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


Sen. Emil Jones, III

Filed: 3/25/2022





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2    AMENDMENT NO. ______. Amend House Bill 4501 by replacing
3everything after the enacting clause with the following:
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7    (Section scheduled to be repealed on January 1, 2026)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



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1Professional Regulation.
2    "Secretary" means the Secretary of Financial and
3Professional Regulation.
4    "Board" means the Board of Dentistry.
5    "Dentist" means a person who has received a general
6license pursuant to paragraph (a) of Section 11 of this Act and
7who may perform any intraoral and extraoral procedure required
8in the practice of dentistry and to whom is reserved the
9responsibilities specified in Section 17.
10    "Dental hygienist" means a person who holds a license
11under this Act to perform dental services as authorized by
12Section 18.
13    "Dental assistant" means an appropriately trained person
14who, under the supervision of a dentist, provides dental
15services as authorized by Section 17.
16    "Expanded function dental assistant" means a dental
17assistant who has completed the training required by Section
1817.1 of this Act.
19    "Dental laboratory" means a person, firm or corporation
21        (i) engages in making, providing, repairing or
22    altering dental prosthetic appliances and other artificial
23    materials and devices which are returned to a dentist for
24    insertion into the human oral cavity or which come in
25    contact with its adjacent structures and tissues; and
26        (ii) utilizes or employs a dental technician to



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1    provide such services; and
2        (iii) performs such functions only for a dentist or
3    dentists.
4    "Supervision" means supervision of a dental hygienist or a
5dental assistant requiring that a dentist authorize the
6procedure, remain in the dental facility while the procedure
7is performed, and approve the work performed by the dental
8hygienist or dental assistant before dismissal of the patient,
9but does not mean that the dentist must be present at all times
10in the treatment room.
11    "General supervision" means supervision of a dental
12hygienist requiring that the patient be a patient of record,
13that the dentist examine the patient in accordance with
14Section 18 prior to treatment by the dental hygienist, and
15that the dentist authorize the procedures which are being
16carried out by a notation in the patient's record, but not
17requiring that a dentist be present when the authorized
18procedures are being performed. The issuance of a prescription
19to a dental laboratory by a dentist does not constitute
20general supervision.
21    "Public member" means a person who is not a health
22professional. For purposes of board membership, any person
23with a significant financial interest in a health service or
24profession is not a public member.
25    "Dentistry" means the healing art which is concerned with
26the examination, diagnosis, treatment planning and care of



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1conditions within the human oral cavity and its adjacent
2tissues and structures, as further specified in Section 17.
3    "Branches of dentistry" means the various specialties of
4dentistry which, for purposes of this Act, shall be limited to
5the following: endodontics, oral and maxillofacial surgery,
6orthodontics and dentofacial orthopedics, pediatric dentistry,
7periodontics, prosthodontics, oral and maxillofacial
8radiology, and dental anesthesiology.
9    "Specialist" means a dentist who has received a specialty
10license pursuant to Section 11(b).
11    "Dental technician" means a person who owns, operates or
12is employed by a dental laboratory and engages in making,
13providing, repairing or altering dental prosthetic appliances
14and other artificial materials and devices which are returned
15to a dentist for insertion into the human oral cavity or which
16come in contact with its adjacent structures and tissues.
17    "Impaired dentist" or "impaired dental hygienist" means a
18dentist or dental hygienist who is unable to practice with
19reasonable skill and safety because of a physical or mental
20disability as evidenced by a written determination or written
21consent based on clinical evidence, including deterioration
22through the aging process, loss of motor skills, abuse of
23drugs or alcohol, or a psychiatric disorder, of sufficient
24degree to diminish the person's ability to deliver competent
25patient care.
26    "Nurse" means a registered professional nurse, a certified



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1registered nurse anesthetist licensed as an advanced practice
2registered nurse, or a licensed practical nurse licensed under
3the Nurse Practice Act.
4    "Patient of record" means a patient for whom the patient's
5most recent dentist has obtained a relevant medical and dental
6history and on whom the dentist has performed an examination
7and evaluated the condition to be treated.
8    "Dental responder" means a dentist or dental hygienist who
9is appropriately certified in disaster preparedness,
10immunizations, and dental humanitarian medical response
11consistent with the Society of Disaster Medicine and Public
12Health and training certified by the National Incident
13Management System or the National Disaster Life Support
15    "Mobile dental van or portable dental unit" means any
16self-contained or portable dental unit in which dentistry is
17practiced that can be moved, towed, or transported from one
18location to another in order to establish a location where
19dental services can be provided.
20    "Public health dental hygienist" means a hygienist who
21holds a valid license to practice in the State, has 2 years of
22full-time clinical experience or an equivalent of 4,000 hours
23of clinical experience and has completed at least 42 clock
24hours of additional structured courses in dental education in
25advanced areas specific to public health dentistry.
26    "Public health setting" means a federally qualified health



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1center; a federal, State, or local public health facility;
2Head Start; a special supplemental nutrition program for
3Women, Infants, and Children (WIC) facility; or a certified
4school-based health center or school-based oral health
5program; or a prison.
6    "Public health supervision" means the supervision of a
7public health dental hygienist by a licensed dentist who has a
8written public health supervision agreement with that public
9health dental hygienist while working in an approved facility
10or program that allows the public health dental hygienist to
11treat patients, without a dentist first examining the patient
12and being present in the facility during treatment, (1) who
13are eligible for Medicaid or (2) who are uninsured and whose
14household income is not greater than 200% of the federal
15poverty level.
16    "Teledentistry" means the use of telehealth systems and
17methodologies in dentistry and includes patient care and
18education delivery using synchronous and asynchronous
19communications under a dentist's authority as provided under
20this Act.
21(Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19;
22102-93, eff. 1-1-22; 102-588, eff. 8-20-21.)
23    (225 ILCS 25/17)  (from Ch. 111, par. 2317)
24    (Section scheduled to be repealed on January 1, 2026)
25    Sec. 17. Acts constituting the practice of dentistry. A



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



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



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



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1        instructors have instructed continuously in this State
2        since January 1, 1986; or
3            (ii) when holding the rank of full professor at
4        such approved dental school or college and possessing
5        a current valid license or authorization to practice
6        dentistry in another country; or
7        (e) The practice of dentistry by licensed dentists of
8    other states or countries at meetings of the Illinois
9    State Dental Society or component parts thereof, alumni
10    meetings of dental colleges, or any other like dental
11    organizations, while appearing as clinicians; or
12        (f) The use of X-Ray machines for exposing X-Ray films
13    of dental or oral tissues by dental hygienists or dental
14    assistants; or
15        (g) The performance of any dental service by a dental
16    assistant, if such service is performed under the
17    supervision and full responsibility of a dentist. In
18    addition, after being authorized by a dentist, a dental
19    assistant may, for the purpose of eliminating pain or
20    discomfort, remove loose, broken, or irritating
21    orthodontic appliances on a patient of record.
22        For purposes of this paragraph (g), "dental service"
23    is defined to mean any intraoral procedure or act which
24    shall be prescribed by rule or regulation of the
25    Department. Dental service, however, shall not include:
26            (1) Any and all diagnosis of or prescription for



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1        treatment of disease, pain, deformity, deficiency,
2        injury or physical condition of the human teeth or
3        jaws, or adjacent structures.
4            (2) Removal of, or restoration of, or addition to
5        the hard or soft tissues of the oral cavity, except for
6        the placing, carving, and finishing of amalgam
7        restorations and placing, packing, and finishing
8        composite restorations by dental assistants who have
9        had additional formal education and certification.
10            A dental assistant may place, carve, and finish
11        amalgam restorations, place, pack, and finish
12        composite restorations, and place interim restorations
13        if he or she (A) has successfully completed a
14        structured training program as described in item (2)
15        of subsection (g) provided by an educational
16        institution accredited by the Commission on Dental
17        Accreditation, such as a dental school or dental
18        hygiene or dental assistant program, or (B) has at
19        least 4,000 hours of direct clinical patient care
20        experience and has successfully completed a structured
21        training program as described in item (2) of
22        subsection (g) provided by a statewide dental
23        association, approved by the Department to provide
24        continuing education, that has developed and conducted
25        training programs for expanded functions for dental
26        assistants or hygienists. The training program must:



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1        (i) include a minimum of 16 hours of didactic study and
2        14 hours of clinical manikin instruction; all training
3        programs shall include areas of study in nomenclature,
4        caries classifications, oral anatomy, periodontium,
5        basic occlusion, instrumentations, pulp protection
6        liners and bases, dental materials, matrix and wedge
7        techniques, amalgam placement and carving, rubber dam
8        clamp placement, and rubber dam placement and removal;
9        (ii) include an outcome assessment examination that
10        demonstrates competency; (iii) require the supervising
11        dentist to observe and approve the completion of 8
12        amalgam or composite restorations; and (iv) issue a
13        certificate of completion of the training program,
14        which must be kept on file at the dental office and be
15        made available to the Department upon request. A
16        dental assistant must have successfully completed an
17        approved coronal polishing and dental sealant course
18        prior to taking the amalgam and composite restoration
19        course.
20            A dentist utilizing dental assistants shall not
21        supervise more than 4 dental assistants at any one
22        time for placing, carving, and finishing of amalgam
23        restorations or for placing, packing, and finishing
24        composite restorations.
25            (3) Any and all correction of malformation of
26        teeth or of the jaws.



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1            (4) Administration of anesthetics, except for
2        monitoring of nitrous oxide, conscious sedation, deep
3        sedation, and general anesthetic as provided in
4        Section 8.1 of this Act, that may be performed only
5        after successful completion of a training program
6        approved by the Department. A dentist utilizing dental
7        assistants shall not supervise more than 4 dental
8        assistants at any one time for the monitoring of
9        nitrous oxide.
10            (5) Removal of calculus from human teeth.
11            (6) Taking of material or digital scans for final
12        impressions for the fabrication of prosthetic
13        appliances, crowns, bridges, inlays, onlays, or other
14        restorative or replacement dentistry.
15            (7) The operative procedure of dental hygiene
16        consisting of oral prophylactic procedures, except for
17        coronal polishing and pit and fissure sealants, which
18        may be performed by a dental assistant who has
19        successfully completed a training program approved by
20        the Department. Dental assistants may perform coronal
21        polishing under the following circumstances: (i) the
22        coronal polishing shall be limited to polishing the
23        clinical crown of the tooth and existing restorations,
24        supragingivally; (ii) the dental assistant performing
25        the coronal polishing shall be limited to the use of
26        rotary instruments using a rubber cup or brush



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1        polishing method (air polishing is not permitted); and
2        (iii) the supervising dentist shall not supervise more
3        than 4 dental assistants at any one time for the task
4        of coronal polishing or pit and fissure sealants.
5            In addition to coronal polishing and pit and
6        fissure sealants as described in this item (7), a
7        dental assistant who has at least 2,000 hours of
8        direct clinical patient care experience and who has
9        successfully completed a structured training program
10        provided by (1) an educational institution including,
11        but not limited to, such as a dental school or dental
12        hygiene or dental assistant program, or (2) a
13        continuing education provider approved by the
14        Department, or (3) by a statewide dental or dental
15        hygienist association, approved by the Department on
16        or before January 1, 2017 (the effective date of
17        Public Act 99-680), that has developed and conducted a
18        training program for expanded functions for dental
19        assistants or hygienists may perform: (A) coronal
20        scaling above the gum line, supragingivally, on the
21        clinical crown of the tooth only on patients 17 12
22        years of age or younger who have an absence of
23        periodontal disease and who are not medically
24        compromised or individuals with special needs and (B)
25        intracoronal temporization of a tooth. The training
26        program must: (I) include a minimum of 16 hours of



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1        instruction in both didactic and clinical manikin or
2        human subject instruction; all training programs shall
3        include areas of study in dental anatomy, public
4        health dentistry, medical history, dental emergencies,
5        and managing the pediatric patient; (II) include an
6        outcome assessment examination that demonstrates
7        competency; (III) require the supervising dentist to
8        observe and approve the completion of 6 full mouth
9        supragingival scaling procedures unless the training
10        was received as part of a Commission on Dental
11        Accreditation approved dental assistant program; and
12        (IV) issue a certificate of completion of the training
13        program, which must be kept on file at the dental
14        office and be made available to the Department upon
15        request. A dental assistant must have successfully
16        completed an approved coronal polishing course prior
17        to taking the coronal scaling course. A dental
18        assistant performing these functions shall be limited
19        to the use of hand instruments only. In addition,
20        coronal scaling as described in this paragraph shall
21        only be utilized on patients who are eligible for
22        Medicaid, or who are uninsured, or and whose household
23        income is not greater than 400% 200% of the federal
24        poverty level. A dentist may not supervise more than 2
25        dental assistants at any one time for the task of
26        coronal scaling. This paragraph is inoperative on and



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1        after January 1, 2026.
2        The limitations on the number of dental assistants a
3    dentist may supervise contained in items (2), (4), and (7)
4    of this paragraph (g) mean a limit of 4 total dental
5    assistants or dental hygienists doing expanded functions
6    covered by these Sections being supervised by one dentist;
7    or
8        (h) The practice of dentistry by an individual who:
9            (i) has applied in writing to the Department, in
10        form and substance satisfactory to the Department, for
11        a general dental license and has complied with all
12        provisions of Section 9 of this Act, except for the
13        passage of the examination specified in subsection (e)
14        of Section 9 of this Act; or
15            (ii) has applied in writing to the Department, in
16        form and substance satisfactory to the Department, for
17        a temporary dental license and has complied with all
18        provisions of subsection (c) of Section 11 of this
19        Act; and
20            (iii) has been accepted or appointed for specialty
21        or residency training by a hospital situated in this
22        State; or
23            (iv) has been accepted or appointed for specialty
24        training in an approved dental program situated in
25        this State; or
26            (v) has been accepted or appointed for specialty



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1        training in a dental public health agency situated in
2        this State.
3        The applicant shall be permitted to practice dentistry
4    for a period of 3 months from the starting date of the
5    program, unless authorized in writing by the Department to
6    continue such practice for a period specified in writing
7    by the Department.
8        The applicant shall only be entitled to perform such
9    acts as may be prescribed by and incidental to his or her
10    program of residency or specialty training and shall not
11    otherwise engage in the practice of dentistry in this
12    State.
13        The authority to practice shall terminate immediately
14    upon:
15            (1) the decision of the Department that the
16        applicant has failed the examination; or
17            (2) denial of licensure by the Department; or
18            (3) withdrawal of the application.
19(Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21.)
20    (225 ILCS 25/17.1)
21    (Section scheduled to be repealed on January 1, 2026)
22    Sec. 17.1. Expanded function dental assistants.
23    (a) A dental assistant who has completed training as
24provided in subsection (b) of this Section in all of the
25following areas may hold himself or herself out as an expanded



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1function dental assistant:
2        (1) Taking material or digital scans for final
3    impressions after completing a training program that
4    includes either didactic objectives or clinical skills and
5    functions that demonstrate competency.
6        (2) Performing pulp vitality test after completing a
7    training program that includes either didactic objectives
8    or clinical skills and functions that demonstrate
9    competency.
10        (3) Placing, carving, and finishing of amalgam
11    restorations and placing, packing, and finishing composite
12    restorations as allowed under Section 17.
13        (3.5) Coronal scaling as allowed under Section 17.
14        (4) Starting the flow of oxygen and monitoring of
15    nitrous oxide-oxygen analgesia as allowed under Section
16    17.
17        (5) Coronal polishing and pit and fissure sealants as
18    allowed under Section 17.
19        (6) Intracoronal temporization of a tooth.
20    All procedures listed in paragraphs (1) through (6) (5)
21for dental assistants must be performed under the supervision
22of a dentist, requiring the dentist authorizes the procedure,
23remains in the dental facility while the procedure is
24performed, and approves the work performed by the dental
25assistant before dismissal of the patient, but the dentist is
26not required to be present at all times in the treatment room.



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1    After the completion of training as provided in subsection
2(b) of this Section, an expanded function dental assistant may
3perform any of the services listed in this subsection (a)
4pursuant to the limitations of this Act.
5    (b) Certification and training as an expanded function
6dental assistant must be obtained from one of the following
7sources: (i) an approved continuing education sponsor; (ii) a
8dental assistant training program approved by the Commission
9on Dental Accreditation of the American Dental Association; or
10(iii) a training program approved by the Department.
11    Training required under this subsection (b) must also
12include Basic Life Support certification, as described in
13Section 16 of this Act. Proof of current certification shall
14be kept on file with the supervising dentist.
15    (c) Any procedures listed in subsection (a) that are
16performed by an expanded function dental assistant must be
17approved by the supervising dentist and examined prior to
18dismissal of the patient. The supervising dentist shall be
19responsible for all dental services or procedures performed by
20the dental assistant.
21    (d) Nothing in this Section shall be construed to alter
22the number of dental assistants that a dentist may supervise
23under paragraph (g) of Section 17 of this Act.
24    (e) Nothing in this Act shall: (1) require a dental
25assistant to be certified as an expanded function dental
26assistant or (2) prevent a dentist from training dental



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1assistants in accordance with the provisions of Section 17 or
217.1 of this Act or rules pertaining to dental assistant
4(Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19;
5101-162, eff. 7-26-19.)
6    (225 ILCS 25/18)   (from Ch. 111, par. 2318)
7    (Section scheduled to be repealed on January 1, 2026)
8    Sec. 18. Acts constituting the practice of dental hygiene;
10    (a) A person practices dental hygiene within the meaning
11of this Act when he or she performs the following acts under
12the supervision of a dentist:
13        (i) the operative procedure of dental hygiene,
14    consisting of oral prophylactic procedures;
15        (ii) the exposure and processing of X-Ray films of the
16    teeth and surrounding structures;
17        (iii) the application to the surfaces of the teeth or
18    gums of chemical compounds designed to be desensitizing
19    agents or effective agents in the prevention of dental
20    caries or periodontal disease;
21        (iv) all services which may be performed by a dental
22    assistant as specified by rule pursuant to Section 17, and
23    a dental hygienist may engage in the placing, carving, and
24    finishing of amalgam restorations only after obtaining
25    formal education and certification as determined by the



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1    Department;
2        (v) administration and monitoring of nitrous oxide
3    upon successful completion of a training program approved
4    by the Department;
5        (vi) administration of local anesthetics upon
6    successful completion of a training program approved by
7    the Department; and
8        (vii) such other procedures and acts as shall be
9    prescribed by rule or regulation of the Department.
10    (b) A dental hygienist may be employed or engaged only:
11        (1) by a dentist;
12        (2) by a federal, State, county, or municipal agency
13    or institution;
14        (3) by a public or private school; or
15        (4) by a public clinic operating under the direction
16    of a hospital or federal, State, county, municipal, or
17    other public agency or institution.
18    (c) When employed or engaged in the office of a dentist, a
19dental hygienist may perform, under general supervision, those
20procedures found in items (i) through (iv) of subsection (a)
21of this Section, provided the patient has been examined by the
22dentist within one year of the provision of dental hygiene
23services, the dentist has approved the dental hygiene services
24by a notation in the patient's record and the patient has been
25notified that the dentist may be out of the office during the
26provision of dental hygiene services.



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1    (d) If a patient of record is unable to travel to a dental
2office because of illness, infirmity, or imprisonment, a
3dental hygienist may perform, under the general supervision of
4a dentist, those procedures found in items (i) through (iv) of
5subsection (a) of this Section, provided the patient is
6located in a long-term care facility licensed by the State of
7Illinois, a mental health or developmental disability
8facility, or a State or federal prison. The dentist shall
9either personally examine and diagnose the patient or utilize
10approved teledentistry communication methods and determine
11which services are necessary to be performed, which shall be
12contained in an order to the hygienist and a notation in the
13patient's record. Such order must be implemented within 45 120
14days of its issuance, and an updated medical history and
15observation of oral conditions must be performed by the
16hygienist immediately prior to beginning the procedures to
17ensure that the patient's health has not changed in any manner
18to warrant a reexamination by the dentist.
19    (e) School-based oral health care, consisting of and
20limited to oral prophylactic procedures, sealants, and
21fluoride treatments, may be provided by a dental hygienist
22under the general supervision of a dentist. A dental hygienist
23may not provide other dental hygiene treatment in a
24school-based setting, including but not limited to
25administration or monitoring of nitrous oxide or
26administration of local anesthetics. The school-based



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1procedures may be performed provided the patient is located at
2a public or private school and the program is being conducted
3by a State, county or local public health department
4initiative or in conjunction with a dental school or dental
5hygiene program. The dentist shall personally examine and
6diagnose the patient and determine which services are
7necessary to be performed, which shall be contained in an
8order to the hygienist and a notation in the patient's record.
9Any such order for sealants must be implemented within 120
10days after its issuance. Any such order for oral prophylactic
11procedures or fluoride treatments must be implemented within
12180 days after its issuance. An updated medical history and
13observation of oral conditions must be performed by the
14hygienist immediately prior to beginning the procedures to
15ensure that the patient's health has not changed in any manner
16to warrant a reexamination by the dentist.
17    (f) Without the supervision of a dentist, a dental
18hygienist may perform dental health education functions,
19including instruction in proper oral health care and dental
20hygiene in either a school setting or long-term care facility.
21In addition, a dental hygienist may record care histories and
22oral conditions observed at any time prior to a clinical exam
23by a dentist and may record case histories and oral conditions
25    (g) The number of dental hygienists practicing in a dental
26office shall not exceed, at any one time, 4 times the number of



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1dentists practicing in the office at the time.
2    (h) A dental hygienist who is certified as a public health
3dental hygienist may provide services to patients: (1) who are
4eligible for Medicaid or (2) who are uninsured and whose
5household income is not greater than 200% of the federal
6poverty level. A public health dental hygienist may perform
7oral assessments, perform screenings, and provide educational
8and preventative services as provided in subsection (b) of
9Section 18.1 of this Act. The public health dental hygienist
10may not administer local anesthesia or nitrous oxide, or
11place, carve, or finish amalgam restorations or provide
12periodontal therapy under this exception. Each patient must
13sign a consent form that acknowledges that the care received
14does not take the place of a regular dental examination. The
15public health dental hygienist must provide the patient or
16guardian a written referral to a dentist for assessment of the
17need for further dental care at the time of treatment. Any
18indication or observation of a condition that could warrant
19the need for urgent attention must be reported immediately to
20the supervising dentist for appropriate assessment and
22    This subsection (h) is inoperative on and after January 1,
24    (i) A dental hygienist performing procedures listed in
25paragraphs (1) through (4) of subsection (a) of Section 17.1
26must be under the supervision of a dentist, requiring the



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1dentist authorizes the procedure, remains in the dental
2facility while the procedure is performed, and approves the
3work performed by the dental hygienist before dismissal of the
4patient, but the dentist is not required to be present at all
5times in the treatment room.
6    (j) A dental hygienist may perform actions described in
7paragraph (5) of subsection (a) of Section 17.1 under the
8general supervision of a dentist as described in this Section.
9(Source: P.A. 100-976, eff. 1-1-19; 101-162, eff. 7-26-19.)".