Amended  IN  Senate  April 23, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill
No. 1453

Introduced by Senator Ashby

February 16, 2024

An act to repeal Section 1607 of amend Sections 1628.7, 1632, 1632.5, 1632.55, 1634.1, 1635.5, 1638.1, 1646, 1646.1, 1646.2, 1646.3, 1646.9, 1647.2, 1647.3, 1647.6, 1647.18, 1647.19, 1647.20, 1647.22, 1647.30, 1647.31, 1647.32, 1700, 1718.3, 1724, 1740, 1750, 1750.1, 1750.2, 1750.3, 1750.4, 1750.5, 1752.1, 1752.4, 1753, 1753.5, 1753.6, 1804, and 1907 of, to add Sections 1646.12, 1647.37, 1647.38, 1754.5, and 1755 of, to repeal Sections 1607, 1632.1, 1749.1, 1752.6, 1753.7, and 2079 of, and to repeal and add Sections 1647.35, 1647.36, 1701.5, and 1741 of, the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 1453, as amended, Ashby. Dentistry: board meetings. Dentistry.
Existing law, the Dental Practice Act, requires the licensure of dentists by the Dental Board of California. Existing law requires the board to meet regularly once each year in the San Francisco Bay area and once each year in southern California, and other times and places as the board may designate, for the purpose of transacting its business. establishes the Dental Board of California to license and regulate the practice of dentistry, and establishes requirements for meetings of the board, admission to, and practice of, dentistry, licensure and regulation of dental auxiliaries, the use of anesthesia and sedation, and the use of fictitious business names by dental corporations.

This bill would repeal the above-described meeting requirement.

This bill, among other changes to the act, would delete a provision requiring the board to meet regularly once each year in the San Francisco Bay Area and once each year in southern California. The bill would revise application and examination requirements, requirements for the application and issuance of an elective facial cosmetic surgery permit, and would delete a provision requiring the board to appoint a credentialing committee to review the qualifications of each applicant for an elective facial cosmetic surgery permit.
Existing law governs the use of deep sedation, general anesthesia, moderate sedation, oral conscious sedation for adults, and pediatric minimal sedation.
This bill would revise and recast the requirements for obtaining authorization for, and the administration of, general anesthesia and sedation, including requirements relating to the physical presence of a dentist administering or ordering general anesthesia or deep sedation. The bill would make certain patient records submitted to the board confidential and not subject to disclosure pursuant to the California Public Records Act. The bill would provide for the expiration of a pediatric endorsement, and would revise requirements for the administration of general anesthesia by a physician and surgeon.
This bill would revise requirements and conditions for obtaining a permit for, and practicing under, a fictitious name. The bill would revise provisions affecting the cancellation of expired licenses, and would establish a fee for a pediatric endorsement, deep sedation or general anesthesia permit, or moderate sedation permit of up to $1,000, and a fee not to exceed $600 for a pediatric endorsement, which would be deposited into the State Dentistry Fund.
Existing law provides for the licensure and regulation of dental auxiliaries, including registered dental assistants, registered dental assistants in extended functions, orthodontist assistants, and dental sedation assistants, and sets forth duties and functions that those dental auxiliaries are authorized to perform.
This bill would, among other changes, revise requirements and conditions of supervision of dental assistants by employers and licensed dentists, training and education requirements for dental assistants, and the functions and duties a dental assistant is authorized to perform. The bill would establish requirements for courses in radiation safety and infection control for certain unlicensed dental assistants.
Existing law establishes requirements for obtaining an orthodontist assistant permit or a dental sedation assistant permit from the board, including licensure as a registered dental assistant, and sets forth the duties and functions that a person holding an orthodontic assistant permit or a dental sedation assistant permit may perform.
The bill would revise and recast the requirements to obtain an orthodontic assistant permit or a dental sedation assistant permit, and would revise the duties and functions that a person holding an orthodontic assistant permit or dental sedation assistant permit is authorized to perform. The bill would revise requirements for licensure and practice as a registered dental assistant and a registered dental assistant in extended functions, and would revise specified requirements for applying for and receiving a license as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions.
The bill would make other related and conforming changes. By expanding the scope of a crime under the act, the bill would impose a state-mandated local program.
Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest.
This bill would make legislative findings to that effect.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NOYES  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1607 of the Business and Professions Code is repealed.

SEC. 2.

 Section 1628.7 of the Business and Professions Code is amended to read:

1628.7.
 (a) The board may deny licensure to any applicant who is guilty of unprofessional conduct or of any cause that would subject a licensee to revocation or suspension of their license. The board may, upon an applicant’s successful completion of the board examination, board’s licensure requirements, in its sole discretion, issue a probationary license to an applicant for licensure as a dentist or dental auxiliary. The board may require, as a term or condition of issuing the probationary license, the applicant to do any of the following, including, but not limited to:
(1) Successfully complete a professional competency examination.
(2) Submit to a medical or psychological evaluation.
(3) Submit to continuing medical or psychological treatment.
(4) Abstain from the use of alcohol or drugs.
(5) Submit to random fluid testing for alcohol or controlled substance abuse.
(6) Submit to continuing participation in a board approved rehabilitation program.
(7) Restrict the type or circumstances of practice.
(8) Submit to continuing education and coursework.
(9) Comply with requirements regarding notification to employer and changes of employment.
(10) Comply with probation monitoring.
(11) Comply with all laws and regulations governing the practice of dentistry.
(12) Limit practice to a supervised structured environment in which the licensee’s activities shall be supervised by another dentist.
(13) Submit to total or partial restrictions on drug prescribing privileges.
(b) The board shall provide the decision placing the applicant on probation in plain view on the board’s internet website.

(b)

(c) The Unless otherwise specified by the board, the term of probation shall be for three years and the licensee may petition the board for early termination, or modification of a condition of, the probation in accordance with subdivision (b) of Section 1686.

(c)The proceeding under this section shall be conducted in accordance with the provisions of Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.

(d)The board shall adopt written guidelines on how to make probation assignments for licensees and shall ensure that probationary and evaluation reports are conducted consistently and regularly.

(d) An applicant shall not be eligible to reapply for licensure for a minimum of one year from the effective date of the denial of their application.
(e) Upon successful completion of all terms and conditions of probation or termination of the probationary terms and conditions pursuant to subdivision (c), the board may issue an unrestricted license to the licensee.
(f) Adjudication under the Administrative Procedure Act (Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code) shall not be required to issue a probationary license pursuant to subdivision (a).

SEC. 3.

 Section 1632 of the Business and Professions Code is amended to read:

1632.
 (a) The board shall require each applicant to successfully complete the written examination of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
(b) The board shall require each applicant to successfully complete an examination in California law and ethics developed and administered by the board. The board shall provide a separate application for this examination. The board shall ensure that the law and ethics examination reflects current law and regulations, and ensure that the examinations are randomized. Applicants shall submit this application and required fee to the board in order to take this examination. In addition to the aforementioned application, the only other requirement for taking this examination shall be certification from the dean of the qualifying dental school or the dean’s delegate attended by the applicant that the applicant has graduated, or will graduate, or is expected to graduate. Applicants who submit completed applications and certification from the dean at least 15 days prior to a scheduled examination shall be scheduled to take the examination. Successful results of the examination shall, as established by board regulation, remain valid for two years from the date that the applicant is notified of having passed the examination.
(c) Except as otherwise provided in Section 1632.5, the board shall require each applicant to have taken and received a passing score on one of the following:

(1)(A)A portfolio examination of the applicant’s competence to enter the practice of dentistry. This examination shall be conducted while the applicant is enrolled in a dental school program at a board-approved school located in California. This examination shall utilize uniform standards of clinical experiences and competencies, as approved by the board pursuant to Section 1632.1. The applicant shall pass a final assessment of the submitted portfolio at the end of the applicant’s dental school program. Before any portfolio assessment may be submitted to the board, the applicant shall remit the required fee to the board to be deposited into the State Dentistry Fund, and a letter of good standing signed by the dean of the applicant’s dental school or the dean’s delegate stating that the applicant has graduated or will graduate with no pending ethical issues.

(B)The board shall provide a report on how many other states have recognized licensure by portfolio examination at the time of its sunset review pursuant to subdivision (d) of Section 1601.1. The report shall be submitted in compliance with Section 9795 of the Government Code.

(2)Either one of the following examinations:

(A)

(1) A clinical and written examination administered by the Western Regional Examining Board within five years prior to the date of their application for a license under this section.

(B)

(2) The clinical and written examination developed by the American Board of Dental Examiners, Inc., within five years prior to the date of their application for a license under this section.
(d) Notwithstanding subdivision (b) of Section 1628, the board is authorized to do either of the following:
(1) Approve an application for examination from, and to examine an applicant who is enrolled in, but has not yet graduated from, a reputable dental school approved by the board.
(2) Accept the results of an examination described in paragraph (2) of subdivision (c) submitted by an applicant who was enrolled in, but had not graduated from, a reputable dental school approved by the board at the time the examination was administered.
In either case, the board shall require the dean of that school or the dean’s delegate to furnish satisfactory proof that the applicant will graduate within one year of the date the examination was administered or as provided in paragraph (1) of subdivision (c). administered.
(e) The board may determine the testing format, as related to patients, for the examination provided pursuant to subparagraph (B) of paragraph (2) of subdivision (c).

SEC. 4.

 Section 1632.1 of the Business and Professions Code is repealed.
1632.1.

(a)With regard to the portfolio examination specified in paragraph (1) of subdivision (c) of Section 1632, the board shall independently monitor and audit the standardization and calibration of dental school competency instructors at least biennially to ensure standardization and an acceptable level of calibration in the grading of the examination. Each dental school’s competency examinations shall be audited biennially by the board.

(b)The board shall oversee all aspects of the portfolio examination process specified in paragraph (1) of subdivision (c) of Section 1632 and under this section, but shall not interfere with the dental school authority to establish and deliver an accredited curriculum. The board shall determine an end-of-year deadline, in consultation with the current board-approved dental schools, to determine when the portfolio examinations shall be completed and submitted to the board for review by the board’s examiners.

(c)The board, in consultation with the current board-approved dental schools, shall approve portfolio examination competencies and the minimum number of clinical experiences required for successful completion of the portfolio examination.

(d)The board shall require and verify successful completion of competency examinations that were performed on a patient of record of a board-approved dental school, including, but not limited to, the following:

(1)Comprehensive oral diagnosis and treatment planning.

(2)Periodontics.

(3)Direct restorations.

(4)Indirect restorations.

(5)Removable prosthodontics.

(6)Endodontics.

SEC. 5.

 Section 1632.5 of the Business and Professions Code is amended to read:

1632.5.
 (a) Prior to implementation of paragraph (2) of subdivision (c) of Section 1632, the department’s Office of Professional Examination Services shall review the Western Regional Examining Board examination to ensure compliance with the requirements of Section 139 and to certify that the examination process meets those standards. If the department determines that the examination process fails to meet those standards, paragraph (2) of subdivision (c) of Section 1632 shall not be implemented. The review of the Western Regional Examining Board examination shall be conducted during or after the Dental Board of California’s occupational analysis scheduled for the 2004–05 fiscal year, but not later than September 30, 2005. However, an applicant who successfully completes the Western Regional Examining Board examination on or after January 1, 2005, shall be deemed to have met the requirements of subdivision (c) of Section 1632 if the department certifies that the Western Regional Examining Board examination meets the standards set forth in this subdivision.
(b) The Western Regional Examining Board examination process shall be regularly reviewed by the department pursuant to Section 139.
(c) The Western Regional Examining Board examination shall meet the mandates of subdivision (a) of Section 12944 of the Government Code.
(d) As part of its next scheduled review by the Joint Committee on Boards, Commissions, and Consumer Protection, the Dental Board of California shall report to that committee and the department on the pass rates of applicants who sat for the Western Regional Examining Board examination, compared with the pass rates of applicants who sat for the state clinical and written examination administered by the Dental Board of California. This report shall be a component of the evaluation of the examination process that is based on psychometrically sound principles for establishing minimum qualifications and levels of competency.

SEC. 6.

 Section 1632.55 of the Business and Professions Code is amended to read:

1632.55.
 (a) Prior to implementation of subparagraph (B) of paragraph (2) of subdivision (c) of Section 1632, the department’s Office of Professional Examination Services shall review the American Board of Dental Examiners, Inc. examination to ensure compliance with the requirements of Section 139 and to certify that the examination process meets those standards, and deliver this review to the Dental Board of California. If the department determines that the examination process fails to meet those standards, does not deliver the review to the Dental Board of California, or if the American Board of Dental Examiners, Inc. fails to pay the costs and expenses the board incurs, as described in subdivision (d), subparagraph (B) of paragraph (2) of subdivision (c) of Section 1632 shall not be implemented.
(b) The American Board of Dental Examiners, Inc. examination process shall be regularly reviewed by the department pursuant to Section 139.
(c) The American Board of Dental Examiners, Inc. examination shall meet the mandates of subdivision (a) of Section 12944 of the Government Code.
(d) The American Board of Dental Examiners, Inc. shall pay all reasonable costs and expenses the board incurs for the purposes of implementing this section.
(e) The American Board of Dental Examiners, Inc. examination may only be accepted for licensure by a candidate after it is determined that the examination has met the requirements of this section. Examinations taken prior to that date may not be used for licensure.

SEC. 7.

 Section 1634.1 of the Business and Professions Code is amended to read:

1634.1.
 Notwithstanding Section 1634, the board may grant a license to practice dentistry to an applicant who submits all of the following to the board:
(a) A completed application form and all fees required by the board.
(b) Satisfactory evidence of having graduated from a dental school approved by a national accrediting body approved by the board or by the Commission on Dental Accreditation of the American Dental Association.
(c) Satisfactory evidence of having completed a clinically based advanced education program in general dentistry or an advanced education program in general practice residency that is, at minimum, one year in duration and is accredited by either the Commission on Dental Accreditation of the American Dental Association or a national accrediting body approved by the board. The advanced education program shall include a certification of clinical residency program completion approved by the board, to be completed upon the resident’s successful completion of the program in order to evaluate the resident’s competence to practice dentistry in the state. The certification shall be within two years prior to the date of the resident’s application for a license under this section. Completion of the program shall be within two years prior to the date of their application for a license under this section.
(d) Satisfactory evidence of having successfully completed the written examination of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
(e) Satisfactory evidence of having successfully completed an examination in California law and ethics.
(f) Proof that the applicant has not failed the a state, regional, or national examination for licensure to practice dentistry under this chapter within five years prior to the date of the resident’s application for a license under this chapter. If the applicant subsequently passed the examination for licensure, the prior failure shall not make the applicant ineligible under this subdivision.

SEC. 8.

 Section 1635.5 of the Business and Professions Code is amended to read:

1635.5.
 (a) Notwithstanding Section 1634, the board may grant a license to practice dentistry to an applicant who has not taken an examination before the board, if the applicant submits all of the following to the board:
(1) A completed application form and all fees required by the board.
(2) Proof of a current an active and unrestricted license issued by another state state, district, or territory of the United States to practice dentistry that is not revoked or suspended or otherwise restricted. subject to any current or pending disciplinary action such as revocation, suspension, or probation.
(3) Proof that the applicant has either been in active clinical practice in another state, district, or territory of the United States or has been a full-time faculty member in an accredited dental education program and in active clinical practice for a total of at least 5,000 hours in five of the seven consecutive within the past five years immediately preceding the date of his or her the application under this section. The clinical practice requirement shall be deemed met if may be met by submitting documentation of any of the following is submitted: following:
(A) The applicant may receive credit for two of the five years of clinical practice by demonstrating completion of a If the applicant has completed a residency training program accredited by the American Dental Association Commission on Dental Accreditation, including, but not limited to, a general practice residency, an advanced education in general dentistry program, or a training program in a specialty recognized by the American Dental Association. Association, the applicant may receive credit of 1,000 hours for each year, up to 2,000 hours, of clinical practice completed in the residency training program.
(B)  The applicant agrees to practice dentistry full time for a minimum of 32 hours per week for two years in at least one primary care clinic licensed under subdivision (a) of Section 1204 of the Health and Safety Code or primary care clinic exempt from licensure pursuant to subdivision (c) of Section 1206 of the Health and Safety Code, or a clinic owned or operated by a public hospital or health system, or a clinic owned and operated by a hospital that maintains the primary contract with a county government to fill the county’s role under Section 17000 of the Welfare and Institutions Code. The applicant shall submit written documentation, executed by the authorized agent of the clinic, verifying compliance with this requirement. The board may periodically request verification of compliance with these requirements, and may revoke the license upon a finding that the employment requirement, or any other requirement of this subparagraph, has not been met. Full-time status shall be defined by the board for the purposes of this subparagraph, and the board may establish exemptions to this requirement on a case-by-case basis. requirements.
(C)  The applicant agrees to teach or practice dentistry full time in California for a minimum average of 40 hours per week for two years in at least one accredited dental education program as approved by the Dental Board of California. program approved by the board. The applicant shall submit written documentation, executed by the authorized agent of the program, verifying compliance with this requirement. The board may periodically request verification of compliance with these requirements, and may revoke the license upon a finding that the employment requirement, or any other requirement of this subparagraph, has not been met. Full-time status shall be defined by the board for the purposes of this subparagraph, and the board may establish exemptions to this requirement on a case-by-case basis.
(4) Proof that the applicant has not been subject to disciplinary action by any state in which he or she the applicant is or has been previously licensed to practice dentistry. If the applicant has been subject to disciplinary action, the board shall review that action to determine if it presents sufficient evidence of a violation of Article 4 (commencing with Section 1670) to warrant the submission of additional information from the applicant or the denial of the application for licensure.
(5) A signed release allowing the disclosure of information from the National Practitioner Data Bank and the verification of registration status with the federal Drug Enforcement Administration. The board shall review this information to determine if it presents sufficient evidence of a violation of Article 4 (commencing with Section 1670) to warrant the submission of additional information from the applicant or the denial of the application for licensure.
(6) Proof that the applicant has not failed the a state, regional, or national examination for licensure to practice dentistry under this chapter within five years prior to the date of his or her the application for a license under this section. If the applicant subsequently passed the examination for licensure, the prior failure shall not make the applicant ineligible under this paragraph.
(7) An acknowledgment by the applicant executed under penalty of perjury and automatic forfeiture of license, of the following:
(A) That the information provided by the applicant to the board is true and correct, to the best of his or her their knowledge and belief.
(B) That the applicant has not been convicted of an offense involving conduct that would violate Section 810.
(8) Documentation of 50 units of continuing education completed within two years of the date of his or her the application under this section. The continuing education shall include the mandatory coursework prescribed by the board pursuant to subdivision (b) of Section 1645.
(9) Any other information as specified by the board to the extent it is required of applicants for licensure by examination under this article.
(b) The board shall provide in the application packet to each out-of-state dentist pursuant to this section the following information:
(1) The location of dental manpower shortage areas that exist in the state.
(2) Those not-for-profit clinics and public hospitals seeking to contract with licensees for dental services.
(c) (1) The board shall review the impact of this section on the availability of dentists in California and report to the appropriate policy and fiscal committees of the Legislature by January 1, 2008. The report shall include a separate section providing data specific to those dentists who intend to fulfill the alternative clinical practice requirements of subparagraph (B) of paragraph (3) of subdivision (a). The report shall include, but not be limited to, all of the following:
(A) The total number of applicants from other states who have sought licensure.
(B) The number of dentists from other states licensed pursuant to this section, as well as the number of licenses not granted and the reasons why each license was not granted.
(C) The location of the practice of dentists licensed pursuant to this section.
(D) The number of dentists licensed pursuant to this section who establish a practice in a rural area or in an area designated as having a shortage of practicing dentists or no dentists at all.
(E) The length of time dentists licensed pursuant to this section maintained their practice in the reported location. This information shall be reported separately for dentists described in subparagraphs (C) and (D).
(2) In identifying a dentist’s location of practice, the board shall use medical service study areas or other appropriate geographic descriptions for regions of the state.
(3) If appropriate, the board may report the information required by paragraph (1) separately for primary care dentists and specialists.
(d) The board is authorized to contract with a third party or parties to review applications filed under this section and to advise the board as to whether the applications are complete. The contracting party, its agents, and its employees shall agree to be bound by all provisions of law applicable to the board, its members, and staff, governing custody and confidentiality of materials submitted by applicants for licensure.
(e) The board, in issuing a license under this section board may issue a temporary, restricted license, valid for two years, to an applicant qualified under subparagraph (B) or (C) of paragraph (3) of subdivision (a), may impose a restriction authorizing that authorizes the holder to practice dentistry only in the facilities described in subparagraph (B) of paragraph (3) of subdivision (a) or only to practice or teach dentistry at the accredited dental education programs described in subparagraph (C) of paragraph (3) of subdivision (a). Upon the expiration of the two-year term, all location restrictions on the license shall be removed and the holder is authorized to practice dentistry in accordance with this chapter in any allowable setting in the state. The Board shall immediately terminate the license issued pursuant to this subdivision upon a finding that the requirements of subparagraph (B) or (C) of paragraph (3) of subdivision (a), as applicable, have not been met. Upon termination of the license, the board shall issue a notice of termination that shall require the licensee to immediately cease dental practice. Upon the licensee’s completion of the license requirements under this section and the expiration of the two-year term, all location restrictions on the license shall be removed and an unrestricted license shall be issued.
(f) Notwithstanding any other provision of law, a holder of a license issued by the board before January 1, 2006, under this section who committed to complete the remainder of the five years of clinical practice requirement by a contract either to practice dentistry full time in a facility described in subparagraph (B) of paragraph (3) of subdivision (a) or to teach or practice dentistry full time in an accredited dental education program approved by the board, board pursuant to subparagraph (C) of paragraph (3) of subdivision (a) shall be required to complete only two years of service under the contract in order to fulfill his or her the obligation under this section. Upon the expiration of that two-year term, all location restrictions on the license shall be removed and the holder is authorized to practice dentistry in accordance with this chapter in any allowable setting in the state.
(g) A license issued pursuant to this section shall be considered a valid, unrestricted license for purposes of Section 1972.

SEC. 9.

 Section 1638.1 of the Business and Professions Code is amended to read:

(a)(1)A person licensed pursuant to Section 1634 who wishes to perform elective facial cosmetic surgery shall first apply for and receive a permit to perform elective facial cosmetic surgery from the board.

(2)A permit issued pursuant to this section shall be valid for a period of two years and must be renewed by the permitholder at the time his or her license is renewed. Every six years, prior to renewal of the permitholder’s license and permit, the permitholder shall submit evidence acceptable to the credentialing committee that he or she has maintained continued competence to perform the procedures authorized by the permit. The credentialing committee may limit a permit consistent with paragraph (1) of subdivision (e) if it is not satisfied that the permitholder has established continued competence.

(b)The board may adopt regulations for the issuance of the permit that it deems necessary to protect the health, safety, and welfare of the public.

1638.1.
 (a) The board may issue an elective facial cosmetic surgery permit to perform one of the following categories of elective facial cosmetic surgical procedures:
(1) Cosmetic contouring of the osteocartilaginous facial structure, which may include, but is not limited to, rhinoplasty and otoplasty.
(2) Cosmetic contouring or rejuvenation of the facial soft tissue, which may include, but is not limited to, facelift, blepharoplasty, facial skin resurfacing, or lip augmentation.
(3) Procedures under both paragraphs (1) and (2).

(c)

(b) A licensee may obtain a permit who desires to perform elective facial cosmetic surgery by furnishing all of the following information shall apply to the board on an application form approved by the board: prescribed by the board and submit all of the following:
(1) Proof of successful completion of an oral and maxillofacial surgery residency program accredited by the Commission on Dental Accreditation of the American Dental Association.
(2) Proof that the applicant has satisfied licensee has satisfied all of the criteria specified in either subparagraph (A) or (B):
(A) (i) Is The licensee is certified, or is a candidate for certification, by the American Board of Oral and Maxillofacial Surgery.
(ii) Submits to the board a A letter from the program director of the accredited residency program, or from the director of a postresidency fellowship program accredited by the Commission on Dental Accreditation of the American Dental Association, stating that the licensee has the education, training, and competence necessary to perform the surgical procedures set forth in paragraphs (1) to (3), inclusive, of subdivision (a) that the licensee has notified the board he or she the licensee intends to perform.

(iii)Submits documentation to the board of at least 10 operative reports from residency training or proctored procedures that are representative of procedures that the licensee intends to perform from both of the following categories:

(I)Cosmetic contouring of the osteocartilaginous facial structure, which may include, but is not limited to, rhinoplasty and otoplasty.

(II)Cosmetic soft tissue contouring or rejuvenation, which may include, but is not limited to, facelift, blepharoplasty, facial skin resurfacing, or lip augmentation.

(iii) Documentation of at least 10 operative reports from residency training or proctored surgical procedures performed at minimum in the role of surgical first assistant within five years from the date of application for each category of permit set forth in paragraphs (1) or (2) of subdivision (b) for which the licensee seeks a permit. If the licensee seeks a permit set forth in paragraph (3) of subdivision (b), the licensee shall submit 10 operative reports for each category specified in paragraphs (1) and (2) of subdivision (b). Each operative report shall indicate all of the following:
(I) Name of the licensee.
(II) Category of procedure and specific type of procedure performed.
(III) Date of the procedure.
(IV) The role in which the licensee participated in the procedure.
(iv) Submits documentation to the board Documentation showing the surgical privileges the applicant licensee possesses at any licensed general acute care hospital and any licensed outpatient surgical facility in this state.
(B) (i) Has The licensee has been granted privileges by the medical staff at a licensed general acute care hospital to perform the surgical procedures set forth in paragraph (A) paragraphs (1) to (3), inclusive, of subdivision (b) at that hospital.
(ii) Submits to the board the documentation Documentation described in clause (iii) of subparagraph (A).
(3) Proof that the applicant licensee is on active status on the staff of a general acute care hospital and maintains the necessary privileges based on the bylaws of the hospital to maintain that status.

(d)

(c) The application shall be accompanied by an application fee required by the board for an initial permit. The fee to renew a permit shall not exceed the maximum amount prescribed in Section 1724.

(e)(1)The board shall appoint a credentialing committee to review the qualifications of each applicant for a permit. Upon completion of the review of an applicant, the committee shall make a recommendation to the board on whether to issue or not issue a permit to the applicant. The permit may be unqualified, entitling the permitholder to perform any facial cosmetic surgical procedure authorized by this section, or it may contain limitations if the credentialing committee is not satisfied that the applicant has the training or competence to perform certain classes of procedures, or if the applicant has not requested to be permitted for all procedures authorized by this section.

(2)The credentialing committee shall be comprised of five members, as follows:

(A)A physician and surgeon with a specialty in plastic and reconstructive surgery who maintains active status on the staff of a licensed general acute care hospital in this state.

(B)A physician and surgeon with a specialty in otolaryngology who maintains active status on the staff of a licensed general acute care hospital in this state.

(C)Three oral and maxillofacial surgeons licensed by the board who are board certified by the American Board of Oral and Maxillofacial Surgeons, and who maintain active status on the staff of a licensed general acute care hospital in this state, at least one of whom shall be licensed as a physician and surgeon in this state. Two years after the effective date of this section, any oral and maxillofacial surgeon appointed to the committee who is not licensed as a physician and surgeon shall hold a permit pursuant to this section.

(3)The board shall solicit from the following organizations input and recommendations regarding members to be appointed to the credentialing committee:

(A)The Medical Board of California.

(B)The California Dental Association.

(C)The California Association of Oral and Maxillofacial Surgeons.

(D)The California Medical Association.

(E)The California Society of Plastic Surgeons.

(F)Any other source that the board deems appropriate.

(4)The credentialing committee shall meet at a time and place directed by the board to evaluate applicants for permits. A quorum of three members shall be required for the committee to consider applicants and make recommendations to the board.

(d) The board may adopt regulations for the issuance of the permit that it deems necessary to protect the health, safety, and welfare of the public.

(f)

(e) A licensee may not perform any elective, facial cosmetic surgical procedure except at a general acute care hospital, a licensed outpatient surgical facility, or an outpatient surgical facility accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the American Commission, the Accreditation Association for Ambulatory Health Care (AAAHC), the Medicare program, or an accreditation agency approved by the Medical Board of California pursuant to subdivision (g) of Section 1248.1 of the Health and Safety Code.

(g)

(f) For purposes of this section, the following terms shall have the following meanings:
(1) “Elective cosmetic surgery” means any procedure defined as cosmetic surgery in subdivision (d) of Section 1367.63 of the Health and Safety Code, and excludes any procedure that constitutes reconstructive surgery, as defined in subdivision (c) of Section 1367.63 of the Health and Safety Code.
(2) “Facial” means those regions of the human body described in Section 1625 and in any regulations adopted pursuant to that section by the board.

(h)

(g) A holder of a permit issued pursuant to this section shall not perform elective facial cosmetic surgical procedures unless he or she the permitholder has malpractice insurance or other financial security protection that would satisfy the requirements of Section 2216.2 and any regulations adopted thereunder.

(i)

(h) A holder of a permit shall comply with the requirements of subparagraph (D) of paragraph (2) of subdivision (a) of Section 1248.15 of the Health and Safety Code, and the reporting requirements specified in Section 2240, with respect to any surgical procedure authorized by this section, in the same manner as a physician and surgeon.

(j)

(i) Any violation of this section constitutes unprofessional conduct and is grounds for the revocation or suspension of the person’s permit, license, or both, or the person may be reprimanded or placed on probation. Proceedings initiated by the board under this section shall be conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the board shall have all the powers granted therein.
(j) A permit issued pursuant to this section shall be valid for a period of two years and must be renewed by the permitholder at the time the dentist license is renewed.
(k) A permitholder shall be required to complete 24 hours of approved courses of study related to elective cosmetic surgery as a condition of renewal of a permit. Those courses of study shall be credited toward the total continuing education hours required by the board pursuant to Section 1645.
(l) Permits issued prior to January 1, 2025, that limit the type of procedure under the general permit category provided under paragraph (1) or (2) of subdivision (a) authorized to be performed by the permitholder shall not be renewed. This subdivision shall not apply to a permit that authorized the permitholder to practice any procedure under the general permit category specified under paragraph (1) or (2) of subdivision (a). The permitholder who seeks to continue performing the procedure previously limited by the permit shall submit an application to the board for issuance of a new permit under paragraph (1), (2), or (3) of subdivision (a), and the board may request the permitholder to submit additional documentation demonstrating the permitholder’s competency for issuance of such permit. The application shall be treated as a renewal application for purposes of subdivision (m) of section 1724.

(k)

(m) On or before January 1, 2009, 2025, and every four years thereafter, the board shall report to the Joint Committee on Boards, Commissions and Consumer Protection Sunset Review Committee on all of the following:
(1) The number of persons licensed pursuant to Section 1634 who apply to receive a permit to perform elective facial cosmetic surgery from the board pursuant to subdivision (a). this section.

(2)The recommendations of the credentialing committee to the board.

(3)The board’s action on recommendations received by the credentialing committee.

(4)

(2) The number of persons receiving a permit from the board to perform elective facial cosmetic surgery.

(5)

(3) The number of complaints filed by or on behalf of patients who have received elective facial cosmetic surgery by persons who have received a permit from the board to perform elective facial cosmetic surgery.

(6)

(4) Action taken by the board resulting from complaints filed by or on behalf of patients who have received elective facial cosmetic surgery by persons who have received a permit from the board to perform elective facial cosmetic surgery.
(n) As used in this section, “good standing” means the license is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

SEC. 10.

 Section 1646 of the Business and Professions Code is amended to read:

1646.
 As used in this article, the following definitions apply:
(a) “Deep sedation” means a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.
(b) “General anesthesia” means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.
(c) “Good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

SEC. 11.

 Section 1646.1 of the Business and Professions Code is amended to read:

1646.1.
 (a) A dentist shall possess either a current license in good standing and a general anesthesia permit issued by the board or a permit under Section 1638 or 1640 and a general anesthesia permit issued by the board an active dentist license or a permit under Section 1638 or 1640 issued by the board and an active general anesthesia permit in order to administer or order the administration of deep sedation or general anesthesia on an outpatient basis for dental patients.
(b) A dentist shall possess a pediatric endorsement of their general anesthesia permit to administer or order the administration of deep sedation or general anesthesia to patients under seven years of age.
(c) A dentist shall be physically within the dental office at the time of ordering, and during the administration of, general anesthesia or deep sedation. who administers or orders the administration of general anesthesia or deep sedation shall be physically present in the treatment facility while the patient is under general anesthesia or deep sedation.
(d) For patients under 13 years of age, all of the following shall apply:
(1) The operating dentist and at least two additional personnel shall be present throughout the procedure involving deep sedation or general anesthesia.
(2) If the operating dentist is the permitted anesthesia provider, then both of the following shall apply:
(A) The operating dentist and at least one of the additional personnel shall maintain current certification in Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The additional personnel who is certified in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be solely dedicated to monitoring the patient and shall be trained to read and respond to monitoring equipment including, but not limited to, pulse oximeter, cardiac monitor, blood pressure, pulse, capnograph, and respiration monitoring devices.
(B) The operating dentist shall be responsible for initiating and administering any necessary emergency response.
(3) If a dedicated permitted anesthesia provider is monitoring the patient and administering deep sedation or general anesthesia, both of the following shall apply:
(A) The anesthesia provider and the operating dentist, or one other trained personnel, shall be present throughout the procedure and shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(B) The anesthesia provider shall be responsible for initiating and administering any necessary emergency response and the operating dentist, or other trained and designated personnel, shall assist the anesthesia provider in emergency response.
(e) This article does not apply to the administration of local anesthesia, minimal sedation, or moderate sedation.

SEC. 12.

 Section 1646.2 of the Business and Professions Code is amended to read:

1646.2.
 (a) A dentist who desires to administer or order the administration of deep sedation or general anesthesia shall apply to the board on an application form prescribed by the board. The dentist must shall possess a dentist license or a permit under Section 1638 or 1640 issued by the board that is in good standing, submit an application fee and produce evidence showing that he or she has they have successfully completed a minimum of one year of advanced training in anesthesiology and related academic subjects approved by the board, or equivalent training or experience approved by the board, beyond the undergraduate school level.
(b) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c) A dentist may apply for a pediatric endorsement for the general anesthesia permit by providing proof of successful completion of all of the following:
(1) A Commission on Dental Accreditation (CODA)-accredited or equivalent residency training program that provides competency in the administration of deep sedation and general anesthesia on pediatric patients.
(2) At least 20 cases of deep sedation or general anesthesia to patients under seven years of age in the 24-month time period directly preceding application for a pediatric endorsement to establish competency, both at the time of initial application and at renewal. The applicant or permitholder shall maintain and be able to provide proof of these cases upon request by the board for up to three permit renewal periods. Patient records submitted to the board pursuant to this paragraph shall be confidential and shall not be disclosed pursuant to any state law, including, but not limited to, the California Public Records Act (Division 10 (commencing with Section 7920.000) of the Government Code), except for disclosure pursuant to a lawfully issued subpoena or a written request from a government agency responsible for either enforcement of civil or criminal laws or the professional licensing of individuals that is conducting an investigation about the applicant.
(3) Current certification in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) or other board-approved training in pediatric life support and airway management, pursuant to Section 1601.8, for the duration of the permit.
(d) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of pediatric sedation to patients under seven years of age may administer deep sedation and general anesthesia to patients under seven years of age under the direct supervision of a general anesthesia permitholder with a pediatric endorsement. The applicant may count these cases toward the 20 cases required to qualify for the applicant’s pediatric endorsement.

SEC. 13.

 Section 1646.3 of the Business and Professions Code is amended to read:

1646.3.
 (a) A physical evaluation and medical history shall be taken before the administration of deep sedation or general anesthesia.
(b) Any dentist holding a permit shall maintain medical Medical history, physical evaluation, deep sedation, and general anesthesia records shall be maintained as required by board regulations.

SEC. 14.

 Section 1646.9 of the Business and Professions Code is amended to read:

1646.9.
 (a) A physician and surgeon licensed by the Medical Board of California or Osteopathic Medical Board of California pursuant to Chapter 5 (commencing with Section 2000) may administer deep sedation or general anesthesia in the office of a licensed dentist for dental patients, without regard to whether the dentist possesses a permit issued pursuant to this article, if all of the following conditions are met:
(1) The physician and surgeon possesses a current license in good standing an active license to practice medicine in this state.
(2) The physician and surgeon holds a valid an active general anesthesia permit issued by the Dental Board of California pursuant to subdivision (b).
(3) The physician and surgeon meets the requirements of subdivision (d) of Section 1646.1.
(b) A physician and surgeon who desires to administer deep sedation or general anesthesia as set forth in subdivision (a) shall possess a license issued by the Medical Board of California or the Osteopathic Medical Board of California, as applicable, that is in good standing, shall apply to the board on an application form prescribed by the board and shall board, and shall submit all of the following:
(1) Certified license history issued by the Medical Board of California or Osteopathic Medical Board of California, as applicable to the applicant’s license, showing the physician and surgeon license number and current license status.

(1)

(2) The payment of an application fee prescribed by this article.

(2)

(3) Evidence satisfactory to the Medical Board of California showing that the applicant has successfully completed a postgraduate residency training program in anesthesiology that is recognized by the American Council on Accreditation Council for Graduate Medical Education, as set forth in Section 2079. Education.

(3)

(4) Documentation demonstrating that all equipment and drugs required by the board are on the premises for use in any dental office in which he or she the applicant administers deep sedation or general anesthesia.

(4)

(5) Information relative to the current membership of the applicant on hospital medical staffs.
(c) Prior to issuance or renewal of a permit pursuant to this section, the board may, at its discretion, require an onsite inspection and evaluation of the facility, equipment, personnel, including, but not limited to, the physician and surgeon, and procedures utilized. At least one of the persons evaluating the procedures utilized by the physician and surgeon shall be a licensed physician and surgeon expert in outpatient deep sedation or general anesthesia who has been authorized or retained under contract by the board for this purpose.
(d) The permit of a physician and surgeon who has failed an onsite inspection and evaluation shall be automatically suspended 30 days after the date on which the board notifies the physician and surgeon of the failure unless within that time period the physician and surgeon has retaken and passed an onsite inspection and evaluation. Every physician and surgeon issued a permit under this article shall have an onsite inspection and evaluation at least once every five years. Refusal to submit to an inspection shall result in automatic denial or revocation of the permit.
(e) A physician and surgeon who additionally meets the requirements of paragraphs (2) and (3) of subdivision (c) of Section 1646.2 may apply to the board for a pediatric endorsement to provide deep sedation or general anesthesia to a child under seven years of age. A physician and surgeon without sufficient cases to obtain a pediatric endorsement may qualify for the endorsement pursuant to the requirements of subdivision (d) of Section 1646.2.

SEC. 15.

 Section 1646.12 is added to the Business and Professions Code, to read:

1646.12.
 A pediatric endorsement shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.

SEC. 16.

 Section 1647.2 of the Business and Professions Code is amended to read:

1647.2.
 (a) A dentist may administer or order the administration of moderate sedation on an outpatient basis for a dental patient if one of the following conditions is met: if the dentists possesses an active dentist license or permit under Section 1638 or 1640 issued by the board and either an active general anesthesia permit or a moderate sedation permit.

(1)The dentist possesses a current license in good standing and either holds a valid general anesthesia permit or obtains a moderate sedation permit.

(2)The dentist possesses a current permit under Section 1638 or 1640 and either holds a valid general anesthesia permit or obtains a moderate sedation permit.

(b) A dentist moderate sedation permitholder shall obtain a pediatric endorsement on the moderate sedation permit prior to administering moderate sedation to a patient under 13 years of age.
(c) (1) A dentist who moderate sedation permitholder who administers or orders the administration of moderate sedation shall be physically present in the treatment facility while the patient is sedated.
(2) For patients under 13 years of age, there shall be at least two support personnel in addition to the operating dentist present at all times during the procedure involving moderate sedation. The operating dentist and one personnel member shall maintain current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8. The personnel member with current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management shall be dedicated to monitoring the patient during the procedure involving moderate sedation and may assist with interruptible patient-related tasks of short duration, such as holding an instrument.
(d) A dentist with a moderate sedation permit or a moderate sedation permit with a pediatric endorsement A moderate sedation permitholder shall possess the training, equipment, and supplies to rescue a patient from an unintended deeper level of sedation.
(e) This article shall not apply to the administration of local anesthesia, minimal sedation, deep sedation, or general anesthesia.

SEC. 17.

 Section 1647.3 of the Business and Professions Code is amended to read:

1647.3.
 (a) A dentist who desires to administer or to order the administration of moderate sedation shall possess a dentist license or a permit under Section 1638 or 1640 issued by the board that is in good standing and apply to the board on an application form prescribed by the board. The dentist shall submit an application fee and produce evidence showing that he or she the dentist has successfully completed training in moderate sedation that meets the requirements of subdivision (c).
(b) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c) Training in the administration of moderate sedation shall be acceptable if it meets all of the following as approved by the board:
(1) Consists of at least 60 hours of instruction.
(2) Requires satisfactory completion of at least 20 cases of administration of moderate sedation for a variety of dental procedures.
(3) Complies with the requirements of the Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students of the American Dental Association, including, but not limited to, certification of competence in rescuing patients from a deeper level of sedation than intended, and managing the airway, intravascular or intraosseous access, and reversal medications.
(d) A dentist may apply for a pediatric endorsement for a moderate sedation permit by confirming all of the following:
(1) Successful completion of residency in pediatric dentistry accredited by the Commission on Dental Accreditation (CODA) or the equivalent training in pediatric moderate sedation, as determined by the board.
(2) Successful completion of at least 20 cases of moderate sedation to patients under 13 years of age to establish competency in pediatric moderate sedation, both at the time of the initial application and at renewal. The applicant or permitholder shall maintain and shall provide proof of these cases upon request by the board for up to three permit renewal periods.
(3) In order to provide moderate sedation to children under seven years of age, a dentist shall establish and maintain current competency for this pediatric population by completing 20 cases of moderate sedation for children under seven years of age in the 24-month period immediately preceding application for the pediatric endorsement and for each permit renewal period.
(4) Current certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8.
(e) A moderate sedation permitholder with a pediatric endorsement shall maintain current and continuous certification in Pediatric Advanced Life Support (PALS) and airway management or other board-approved training in pediatric life support and airway management, adopted pursuant to Section 1601.8, for the duration of the permit.
(f) Applicants for a pediatric endorsement who otherwise qualify for the pediatric endorsement but lack sufficient cases of moderate sedation to patients under 13 years of age may administer moderate sedation to patients under 13 years of age under the direct supervision of a general anesthesia or moderate sedation permitholder with who possesses a pediatric endorsement. The applicant may count these cases toward the 20 required in order to qualify for the applicant’s pediatric endorsement.
(g) Moderate sedation permit holders permitholders with a pediatric endorsement seeking to provide moderate sedation to children under seven years of age, but who lack sufficient cases of moderate sedation to patients under seven years of age pursuant to paragraph (3) of subdivision (d), may administer moderate sedation to patients under seven years of age under the direct supervision of a permitholder who meets those qualifications. general anesthesia or moderate sedation permitholder who possesses a pediatric endorsement to administer general anesthesia or moderate sedation to patients under seven years of age.
(h) Patient records submitted to the board pursuant to paragraph (2) of subdivision (c) and paragraphs (2) and (3) of subdivision (d) shall be confidential and shall not be disclosed pursuant to any state law, including, but not limited to, the California Public Records Act (Division 10 (commencing with Section 7920.000) of the Government Code), except for disclosure pursuant to a lawfully issued subpoena or a written request from a government agency responsible for either enforcement of civil or criminal laws or the professional licensing of individuals that is conducting an investigation about the applicant.
(i) If the procedures under paragraph (2) of subdivision (c) or paragraph (3) of subdivision (d) are performed in a dental office located in this state, the following shall apply:
(1) All office facility, equipment, and staff requirements for moderate sedation permit holders shall be met.
(2) The procedures shall be performed under the direct supervision of a California-licensed dentist who holds a board-issued general anesthesia or moderate sedation permit.
(3) For procedures performed under paragraph (3) of subdivision (d), the procedures shall be performed under the direct supervision of a California-licensed dentist who holds a board-issued general anesthesia or moderate sedation permit with a pediatric endorsement issued by the board.
(4) The procedures shall be supervised in compliance with subdivision (a) of Section 1682.
(j) For purposes of this section, “good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

SEC. 18.

 Section 1647.6 of the Business and Professions Code is amended to read:

1647.6.
 (a) A physical evaluation and medical history shall be taken before the administration of moderate sedation.
(b) Any dentist holding a permit shall maintain records Records of the physical evaluation, medical history, and moderate sedation procedures used shall be maintained as required by board regulations.

SEC. 19.

 Section 1647.18 of the Business and Professions Code is amended to read:

1647.18.
 As used in this article, the following terms have the following meanings:
(a) “Adult patient” means a dental patient 13 years of age or older.

(b)“Certification” means the issuance of a certificate to a dentist licensed by the board who provides the board with his or her name and the location at which the administration of oral conscious sedation will occur, and fulfills the requirements specified in Sections 1647.12 and 1647.13.

(b) Good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.
(c) “Oral conscious sedation” means a minimally depressed level of consciousness produced by oral medication that retains the patient’s ability to maintain independently and continuously an airway, and respond appropriately to physical stimulation or verbal command. “Oral conscious sedation” does not include dosages less than or equal to the single maximum recommended dose that can be prescribed for home use.
(1) The drugs and techniques used in oral conscious sedation shall have a margin of safety wide enough to render unintended loss of consciousness unlikely. Further, patients whose only response is reflex withdrawal from painful stimuli would not be considered to be in a state of oral conscious sedation.
(2) For the handicapped individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness for that individual should be maintained.

SEC. 20.

 Section 1647.19 of the Business and Professions Code is amended to read:

(a)Notwithstanding subdivision (a) of Section 1647.2, a dentist may not administer oral conscious sedation on an outpatient basis to an adult patient unless the dentist possesses a current license in good standing to practice dentistry in California, and one of the following conditions is met:

(1)The dentist holds a valid general anesthesia permit, holds a conscious sedation permit, has been certified by the board, pursuant to Section 1647.20, to administer oral sedation to adult patients, or has been certified by the board, pursuant to Section 1647.12, to administer oral conscious sedation to minor patients.

(2)The dentist possesses a current permit issued under Section 1638 or 1640 and either holds a valid general anesthesia permit, or conscious sedation permit, or possesses a certificate as a provider of oral conscious sedation to adult patients in compliance with, and pursuant to, this article.

(b)Certification as a provider of oral conscious sedation to adult patients expires at the same time the license or permit of the dentist expires unless renewed at the same time the dentist’s license or permit is renewed after its issuance, unless certification is renewed as provided in this article.

1647.19.
 (a) A dentist may administer or order the administration of oral conscious sedation on an outpatient basis to an adult patient if the dentist possesses an active dentist license or permit issued under Section 1638 or 1640 and an active general anesthesia permit, moderate sedation permit, or adult oral conscious sedation certificate pursuant to Section 1647.20.
(b) An adult oral conscious sedation certificate shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.
(c) This article shall not apply to the administration of local anesthesia or a mixture of nitrous oxide and oxygen, or to the administration, dispensing, or prescription of postoperative medications.

SEC. 21.

 Section 1647.20 of the Business and Professions Code is amended to read:

1647.20.
 A dentist who desires to administer, or order the administration of, oral conscious sedation for adult patients, who does not hold a general anesthesia permit, as provided in Sections 1646.1 and 1646.2, does not hold a conscious sedation permit, as provided in Sections 1647.2 and 1647.3, and has not been certified by the board, pursuant to Section 1647.12, to administer oral conscious sedation to minor patients, shall register his or her name with the board on a registration form prescribed by the board. The dentist shall submit the registration fee and evidence showing that he or she or a moderate sedation permit, as provided in Sections 1647.2 and 1647.3, shall possess a dentist license or a permit under Section 1638 or 1640 issued by the board that is in good standing, apply to the board on an application form prescribed by the board, and submit the certification fee and evidence showing that the dentist satisfies any of the following requirements:
(a) Satisfactory completion of a postgraduate program in oral and maxillofacial surgery approved by either the Commission on Dental Accreditation or a comparable organization approved by the board.
(b) Satisfactory completion of a periodontics or general practice residency or other advanced education in a general dentistry program approved by the board.
(c) Satisfactory completion of a board-approved educational program on oral medications and sedation.

(d)For an applicant who has been using oral conscious sedation in connection with the treatment of adult patients, submission of documentation as required by the board of 10 cases of oral conscious sedation satisfactorily performed by the applicant on adult patients in any three-year period ending no later than December 31, 2005.

SEC. 22.

 Section 1647.22 of the Business and Professions Code is amended to read:

1647.22.
 (a) A physical evaluation and medical history shall be taken before the administration of oral conscious sedation to an adult. Any dentist who administers, or orders the administration of, oral conscious sedation to an adult shall maintain records Records of the physical evaluation, medical history, and oral conscious sedation procedures used shall be maintained as required by the board regulations.
(b) A dentist who administers, or who orders the administration of, oral conscious sedation for an adult patient shall be physically present in the treatment facility while the patient is sedated, and shall be present until discharge of the patient from the facility.
(c) The drugs and techniques used in oral conscious sedation to adults shall have a margin of safety wide enough to render unintended loss of consciousness unlikely.

SEC. 23.

 Section 1647.30 of the Business and Professions Code is amended to read:

1647.30.
 (a)As used in this article, “minimal the following definitions apply:
(a) “Minimal sedation” means a drug-induced state during which patients respond normally to verbal commands. commands, and conforms to all of the following:
(1)  Although cognitive function and coordination may be impaired, airway reflexes, ventilatory, and cardiovascular functions are unaffected.

(b)

(2) The drugs and techniques used in minimal sedation shall have a margin of safety wide enough to render unintended loss of consciousness unlikely. Further, patients
(3) Patients who require tactile stimulation to elicit a response to verbal commands shall not be considered to be in a state of minimal sedation.

(c)

(4) For the very young or developmentally delayed individual, incapable of the usually expected verbal response, a minimally depressed level of consciousness should be maintained.
(b) “Good standing” means the license or permit is active and unrestricted by disciplinary action taken pursuant to Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, is not the subject of an unresolved complaint or review procedure, and is not the subject of any unresolved disciplinary proceeding.

SEC. 24.

 Section 1647.31 of the Business and Professions Code is amended to read:

1647.31.
 (a) A dentist may administer or order the administration of pediatric minimal sedation on an outpatient basis for pediatric dental patients under 13 years of age, if one of the following conditions is met: the dentist possesses an active dentist license or permit under Section 1630 or 1640 issued by the board and an active general anesthesia permit, moderate sedation permit with a pediatric endorsement, or a pediatric minimal sedation permit.

(1)The dentist holds a current permit for deep sedation and general anesthesia, or holds a current permit for moderate sedation with a pediatric endorsement, or obtains a pediatric minimal sedation permit.

(2)The dentist possesses a current permit under Section 1638 or 1640 and holds a valid deep sedation and general anesthesia permit, a moderate sedation permit with a pediatric endorsement, or obtains a pediatric minimal sedation permit.

(b) A dentist who administers or orders the administration of pediatric minimal sedation shall be physically present in the treatment facility while the patient is sedated.
(c) A dentist with a pediatric minimal sedation permit shall possess the training, equipment, and supplies to rescue a patient from an unintended deeper level of sedation.
(d) This article does not apply to the administration of local anesthesia, moderate sedation, deep sedation, or general anesthesia.

SEC. 25.

 Section 1647.32 of the Business and Professions Code is amended to read:

1647.32.
 (a) A dentist who desires to administer or order the administration of pediatric minimal sedation shall apply to the board on an application form prescribed by the board. The dentist shall possess a current license dentist license or permit under Section 1638 or 1640 in good standing, submit an application fee, and produce evidence showing that he or she the dentist has successfully completed training in pediatric minimal sedation that meets the requirements of subdivision (c).
(b) The application for a permit shall include documentation that equipment and drugs required by the board are on the premises.
(c) Training in the administration of pediatric minimal sedation shall be acceptable if it meets either of the following as approved by the board:
(1) Consists of at least 24 hours of pediatric minimal sedation instruction in addition to one clinical case. The pediatric minimal sedation instruction shall include training in pediatric monitoring, airway management, and resuscitation and patient rescue from moderate sedation.
(2) Completion of a CODA-approved residency in pediatric dentistry.
(d) A dentist shall be limited to administering a single drug whose primary purpose is sedative via the oral route, either singly or in divided doses, not to exceed the manufacturer’s maximum recommended dose, plus a mix of nitrous oxide and oxygen and adjunctive agents such that the drugs either singly or in combination are unlikely to produce a state of unintended moderate sedation. This section shall not be construed to restrict the administration of adjunctive medication intended to relieve pain, affect the onset or duration of the primary sedative agent, or to reduce the side effects of sedation, including nausea or emesis.
(e) The operating dentist and a minimum of one additional personnel who are both trained in the monitoring and resuscitation of pediatric patients, as approved by the board, shall be present during the administration of minimal sedation.

SEC. 26.

 Section 1647.35 of the Business and Professions Code is repealed.
1647.35.

A permitholder who has a permit that was issued before January 1, 2022, that authorized the permitholder to administer or order the administration of oral conscious sedation for minor patients under prior Article 2.85 (commencing with Section 1647.10) may follow the terms of that existing permit until it expires. Any permit issued or renewed pursuant to this article on or after January 1, 2022, shall require the permitholder to follow the requirements of this article.

SEC. 27.

 Section 1647.35 is added to the Business and Professions Code, to read:

1647.35.
 A pediatric minimal sedation permitholder shall be required to complete a minimum of seven hours of approved courses of study related to pediatric minimal sedation as a condition of renewal of the permit. Those courses of study shall be credited toward the total continuing education required by the board pursuant to Section 1645.

SEC. 28.

 Section 1647.36 of the Business and Professions Code is repealed.
1647.36.

This article shall become operative on January 1, 2022.

SEC. 29.

 Section 1647.36 is added to the Business and Professions Code, to read:

1647.36.
 (a) A physical evaluation and medical history shall be taken before the administration of pediatric minimal sedation.
(b) Records of the physical evaluation, medical history, and pediatric minimal sedation procedures used shall be maintained as required by board regulations.

SEC. 30.

 Section 1647.37 is added to the Business and Professions Code, to read:

1647.37.
 A pediatric minimal sedation permit shall expire on the date specified in Section 1715 that next occurs after its issuance, unless it is renewed as provided in this article.

SEC. 31.

 Section 1647.38 is added to the Business and Professions Code, to read:

1647.38.
 An oral conscious sedation for minor patients permitholder who has a permit that was issued before January 1, 2022, that authorized the permitholder to administer or order the administration of oral conscious sedation for minor patients under prior Article 2.85 (commencing with Section 1647.10) may follow the terms of that existing permit until it expires. Any pediatric minimal sedation permit issued or renewed pursuant to this article on or after January 1, 2022, shall require the permitholder to follow the requirements of this article.

SEC. 32.

 Section 1700 of the Business and Professions Code is amended to read:

1700.
 Any person, company, or association is guilty of a misdemeanor, and upon conviction thereof shall be punished by imprisonment in the county jail not less than 10 days nor more than one year, or by a fine of not less than one hundred dollars ($100) nor more than one thousand five hundred dollars ($1,500), or by both fine and imprisonment, who:
(a) Assumes the degree of “doctor of dental surgery,” “doctor of dental science,” or “doctor of dental medicine” or appends the letters “D.D.S.,” or “D.D.Sc.” or “D.M.D.” to his or her their name without having had the right to assume the title conferred upon him or her them by diploma from a recognized dental college or school legally empowered to confer the same.
(b) Assumes any title, or appends any letters to his or her their name, with the intent to represent falsely that he or she has they have received a dental degree or license.
(c) Engages in the practice of dentistry without causing to be displayed in a conspicuous place in his or her office the name of each and every person employed there in the practice of an area that is likely to be seen by all patients who use the facility, the original or copy of the current license, permit, or registration of each person employed at the facility to practice dentistry.
(d) Within 10 days after demand is made by the executive officer of the board, fails to furnish to the board the name and address of all persons practicing or assisting in the practice of dentistry in the office of the person, company, or association, at any time within 60 days prior to the demand, together with a sworn statement showing under and by what license or authority this person, company, or association and any employees are or have been practicing dentistry. This sworn statement shall not be used in any prosecution under this section.
(e) Is under the influence of alcohol or a controlled substance while engaged in the practice of dentistry in actual attendance on patients to an extent that impairs his or her their ability to conduct the practice of dentistry with safety to patients and the public.

SEC. 33.

 Section 1701.5 of the Business and Professions Code is repealed.
1701.5.

Any dentist who is a sole proprietor, dentists who are organized as an association, partnership, or group, or any dental corporation that desires to practice under any name that would otherwise be in violation of Section 1701 may practice under this name if the dentist, association, partnership, group, or dental corporation obtains and maintains in current status a fictitious name permit issued by the board under this section.

(a)To obtain or renew a fictitious name permit pursuant to subdivision (a), the dentist, association, partnership, group, or dental corporation shall apply to the board on an application form prescribed by the board and provide all of the following information:

(b)The names, license numbers, and contact information for each applicant engaging the practice under the fictitious

Any permits issued under this section may be revoked or suspended at any time that the board finds that any one of the requirements for original issuance of a permit is no longer being fulfilled by the holder to whom the permit was issued. Proceedings for revocation or suspension shall be governed by the Administrative Procedure Act.

In the event charges of unprofessional conduct are filed against the holder of a permit issued under this section, or a member of an association or partnership or a member of a group or corporation to whom a permit has been issued under this section, proceedings shall not be commenced for revocation or suspension of the permit until final determination of the charges of unprofessional conduct and unless the charges have resulted in revocation or suspension of license.

SEC. 34.

 Section 1701.5 is added to the Business and Professions Code, to read:

1701.5.
 (a) Any dentist who as a sole proprietor, dentists who are organized as an association, partnership, or group, or a dental corporation that desires to practice under any name that would otherwise be in violation of Section 1701 may practice under this name if the dentist, association, partnership, group, or dental corporation obtains and maintains in current status a fictitious name permit issued by the board under this section.
(b) To obtain or renew a fictitious name permit, the dentist, association, partnership, group, or dental corporation shall apply to the board on an application form prescribed by the board and provide all of the following information:
(1) The names, license numbers, and contact information for each applicant engaging in practice under the fictitious name.
(2) The address of the place or establishment, or the portion thereof, where the applicant or applicants practice under the fictitious name.
(3) Evidence that the place or establishment, or the portion thereof, identified in paragraph (2) is owned or leased by the applicant or applicants, and the practice conducted at the place or establishment, or portion thereof, is wholly owned and entirely controlled by the applicant or applicants.
(4) The fictitious name under which the applicant or applicants propose to engage in dental practice that contains at least one of the following designations: “dental group,” “dental practice,” “dental office,” or “dental corporation,” as applicable pursuant to Section 1804, and is in conformity with Section 651 and subdivisions (i) and (l) of Section 1680.
(c) All applicants shall hold an active license that is not subject to any pending license enforcement action.
(d) Initial permit application and renewal fees shall be submitted to the board in accordance with Section 1724.5.
(e) A permit issued under this section by the board shall be issued for a two-year term.
(f) Any permit issued under this section may be revoked or suspended at any time that the board finds that any one of the requirements for original issuance of a permit is no longer being fulfilled by the holder to whom the permit was issued. Proceedings for revocation ro suspension shall be governed by Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code.
(g) A fictitious name permit issued to a dentist as the sole proprietor shall be suspended or revoked in the event the dentist’s license to practice dentistry is suspended or revoked.
(h) In the event charges of unprofessional conduct are filed against a member of an association, or partnership, group, or dental corporation to whom a permit has been issued under this section, proceedings shall not be commenced for revocation or suspension of the permit issued under this section until final determination of the charges of unprofessional conduct and unless the charges have resulted in revocation or suspension of the member’s license, registration, or permit.
(i) Any departures of dentists engaged in practice under the fictitious name shall be reported by the departing dentist to the board within 30 days of such departure. If a departing dentist is the dentist whose family name was used in the fictitious name, the departing dentist shall be removed as a permitholder, as applicable, and the remaining permitholders shall apply to the board to change the fictitious name to remove only the family name of the departing dentist.
(j) If an additional dentist desires to engage in practice under the fictitious name, the fictitious name permit shall be cancelled and a new fictitious name permit application shall be submitted to the board.

SEC. 35.

 Section 1718.3 of the Business and Professions Code is amended to read:

1718.3.
 (a)A license that is not renewed within five years after its expiration shall be cancelled and shall not be renewed, restored, reinstated, or reissued thereafter, but the holder of the license may apply for and obtain a new license if the following requirements are satisfied:

(1)

(a) No fact, circumstance, or condition exists which would justify denial of licensure under Section 480.

(2)

(b) The licenseholder pays all of the fees that would be required if the licenseholder were then applying for the license for the first time and all renewal and delinquency fees delinquency fees, if any, that have accrued since the date on which the licenseholder last renewed the license. Delinquency fees shall not accrue after the license has been cancelled pursuant to this section.

(3)The licenseholder takes and passes the examination, if any, that would be required if the licenseholder were then applying for the license for the first time, or otherwise establishes to the satisfaction of the board that with due regard for the public interest, the licenseholder is qualified to practice the profession or activity in which the licenseholder again seeks to be licensed.

(4)

(c) The licenseholder applies for licensure, as a new applicant, through one of the available licensing pathways under this division and meets all the requirements for licensure outlined therein.

(b)The board may impose conditions on any license issued pursuant to this section, as it deems necessary.

(c)The board may by regulation provide for the waiver or refund of all or any part of the examination fee in those cases in which a license is issued without an examination under this section.

(d) For purposes of subdivision (c), a licenseholder who was previously eligible for examination pursuant to subdivision (e) of Section 1628 shall be eligible to take the examination required by Section 1632 pursuant to the terms of subdivision (e) of Section 1628.

SEC. 36.

 Section 1724 of the Business and Professions Code is amended to read:

1724.
 The amount of charges and fees for dentists licensed pursuant to this chapter shall be established by the board as is necessary for the purpose of carrying out the responsibilities required by this chapter as it relates to dentists, subject to the following limitations:
(a) The fee for an application for licensure qualifying pursuant to paragraph (1) of subdivision (c) of Section 1632 shall not exceed one thousand five hundred dollars ($1,500). The fee for an application for licensure qualifying pursuant to paragraph (2) of subdivision (c) of Section 1632 shall not exceed one thousand dollars ($1,000).
(b) The fee for an application for licensure qualifying pursuant to Section 1634.1 shall not exceed one thousand dollars ($1,000).
(c) The fee for an application for licensure qualifying pursuant to Section 1635.5 shall not exceed one thousand dollars ($1,000).
(d) The fee for an initial license and for the renewal of a license is five hundred twenty-five dollars ($525). On and after January 1, 2016, the fee for an initial license shall not exceed six hundred fifty dollars ($650), and the fee for the renewal of a license shall not exceed six hundred fifty dollars ($650). On and after January 1, 2018, the fee for an initial license shall not exceed eight hundred dollars ($800), and the fee for the renewal of a license shall not exceed eight hundred dollars ($800).
(e) The fee for an application for a special permit shall not exceed one thousand dollars ($1,000), and the renewal fee for a special permit shall not exceed six hundred dollars ($600).
(f) The delinquency fee shall be 50 percent of the renewal fee for such a license or permit in effect on the date of the renewal of the license or permit.
(g) The penalty for late registration of change of place of practice shall not exceed seventy-five dollars ($75).
(h) The fee for an application for an additional office permit shall not exceed seven hundred fifty dollars ($750), and the fee for the renewal of an additional office permit shall not exceed three hundred seventy-five dollars ($375).
(i) The fee for issuance of a replacement pocket license, replacement wall certificate, or replacement engraved certificate shall not exceed one hundred twenty-five dollars ($125).
(j) The fee for a provider of continuing education shall not exceed five hundred dollars ($500) per year.
(k) The fee for application for a referral service permit and for renewal of that permit shall not exceed twenty-five dollars ($25).
(l) The fee for application for an extramural facility permit and for the renewal of a permit shall not exceed twenty-five dollars ($25).
(m) The fee for an application for an elective facial cosmetic surgery permit shall not exceed four thousand dollars ($4,000), and the fee for the renewal of an elective facial cosmetic surgery permit shall not exceed eight hundred dollars ($800).
(n) The fee for an application for an oral and maxillofacial surgery permit shall not exceed one thousand dollars ($1,000), and the fee for the renewal of an oral and maxillofacial surgery permit shall not exceed one thousand two hundred dollars ($1,200).
(o) The fee for an application for a general anesthesia permit shall not exceed one thousand dollars ($1,000), and the fee for the renewal of a general anesthesia permit shall not exceed six hundred dollars ($600).
(p) The fee for an onsite inspection and evaluation related to a general anesthesia or moderate sedation permit shall not exceed four thousand five hundred dollars ($4,500).
(q) The fee for an application for a moderate sedation permit shall not exceed one thousand dollars ($1,000), and the fee for the renewal of a conscious moderate sedation permit shall not exceed six hundred dollars ($600).
(r) The fee for an application for an oral conscious sedation permit certificate shall not exceed one thousand dollars ($1,000), and the fee for the renewal of an adult oral conscious sedation permit certificate shall not exceed six hundred dollars ($600).
(s) The fee for an application for a pediatric minimal sedation permit shall not exceed one thousand dollars ($1,000), and the fee for the renewal of a pediatric minimal sedation permit shall not exceed six hundred dollars ($600).
(t) The fee for an application for a pediatric endorsement for a general anesthesia permit, deep sedation or general anesthesia permit, or moderation sedation permit shall not exceed one thousand dollars ($1,000), and the fee for the renewal of a pediatric endorsement shall not exceed six hundred dollars ($600).

(t)

(u) The fee for a certification of licensure shall not exceed one hundred twenty-five dollars ($125).

(u)

(v) The fee for an application for the law and ethics examination shall not exceed two hundred fifty dollars ($250).

(v)This section shall become operative on January 1, 2022.

SEC. 37.

 Section 1740 of the Business and Professions Code is amended to read:

1740.
 It is the intention of the Legislature by enactment of this article to permit the full utilization of dental assistants in order to meet the dental care needs of all the state’s citizens. The Legislature further intends that the classifications of dental assistants established pursuant to by this article permit the continual advancement of persons to successively higher levels of licensure with additional education and training. The Legislature further intends that the Dental Board of California, in implementing this article, give specific consideration to consider the recommendations of the Dental Assisting Council, established pursuant to Section 1742.

SEC. 38.

 Section 1741 of the Business and Professions Code is repealed.
1741.

As used in this article:

(a)“Board” means the Dental Board of California.

(b)“Direct supervision” means supervision of dental procedures based on instructions given by a licensed dentist, who must be physically present in the treatment facility during the performance of those procedures.

(c)“General supervision” means supervision of dental procedures based on instructions given by a licensed dentist but not requiring the physical presence of the supervising dentist during the performance of those procedures.

SEC. 39.

 Section 1741 is added to the Business and Professions Code, to read:

1741.
 As used in this article:
(a) “Alternative dental assisting program” means a program offered by an institution of secondary or postsecondary education which has a current accreditation from the Commission on Dental Accreditation or is accredited or approved by an agency recognized by the United States Department of Education or State Department of Education including career health and technical education programs, regional occupation centers or programs, or apprenticeship programs registered by the State Department of Education or Division of Apprenticeship Standards of the Department of Industrial Relations in allied dental programs, and whereby a certificate of completion from the program shall serve as a pathway component for licensure as a registered dental assistant.
(b) “Basic supportive dental procedures” means procedures that have technically elementary characteristics, are completely reversible, and are unlikely to precipitate potentially hazardous conditions for the patient being treated, including extraoral tasks involving sterilization procedures and infection control and disease prevention tasks.
(c) “Board” means the Dental Board of California.
(d) “Certified dental assistant” means an individual who has successfully passed the general chairside assisting, radiation health and safety, and infection control examinations administered by the Dental Assisting National Board and has an active certification satisfactory to terms and conditions of the Dental Assisting National Board at the time of application for a dental assisting license. A current and valid certified dental assistant certificate is not required for subsequent licensure renewals.
(e) “Certificate of completion” means a certificate which shall include, at minimum, the participant’s name, the name of the course or program completed, the name of the course or program provider, including the board-issued approval number, the date or date range of completed course of program, and the number of completed hours of the course or program that verifies the participant has successfully completed any of the following:
(1) A board-approved educational course or program in dental assisting.
(2) A continuing education course provided by a board-approved continuing education provider.
(3) An alternative dental assisting program.
(f) “Continuing education” means a course of study specific to the performance of dental-related procedures, where a license or permit issued pursuant to this article is impacted, and where the education is directly related to the clinical and supplemental duties and functions of dental assistants, registered dental assistants, registered dental assistants in extended functions, and dental assisting permitholders, as defined in this article. The continuing education coursework must follow the provisions outlined in board regulations.
(g) “Council” means the Dental Assisting Council of the Dental Board of California.
(h) “Course” means an educational offering, class, presentation, meeting, or other similar event.
(i) “Dental assistant” means an individual who, without a license, may perform only basic supportive dental procedures described in Sections 1750 and 1750.1.
(j) “Direct supervision” means supervision of dental procedures based on instructions given by a licensed dentist, who shall be physically present in the treatment facility during the performance of those procedures.
(k) “General supervision” means supervision of dental procedures based on instructions given by a licensed dentist but not requiring the physical presence of the supervising dentist during the performance of those procedures.
(l) “Good standing” means the licensee or permitholder has not been disciplined and is not the subject of any unresolved disciplinary proceeding.
(m) “Preceptee” means an unlicensed dental assistant who is supervised by a California-licensed dentist or dentists in good standing and is participating in a preceptorship in dental assisting to learn the clinical skills and acquire procedural knowledge through work experience and supplemental dental assisting coursework.
(n) “Preceptor” means a California-licensed dentist in good standing who directly supervises and provides on-the-job training to a preceptee in a preceptorship in dental assisting by evaluating clinical competence, documenting completion of clinical chairside work experience, learning, and clinical progress, teaching and promoting clinical reasoning, and ensuring the preceptee has completed course requirements before performing dental assisting duties pursuant to Section 1750.1. A preceptee may have more than one California licensed dentist serve as a preceptor.
(o) “Preceptorship in dental assisting” means supervised on-the-job training of a preceptee by a preceptor in the performance of duties specified in Section 1750.1 in a competent manner as determined by the preceptor pursuant to the requirements set forth in paragraph (5) of subdivision (a) of Section 1752.1.
(p) “Registered dental assistant” means a person licensed by the board to perform all procedures authorized under Section 1752.4.
(q) “Registered dental assistant in extended functions” means a person licensed by the board to perform all procedures authorized under Section 1753.5.
(r) “Satisfactory work experience” means performance of the duties specified in Section 1750.1 in a competent manner as determined by the supervising dentist or dentists, who shall certify under penalty of perjury under the laws of the State of California the applicant’s completion of the work experience.

SEC. 40.

 Section 1749.1 of the Business and Professions Code is repealed.
1749.1.

In addition to any other examination required by this article, the board may require applicants for licensure under this article to successfully complete the Registered Dental Assistant Combined Written and Law and Ethics Examination.

SEC. 41.

 Section 1750 of the Business and Professions Code is amended to read:

1750.
 (a) A dental assistant is an individual who, without a license, may perform basic supportive dental procedures, as authorized by Section 1750.1 and by regulations adopted by the board, under the supervision of a licensed dentist. “Basic supportive dental procedures” are those procedures that have technically elementary characteristics, are completely reversible, and are unlikely to precipitate potentially hazardous conditions for the patient being treated.
(b) The supervising licensed dentist shall be directly responsible for determining the competency of the dental assistant to perform the basic supportive dental procedures, as authorized by Section 1750.1.
(c) The employer of a dental assistant shall be responsible for ensuring that the dental assistant has successfully completed a board-approved eight-hour course in infection control prior to performing any basic supportive dental procedures involving potential exposure to blood, saliva, or other potentially infectious materials.
(d) The employer shall maintain evidence for the length of the employment for the dental assistant at the supervising dentist’s treatment facility to verify the dental assistant has met and maintained all certification requirements as dictated by statute and regulation.
(e) The employer shall inform the dental assistant of the educational requirements described below to maintain employment as an unlicensed dental assistant.

(c)

(f) The employer of a dental assistant shall be responsible for ensuring that the dental assistant who has been in continuous employment for 120 days or more, employed continuously or on an intermittent basis by that employer for one year from the date of first employment has already successfully completed, or successfully completes, all of the following within a one year of the first date of employment: employment and provides evidence to the employer:
(1) A board-approved two-hour course in the Dental Practice Act.

(2)A board-approved eight-hour course in infection control.

(3)A course in basic life support offered by an instructor approved by the American Red Cross or the American Heart Association, or any other course approved by the board as equivalent and that provides the student the opportunity to engage in hands-on simulated clinical scenarios.

(2) A course satisfying the requirements of the Division of Occupational Safety and Health’s bloodborne pathogens training consisting of at least two hours of didactic training.
(3) Evidence of a current certification in basic life support issued by the American Red Cross, or the American Heart Association, the American Safety and Health Institute, the American Dental Association’s Continuing Education Recognition Program, or the Academy of General Dentistry’s Program Approval for Continuing Education, in accordance with both of the following:
(A) The dental assistant shall be responsible for maintaining current certification in basic life support to perform duties involving patients.

(d)

(B) The employer of a dental assistant shall be responsible for ensuring that the dental assistant maintains certification in basic life support.

(e)This section shall become operative on January 1, 2010.

(4) To perform radiographic procedures, a dental assistant shall comply with Section 1656. The radiation safety course shall follow the provisions specified by the board by regulation. The original or a copy of the current, valid certificate issued by a board-approved radiation safety course provider shall be publicly displayed at the treatment facility where the dental assistant performs dental services.
(5) To perform coronal polishing prior to licensure as a registered dental assistant, an unlicensed dental assistant shall complete one of the requirements specified in paragraph (1), (2), (3), (4), or (5) of subdivision (a) of Section 1752.1 and obtain a certificate of completion in coronal polishing as part of the curriculum.
(A) Coronal polishing performed pursuant to this paragraph shall be performed under the direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist, who shall, at minimum, evaluate each patient after coronal polishing procedures are performed by the dental assistant.
(B) The original or a copy of the current, valid certificate issued by a board-approved coronal polish course provider shall be publicly displayed at the treatment facility where the dental assistant performs dental services.

SEC. 42.

 Section 1750.1 of the Business and Professions Code is amended to read:

1750.1.
 (a) A dental assistant may perform the following duties under the general supervision of a supervising and pursuant to the order, control, and full professional responsibility of a licensed dentist:
(1) Extra-oral duties or procedures specified by the supervising licensed dentist, provided that these duties or procedures that meet the definition of a basic supportive procedure specified in Section 1750. subdivision (b) of Section 1741. Duties may include a procedure that requires the use of personal protective equipment, laboratory functions, and sterilization and disinfection procedures described in Section 1005 of Title 16 of the California Code of Regulations and Section 5193 of Title 8 of the California Code of Regulations.
(2) Operate dental radiography equipment for the purpose of oral radiography if the dental assistant has complied with the requirements of Section 1656.
(3) Perform intraoral and extraoral photography.
(b) A dental assistant may perform the following duties under the direct supervision of a supervising and pursuant to the order, control, and full professional responsibility of a licensed dentist:
(1) Apply nonaerosol and noncaustic topical agents.
(2) Apply topical agents, including all forms of topical fluoride.
(3) Take intraoral impressions for all nonprosthodontic appliances.
(4) Take facebow transfers and bite registrations.
(5) Place and remove rubber dams or other isolation devices.
(6) Place, wedge, and remove matrices for restorative procedures.
(7) Remove postextraction dressings after inspection of the surgical site by the supervising licensed dentist.
(8) Perform measurements for the purposes of orthodontic treatment.

(9)Cure restorative or orthodontic materials in operative site with a light-curing device.

(9) Cure dental materials used for procedures with a light curing device.
(10) Examine orthodontic appliances.
(11) Place and remove orthodontic separators.
(12) Remove ligature ties and archwires.
(13) After adjustment by the dentist, examine and seat removable orthodontic appliances and deliver care instructions to the patient.
(14) Remove periodontal dressings.
(15) Remove sutures after inspection of the site by the dentist.
(16) Place patient monitoring sensors.

(17)Monitor patient sedation, limited to reading and transmitting information from the monitor display during the intraoperative phase of surgery for electrocardiogram waveform, carbon dioxide and end tidal carbon dioxide concentrations, respiratory cycle data, continuous noninvasive blood pressure data, or pulse arterial oxygen saturation measurements, for the purpose of interpretation and evaluation by a supervising licensed dentist who shall be at the patient’s chairside during this procedure.

(18)Assist in the administration of nitrous oxide when used for analgesia or sedation. A dental assistant shall not start the administration of the gases and shall not adjust the flow of the gases unless instructed to do so by the supervising licensed dentist who shall be present at the patient’s chairside during the implementation of these instructions. This paragraph shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency.

(c)Notwithstanding subdivision (b), when operating in a school-based setting or a public health program created or administered by a federal, state, county, or local governmental entity pursuant to Sections 104762 and 104830 of the Health and Safety Code, a dental assistant may apply topical fluoride under the general direction of a licensed dentist or physician.

(d)Under the supervision of a registered dental hygienist in alternative practice, a dental assistant may perform intraoral retraction and suctioning.

(17) Adjust the flow of nitrous oxide gas if deemed necessary and directed by the supervising dentist who shall be present in the operatory directly supervising the adjustment.
(18) Extraoral functions specified by the supervising dentist that meet the definition of basic supportive dental procedures specified in subdivision (b) of Section 1741. Such duties may include patient monitoring, placing monitoring sensors, taking of vital signs, or other extraoral procedures related to the scope of their practice.
(19) In response to a medical emergency and under the direct supervision, order, control, and full professional responsibility of the licensed dentist, a dental assistant may administer or assist in the administration of oxygen.

(e)

(c) The board may specify additional allowable duties by regulation.

(f)

(d) The duties of a dental assistant or a dental assistant holding a permit in orthodontic assisting or in dental sedation do shall not include any of the following procedures unless specifically allowed by law:
(1) Diagnosis and comprehensive treatment planning.
(2) Placing, finishing, or removing permanent restorations.
(3) Surgery or cutting on hard and soft tissue including, but not limited to, the removal of teeth and the cutting and suturing of soft tissue.
(4) Prescribing medication.

(5)Starting or adjusting local or general anesthesia or oral or parenteral conscious sedation, except for the administration of nitrous oxide and oxygen, whether administered alone or in combination with each other and except as otherwise provided by law.

(g)The duties of a dental assistant are defined in subdivision (a) of Section 1750 and do not include any duty or procedure that only an orthodontic assistant permitholder, dental sedation assistant permitholder, registered dental assistant, registered dental assistant in extended functions, registered dental hygienist, or registered dental hygienist in alternative practice is allowed to perform.

(h)This section shall become operative on January 1, 2010.

(5) Starting the flow of nitrous oxide gas.
(6) Administration of local or general anesthesia or sedation.
(e) Unless otherwise permitted in this section, the duties of a dental assistant do not include any duty or procedure that only a registered dental assistant, registered dental assistant in extended functions, orthodontic assistant, dental sedation assistant, registered dental hygienist, or registered dental hygienist in alternative practice is allowed to perform.
(f) The placement of pit and fissure sealants may only be performed by a registered dental assistant, registered dental assistant in extended functions, registered dental hygienist, or registered dental hygienist in alternative practice.

SEC. 43.

 Section 1750.2 of the Business and Professions Code is amended to read:

1750.2.
 (a) The board may issue an orthodontic assistant permit to a person who files a completed application including a fee and provides evidence, satisfactory to the board, of all of the following eligibility requirements:

(1)Current, active, and valid licensure as a registered dental assistant or completion of at least 12 months of verifiable work experience as a dental assistant.

(2)

(1) Successful completion completion, within five years before the date the application is received, of a two-hour board-approved course in the Dental Practice Act and an eight-hour board-approved course in infection control.

(3)

(2) Successful completion of a course in basic life support offered by an instructor approved issued by the American Red Cross or Cross, the American Heart Association, or any other course approved by the board as equivalent. the American Safety and Health Institute, the American Dental Association’s Continuing Education Recognition Program, or the Academy of General Dentistry’s Program Approval for Continuing Education.

(4)

(3) Successful completion of a board-approved orthodontic assistant course, which may commence after the completion of six months of work experience as a dental assistant. course.
(4) A full set of fingerprints for purposes of conducting a criminal history record check.
(5) Passage of a written examination administered by the board after completion of all of the other requirements of this subdivision. The written examination shall encompass the knowledge, skills, and abilities necessary to competently perform the duties specified in Section 1750.3.
(b) A person who holds an orthodontic assistant permit pursuant to this section shall be subject to a permit pursuant to this section shall be responsible for obtaining recertification in basic life support as part of permit renewal and completing the same continuing education requirements for registered dental assistants as established by the board pursuant to Section 1645 and the renewal requirements of Article 6 (commencing with Section 1715).
(c) The original or a copy of the current, valid permit issued by the board shall be publicly displayed at the treatment facility where the permitholder performs dental services.
(d) Preparation or execution of false documentation of satisfaction of any requirement under this section shall be considered unprofessional conduct and grounds for license denial, revocation, or suspension.

SEC. 44.

 Section 1750.3 of the Business and Professions Code is amended to read:

1750.3.
 (a) A person holding an orthodontic assistant permit pursuant to Section 1750.2 may perform the following duties under the direct supervision under the general supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist all duties that a dental assistant is allowed to perform and the following duties under the direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist:

(a)

(1) All duties that a dental assistant is allowed to perform.

(b)Prepare teeth for bonding, and select, preposition, and cure orthodontic brackets after their position has been approved by the supervising licensed dentist.

(2) Isolate, condition, etch, and prepare teeth for cemented provisional attachments, bonded attachments, aligner buttons, aligner connections, orthodontic brackets, and appliances only after their position has been approved by the supervising licensed dentist and before curing.

(c)

(3) Remove only orthodontic brackets and attachments with removal of the bonding material by the supervising licensed dentist.

(d)

(4) Size, fit, and cement orthodontic bands. secure orthodontic bands and brackets using appropriate materials only after their position has been approved by the supervising licensed dentist and before curing.

(e)

(5) Remove orthodontic bands brackets and attachments and remove excess cement from supragingival surfaces of teeth with a hand instrument. instrument, with the removal of any remaining material by the supervising licensed dentist or registered dental assistant in extended functions licensed on or after January 1, 2010.

(f)

(6) Place and ligate archwires.

(g)

(7) Remove excess cement with an ultrasonic scaler from supragingival surfaces of teeth undergoing orthodontic treatment.

(h)

(8) Any additional duties that the board may prescribe by regulation.
(b) The original or a copy of the current, valid permit issued by the board shall be publicly displayed at the treatment facility where the permitholder performs dental services.

SEC. 45.

 Section 1750.4 of the Business and Professions Code is amended to read:

1750.4.
 (a) The board may issue a dental sedation assistant permit to a person who files a completed application including a fee application, pays the applicable fee, and provides evidence, satisfactory to the board, of all of the following eligibility requirements:
(1) Current, active, and valid licensure as a registered dental assistant assistant, registered dental assistant in extended functions, or completion of at least 12 months of verifiable work experience as a dental assistant.
(2) Successful completion completion, within five years before the date the application is received, of a two-hour board-approved course in the Dental Practice Act and an eight-hour board-approved course in infection control.

(3)Successful completion of a course in basic life support offered by an instructor approved by the American Red Cross or the American Heart Association, or any other course approved by the board as equivalent.

(3) Evidence of a current certification in basic life support issued by the American Red Cross, the American Heart Association, the American Safety and Health Institute, the American Dental Association’s Continuing Education Recognition Program, or the Academy of General Dentistry’s Program Approval for Continuing Education.
(4) Successful completion of a board-approved dental sedation assistant course, which may commence after the completion of six months of work experience as a dental assistant. as specified by the board by regulation.
(5) A full set of fingerprints for purposes of conducting a criminal history record check.

(5)

(6) Passage of a written examination administered by the board after completion of all of the other requirements of this subdivision. The written examination shall encompass the knowledge, skills, and abilities necessary to competently perform the duties specified in Section 1750.5.

(b)A person who holds a permit pursuant to this section shall be subject to the continuing education requirements established by the board pursuant to Section 1645 and the renewal requirements of Article 6 (commencing with Section 1715).

(b) A person who holds a permit pursuant to this section shall be responsible for obtaining recertification in basic life support as part of permit renewal and completing the same continuing education requirements for registered dental assistants as established by the board pursuant to Section 1645 and the renewal requirements of Article 6 (commencing with Section 1715).
(c) The original or a copy of the current, valid permit issued by the board shall be publicly displayed at the treatment facility where the permitholder performs dental services.
(d) Preparation or execution of false documentation of satisfaction of any requirement under this section shall be considered unprofessional conduct and grounds for license denial, revocation, or suspension.

SEC. 46.

 Section 1750.5 of the Business and Professions Code is amended to read:

(a)A person holding a dental sedation assistant permit pursuant to Section 1750.4 may perform the following duties under the direct supervision of a licensed dentist or other licensed health care professional authorized to administer moderate sedation, deep sedation, or general anesthesia in the dental office:

(1)All duties that a dental assistant is allowed to perform.

1750.5.
 (a) A dental assistant, registered dental assistant, or registered dental assistant in extended functions who holds a dental sedation assistant permit may perform under general supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist all duties that a dental assistant is allowed to perform and the following duties under the direct supervision and pursuant to the order, control, and full professional responsibility of a current, valid licensed dentist or other licensed health care professional authorized to administer moderate sedation, deep sedation, or general anesthesia in the treatment facility:

(2)

(1) Monitor patients undergoing moderate sedation, deep sedation, or general anesthesia utilizing data from noninvasive instrumentation such as pulse oximeters, electrocardiograms, capnography, blood pressure, pulse, and respiration rate monitoring devices. Evaluation of the condition of a sedated patient shall remain the responsibility of the supervising dentist or other the licensed health care professional authorized to administer moderate sedation, deep sedation, or general anesthesia, who shall be at the patient’s chairside while moderate sedation, deep sedation, or general anesthesia is being administered.

(3)

(2) Drug identification and draw, limited to identification of appropriate medications, ampule and vial preparation, and withdrawing drugs of correct amount as verified by the supervising licensed dentist. dentist, or the licensed health care professional authorized to administer moderate sedation, deep sedation, or general anesthesia.

(4)

(3) Add drugs, medications, and fluids to intravenous lines using a syringe, provided that a supervising licensed dentist is present at the patient’s chairside, limited to determining patency of intravenous line, selection of injection port, syringe insertion into injection port, occlusion of intravenous line and blood aspiration, line release, and injection of drugs for appropriate time interval. The exception to this duty is that the initial dose of a drug or medication shall be administered by the supervising licensed dentist. dentist or licensed health care professional authorized to administer moderate sedation, deep sedation, or general anesthesia.

(5)

(4) Removal of intravenous lines.

(6)

(5) Any additional duties that the board may prescribe by regulation.

(7)

(b) The duties listed in paragraphs (2) to (5), (1) to (4), inclusive, of subdivision (a) may not be performed in any setting other than a dental office or dental clinic.

(b)This section shall become operative on January 1, 2022.

(c) The original or a copy of the current, valid permit issued by the board shall be publicly displayed at the treatment facility where the permitholder performs dental services.

SEC. 47.

 Section 1752.1 of the Business and Professions Code is amended to read:

1752.1.
 (a) The board may license as a registered dental assistant a person who files an application application, pays the applicable fee, and submits written evidence, satisfactory to the board, of one of the following eligibility requirements:
(1) Graduation from an educational program in registered dental assisting approved by the board, and satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board.

(2)For individuals applying prior to January 1, 2010, evidence of completion of satisfactory work experience of at least 12 months as a dental assistant in California or another state and satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board.

(3)For individuals applying on or after January 1, 2010, evidence of completion of satisfactory work experience of at least 15 months as a dental assistant in California or another state and satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board.

(b)For purposes of this section, “satisfactory work experience” means performance of the duties specified in Section 1750.1 in a competent manner as determined by the employing dentist, who shall certify to such satisfactory work experience in the application.

(2) Completion of satisfactory work experience performing the duties of a dental assistant, as defined in Section 1750.1, which includes at least 15 months and a minimum of 1,280 hours before the submission of the application.
(3) Possession of a current, valid certification as a certified dental assistant, as issued by the Dental Assisting National Board, and completion of all education requirements specified in Sections 1750 and 1750.2.
(4) An alternative dental assisting program as defined in subdivision (a) of Section 1741 that includes all the following:
(A) At least 500 hours of didactic and laboratory coursework in dental assisting-related topics that shall encompass all aspects of clinical chairside assisting, including, but not limited to, medical and dental emergencies, first aid and safety precautions, protocols and armamentaria associated with a variety of dental assisting chairside procedures, dental materials, and skill development courses associated with operative and specialty dentistry and that include education as specified in Sections 1750 and 1750.2.
(B) At least 300 hours of clinical chairside work experience, involving the allowable duties described in Section 1750.1, directly supervised, evaluated, and documented by a supervising licensed dentist.
(5) A preceptorship in dental assisting that includes all the following:
(A) At least 500 hours of clinical chairside work experience documented on a form furnished by the board, involving allowable duties described in Section 1750.1, directly supervised, evaluated, and documented by a preceptor, who certifies under penalty of perjury under the laws of the State of California to the applicant’s completion of the clinical chairside work experience. Clinical work experience that meets the eligibility requirements of this term performed as a dental assistant within the two years immediately preceding the effective date of this section may be used to satisfy this requirement.
(B) At least 300 hours documented on a form furnished by the board of coursework in dental assisting-related topics, inclusive of the education required in Sections 1750 and 1750.2, which may be obtained concurrent to the work experience and satisfies all the following:
(i) The coursework shall include education defined in Sections 1750 and 1750.2, and encompass all aspects of clinical chairside assisting, including, but not limited to, medical and dental emergencies, first aid and safety precautions, protocols and armamentaria associated with a variety of dental assisting chairside procedures, dental materials, and skill development courses associated with operative and specialty dentistry.
(ii) Courses shall be obtained through a board-approved dental assisting educational program or course provider, a board-registered provider of continuing education courses, the American Dental Association’s Continuing Education Recognition Program, or a provider approved by the Academy of General Dentistry Program Approval for Continuing Education.
(iii) For purposes of paragraph (5) of subdivision (a) of Section 1752.1 and Section 1750.2, the preceptee’s completion of the coursework shall be verified by the preceptor, who shall certify under penalty of perjury under the laws of the State of California verification of the preceptee’s completion of the required coursework.

(c)

(b) The board shall give credit toward the work experience referred to in this section to persons who have graduated from a dental assisting program in a postsecondary institution approved by the Department of Education or in a secondary institution, regional occupational center, or regional occupational program, that are not, however, approved by the board pursuant to subdivision (a). The credit shall equal the total weeks spent in classroom training and internship on a week-for-week basis. The board, in cooperation with the Superintendent of Public Instruction, shall establish the minimum criteria for the curriculum of nonboard-approved programs. Additionally, the board shall notify those programs only if the program’s curriculum does not meet established minimum criteria, as established for board-approved registered dental assistant programs, except any requirement that the program be given in a postsecondary institution. Graduates of programs not meeting established minimum criteria shall not qualify for satisfactory work experience as defined by this section.

(d)In addition to the requirements specified in subdivision (a), each applicant for registered dental assistant licensure shall provide evidence of having successfully completed board-approved courses in radiation safety and coronal polishing as a condition of licensure. The length and content of the courses shall be governed by applicable board regulations.

(e)In addition to the requirements specified in subdivisions (a) and (d), individuals applying for registered dental assistant licensure on or after January 1, 2010, shall demonstrate satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board and shall provide written evidence of successful completion within five years prior to application of all of the following:

(c) In addition to the requirements specified in subdivision (a), individuals applying for registered dental assistant licensure shall provide written evidence of successful completion within five years before the date of the application received by the board of all of the following:
(1) A board-approved two-hour course in the Dental Practice Act.
(2) A board-approved An eight-hour course in infection control.

(3)A course in basic life support offered by an instructor approved by the American Red Cross or the American Heart Association, or any other course approved by the board as equivalent.

(3) A board-approved course in radiation safety.
(4) A board-approved course in coronal polishing.
The length and content of these courses shall be governed by this chapter and applicable board regulations.
(5) Evidence of a current certification in basic life support issued by the American Red Cross, the American Heart Association, the American Safety and Health Institution, the American Dental Association’s Continuing Education Recognition Program, or the Academy of General Dentistry’s Program Approval for Continuing Education.
(d) Satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board.
(e) A full set of fingerprints for purposes of conducting a criminal history record check.
(f)  A registered dental assistant may apply for an orthodontic assistant permit or a dental sedation assistant permit, or both, by submitting written evidence of the following:
(1) Successful completion of a board-approved orthodontic assistant or dental sedation assistant course, as applicable.
(2) Passage of the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board that shall encompass the knowledge, skills, and abilities necessary to competently perform the duties of the particular permit.
(g)  A registered dental assistant with permits in either orthodontic assisting or dental sedation assisting shall be referred to as an “RDA with orthodontic assistant permit,” or “RDA with dental sedation assistant permit,” as applicable. These terms shall be used for reference purposes only and do not create additional categories of licensure.
(h)  Completion of the continuing education requirements established by the board pursuant to Section 1645 by a registered dental assistant who also holds a permit as an orthodontic assistant or dental sedation assistant shall fulfill the continuing education requirements for the permit or permits.

(i)The board shall, in consultation with the Office of Professional Examination Services, conduct a review to determine whether a practical examination is necessary to demonstrate competency of registered dental assistants, and if so, how this examination should be developed and administered. The board shall submit its review and determination to the appropriate policy committees of the Legislature on or before July 1, 2017.

(j)Notwithstanding any other law, if the review conducted by the Office of Professional Examination Services pursuant to subdivision (i) concludes that the practical examination is unnecessary or does not accurately measure the competency of registered dental assistants, the board may vote to suspend the practical examination. The suspension of the practical examination shall commence on the date the board votes to suspend the practical examination.

(i) For individuals with current and active California licensure as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions, satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the board will be sufficient to qualify to apply for licensure as a registered dental assistant.

(k)

(j) The Registered Dental Assistant Combined Written and Law and Ethics Examination required by this section shall comply with Section 139.

SEC. 48.

 Section 1752.4 of the Business and Professions Code is amended to read:

1752.4.
 (a) A registered dental assistant may perform all of the following duties: duties and procedures of a dental assistant as specified in subdivisions (a), (b), and (c) of Section 1750.1 and may perform all the following duties under the direction and pursuant to the order, control, and full professional responsibility of a licensed dentist:
(1) All duties that a dental assistant is allowed to perform.
(2) Mouth-mirror inspections of the oral cavity, to include charting of obvious lesions, existing restorations, and missing teeth.
(3) Apply and activate bleaching agents using a nonlaser light-curing device.
(4) Use of automated caries detection devices and materials to gather information for diagnosis by the dentist. and recording findings before placement of pit and fissure sealants.
(5) Obtain intraoral images for computer-aided design (CAD), milled restorations.
(6) Pulp vitality testing and recording of findings.
(7) Place bases, liners, etch, and bonding agents. agents for restorative procedures.
(8) Chemically prepare teeth for bonding. bonding for restorative procedures.
(9) Place, adjust, and finish direct provisional restorations.
(10) Fabricate, adjust, cement, and remove indirect provisional restorations, including stainless steel crowns when used as a provisional restoration.
(11) Place post-extraction dressings after inspection of the surgical site by the supervising licensed dentist.
(12) Place periodontal dressings.
(13) Dry endodontically treated canals using absorbent paper points.

(14)Adjust dentures extra-orally.

(14) Perform sore-spot adjustment only of dentures extraorally.
(15) Perform tissue conditioning and soft reline of dentures.

(15)

(16) Remove excess cement from surfaces of teeth with a hand instrument.

(16)

(17) Polish coronal surfaces of the teeth.

(17)Place ligature ties and archwires.

(18)  Remove orthodontic bands.
(19)  All duties that the board may prescribe by regulation.
(b) A registered dental assistant may only perform the following additional duties if he or she has completed after successfully completing a board-approved registered dental assistant educational program or board-approved course in those duties, or if he or she has provided evidence, satisfactory to the board, of having completed a board-approved course in those duties.
(1) Remove excess cement with an ultrasonic scaler from supragingival surfaces of teeth undergoing orthodontic treatment.
(2) The allowable duties of an orthodontic assistant permitholder as specified in Section 1750.3. A registered dental assistant shall not be required to complete further instruction in the duties of placing ligature ties and archwires, removing orthodontic bands, and removing excess cement from tooth surfaces with a hand instrument.
(3) The allowable duties of a dental sedation assistant permitholder as specified in Section 1750.5.
(4) The application of pit and fissure sealants.
(c) Except as provided in Section 1777, the supervising licensed dentist shall be responsible for ensuring completion of course to perform additional duties and determining whether each authorized procedure performed by a registered dental assistant should be performed under general or direct supervision.

(d)This section shall become operative on January 1, 2010.

(d) The supervising dentist shall be responsible for determining whether each authorized procedure in subdivision (a) performed by a registered dental assistant should be performed under general or direct supervision.
(e) A registered dental assistant may perform the following duties under direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist:
(1) Etch, bond, and attach composite buttons or attachments for orthodontic procedures.
(2) Size, fit, secure, and remove orthodontic bands using appropriate dental materials.
(f) Notwithstanding subdivision (b), a registered dental assistant may perform a duty specified in this section using contemporary techniques and materials designed for use in the performance of that duty under the direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist if the registered dental assistant has completed the appropriate education and training, and whose skill, knowledge, and education in the use of such contemporary technique or material has been determined clinically competent by the supervising licensed dentist.

SEC. 49.

 Section 1752.6 of the Business and Professions Code is repealed.
1752.6.

A registered dental assistant licensed on and after January 1, 2010, shall provide evidence of successful completion of a board-approved course in the application of pit and fissure sealants prior to the first expiration of his or her license that requires the completion of continuing education as a condition of renewal. The license of a registered dental assistant who does not provide evidence of successful completion of that course shall not be renewed until evidence of course completion is provided.

SEC. 50.

 Section 1753 of the Business and Professions Code is amended to read:

1753.
 (a) On and after January 1, 2010, the board may license as a registered dental assistant in extended functions a person who submits written evidence, satisfactory to the board, of all of the following eligibility requirements:

(1)Current licensure as a registered dental assistant or completion of the requirements for licensure as a registered dental assistant.

(2)Successful completion of a board-approved course in the application of pit and fissure sealants.

(1) A board-prescribed application and applicable fees.
(2) A full set of fingerprints for purposes of conducting a criminal history check.
(3) A valid, current, and active registered dental assistant license issued by the board.

(3)

(4) Successful completion of either of the following:
(A) An extended functions postsecondary program approved by the board in all of the procedures specified in Section 1753.5.
(B) An extended functions postsecondary program approved by the board to teach the duties that registered dental assistants in extended functions were allowed to perform pursuant to board regulations prior to January 1, 2010, and a course approved by the board in the procedures specified in paragraphs (1), (2), (5), and (7) to (11), inclusive, of subdivision (b) of Section 1753.5.
(5) Evidence of a current certification in basic life support issued by the American Red Cross, the American Heart Association, the American Safety and Health Institute, the American Dental Association’s Continuing Education Provider Recognition (CERP) Programs, or the Academy of General Dentistry’s Program Approval for Continuing Education (PACE).
(6) Evidence of successful completion of a board-approved pit and fissure sealant course.

(4)

(7) Passage of a written examination administered by the board. The board shall designate whether the written examination shall be administered by the board or by the board-approved extended functions program.
(b) A registered dental assistant in extended functions may apply for an orthodontic assistant permit or a dental sedation assistant permit, or both, by providing written evidence of the following:
(1) Successful completion of a board-approved orthodontic assistant or dental sedation assistant course, as applicable.
(2) Passage of a written examination administered by the board that shall encompass the knowledge, skills, and abilities necessary to competently perform the duties of the particular permit.
(c) A registered dental assistant in extended functions with permits in either orthodontic assisting or dental sedation assisting shall be referred to as an “RDAEF with orthodontic assistant permit,” or “RDAEF with dental sedation assistant permit,” as applicable. These terms shall be used for reference purposes only and do not create additional categories of licensure.
(d) Completion of the continuing education requirements established by the board pursuant to Section 1645 by a registered dental assistant in extended functions who also holds a permit as an orthodontic assistant or dental sedation assistant shall fulfill the continuing education requirement for such permit or permits.
(e) The licensee shall be responsible for complying with all applicable licensure renewal requirements, including continuing education pursuant to Section 1645.

SEC. 51.

 Section 1753.5 of the Business and Professions Code is amended to read:

1753.5.
 (a) A registered dental assistant in extended functions licensed on or after January 1, 2010, is authorized to perform all duties and procedures that a registered dental assistant is authorized to perform as specified in and limited by Section 1752.4, and those duties that the board may prescribe by regulation.
(b) A registered dental assistant in extended functions licensed on or after January 1, 2010, is authorized to perform the following additional procedures under direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist:

(1)Conduct preliminary evaluation of the patient’s oral health, including, but not limited to, charting, intraoral and extra-oral evaluation of soft tissue, classifying occlusion, and myofunctional evaluation.

(2)Perform oral health assessments in school-based, community health project settings under the direction of a dentist, registered dental hygienist, or registered dental hygienist in alternative practice.

(3)Cord retraction of gingiva for impression procedures.

(4)Size and fit endodontic master points and accessory points.

(5)Cement endodontic master points and accessory points.

(6)Take final impressions for permanent indirect restorations.

(7)Take final impressions for tooth-borne removable prosthesis.

(8)Polish and contour existing amalgam restorations.

(9)Place, contour, finish, and adjust all direct restorations.

(10)Adjust and cement permanent indirect restorations.

(11)Other procedures authorized by regulations adopted by the board.

(c)All procedures required to be performed under direct supervision shall be checked and approved by the supervising licensed dentist prior to the patient’s dismissal from the office.

(1) Perform oral health assessments, including intraoral evaluations to identify oral lesions, extraoral evaluations of soft tissue, classifying occlusion, performing myofunctional evaluations, and oral cancer screenings as authorized by the supervising dentist.
(2) Tissue retraction of gingivae for impression and restorative procedures.
(3) Perform post, core, and build-up procedures in conjunction with direct and indirect restorations.
(4) Perform final impression procedures for permanent direct and indirect restorations including implants.
(5) Perform final impressions for removable prosthesis.
(6) Place, contour, finish, and adjust all direct restorations.
(7) Adjust and adhere all permanent indirect restorations.
(8) Other procedures authorized by regulations adopted by the board.
(c) A registered dental assistant in extended functions licensed on or after January 1, 2010, may perform a duty specified in this section using contemporary techniques and materials designed for use in the performance of that duty under the direct supervision and pursuant to the order, control, and full professional responsibility of a licensed dentist if the registered dental assistant in extended functions has completed the appropriate education and training, and whose skill, knowledge, and education in the use of such contemporary technique or material has been determined clinically competent by the supervising licensed dentist.

SEC. 52.

 Section 1753.6 of the Business and Professions Code is amended to read:

1753.6.
 (a)Each person who holds a license as a registered dental assistant in extended functions on the operative date of this section may only perform those procedures that a registered dental assistant is allowed to perform as specified in and limited by Section 1752.4, and the procedures specified in paragraphs (1) to (6), subdivisions (a) to (d) inclusive, until the person provides evidence of having completed a board-approved course in the additional procedures specified in paragraphs (1), (2), (5), and (7) to (11), inclusive, of subdivision (b) of Section 1753.5:

(1)

(a) Cord retraction of gingiva for impression procedures.

(2)

(b) Take final impressions for permanent indirect restorations.

(3)Formulate indirect patterns for endodontic post and core castings.

(4)Fit trial endodontic filling points.

(5)

(c) Apply pit and fissure sealants.

(6)

(d) Remove excess cement from subgingival tooth surfaces with a hand instrument.

(b)This section shall become operative on January 1, 2010.

SEC. 53.

 Section 1753.7 of the Business and Professions Code is repealed.
1753.7.

A licensed dentist may simultaneously utilize in his or her practice no more than three registered dental assistants in extended functions or registered dental hygienists in extended functions licensed pursuant to Section 1753 or 1918.

SEC. 54.

 Section 1754.5 is added to the Business and Professions Code, to read:

1754.5.
 (a) A radiation safety course shall have the primary purpose of providing theory, laboratory, and clinical application in radiographic techniques. The board shall approve only those courses that adhere to the minimum requirements of this section.
(b) A course provider applying for initial board approval shall submit a completed application for course approval, on a form provided by the board, accompanied by the applicable fee. The board may approve or deny approval after it evaluates all components of the course.
(c) Continuation of approval will be contingent upon continued compliance with Sections 1070 and 1070.1 of Title 16 of the California Code of Regulations and all requirements set forth in this section.
(d) Providers shall make adequate provisions for appropriate supervision, operation, and facilities when used for laboratory and preclinical instruction.
(e) A course in radiation safety shall be of sufficient duration for the student to achieve minimum competence, but in no event less than 32 hours, including at least 8 hours of didactic instruction, at least 12 hours of laboratory instruction, and at least 12 hours of supervised clinical instruction.
(f) A course shall establish specific instructional objectives. The theoretical aspects of the course shall provide the content necessary for students to make safe and ethical judgments regarding radiation safety.
(g) Objective evaluation criteria shall be used for measuring student progress. Students shall be provided with specific performance objectives and the evaluation criteria that will be used for all evaluation and testing procedures.
(h) Areas of didactic instruction shall include, at a minimum, all of the following:
(1) Radiation physics and biology.
(2) Radiation protection and safety.
(3) Recognition of normal intraoral and extraoral anatomical landmarks.
(4) Radiograph exposure and processing techniques.
(5) Radiograph mounting or sequencing, and viewing, including anatomical landmarks of the oral cavity.
(6) Intraoral techniques including holding devices and image receptors.
(7) Proper use of patient protection devices and personal protective equipment for operator use.
(8) Identification and correction of faulty radiographs.
(9) Introduction to contemporary equipment and devices including the use of computerized digital radiography and extraoral imaging that may include panographs or cone-beam imaging.
(10) Techniques and exposure guidelines for a variety of patients including, but not limited to, adult, pediatric, edentulous, partially edentulous, endodontic, and patients with special needs.
(11) Radiographic record management.
(i) For the student to achieve minimum competence in the application of dental radiographic techniques and radiation safety, all the following shall be met by a board-approved course:
(1) Successful completion of laboratory experiences consisting of at least two bitewing radiographic series and two full mouth intraoral radiographic series using an x-ray training mannequin designed for radiographic exposures utilizing any dental radiographic image receptor or device deemed appropriate by the course director.
(2) Successful completion of clinical experiences consisting of at least three full-mouth intraoral radiographic series using any dental radiographic image receptor or device deemed appropriate by the course director or supervising dentist.
(j) All clinical radiographs shall be made using diagnostic criteria established by the course of instruction and shall in no event exceed three reexposures per series.
(k) Completion of student and instructor written evaluations of each radiographic series identifying errors, causes of error, correction of errors, and, if applicable, the number of reexposures necessary for successful completion of a series to clinical competency.
(l) The student shall successfully complete a comprehensive written exam prior to the completion of the course. The exam shall include questions specific to items addressed in Article 4 (commencing with Section 30305) of Group 3 of Subchapter 4 of Chapter 5 of Division 1 of Title 17 of California Code of Regulations relative to the special requirements for the use of x-ray in the healing arts.
(m) Extramural dental facilities may be utilized by a course for the purposes of clinical experiences. Clinical oversight shall be performed under the general supervision of a licensed dentist who shall authorize the student to perform, at minimum, three radiographic series. Didactic and laboratory instruction shall be provided only by course faculty or instructional staff prior to clinical performances.
(n) Programs and courses using extramural dental faculties for dental radiographic clinical experiences shall provide to the board, upon request or renewal of provider status, copies of all contracts of affiliation and documentation demonstrating compliance with board regulations.
(o) Upon successful completion of the course, students shall receive a certificate of completion as defined in subdivision (e) of Section 1741.
(p) The board shall provide a 90-day notice of compliance for radiation safety course providers subject to this section.

SEC. 55.

 Section 1755 is added to the Business and Professions Code, to read:

1755.
 (a) A course in infection control is one that has as its main purpose providing theory and clinical application in infection control practices and principles where the protection of the public is its primary focus.
(b) An unlicensed dental assistant not enrolled in a board-approved program for registered dental assisting or an alternative dental assisting program as defined in subdivision (a) of Section 1741, shall complete one of the following infection control certification courses:
(1) A board-approved eight-hour course, with six hours being didactic instruction and two hours being laboratory instruction.
(2) A board-approved eight-hour course, with six hours of didactic instruction and at least two hours of laboratory instruction using video or a series of video training tools, all of which may be delivered using live, interactive, or online learning mechanisms or a combination thereof.
(c) A course shall establish specific instructional objectives. Instruction shall provide the content necessary for students to make safe and ethical judgments regarding infection control and asepsis.
(d) Objective evaluation criteria shall be used for measuring student progress. Students shall be provided with specific performance objectives and the evaluation criteria that will be used for didactic testing.
(e) To maintain approval, course providers approved prior to the effective date of this section, shall submit to the board a completed “Notice of Compliance with New Requirements for 8-Hour Infection Control Courses” by April 1, 2025.
(f) Didactic instruction shall include, at a minimum, all of the following as they relate to Cal/OSHA regulations, as set forth in Sections 300 to 344.85, inclusive, of Title 8 of the California Code of Regulations, and the board’s Minimum Standards for Infection Control, as set forth in Section 1005 of Title 16 of the California Code of Regulations:
(1) Basic dental science and microbiology as they relate to infection control in dentistry.
(2) Legal and ethical aspects of infection control procedures.
(3) Terms and protocols specified in Section 1005 of Title 16 of the California Code of Regulations regarding the minimum standards for infection control.
(4) Principles of modes of disease transmission and prevention.
(5) Principles, techniques, and protocols of hand hygiene, personal protective equipment, surface barriers and disinfection, sterilization, sanitation, and hazardous chemicals associated with infection control.
(6) Principles and protocols of sterilizer monitoring and the proper loading, unloading, storage, and transportation of instruments to work area.
(7) Principles and protocols associated with sharps management.
(8) Principles and protocols of infection control for laboratory areas.
(9) Principles and protocols of waterline maintenance.
(10) Principles and protocols of regulated and nonregulated waste management.
(11) Principles and protocols related to injury and illness prevention, hazard communication, general office safety, exposure control, postexposure requirements, and monitoring systems for radiation safety and sterilization systems.
(g) Upon successful completion of the course, students shall receive a certificate of completion as defined in subdivision (e) of Section 1741.

SEC. 56.

 Section 1804 of the Business and Professions Code is amended to read:

1804.
 Notwithstanding subdivision (i) of Section 1680 and subdivision (g) of Section 1701, the name of a dental corporation and any name or names under which it may be rendering professional services shall contain and be restricted to the name or the last name of one or more of the present, prospective, or former shareholders and shall include the words “dental corporation” or wording or abbreviations denoting corporate existence, unless otherwise authorized by a valid permit issued pursuant to Section 1701.5. existence.

SEC. 57.

 Section 1907 of the Business and Professions Code is amended to read:

1907.
 The following functions may be performed by a registered dental hygienist, in addition to those authorized pursuant to Sections 1908 to 1914, inclusive:
(a) All functions that may be performed by a registered dental assistant.
(b) All persons holding a license as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions as of December 31, 2005, are authorized to perform the duties of a registered dental assistant specified in this chapter. All persons issued a license as a registered dental hygienist, registered dental hygienist in alternative practice, or registered dental hygienist in extended functions on or after January 1, 2006, shall qualify apply for and receive a registered dental assistant license in accordance with subdivision (i) of Section 1752.1 and successfully complete any additional education required by subdivision (b) of Section 1752.4 prior to performance of the duties of a registered dental assistant specified in this chapter.

SEC. 58.

 Section 2079 of the Business and Professions Code is repealed.
2079.

(a)A physician and surgeon who desires to administer general anesthesia in the office of a dentist pursuant to Section 1646.9, shall provide the Medical Board of California with a copy of the application submitted to the Dental Board of California pursuant to subdivision (b) of Section 1646.9 and a fee established by the board not to exceed the costs of processing the application as provided in this section.

(b)The Medical Board of California shall review the information submitted and take action as follows:

(1)Inform the Dental Board of California whether the physician and surgeon has a current license in good standing to practice medicine in this state.

(2)Verify whether the applicant has successfully completed a postgraduate residency training program in anesthesiology and whether the program has been recognized by the American Council on Graduate Medical Education.

(3)Inform the Dental Board of California whether the Medical Board of California has determined that the applicant has successfully completed the postgraduate residency training program in anesthesiology recognized by the American Council on Graduate Medicine.

SEC. 59.

 The Legislature finds and declares that Sections 12 and 17 of this act, which amend Sections 1646.2 and 1647.3 of the Business and Professions Code, imposes a limitation on the public’s right of access to the meetings of public bodies or the writings of public officials and agencies within the meaning of Section 3 of Article I of the California Constitution. Pursuant to that constitutional provision, the Legislature makes the following findings to demonstrate the interest protected by this limitation and the need for protecting that interest:
Making records confidential regarding patient records submitted to the board protects the individual’s right to privacy in that person’s medical history and the personal information included within those records, documents, or forms.

SEC. 60.

 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.