Illinois General Assembly - Full Text of HB4501
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Full Text of HB4501  102nd General Assembly




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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, 17.1, and 18 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7    (Section scheduled to be repealed on January 1, 2026)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; or 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 and whose
7household income is not greater than 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.)
16    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
17    (Section scheduled to be repealed on January 1, 2026)
18    Sec. 17. Acts constituting the practice of dentistry. A
19person practices dentistry, within the meaning of this Act:
20        (1) Who represents himself or herself as being able to
21    diagnose or diagnoses, treats, prescribes, or operates for
22    any disease, pain, deformity, deficiency, injury, or
23    physical condition of the human tooth, teeth, alveolar
24    process, gums or jaw; or
25        (2) Who is a manager, proprietor, operator or



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



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



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



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



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



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



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1        assistants at any one time for the monitoring of
2        nitrous oxide.
3            (5) Removal of calculus from human teeth.
4            (6) Taking of material or digital scans for final
5        impressions for the fabrication of prosthetic
6        appliances, crowns, bridges, inlays, onlays, or other
7        restorative or replacement dentistry.
8            (7) The operative procedure of dental hygiene
9        consisting of oral prophylactic procedures, except for
10        coronal polishing and pit and fissure sealants, which
11        may be performed by a dental assistant who has
12        successfully completed a training program approved by
13        the Department. Dental assistants may perform coronal
14        polishing under the following circumstances: (i) the
15        coronal polishing shall be limited to polishing the
16        clinical crown of the tooth and existing restorations,
17        supragingivally; (ii) the dental assistant performing
18        the coronal polishing shall be limited to the use of
19        rotary instruments using a rubber cup or brush
20        polishing method (air polishing is not permitted); and
21        (iii) the supervising dentist shall not supervise more
22        than 4 dental assistants at any one time for the task
23        of coronal polishing or pit and fissure sealants.
24            In addition to coronal polishing and pit and
25        fissure sealants as described in this item (7), a
26        dental assistant who has at least 2,000 hours of



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



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1        observe and approve the completion of 6 full mouth
2        supragingival scaling procedures unless the training
3        was received as part of a Commission on Dental
4        Accreditation approved dental assistant program; and
5        (IV) issue a certificate of completion of the training
6        program, which must be kept on file at the dental
7        office and be made available to the Department upon
8        request. A dental assistant must have successfully
9        completed an approved coronal polishing course prior
10        to taking the coronal scaling course. A dental
11        assistant performing these functions shall be limited
12        to the use of hand instruments only. In addition,
13        coronal scaling as described in this paragraph shall
14        only be utilized on patients who are eligible for
15        Medicaid, or who are uninsured, or and whose household
16        income is not greater than 300% 200% of the federal
17        poverty level. A dentist may not supervise more than 2
18        dental assistants at any one time for the task of
19        coronal scaling. This paragraph is inoperative on and
20        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.)
13    (225 ILCS 25/17.1)
14    (Section scheduled to be repealed on January 1, 2026)
15    Sec. 17.1. Expanded function dental assistants.
16    (a) A dental assistant who has completed training as
17provided in subsection (b) of this Section in all of the
18following areas may hold himself or herself out as an expanded
19function dental assistant:
20        (1) Taking material or digital scans for final
21    impressions after completing a training program that
22    includes either didactic objectives or clinical skills and
23    functions that demonstrate competency.
24        (2) Performing pulp vitality test after completing a
25    training program that includes either didactic objectives



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1    or clinical skills and functions that demonstrate
2    competency.
3        (3) Placing, carving, and finishing of amalgam
4    restorations and placing, packing, and finishing composite
5    restorations as allowed under Section 17.
6        (3.5) Coronal scaling as allowed under Section 17.
7        (4) Starting the flow of oxygen and monitoring of
8    nitrous oxide-oxygen analgesia as allowed under Section
9    17.
10        (5) Coronal polishing and pit and fissure sealants as
11    allowed under Section 17.
12        (6) Intracoronal temporization of a tooth.
13    All procedures listed in paragraphs (1) through (6) (5)
14for dental assistants must be performed under the supervision
15of a dentist, requiring the dentist authorizes the procedure,
16remains in the dental facility while the procedure is
17performed, and approves the work performed by the dental
18assistant before dismissal of the patient, but the dentist is
19not required to be present at all times in the treatment room.
20    After the completion of training as provided in subsection
21(b) of this Section, an expanded function dental assistant may
22perform any of the services listed in this subsection (a)
23pursuant to the limitations of this Act.
24    (b) Certification and training as an expanded function
25dental assistant must be obtained from one of the following
26sources: (i) an approved continuing education sponsor; (ii) a



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1dental assistant training program approved by the Commission
2on Dental Accreditation of the American Dental Association; or
3(iii) a training program approved by the Department.
4    Training required under this subsection (b) must also
5include Basic Life Support certification, as described in
6Section 16 of this Act. Proof of current certification shall
7be kept on file with the supervising dentist.
8    (c) Any procedures listed in subsection (a) that are
9performed by an expanded function dental assistant must be
10approved by the supervising dentist and examined prior to
11dismissal of the patient. The supervising dentist shall be
12responsible for all dental services or procedures performed by
13the dental assistant.
14    (d) Nothing in this Section shall be construed to alter
15the number of dental assistants that a dentist may supervise
16under paragraph (g) of Section 17 of this Act.
17    (e) Nothing in this Act shall: (1) require a dental
18assistant to be certified as an expanded function dental
19assistant or (2) prevent a dentist from training dental
20assistants in accordance with the provisions of Section 17 or
2117.1 of this Act or rules pertaining to dental assistant
23(Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19;
24101-162, eff. 7-26-19.)
25    (225 ILCS 25/18)   (from Ch. 111, par. 2318)



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1    (Section scheduled to be repealed on January 1, 2026)
2    Sec. 18. Acts constituting the practice of dental hygiene;
4    (a) A person practices dental hygiene within the meaning
5of this Act when he or she performs the following acts under
6the supervision of a dentist:
7        (i) the operative procedure of dental hygiene,
8    consisting of oral prophylactic procedures;
9        (ii) the exposure and processing of X-Ray films of the
10    teeth and surrounding structures;
11        (iii) the application to the surfaces of the teeth or
12    gums of chemical compounds designed to be desensitizing
13    agents or effective agents in the prevention of dental
14    caries or periodontal disease;
15        (iv) all services which may be performed by a dental
16    assistant as specified by rule pursuant to Section 17, and
17    a dental hygienist may engage in the placing, carving, and
18    finishing of amalgam restorations only after obtaining
19    formal education and certification as determined by the
20    Department;
21        (v) administration and monitoring of nitrous oxide
22    upon successful completion of a training program approved
23    by the Department;
24        (vi) administration of local anesthetics upon
25    successful completion of a training program approved by
26    the Department; and



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1        (vii) such other procedures and acts as shall be
2    prescribed by rule or regulation of the Department.
3    (b) A dental hygienist may be employed or engaged only:
4        (1) by a dentist;
5        (2) by a federal, State, county, or municipal agency
6    or institution;
7        (3) by a public or private school; or
8        (4) by a public clinic operating under the direction
9    of a hospital or federal, State, county, municipal, or
10    other public agency or institution.
11    (c) When employed or engaged in the office of a dentist, a
12dental hygienist may perform, under general supervision, those
13procedures found in items (i) through (iv) of subsection (a)
14of this Section, provided the patient has been examined by the
15dentist within one year of the provision of dental hygiene
16services, the dentist has approved the dental hygiene services
17by a notation in the patient's record and the patient has been
18notified that the dentist may be out of the office during the
19provision of dental hygiene services.
20    (d) If a patient of record is unable to travel to a dental
21office because of illness, infirmity, or imprisonment, a
22dental hygienist may perform, under the general supervision of
23a dentist, those procedures found in items (i) through (iv) of
24subsection (a) of this Section, provided the patient is
25located in a long-term care facility licensed by the State of
26Illinois, a mental health or developmental disability



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1facility, or a State or federal prison. The dentist shall
2either personally examine and diagnose the patient or utilize
3approved teledentistry communication methods and determine
4which services are necessary to be performed, which shall be
5contained in an order to the hygienist and a notation in the
6patient's record. Such order must be implemented within 45 120
7days of its issuance, and an updated medical history and
8observation of oral conditions must be performed by the
9hygienist immediately prior to beginning the procedures to
10ensure that the patient's health has not changed in any manner
11to warrant a reexamination by the dentist.
12    (e) School-based oral health care, consisting of and
13limited to oral prophylactic procedures, sealants, and
14fluoride treatments, may be provided by a dental hygienist
15under the general supervision of a dentist. A dental hygienist
16may not provide other dental hygiene treatment in a
17school-based setting, including but not limited to
18administration or monitoring of nitrous oxide or
19administration of local anesthetics. The school-based
20procedures may be performed provided the patient is located at
21a public or private school and the program is being conducted
22by a State, county or local public health department
23initiative or in conjunction with a dental school or dental
24hygiene program. The dentist shall personally examine and
25diagnose the patient and determine which services are
26necessary to be performed, which shall be contained in an



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1order to the hygienist and a notation in the patient's record.
2Any such order for sealants must be implemented within 120
3days after its issuance. Any such order for oral prophylactic
4procedures or fluoride treatments must be implemented within
5180 days after its issuance. An updated medical history and
6observation of oral conditions must be performed by the
7hygienist immediately prior to beginning the procedures to
8ensure that the patient's health has not changed in any manner
9to warrant a reexamination by the dentist.
10    (f) Without the supervision of a dentist, a dental
11hygienist may perform dental health education functions,
12including instruction in proper oral health care and dental
13hygiene in either a school setting or long-term care facility.
14In addition, a dental hygienist may record care histories and
15oral conditions observed at any time prior to a clinical exam
16by a dentist and may record case histories and oral conditions
18    (g) The number of dental hygienists practicing in a dental
19office shall not exceed, at any one time, 4 times the number of
20dentists practicing in the office at the time.
21    (h) A dental hygienist who is certified as a public health
22dental hygienist may provide services to patients: (1) who are
23eligible for Medicaid or (2) who are uninsured and whose
24household income is not greater than 300% 200% of the federal
25poverty level. A public health dental hygienist may perform
26oral assessments, perform screenings, and provide educational



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1and preventative services as provided in subsection (b) of
2Section 18.1 of this Act. The public health dental hygienist
3may not administer local anesthesia or nitrous oxide, or
4place, carve, or finish amalgam restorations or provide
5periodontal therapy under this exception. Each patient must
6sign a consent form that acknowledges that the care received
7does not take the place of a regular dental examination. The
8public health dental hygienist must provide the patient or
9guardian a written referral to a dentist for assessment of the
10need for further dental care at the time of treatment. Any
11indication or observation of a condition that could warrant
12the need for urgent attention must be reported immediately to
13the supervising dentist for appropriate assessment and
15    This subsection (h) is inoperative on and after January 1,
17    (i) A dental hygienist performing procedures listed in
18paragraphs (1) through (4) of subsection (a) of Section 17.1
19must be under the supervision of a dentist, requiring the
20dentist authorizes the procedure, remains in the dental
21facility while the procedure is performed, and approves the
22work performed by the dental hygienist before dismissal of the
23patient, but the dentist is not required to be present at all
24times in the treatment room.
25    (j) A dental hygienist may perform actions described in
26paragraph (5) of subsection (a) of Section 17.1 under the



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1general supervision of a dentist as described in this Section.
2(Source: P.A. 100-976, eff. 1-1-19; 101-162, eff. 7-26-19.)