State of Illinois
2023 and 2024


Introduced 2/14/2023, by Rep. Katie Stuart


225 ILCS 25/4  from Ch. 111, par. 2304
225 ILCS 25/17  from Ch. 111, par. 2317
225 ILCS 25/18  from Ch. 111, par. 2318
225 ILCS 25/18.1

    Amends the Illinois Dental Practice Act. Changes the definition of "public health supervision". Provides that without the supervision of a dentist, a dental hygienist may perform dental health education functions, including instruction in proper oral health care and dental hygiene in, for example, a school setting, a long-term care facility, and a health fair (rather than just either a school setting and a long-term care facility). Provides that a dental hygienist may record case (rather than care) histories and oral conditions. Provides that a dentist may enter into an agreement for public health supervision with 4 (rather than 2) public health dental hygienists. Provides that the Department of Public Health Oral Health Section shall compile and publicize public health dental hygienist service data annually. Makes other changes.

LRB103 30203 AMQ 56631 b





HB2267LRB103 30203 AMQ 56631 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Dental Practice Act is amended by
5changing Sections 4, 17, 18, and 18.1 as follows:
6    (225 ILCS 25/4)   (from Ch. 111, par. 2304)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 4. Definitions. As used in this Act:
9    "Address of record" means the designated address recorded
10by the Department in the applicant's or licensee's application
11file or license file as maintained by the Department's
12licensure maintenance unit. It is the duty of the applicant or
13licensee to inform the Department of any change of address and
14those changes must be made either through the Department's
15website or by contacting the Department.
16    "Department" means the Department of Financial and
17Professional Regulation.
18    "Secretary" means the Secretary of Financial and
19Professional Regulation.
20    "Board" means the Board of Dentistry.
21    "Dentist" means a person who has received a general
22license pursuant to paragraph (a) of Section 11 of this Act and
23who may perform any intraoral and extraoral procedure required



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1in the practice of dentistry and to whom is reserved the
2responsibilities specified in Section 17.
3    "Dental hygienist" means a person who holds a license
4under this Act to perform dental services as authorized by
5Section 18.
6    "Dental assistant" means an appropriately trained person
7who, under the supervision of a dentist, provides dental
8services as authorized by Section 17.
9    "Expanded function dental assistant" means a dental
10assistant who has completed the training required by Section
1117.1 of this Act.
12    "Dental laboratory" means a person, firm or corporation
14        (i) engages in making, providing, repairing or
15    altering dental prosthetic appliances and other artificial
16    materials and devices which are returned to a dentist for
17    insertion into the human oral cavity or which come in
18    contact with its adjacent structures and tissues; and
19        (ii) utilizes or employs a dental technician to
20    provide such services; and
21        (iii) performs such functions only for a dentist or
22    dentists.
23    "Supervision" means supervision of a dental hygienist or a
24dental assistant requiring that a dentist authorize the
25procedure, remain in the dental facility while the procedure
26is performed, and approve the work performed by the dental



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1hygienist or dental assistant before dismissal of the patient,
2but does not mean that the dentist must be present at all times
3in the treatment room.
4    "General supervision" means supervision of a dental
5hygienist requiring that the patient be a patient of record,
6that the dentist examine the patient in accordance with
7Section 18 prior to treatment by the dental hygienist, and
8that the dentist authorize the procedures which are being
9carried out by a notation in the patient's record, but not
10requiring that a dentist be present when the authorized
11procedures are being performed. The issuance of a prescription
12to a dental laboratory by a dentist does not constitute
13general supervision.
14    "Public member" means a person who is not a health
15professional. For purposes of board membership, any person
16with a significant financial interest in a health service or
17profession is not a public member.
18    "Dentistry" means the healing art which is concerned with
19the examination, diagnosis, treatment planning and care of
20conditions within the human oral cavity and its adjacent
21tissues and structures, as further specified in Section 17.
22    "Branches of dentistry" means the various specialties of
23dentistry which, for purposes of this Act, shall be limited to
24the following: endodontics, oral and maxillofacial surgery,
25orthodontics and dentofacial orthopedics, pediatric dentistry,
26periodontics, prosthodontics, oral and maxillofacial



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1radiology, and dental anesthesiology.
2    "Specialist" means a dentist who has received a specialty
3license pursuant to Section 11(b).
4    "Dental technician" means a person who owns, operates or
5is employed by a dental laboratory and engages in making,
6providing, repairing or altering dental prosthetic appliances
7and other artificial materials and devices which are returned
8to a dentist for insertion into the human oral cavity or which
9come in contact with its adjacent structures and tissues.
10    "Impaired dentist" or "impaired dental hygienist" means a
11dentist or dental hygienist who is unable to practice with
12reasonable skill and safety because of a physical or mental
13disability as evidenced by a written determination or written
14consent based on clinical evidence, including deterioration
15through the aging process, loss of motor skills, abuse of
16drugs or alcohol, or a psychiatric disorder, of sufficient
17degree to diminish the person's ability to deliver competent
18patient care.
19    "Nurse" means a registered professional nurse, a certified
20registered nurse anesthetist licensed as an advanced practice
21registered nurse, or a licensed practical nurse licensed under
22the Nurse Practice Act.
23    "Patient of record" means a patient for whom the patient's
24most recent dentist has obtained a relevant medical and dental
25history and on whom the dentist has performed an examination
26and evaluated the condition to be treated.



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1    "Dental responder" means a dentist or dental hygienist who
2is appropriately certified in disaster preparedness,
3immunizations, and dental humanitarian medical response
4consistent with the Society of Disaster Medicine and Public
5Health and training certified by the National Incident
6Management System or the National Disaster Life Support
8    "Mobile dental van or portable dental unit" means any
9self-contained or portable dental unit in which dentistry is
10practiced that can be moved, towed, or transported from one
11location to another in order to establish a location where
12dental services can be provided.
13    "Public health dental hygienist" means a hygienist who
14holds a valid license to practice in the State, has 2 years of
15full-time clinical experience or an equivalent of 4,000 hours
16of clinical experience and has completed at least 42 clock
17hours of additional structured courses in dental education in
18advanced areas specific to public health dentistry.
19    "Public health setting" means a federally qualified health
20center; a federal, State, or local public health facility;
21Head Start; a special supplemental nutrition program for
22Women, Infants, and Children (WIC) facility; a certified
23school-based health center or school-based oral health
24program; a prison; or a long-term care facility.
25    "Public health supervision" means the supervision of a
26public health dental hygienist by a licensed dentist who has a



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1written public health supervision agreement with that public
2health dental hygienist while working in an approved facility
3or program that allows the public health dental hygienist to
4treat patients, without a dentist first examining the patient
5and being present in the facility during treatment, (1) who
6are eligible for Medicaid or (2) who are uninsured or and whose
7household income is not greater than 300% 200% of the federal
8poverty level.
9    "Teledentistry" means the use of telehealth systems and
10methodologies in dentistry and includes patient care and
11education delivery using synchronous and asynchronous
12communications under a dentist's authority as provided under
13this Act.
14(Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19;
15102-93, eff. 1-1-22; 102-588, eff. 8-20-21; 102-936, eff.
17    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
18    (Section scheduled to be repealed on January 1, 2026)
19    Sec. 17. Acts constituting the practice of dentistry. A
20person practices dentistry, within the meaning of this Act:
21        (1) Who represents himself or herself as being able to
22    diagnose or diagnoses, treats, prescribes, or operates for
23    any disease, pain, deformity, deficiency, injury, or
24    physical condition of the human tooth, teeth, alveolar
25    process, gums or jaw; or



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1        (2) Who is a manager, proprietor, operator or
2    conductor of a business where dental operations are
3    performed; or
4        (3) Who performs dental operations of any kind; or
5        (4) Who uses an X-Ray machine or X-Ray films for
6    dental diagnostic purposes; or
7        (5) Who extracts a human tooth or teeth, or corrects
8    or attempts to correct malpositions of the human teeth or
9    jaws; or
10        (6) Who offers or undertakes, by any means or method,
11    to diagnose, treat or remove stains, calculus, and bonding
12    materials from human teeth or jaws; or
13        (7) Who uses or administers local or general
14    anesthetics in the treatment of dental or oral diseases or
15    in any preparation incident to a dental operation of any
16    kind or character; or
17        (8) Who takes material or digital scans for final
18    impressions of the human tooth, teeth, or jaws or performs
19    any phase of any operation incident to the replacement of
20    a part of a tooth, a tooth, teeth or associated tissues by
21    means of a filling, crown, a bridge, a denture or other
22    appliance; or
23        (9) Who offers to furnish, supply, construct,
24    reproduce or repair, or who furnishes, supplies,
25    constructs, reproduces or repairs, prosthetic dentures,
26    bridges or other substitutes for natural teeth, to the



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



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



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



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1        restorations and placing, packing, and finishing
2        composite restorations by dental assistants who have
3        had additional formal education and certification.
4            A dental assistant may place, carve, and finish
5        amalgam restorations, place, pack, and finish
6        composite restorations, and place interim restorations
7        if he or she (A) has successfully completed a
8        structured training program as described in item (2)
9        of subsection (g) provided by an educational
10        institution accredited by the Commission on Dental
11        Accreditation, such as a dental school or dental
12        hygiene or dental assistant program, or (B) has at
13        least 4,000 hours of direct clinical patient care
14        experience and has successfully completed a structured
15        training program as described in item (2) of
16        subsection (g) provided by a statewide dental
17        association, approved by the Department to provide
18        continuing education, that has developed and conducted
19        training programs for expanded functions for dental
20        assistants or hygienists. The training program must:
21        (i) include a minimum of 16 hours of didactic study and
22        14 hours of clinical manikin instruction; all training
23        programs shall include areas of study in nomenclature,
24        caries classifications, oral anatomy, periodontium,
25        basic occlusion, instrumentations, pulp protection
26        liners and bases, dental materials, matrix and wedge



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1        techniques, amalgam placement and carving, rubber dam
2        clamp placement, and rubber dam placement and removal;
3        (ii) include an outcome assessment examination that
4        demonstrates competency; (iii) require the supervising
5        dentist to observe and approve the completion of 8
6        amalgam or composite restorations; and (iv) issue a
7        certificate of completion of the training program,
8        which must be kept on file at the dental office and be
9        made available to the Department upon request. A
10        dental assistant must have successfully completed an
11        approved coronal polishing and dental sealant course
12        prior to taking the amalgam and composite restoration
13        course.
14            A dentist utilizing dental assistants shall not
15        supervise more than 4 dental assistants at any one
16        time for placing, carving, and finishing of amalgam
17        restorations or for placing, packing, and finishing
18        composite restorations.
19            (3) Any and all correction of malformation of
20        teeth or of the jaws.
21            (4) Administration of anesthetics, except for
22        monitoring of nitrous oxide, conscious sedation, deep
23        sedation, and general anesthetic as provided in
24        Section 8.1 of this Act, that may be performed only
25        after successful completion of a training program
26        approved by the Department. A dentist utilizing dental



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1        assistants shall not supervise more than 4 dental
2        assistants at any one time for the monitoring of
3        nitrous oxide.
4            (5) Removal of calculus from human teeth.
5            (6) Taking of material or digital scans for final
6        impressions for the fabrication of prosthetic
7        appliances, crowns, bridges, inlays, onlays, or other
8        restorative or replacement dentistry.
9            (7) The operative procedure of dental hygiene
10        consisting of oral prophylactic procedures, except for
11        coronal polishing and pit and fissure sealants, which
12        may be performed by a dental assistant who has
13        successfully completed a training program approved by
14        the Department. Dental assistants may perform coronal
15        polishing under the following circumstances: (i) the
16        coronal polishing shall be limited to polishing the
17        clinical crown of the tooth and existing restorations,
18        supragingivally; (ii) the dental assistant performing
19        the coronal polishing shall be limited to the use of
20        rotary instruments using a rubber cup or brush
21        polishing method (air polishing is not permitted); and
22        (iii) the supervising dentist shall not supervise more
23        than 4 dental assistants at any one time for the task
24        of coronal polishing or pit and fissure sealants.
25            In addition to coronal polishing and pit and
26        fissure sealants as described in this item (7), a



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1        dental assistant who has at least 2,000 hours of
2        direct clinical patient care experience and who has
3        successfully completed a structured training program
4        provided by (1) an educational institution including,
5        but not limited to, a dental school or dental hygiene
6        or dental assistant program, or (2) a continuing
7        education provider approved by the Department, or (3)
8        a statewide dental or dental hygienist association,
9        approved by the Department on or before January 1,
10        2017 (the effective date of Public Act 99-680), that
11        has developed and conducted a training program for
12        expanded functions for dental assistants or hygienists
13        may perform: (A) coronal scaling above the gum line,
14        supragingivally, on the clinical crown of the tooth
15        only on patients 17 years of age or younger who have an
16        absence of periodontal disease and who are not
17        medically compromised or individuals with special
18        needs and (B) intracoronal temporization of a tooth.
19        The training program must: (I) include a minimum of 32
20        hours of instruction in both didactic and clinical
21        manikin or human subject instruction; all training
22        programs shall include areas of study in dental
23        anatomy, public health dentistry, medical history,
24        dental emergencies, and managing the pediatric
25        patient; (II) include an outcome assessment
26        examination that demonstrates competency; (III)



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1        require the supervising dentist to observe and approve
2        the completion of 6 full mouth supragingival scaling
3        procedures unless the training was received as part of
4        a Commission on Dental Accreditation approved dental
5        assistant program; and (IV) issue a certificate of
6        completion of the training program, which must be kept
7        on file at the dental office and be made available to
8        the Department upon request. A dental assistant must
9        have successfully completed an approved coronal
10        polishing course prior to taking the coronal scaling
11        course. A dental assistant performing these functions
12        shall be limited to the use of hand instruments only.
13        In addition, coronal scaling as described in this
14        paragraph shall only be utilized on patients who are
15        eligible for Medicaid, who are uninsured, or whose
16        household income is not greater than 300% of the
17        federal poverty level. A dentist may not supervise
18        more than 2 dental assistants at any one time for the
19        task of coronal scaling. This paragraph is inoperative
20        on and after January 1, 2026.
21        The limitations on the number of dental assistants a
22    dentist may supervise contained in items (2), (4), and (7)
23    of this paragraph (g) mean a limit of 4 total dental
24    assistants or dental hygienists doing expanded functions
25    covered by these Sections being supervised by one dentist;
26    or



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1        (h) The practice of dentistry by an individual who:
2            (i) has applied in writing to the Department, in
3        form and substance satisfactory to the Department, for
4        a general dental license and has complied with all
5        provisions of Section 9 of this Act, except for the
6        passage of the examination specified in subsection (e)
7        of Section 9 of this Act; or
8            (ii) has applied in writing to the Department, in
9        form and substance satisfactory to the Department, for
10        a temporary dental license and has complied with all
11        provisions of subsection (c) of Section 11 of this
12        Act; and
13            (iii) has been accepted or appointed for specialty
14        or residency training by a hospital situated in this
15        State; or
16            (iv) has been accepted or appointed for specialty
17        training in an approved dental program situated in
18        this State; or
19            (v) has been accepted or appointed for specialty
20        training in a dental public health agency situated in
21        this State.
22        The applicant shall be permitted to practice dentistry
23    for a period of 3 months from the starting date of the
24    program, unless authorized in writing by the Department to
25    continue such practice for a period specified in writing
26    by the Department.



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1        The applicant shall only be entitled to perform such
2    acts as may be prescribed by and incidental to his or her
3    program of residency or specialty training and shall not
4    otherwise engage in the practice of dentistry in this
5    State.
6        The authority to practice shall terminate immediately
7    upon:
8            (1) the decision of the Department that the
9        applicant has failed the examination; or
10            (2) denial of licensure by the Department; or
11            (3) withdrawal of the application.
12(Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21;
13102-936, eff. 1-1-23.)
14    (225 ILCS 25/18)   (from Ch. 111, par. 2318)
15    (Section scheduled to be repealed on January 1, 2026)
16    Sec. 18. Acts constituting the practice of dental hygiene;
18    (a) A person practices dental hygiene within the meaning
19of this Act when he or she performs the following acts under
20the supervision of a dentist:
21        (i) the operative procedure of dental hygiene,
22    consisting of oral prophylactic procedures;
23        (ii) the exposure and processing of X-Ray films of the
24    teeth and surrounding structures;
25        (iii) the application to the surfaces of the teeth or



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1    gums of chemical compounds designed to be desensitizing
2    agents or effective agents in the prevention of dental
3    caries or periodontal disease;
4        (iv) all services which may be performed by a dental
5    assistant as specified by rule pursuant to Section 17, and
6    a dental hygienist may engage in the placing, carving, and
7    finishing of amalgam restorations only after obtaining
8    formal education and certification as determined by the
9    Department;
10        (v) administration and monitoring of nitrous oxide
11    upon successful completion of a training program approved
12    by the Department;
13        (vi) administration of local anesthetics upon
14    successful completion of a training program approved by
15    the Department; and
16        (vii) such other procedures and acts as shall be
17    prescribed by rule or regulation of the Department.
18    (b) A dental hygienist may be employed or engaged only:
19        (1) by a dentist;
20        (2) by a federal, State, county, or municipal agency
21    or institution;
22        (3) by a public or private school; or
23        (4) by a public clinic operating under the direction
24    of a hospital or federal, State, county, municipal, or
25    other public agency or institution.
26    (c) When employed or engaged in the office of a dentist, a



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1dental hygienist may perform, under general supervision, those
2procedures found in items (i) through (iv) of subsection (a)
3of this Section, provided the patient has been examined by the
4dentist within one year of the provision of dental hygiene
5services, the dentist has approved the dental hygiene services
6by a notation in the patient's record and the patient has been
7notified that the dentist may be out of the office during the
8provision of dental hygiene services.
9    (d) If a patient of record is unable to travel to a dental
10office because of illness, infirmity, or imprisonment, a
11dental hygienist may perform, under the general supervision of
12a dentist, those procedures found in items (i) through (iv) of
13subsection (a) of this Section, provided the patient is
14located in a long-term care facility licensed by the State of
15Illinois, a mental health or developmental disability
16facility, or a State or federal prison. The dentist shall
17either personally examine and diagnose the patient or utilize
18approved teledentistry communication methods and determine
19which services are necessary to be performed, which shall be
20contained in an order to the hygienist and a notation in the
21patient's record. Such order must be implemented within 45
22days of its issuance, and an updated medical history and
23observation of oral conditions must be performed by the
24hygienist immediately prior to beginning the procedures to
25ensure that the patient's health has not changed in any manner
26to warrant a reexamination by the dentist.



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1    (e) School-based oral health care, consisting of and
2limited to oral prophylactic procedures, sealants, and
3fluoride treatments, may be provided by a dental hygienist
4under the general supervision of a dentist. A dental hygienist
5may not provide other dental hygiene treatment in a
6school-based setting, including but not limited to
7administration or monitoring of nitrous oxide or
8administration of local anesthetics. The school-based
9procedures may be performed provided the patient is located at
10a public or private school and the program is being conducted
11by a State, county or local public health department
12initiative or in conjunction with a dental school or dental
13hygiene program. The dentist shall personally examine and
14diagnose the patient and determine which services are
15necessary to be performed, which shall be contained in an
16order to the hygienist and a notation in the patient's record.
17Any such order for sealants must be implemented within 120
18days after its issuance. Any such order for oral prophylactic
19procedures or fluoride treatments must be implemented within
20180 days after its issuance. An updated medical history and
21observation of oral conditions must be performed by the
22hygienist immediately prior to beginning the procedures to
23ensure that the patient's health has not changed in any manner
24to warrant a reexamination by the dentist.
25    (f) Without the supervision of a dentist, a dental
26hygienist may perform dental health education functions,



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1including instruction in proper oral health care and dental
2hygiene in, for example, either a school setting, a or
3long-term care facility, and a health fair. In addition, a
4dental hygienist may record case care histories and oral
5conditions observed at any time prior to a clinical exam by a
7    (g) The number of dental hygienists practicing in a dental
8office shall not exceed, at any one time, 4 times the number of
9dentists practicing in the office at the time.
10    (h) A dental hygienist who is certified as a public health
11dental hygienist may provide services to patients: (1) who are
12eligible for Medicaid or (2) who are uninsured and whose
13household income is not greater than 300% of the federal
14poverty level. A public health dental hygienist may perform
15oral assessments, perform screenings, and provide educational
16and preventative services as provided in subsection (b) of
17Section 18.1 of this Act. The public health dental hygienist
18may not administer local anesthesia or nitrous oxide, or
19place, carve, or finish amalgam restorations or provide
20periodontal therapy under this exception. Each patient must
21sign a consent form that acknowledges that the care received
22does not take the place of a regular dental examination. The
23public health dental hygienist must provide the patient or
24guardian a written referral to a dentist for assessment of the
25need for further dental care at the time of treatment. Any
26indication or observation of a condition that could warrant



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1the need for urgent attention must be reported immediately to
2the supervising dentist for appropriate assessment and
4    This subsection (h) is inoperative on and after January 1,
6    (i) A dental hygienist performing procedures listed in
7paragraphs (1) through (4) of subsection (a) of Section 17.1
8must be under the supervision of a dentist, requiring the
9dentist authorizes the procedure, remains in the dental
10facility while the procedure is performed, and approves the
11work performed by the dental hygienist before dismissal of the
12patient, but the dentist is not required to be present at all
13times in the treatment room.
14    (j) A dental hygienist may perform actions described in
15paragraph (5) of subsection (a) of Section 17.1 under the
16general supervision of a dentist as described in this Section.
17(Source: P.A. 101-162, eff. 7-26-19; 102-936, eff. 1-1-23.)
18    (225 ILCS 25/18.1)
19    (Section scheduled to be repealed on January 1, 2026)
20    Sec. 18.1. Public health dental supervision
22    (a) When working together in a public health supervision
23relationship, dentists and public health dental hygienists
24shall enter into a public health supervision agreement. The
25dentist providing public health supervision must:



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1        (1) be available to provide an appropriate level of
2    contact, communication, collaboration, and consultation
3    with the public health dental hygienist and must meet
4    in-person with the public health dental hygienist at least
5    quarterly for review and consultation;
6        (2) have specific standing orders or policy guidelines
7    for procedures that are to be carried out for each
8    location or program, although the dentist need not be
9    present when the procedures are being performed;
10        (3) provide for the patient's additional necessary
11    care in consultation with the public health dental
12    hygienist;
13        (4) file agreements and notifications as required; and
14        (5) include procedures for creating and maintaining
15    dental records, including protocols for transmission of
16    all records between the public health dental hygienist and
17    the dentist following each treatment, which shall include
18    a notation regarding procedures authorized by the dentist
19    and performed by the public health dental hygienist and
20    the location where those records are to be kept.
21    Each dentist and hygienist who enters into a public health
22supervision agreement must document and maintain a copy of any
23change or termination of that agreement.
24    Dental records shall be owned and maintained by the
25supervising dentist for all patients treated under public
26health supervision, unless the supervising dentist is an



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1employee of a public health clinic or federally qualified
2health center, in which case the public health clinic or
3federally qualified health center shall maintain the records.
4    If a dentist ceases to be employed or contracted by the
5facility, the dentist shall notify the facility administrator
6that the public health supervision agreement is no longer in
7effect. A new public health supervision agreement is required
8for the public health dental hygienist to continue treating
9patients under public health supervision.
10    A dentist entering into an agreement under this Section
11may supervise and enter into agreements for public health
12supervision with 4 2 public health dental hygienists. This
13shall be in addition to the limit of 4 dental hygienists per
14dentist set forth in subsection (g) of Section 18 of this Act.
15    (b) A public health dental hygienist providing services
16under public health supervision may perform only those duties
17within the accepted scope of practice of dental hygiene, as
19        (1) the operative procedures of dental hygiene,
20    consisting of oral prophylactic procedures, including
21    prophylactic cleanings, application of fluoride, and
22    placement of sealants;
23        (2) the exposure and processing of x-ray films of the
24    teeth and surrounding structures; and
25        (3) such other procedures and acts as shall be
26    prescribed by rule of the Department.



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1    Any patient treated under this subsection (b) must be
2examined by a dentist before additional services can be
3provided by a public health dental hygienist. However, if the
4supervising dentist, after consultation with the public health
5hygienist, determines that time is needed to complete an
6approved treatment plan on a patient eligible under this
7Section, then the dentist may instruct the hygienist to
8complete the remaining services prior to an oral examination
9by the dentist. Such instruction by the dentist to the
10hygienist shall be noted in the patient's records. Any
11services performed under this exception must be scheduled in a
12timely manner and shall not occur more than 30 days after the
13first appointment date.
14    (c) A public health dental hygienist providing services
15under public health supervision must:
16        (1) provide to the patient, parent, or guardian a
17    written plan for referral or an agreement for follow-up
18    that records all conditions observed that should be called
19    to the attention of a dentist for proper diagnosis;
20        (2) have each patient sign a permission slip or
21    consent form that informs them that the service to be
22    received does not take the place of regular dental
23    checkups at a dental office and is meant for people who
24    otherwise would not have access to the service;
25        (3) inform each patient who may require further dental
26    services of that need;



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1        (4) maintain an appropriate level of contact and
2    communication with the dentist providing public health
3    supervision; and
4        (5) complete an additional 4 hours of continuing
5    education in areas specific to public health dentistry
6    yearly.
7    (d) Each public health dental hygienist who has rendered
8services under subsections (c), (d), and (e) of this Section
9must complete a summary report at the completion of a program
10or, in the case of an ongoing program, at least annually. The
11report must be completed in the manner specified by the
12Division of Oral Health in the Department of Public Health
13Oral Health Section including information about each location
14where the public health dental hygienist has rendered these
15services. The public health dental hygienist must submit the
16form to the dentist providing supervision for his or her
17signature before sending it to the Division. The Department of
18Public Health Oral Health Section shall compile and publicize
19public health dental hygienist service data annually.
20    (e) Public health dental hygienists providing services
21under public health supervision may be compensated for their
22work by salary, honoraria, and other mechanisms by the
23employing or sponsoring entity. Nothing in this Act shall
24preclude the entity that employs or sponsors a public health
25dental hygienist from seeking payment, reimbursement, or other
26source of funding for the services provided.



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1    (f) This Section is repealed on January 1, 2026.
2(Source: P.A. 101-162, eff. 7-26-19.)