A dentist holding a Permit B shall maintain a logbook indicating the sedation cases performed. The log shall include the patient name, date, route of sedation administration, drug name and dosage, and the names of anesthesia team members assisting. This information shall be supplied to the Division upon request.

l) A dentist holding a Permit B must also hold an active Illinois Controlled Substances License and current federal Drug Enforcement Administration registration.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.525 Renewal

a) Beginning with the September 30, 2006 renewal, every anesthesia permit issued under the Act shall expire on September 30 every 3 years. The holder of a permit may renew the permit during the month preceding the expiration date by paying the required fee in Section 1220.415 and completing the following:

1) 9 hours of continuing education as required in Section 1220.510(k) or 1220.520(h).

2) Certification of the number of anesthesia cases that the renewal applicant has performed.

3) Certification that the renewal applicant has held at least semiannual emergency drills with staff that participates in Permit A or B related activities. These drills shall consist of the staff actively going through simulated emergencies that may occur during the administration of anesthesia. It is incumbent upon the permit holder to design the emergency drills to ensure adequate preparation of staff in the case of a real emergency. In addition, the staff shall assemble and review the necessary office emergency supplies and equipment intended for use in an actual office emergency, including verifying the expiration dates for emergency medications and checking that batteries for defibrillators and laryngoscopes are properly charged. Documentation of the semiannual drills shall be provided to the Division upon request.

b) No anesthesia permit shall be renewed if the dental license of the permit holder is expired, revoked, suspended or otherwise subject to discipline under Section 23 of the Act.

d) Certification of Anesthesia Cases

1) Each renewal applicant shall certify, on the renewal application, the number of anesthesia cases performed each year by the renewal applicant appropriate to the permit held.

2) The licensee shall be required to maintain the logbooks required in Section 1220.510(n) or 1220.520(k) and shall provide the logbook to the Division upon request.

3) The Division may conduct audits to verify compliance and/or competency. When a licensee is reviewed, the Division will provide notice to the licensee and request that the licensee's anesthesia logbook be submitted. Within 14 days after receipt of the notice, the licensee shall submit to the Division the records required to be kept pursuant to Section 1220.510(h) or 1220.520(e), as appropriate to the permit held, of all anesthesia cases performed during the renewal cycle.

4) When the Division has reason to believe that there is a lack of competency or a lack of compliance, a licensee shall be notified in writing and may request a conference before the Division with a Board member present. When the Division finds a violation of the Act or this Part, it may recommend that steps be taken to begin formal disciplinary proceedings.

(Source: Amended at 34 Ill. Reg. 7205, effective May 5, 2010)

Section 1220.530 Anesthesia Review Panel

a) The Director may appoint an Anesthesia Review Panel that shall consist of six members.

b) The members shall meet the following minimum requirements:

1) Each member shall be a licensed dentist in the State of Illinois whose license is active and in good standing;

2) Three members shall hold an active Permit A;

3) Three members shall hold an active Permit B.

c) The Panel shall:

1) Meet only at the direction of the Director;

2) Be reimbursed for all legitimate, necessary and authorized expenses incurred in attending the meetings of the panel;

3) Review Permit A and Permit B applications at the request of the Director;

4) Recommend to the Director the eligibility of applicants;

5) Recommend to the Director when an on-site inspection may be necessary and conduct an inspection with a Board member present;

6) Evaluate results of on-site inspection and make recommendation to the Director as to eligibility of applicants; and

7) Advise the Director in regard to anesthesiology related matters that include mortality and morbidity statistics.

d) Each Panel member shall serve a 4 year term and may be appointed once.

(Source: Amended at 34 Ill. Reg. 7205, effective May 5, 2010)

Section 1220.540 Approved Programs in Anesthesiology (Repealed)

(Source: Repealed at 34 Ill. Reg. 7205, effective May 5, 2010)

Section 1220.550 Reporting of Adverse Occurrences (Repealed)

(Source: Repealed at 22 Ill. Reg. 14880, effective July 29, 1998)

Section 1220.560 Restoration of Permits

a) A licensee seeking restoration of a permit after it has expired for 12 months or less shall have the permit restored upon payment of $20 plus the current renewal fee. The licensee shall also submit certification of anesthesia cases as provided in Section 1220.525(d) and the records required to be kept pursuant to Section 1220.510(n) or 1220.520(k), as appropriate to the permit held, of all anesthesia cases performed since the permit was last renewed. The permit will be restored if the Division finds that the applicant is competent to provide anesthesia services appropriate to the permit for which restoration is sought.

b) A licensee seeking restoration of a permit after it has expired for more than 12 months shall file an application, on forms supplied by the Division, together with the fees required by Section 1220.415. The licensee shall also submit:

1) Sworn evidence of lawful active practice in another jurisdiction. The evidence shall include a statement from the appropriate board or licensing authority in the other jurisdiction that the licensee was authorized to practice during the term of said active practice; or

2) An affidavit attesting to military service as provided in Section 16 of the Act. If an applicant applies for restoration of the permit within 2 years after termination of such service, he/she shall have the permit restored without paying any lapsed renewal or restoration fees; or

3) For Permit A restoration, proof of the training set forth in Section 1220.510(b)(1) taken 2 years prior to application; or

4) For Permit B restoration, proof of the training set forth in Section 1220.520(a)(1) taken 2 years prior to application.

c) When proof of remedial training is provided, the permit shall not be restored unless and until the Board has reviewed and approved the training. The Board may require the renewal applicant to obtain additional training when it finds that the training completed was not sufficient.

d) A licensee who has been granted restoration, whose license has not been active for less than 5 years due to discipline, and whose license expired during the period of discipline, must comply with the requirements of subsection (a). If the licensee has not had an active license for 5 years or more due to discipline, the licensee must show proof of certification of training pursuant to Sections 1220.510(b) and/or 1220.520(a) or shall be required to complete such additional testing, training, or remedial education as the Board may deem necessary in order to establish the licensee’s present capacity to practice dentistry with reasonable judgment, skill and safety.

(Source: Amended at 47 Ill. Reg. 1672, effective January 23, 2023)

Section 1220.APPENDIX A Pre-clinical Restorative Dentistry Sub-section (Repealed)

Section 1220.APPENDIX A Pre-clinical Restorative Dentistry Sub-section (Repealed)

(Source: Repealed at 13 Ill. Reg. 4191, effective March 16, 1989)

Section 1220.APPENDIX B Dental Assistant Permitted Procedures (Repealed)

(Source: Repealed at 24 Ill. Reg. 13992, effective August 31, 2000)

Section 1220.APPENDIX C Dental Hygienist Permitted Procedures (Repealed)

(Source: Repealed at 24 Ill. Reg. 13992, effective August 31, 2000)

Section 1220.APPENDIX D Characteristics of Levels of Anesthesia*

Factors	Minimal Sedation (No Permit required)	Moderate/Conscious Sedation (Permit A)	Deep Sedation (Permit B)	General Anesthesia (Permit B)
Goal	Decrease anxiety; facilitate coping skills	Decrease or eliminate anxiety; facilitate coping skills	Eliminate anxiety; coping skills over-ridden	Eliminate cognitive, sensory and skeletal motor activity
Definition	Minimally depressed level of consciousness, produced by a pharmacological method, that retains the patient's ability to independently and continually maintain an airway and respond normally to tactile stimulation and verbal command. Although cognitive function and coordination may be modestly impaired, ventilatory and cardiovascular functions are unaffected	Pharmacologically induced depressed state of consciousness (altered consciousness, signs of sleep) under which an individual retains the ability to independently and continuously maintain an airway and respond appropriately to light tactile stimulation and oral commands	Pharmacologically induced controlled state of depressed consciousness, accompanied by partial loss of protective reflexes, including inability to respond purposefully to oral commands. The purposeful response to painful stimulation is maintained	Pharmacologically induced controlled state of unconsciousness accompanied by a partial or complete loss of protective reflexes, including inability to independently maintain an airway and respond purposefully to painful stimulation or oral commands
Personnel	1 (treating dentist)	3 (treating dentist with Permit A; trained person to monitor patient or nurse anesthetist; trained assistant) OR 3 (treating dentist w/o Permit A/B; physician or dentist with Permit A/B; trained assistant)	3 (treating dentist with Permit B; trained person to monitor patient or nurse anesthetist; trained assistant) OR 3 (treating dentist w/o Permit B; physician or dentist with Permit B; trained assistant)	3 (treating dentist with Permit B; trained person to monitor patient or nurse anesthetist, trained assistant) OR 3 (treating dentist w/o Permit B; physician or dentist with Permit B; trained assistant)
Monitoring	Clinical observation and monitoring as appropriate	Preoperative, intraoperative and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation	Preoperative, intraoperative, and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation, EKG monitoring. Defibrillator required	Preoperative, intraoperative, and pre-discharge monitoring of BP, pulse, respiration and oxygen saturation, EKG monitoring. Defibrillator required

* Chart adapted from American Academy of Pediatric Dentistry, Reference Manual 2000-2001, Templates of Definitions and Characteristics for Levels of Sedation and General Anesthesia and the American Dental Association, Guidelines for the Use of Sedation and General Anesthesia by Dentists (October 2012).

(Source: Amended at 38 Ill. Reg. 15907, effective July 25, 2014)