Bill Text: IL SB0167 | 2019-2020 | 101st General Assembly | Chaptered

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Bill Title: Amends the Illinois Dental Practice Act. Defines "teledentistry". Makes changes concerning the requirements that must be met by a dental assistant before the dental assistant may replace, carve, and finish amalgam restorations, place, pack, and finish composite restorations, and place interim restorations. In provisions concerning the qualifications for a permit to administer anesthesia and sedation, requires the Department to ensure that the dentist has completed and maintains certification in advanced cardiac life support or pediatric advanced life support. In provisions concerning death or incapacitation of a dentist, provides that specified personnel may contract with another dentist or dentists to continue the operations of the deceased or incapacitated dentist's practice for a period of one year (rather than no more than one year) from the time of death or incapacitation or the dentist or until the practice is sold, whichever occurs first. Provides that if the practice is not sold within the initial one-year period, the contract may be extended for additional 12-month periods by the Department, but the extension shall not exceed 3 additional 12-month periods. Sets forth specified requirements for extension. Changes repeal and operative dates for various provisions of the Act. Makes other changes. Effective immediately.

Spectrum: Bipartisan Bill

Status: (Passed) 2019-07-26 - Public Act . . . . . . . . . 101-0162 [SB0167 Detail]

Download: Illinois-2019-SB0167-Chaptered.html

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Public Act 101-0162
SB0167 Enrolled LRB101 04886 JRG 49895 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Dental Practice Act is amended by
changing Sections 4, 8.1, 17, 17.1, 18, 18.1, 38.2, and 54.3 as
follows:
(225 ILCS 25/4) (from Ch. 111, par. 2304)
(Section scheduled to be repealed on January 1, 2026)
Sec. 4. Definitions. As used in this Act:
"Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application
file or license file as maintained by the Department's
licensure maintenance unit. It is the duty of the applicant or
licensee to inform the Department of any change of address and
those changes must be made either through the Department's
website or by contacting the Department.
"Department" means the Department of Financial and
Professional Regulation.
"Secretary" means the Secretary of Financial and
Professional Regulation.
"Board" means the Board of Dentistry.
"Dentist" means a person who has received a general license
pursuant to paragraph (a) of Section 11 of this Act and who may

perform any intraoral and extraoral procedure required in the
practice of dentistry and to whom is reserved the
responsibilities specified in Section 17.
"Dental hygienist" means a person who holds a license under
this Act to perform dental services as authorized by Section
18.
"Dental assistant" means an appropriately trained person
who, under the supervision of a dentist, provides dental
services as authorized by Section 17.
"Expanded function dental assistant" means a dental
assistant who has completed the training required by Section
17.1 of this Act.
"Dental laboratory" means a person, firm or corporation
which:
(i) engages in making, providing, repairing or
altering dental prosthetic appliances and other artificial
materials and devices which are returned to a dentist for
insertion into the human oral cavity or which come in
contact with its adjacent structures and tissues; and
(ii) utilizes or employs a dental technician to provide
such services; and
(iii) performs such functions only for a dentist or
dentists.
"Supervision" means supervision of a dental hygienist or a
dental assistant requiring that a dentist authorize the
procedure, remain in the dental facility while the procedure is

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

periodontics, prosthodontics, and oral and maxillofacial
radiology.
"Specialist" means a dentist who has received a specialty
license pursuant to Section 11(b).
"Dental technician" means a person who owns, operates or is
employed by a dental laboratory and engages in making,
providing, repairing or altering dental prosthetic appliances
and other artificial materials and devices which are returned
to a dentist for insertion into the human oral cavity or which
come in contact with its adjacent structures and tissues.
"Impaired dentist" or "impaired dental hygienist" means a
dentist or dental hygienist who is unable to practice with
reasonable skill and safety because of a physical or mental
disability as evidenced by a written determination or written
consent based on clinical evidence, including deterioration
through the aging process, loss of motor skills, abuse of drugs
or alcohol, or a psychiatric disorder, of sufficient degree to
diminish the person's ability to deliver competent patient
care.
"Nurse" means a registered professional nurse, a certified
registered nurse anesthetist licensed as an advanced practice
registered nurse, or a licensed practical nurse licensed under
the Nurse Practice Act.
"Patient of record" means a patient for whom the patient's
most recent dentist has obtained a relevant medical and dental
history and on whom the dentist has performed an examination

and evaluated the condition to be treated.
"Dental responder" means a dentist or dental hygienist who
is appropriately certified in disaster preparedness,
immunizations, and dental humanitarian medical response
consistent with the Society of Disaster Medicine and Public
Health and training certified by the National Incident
Management System or the National Disaster Life Support
Foundation.
"Mobile dental van or portable dental unit" means any
self-contained or portable dental unit in which dentistry is
practiced that can be moved, towed, or transported from one
location to another in order to establish a location where
dental services can be provided.
"Public health dental hygienist" means a hygienist who
holds a valid license to practice in the State, has 2 years of
full-time clinical experience or an equivalent of 4,000 hours
of clinical experience and has completed at least 42 clock
hours of additional structured courses in dental education
approved by rule by the Department in advanced areas specific
to public health dentistry, including, but not limited to,
emergency procedures for medically compromised patients,
pharmacology, medical recordkeeping procedures, geriatric
dentistry, pediatric dentistry, pathology, and other areas of
study as determined by the Department, and works in a public
health setting pursuant to a written public health supervision
agreement as defined by rule by the Department with a dentist

working in or contracted with a local or State government
agency or institution or who is providing services as part of a
certified school-based program or school-based oral health
program.
"Public health setting" means a federally qualified health
center; a federal, State, or local public health facility; Head
Start; a special supplemental nutrition program for Women,
Infants, and Children (WIC) facility; or a certified
school-based health center or school-based oral health
program.
"Public health supervision" means the supervision of a
public health dental hygienist by a licensed dentist who has a
written public health supervision agreement with that public
health dental hygienist while working in an approved facility
or program that allows the public health dental hygienist to
treat patients, without a dentist first examining the patient
and being present in the facility during treatment, (1) who are
eligible for Medicaid or (2) who are uninsured and whose
household income is not greater than 200% of the federal
poverty level.
"Teledentistry" means the use of telehealth systems and
methodologies in dentistry and includes patient care and
education delivery using synchronous and asynchronous
communications under a dentist's authority as provided under
this Act.
(Source: P.A. 99-25, eff. 1-1-16; 99-492, eff. 12-31-15;

99-680, eff. 1-1-17; 100-215, eff. 1-1-18; 100-513, eff.
1-1-18; 100-863, eff. 8-14-18.)
(225 ILCS 25/8.1) (from Ch. 111, par. 2308.1)
(Section scheduled to be repealed on January 1, 2026)
Sec. 8.1. Permit for the administration of anesthesia and
sedation.
(a) No licensed dentist shall administer general
anesthesia, deep sedation, or conscious sedation without first
applying for and obtaining a permit for such purpose from the
Department. The Department shall issue such permit only after
ascertaining that the applicant possesses the minimum
qualifications necessary to protect public safety. A person
with a dental degree who administers anesthesia, deep sedation,
or conscious sedation in an approved hospital training program
under the supervision of either a licensed dentist holding such
permit or a physician licensed to practice medicine in all its
branches shall not be required to obtain such permit.
(b) In determining the minimum permit qualifications that
are necessary to protect public safety, the Department, by
rule, shall:
(1) establish the minimum educational and training
requirements necessary for a dentist to be issued an
appropriate permit;
(2) establish the standards for properly equipped
dental facilities (other than licensed hospitals and

ambulatory surgical treatment centers) in which general
anesthesia, deep sedation, or conscious sedation is
administered, as necessary to protect public safety;
(3) establish minimum requirements for all persons who
assist the dentist in the administration of general
anesthesia, deep sedation, or conscious sedation,
including minimum training requirements for each member of
the dental team, monitoring requirements, recordkeeping
requirements, and emergency procedures;
(4) ensure that the dentist has completed and maintains
current certification in advanced cardiac life support or
pediatric advanced life support and all persons assisting
the dentist or monitoring the administration of general
anesthesia, deep sedation, or conscious sedation maintain
current certification in Basic Life Support (BLS); and
(5) establish continuing education requirements in
sedation techniques and airway management for dentists who
possess a permit under this Section.
When establishing requirements under this Section, the
Department shall consider the current American Dental
Association guidelines on sedation and general anesthesia, the
current "Guidelines for Monitoring and Management of Pediatric
Patients During and After Sedation for Diagnostic and
Therapeutic Procedures" established by the American Academy of
Pediatrics and the American Academy of Pediatric Dentistry, and
the current parameters of care and Office Anesthesia Evaluation

(OAE) Manual established by the American Association of Oral
and Maxillofacial Surgeons.
(c) A licensed dentist must hold an appropriate permit
issued under this Section in order to perform dentistry while a
nurse anesthetist administers conscious sedation, and a valid
written collaborative agreement must exist between the dentist
and the nurse anesthetist, in accordance with the Nurse
Practice Act.
A licensed dentist must hold an appropriate permit issued
under this Section in order to perform dentistry while a nurse
anesthetist administers deep sedation or general anesthesia,
and a valid written collaborative agreement must exist between
the dentist and the nurse anesthetist, in accordance with the
Nurse Practice Act.
For the purposes of this subsection (c), "nurse
anesthetist" means a licensed certified registered nurse
anesthetist who holds a license as an advanced practice
registered nurse.
(Source: P.A. 100-201, eff. 8-18-17; 100-513, eff. 1-1-18.)
(225 ILCS 25/17) (from Ch. 111, par. 2317)
(Section scheduled to be repealed on January 1, 2026)
Sec. 17. Acts constituting the practice of dentistry. A
person practices dentistry, within the meaning of this Act:
(1) Who represents himself or herself as being able to
diagnose or diagnoses, treats, prescribes, or operates for

any disease, pain, deformity, deficiency, injury, or
physical condition of the human tooth, teeth, alveolar
process, gums or jaw; or
(2) Who is a manager, proprietor, operator or conductor
of a business where dental operations are performed; or
(3) Who performs dental operations of any kind; or
(4) Who uses an X-Ray machine or X-Ray films for dental
diagnostic purposes; or
(5) Who extracts a human tooth or teeth, or corrects or
attempts to correct malpositions of the human teeth or
jaws; or
(6) Who offers or undertakes, by any means or method,
to diagnose, treat or remove stains, calculus, and bonding
materials from human teeth or jaws; or
(7) Who uses or administers local or general
anesthetics in the treatment of dental or oral diseases or
in any preparation incident to a dental operation of any
kind or character; or
(8) Who takes material or digital scans for final
impressions of the human tooth, teeth, or jaws or performs
any phase of any operation incident to the replacement of a
part of a tooth, a tooth, teeth or associated tissues by
means of a filling, crown, a bridge, a denture or other
appliance; or
(9) Who offers to furnish, supply, construct,
reproduce or repair, or who furnishes, supplies,

constructs, reproduces or repairs, prosthetic dentures,
bridges or other substitutes for natural teeth, to the user
or prospective user thereof; or
(10) Who instructs students on clinical matters or
performs any clinical operation included in the curricula
of recognized dental schools and colleges; or
(11) Who takes material or digital scans for final
impressions of human teeth or places his or her hands in
the mouth of any person for the purpose of applying teeth
whitening materials, or who takes impressions of human
teeth or places his or her hands in the mouth of any person
for the purpose of assisting in the application of teeth
whitening materials. A person does not practice dentistry
when he or she discloses to the consumer that he or she is
not licensed as a dentist under this Act and (i) discusses
the use of teeth whitening materials with a consumer
purchasing these materials; (ii) provides instruction on
the use of teeth whitening materials with a consumer
purchasing these materials; or (iii) provides appropriate
equipment on-site to the consumer for the consumer to
self-apply teeth whitening materials.
The fact that any person engages in or performs, or offers
to engage in or perform, any of the practices, acts, or
operations set forth in this Section, shall be prima facie
evidence that such person is engaged in the practice of
dentistry.

The following practices, acts, and operations, however,
are exempt from the operation of this Act:
(a) The rendering of dental relief in emergency cases
in the practice of his or her profession by a physician or
surgeon, licensed as such under the laws of this State,
unless he or she undertakes to reproduce or reproduces lost
parts of the human teeth in the mouth or to restore or
replace lost or missing teeth in the mouth; or
(b) The practice of dentistry in the discharge of their
official duties by dentists in any branch of the Armed
Services of the United States, the United States Public
Health Service, or the United States Veterans
Administration; or
(c) The practice of dentistry by students in their
course of study in dental schools or colleges approved by
the Department, when acting under the direction and
supervision of dentists acting as instructors; or
(d) The practice of dentistry by clinical instructors
in the course of their teaching duties in dental schools or
colleges approved by the Department:
(i) when acting under the direction and
supervision of dentists, provided that such clinical
instructors have instructed continuously in this State
since January 1, 1986; or
(ii) when holding the rank of full professor at
such approved dental school or college and possessing a

current valid license or authorization to practice
dentistry in another country; or
(e) The practice of dentistry by licensed dentists of
other states or countries at meetings of the Illinois State
Dental Society or component parts thereof, alumni meetings
of dental colleges, or any other like dental organizations,
while appearing as clinicians; or
(f) The use of X-Ray machines for exposing X-Ray films
of dental or oral tissues by dental hygienists or dental
assistants; or
(g) The performance of any dental service by a dental
assistant, if such service is performed under the
supervision and full responsibility of a dentist. In
addition, after being authorized by a dentist, a dental
assistant may, for the purpose of eliminating pain or
discomfort, remove loose, broken, or irritating
orthodontic appliances on a patient of record.
For purposes of this paragraph (g), "dental service" is
defined to mean any intraoral procedure or act which shall
be prescribed by rule or regulation of the Department.
Dental service, however, shall not include:
(1) Any and all diagnosis of or prescription for
treatment of disease, pain, deformity, deficiency,
injury or physical condition of the human teeth or
jaws, or adjacent structures.
(2) Removal of, or restoration of, or addition to

the hard or soft tissues of the oral cavity, except for
the placing, carving, and finishing of amalgam
restorations and placing, packing, and finishing
composite restorations by dental assistants who have
had additional formal education and certification.
A dental assistant may place, carve, and finish
amalgam restorations, place, pack, and finish
composite restorations, and place interim restorations
if he or she (A) has at least 4,000 hours of direct
clinical patient care experience and has successfully
completed a structured training program as described
in item (2) of subsection (g) provided by: (A) an
educational institution accredited by the Commission
on Dental Accreditation, such as a dental school or
dental hygiene or dental assistant program, or (B) has
at least 4,000 hours of direct clinical patient care
experience and has successfully completed a structured
training program as described in item (2) of subsection
(g) provided by a statewide dental association,
approved by the Department to provide continuing
education, that has developed and conducted training
programs for expanded functions for dental assistants
or hygienists. The training program must: (i) include a
minimum of 16 hours of didactic study and 14 hours of
clinical manikin instruction; all training programs
shall include areas of study in nomenclature, caries

classifications, oral anatomy, periodontium, basic
occlusion, instrumentations, pulp protection liners
and bases, dental materials, matrix and wedge
techniques, amalgam placement and carving, rubber dam
clamp placement, and rubber dam placement and removal;
(ii) include an outcome assessment examination that
demonstrates competency; (iii) require the supervising
dentist to observe and approve the completion of 8
amalgam or composite restorations; and (iv) issue a
certificate of completion of the training program,
which must be kept on file at the dental office and be
made available to the Department upon request. A dental
assistant must have successfully completed an approved
coronal polishing and dental sealant course prior to
taking the amalgam and composite restoration course.
A dentist utilizing dental assistants shall not
supervise more than 4 dental assistants at any one time
for placing, carving, and finishing of amalgam
restorations or for placing, packing, and finishing
composite restorations.
(3) Any and all correction of malformation of teeth
or of the jaws.
(4) Administration of anesthetics, except for
monitoring of nitrous oxide, conscious sedation, deep
sedation, and general anesthetic as provided in
Section 8.1 of this Act, that may be performed only

after successful completion of a training program
approved by the Department. A dentist utilizing dental
assistants shall not supervise more than 4 dental
assistants at any one time for the monitoring of
nitrous oxide.
(5) Removal of calculus from human teeth.
(6) Taking of material or digital scans for final
impressions for the fabrication of prosthetic
appliances, crowns, bridges, inlays, onlays, or other
restorative or replacement dentistry.
(7) The operative procedure of dental hygiene
consisting of oral prophylactic procedures, except for
coronal polishing and pit and fissure sealants, which
may be performed by a dental assistant who has
successfully completed a training program approved by
the Department. Dental assistants may perform coronal
polishing under the following circumstances: (i) the
coronal polishing shall be limited to polishing the
clinical crown of the tooth and existing restorations,
supragingivally; (ii) the dental assistant performing
the coronal polishing shall be limited to the use of
rotary instruments using a rubber cup or brush
polishing method (air polishing is not permitted); and
(iii) the supervising dentist shall not supervise more
than 4 dental assistants at any one time for the task
of coronal polishing or pit and fissure sealants.

In addition to coronal polishing and pit and
fissure sealants as described in this item (7), a
dental assistant who has at least 2,000 hours of direct
clinical patient care experience and who has
successfully completed a structured training program
provided by (1) an educational institution such as a
dental school or dental hygiene or dental assistant
program, or (2) by a statewide dental or dental
hygienist association, approved by the Department on
or before the effective date of this amendatory Act of
the 99th General Assembly, that has developed and
conducted a training program for expanded functions
for dental assistants or hygienists may perform: (A)
coronal scaling above the gum line, supragingivally,
on the clinical crown of the tooth only on patients 12
years of age or younger who have an absence of
periodontal disease and who are not medically
compromised or individuals with special needs and (B)
intracoronal temporization of a tooth. The training
program must: (I) include a minimum of 16 hours of
instruction in both didactic and clinical manikin or
human subject instruction; all training programs shall
include areas of study in dental anatomy, public health
dentistry, medical history, dental emergencies, and
managing the pediatric patient; (II) include an
outcome assessment examination that demonstrates

competency; (III) require the supervising dentist to
observe and approve the completion of 6 full mouth
supragingival scaling procedures; and (IV) issue a
certificate of completion of the training program,
which must be kept on file at the dental office and be
made available to the Department upon request. A dental
assistant must have successfully completed an approved
coronal polishing course prior to taking the coronal
scaling course. A dental assistant performing these
functions shall be limited to the use of hand
instruments only. In addition, coronal scaling as
described in this paragraph shall only be utilized on
patients who are eligible for Medicaid or who are
uninsured and whose household income is not greater
than 200% of the federal poverty level. A dentist may
not supervise more than 2 dental assistants at any one
time for the task of coronal scaling. This paragraph is
inoperative on and after January 1, 2026 2021.
The limitations on the number of dental assistants a
dentist may supervise contained in items (2), (4), and (7)
of this paragraph (g) mean a limit of 4 total dental
assistants or dental hygienists doing expanded functions
covered by these Sections being supervised by one dentist.
(h) The practice of dentistry by an individual who:
(i) has applied in writing to the Department, in
form and substance satisfactory to the Department, for

a general dental license and has complied with all
provisions of Section 9 of this Act, except for the
passage of the examination specified in subsection (e)
of Section 9 of this Act; or
(ii) has applied in writing to the Department, in
form and substance satisfactory to the Department, for
a temporary dental license and has complied with all
provisions of subsection (c) of Section 11 of this Act;
and
(iii) has been accepted or appointed for specialty
or residency training by a hospital situated in this
State; or
(iv) has been accepted or appointed for specialty
training in an approved dental program situated in this
State; or
(v) has been accepted or appointed for specialty
training in a dental public health agency situated in
this State.
The applicant shall be permitted to practice dentistry
for a period of 3 months from the starting date of the
program, unless authorized in writing by the Department to
continue such practice for a period specified in writing by
the Department.
The applicant shall only be entitled to perform such
acts as may be prescribed by and incidental to his or her
program of residency or specialty training and shall not

otherwise engage in the practice of dentistry in this
State.
The authority to practice shall terminate immediately
upon:
(1) the decision of the Department that the
applicant has failed the examination; or
(2) denial of licensure by the Department; or
(3) withdrawal of the application.
(Source: P.A. 99-492, eff. 12-31-15; 99-680, eff. 1-1-17;
100-215, eff. 1-1-18; 100-976, eff. 1-1-19.)
(225 ILCS 25/17.1)
(Section scheduled to be repealed on January 1, 2026)
Sec. 17.1. Expanded function dental assistants.
(a) A dental assistant who has completed training as
provided in subsection (b) of this Section in all of the
following areas may hold himself or herself out as an expanded
function dental assistant:
(1) Taking material or digital scans for final
impressions after completing a training program that
includes either didactic objectives or clinical skills and
functions that demonstrate competency.
(2) Performing pulp vitality test after completing a
training program that includes either didactic objectives
or clinical skills and functions that demonstrate
competency.

(3) Placing, carving, and finishing of amalgam
restorations and placing, packing, and finishing composite
restorations as allowed under Section 17.
(4) Starting the flow of oxygen and monitoring of
nitrous oxide-oxygen analgesia as allowed under Section
17.
(5) Coronal polishing and pit and fissure sealants as
allowed under Section 17.
All procedures listed in paragraphs (1) through (5) for
dental assistants must be performed under the supervision of a
dentist, requiring the dentist authorizes the procedure,
remains in the dental facility while the procedure is
performed, and approves the work performed by the dental
assistant before dismissal of the patient, but the dentist is
not required to be present at all times in the treatment room.
After the completion of training as provided in subsection
(b) of this Section, an expanded function dental assistant may
perform any of the services listed in this subsection (a)
pursuant to the limitations of this Act.
(b) Certification and training as an expanded function
dental assistant must be obtained from one of the following
sources: (i) an approved continuing education sponsor; (ii) a
dental assistant training program approved by the Commission on
Dental Accreditation of the American Dental Association; or
(iii) a training program approved by the Department.
Training required under this subsection (b) must also

include Basic Life Support certification, as described in
Section 16 of this Act. Proof of current certification shall be
kept on file with the supervising dentist.
(c) Any procedures listed in subsection (a) that are
performed by an expanded function dental assistant must be
approved by the supervising dentist and examined prior to
dismissal of the patient. The supervising dentist shall be
responsible for all dental services or procedures performed by
the dental assistant.
(d) Nothing in this Section shall be construed to alter the
number of dental assistants that a dentist may supervise under
paragraph (g) of Section 17 of this Act.
(e) Nothing in this Act shall: (1) require a dental
assistant to be certified as an expanded function dental
assistant or (2) prevent a dentist from training dental
assistants in accordance with the provisions of Section 17 or
17.1 of this Act or rules pertaining to dental assistant
duties.
(Source: P.A. 100-215, eff. 1-1-18; 100-976, eff. 1-1-19.)
(225 ILCS 25/18) (from Ch. 111, par. 2318)
(Section scheduled to be repealed on January 1, 2026)
Sec. 18. Acts constituting the practice of dental hygiene;
limitations.
(a) A person practices dental hygiene within the meaning of
this Act when he or she performs the following acts under the

supervision of a dentist:
(i) the operative procedure of dental hygiene,
consisting of oral prophylactic procedures;
(ii) the exposure and processing of X-Ray films of the
teeth and surrounding structures;
(iii) the application to the surfaces of the teeth or
gums of chemical compounds designed to be desensitizing
agents or effective agents in the prevention of dental
caries or periodontal disease;
(iv) all services which may be performed by a dental
assistant as specified by rule pursuant to Section 17, and
a dental hygienist may engage in the placing, carving, and
finishing of amalgam restorations only after obtaining
formal education and certification as determined by the
Department;
(v) administration and monitoring of nitrous oxide
upon successful completion of a training program approved
by the Department;
(vi) administration of local anesthetics upon
successful completion of a training program approved by the
Department; and
(vii) such other procedures and acts as shall be
prescribed by rule or regulation of the Department.
(b) A dental hygienist may be employed or engaged only:
(1) by a dentist;
(2) by a federal, State, county, or municipal agency or

institution;
(3) by a public or private school; or
(4) by a public clinic operating under the direction of
a hospital or federal, State, county, municipal, or other
public agency or institution.
(c) When employed or engaged in the office of a dentist, a
dental hygienist may perform, under general supervision, those
procedures found in items (i) through (iv) of subsection (a) of
this Section, provided the patient has been examined by the
dentist within one year of the provision of dental hygiene
services, the dentist has approved the dental hygiene services
by a notation in the patient's record and the patient has been
notified that the dentist may be out of the office during the
provision of dental hygiene services.
(d) If a patient of record is unable to travel to a dental
office because of illness, infirmity, or imprisonment, a dental
hygienist may perform, under the general supervision of a
dentist, those procedures found in items (i) through (iv) of
subsection (a) of this Section, provided the patient is located
in a long-term care facility licensed by the State of Illinois,
a mental health or developmental disability facility, or a
State or federal prison. The dentist shall personally examine
and diagnose the patient and determine which services are
necessary to be performed, which shall be contained in an order
to the hygienist and a notation in the patient's record. Such
order must be implemented within 120 days of its issuance, and

an updated medical history and observation of oral conditions
must be performed by the hygienist immediately prior to
beginning the procedures to ensure that the patient's health
has not changed in any manner to warrant a reexamination by the
dentist.
(e) School-based oral health care, consisting of and
limited to oral prophylactic procedures, sealants, and
fluoride treatments, may be provided by a dental hygienist
under the general supervision of a dentist. A dental hygienist
may not provide other dental hygiene treatment in a
school-based setting, including but not limited to
administration or monitoring of nitrous oxide or
administration of local anesthetics. The school-based
procedures may be performed provided the patient is located at
a public or private school and the program is being conducted
by a State, county or local public health department initiative
or in conjunction with a dental school or dental hygiene
program. The dentist shall personally examine and diagnose the
patient and determine which services are necessary to be
performed, which shall be contained in an order to the
hygienist and a notation in the patient's record. Any such
order for sealants must be implemented within 120 days after
its issuance. Any such order for oral prophylactic procedures
or fluoride treatments must be implemented within 180 days
after its issuance. An updated medical history and observation
of oral conditions must be performed by the hygienist

immediately prior to beginning the procedures to ensure that
the patient's health has not changed in any manner to warrant a
reexamination by the dentist.
(f) Without the supervision of a dentist, a dental
hygienist may perform dental health education functions and may
record case histories and oral conditions observed.
(g) The number of dental hygienists practicing in a dental
office shall not exceed, at any one time, 4 times the number of
dentists practicing in the office at the time.
(h) A dental hygienist who is certified as a public health
dental hygienist may provide services to patients: (1) who are
eligible for Medicaid or (2) who are uninsured and whose
household income is not greater than 200% of the federal
poverty level. A public health dental hygienist may perform
oral assessments, perform screenings, and provide educational
and preventative services as provided in subsection (b) of
Section 18.1 of this Act. The public health dental hygienist
may not administer local anesthesia or nitrous oxide, or place,
carve, or finish amalgam restorations or provide periodontal
therapy under this exception. Each patient must sign a consent
form that acknowledges that the care received does not take the
place of a regular dental examination. The public health dental
hygienist must provide the patient or guardian a written
referral to a dentist for assessment of the need for further
dental care at the time of treatment. Any indication or
observation of a condition that could warrant the need for

urgent attention must be reported immediately to the
supervising dentist for appropriate assessment and treatment.
This subsection (h) is inoperative on and after January 1,
2026 2021.
(i) A dental hygienist performing procedures listed in
paragraphs (1) through (4) of subsection (a) of Section 17.1
must be under the supervision of a dentist, requiring the
dentist authorizes the procedure, remains in the dental
facility while the procedure is performed, and approves the
work performed by the dental hygienist before dismissal of the
patient, but the dentist is not required to be present at all
times in the treatment room.
(j) A dental hygienist may perform actions described in
paragraph (5) of subsection (a) of Section 17.1 under the
general supervision of a dentist as described in this Section.
(Source: P.A. 99-492, eff. 12-31-15; 100-976, eff. 1-1-19.)
(225 ILCS 25/18.1)
(Section scheduled to be repealed on January 1, 2021)
Sec. 18.1. Public health dental supervision
responsibilities.
(a) When working together in a public health supervision
relationship, dentists and public health dental hygienists
shall enter into a public health supervision agreement. The
dentist providing public health supervision must:
(1) be available to provide an appropriate level of

contact, communication, collaboration, and consultation
with the public health dental hygienist and must meet
in-person with the public health dental hygienist at least
quarterly for review and consultation;
(2) have specific standing orders or policy guidelines
for procedures that are to be carried out for each location
or program, although the dentist need not be present when
the procedures are being performed;
(3) provide for the patient's additional necessary
care in consultation with the public health dental
hygienist;
(4) file agreements and notifications as required; and
(5) include procedures for creating and maintaining
dental records, including protocols for transmission of
all records between the public health dental hygienist and
the dentist following each treatment, which shall include a
notation regarding procedures authorized by the dentist
and performed by the public health dental hygienist and the
location where those records are to be kept.
Each dentist and hygienist who enters into a public health
supervision agreement must document and maintain a copy of any
change or termination of that agreement.
Dental records shall be owned and maintained by the
supervising dentist for all patients treated under public
health supervision, unless the supervising dentist is an
employee of a public health clinic or federally qualified

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

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

communication with the dentist providing public health
supervision; and
(5) complete an additional 4 hours of continuing
education in areas specific to public health dentistry
yearly.
(d) Each public health dental hygienist who has rendered
services under subsections (c), (d), and (e) of this Section
must complete a summary report at the completion of a program
or, in the case of an ongoing program, at least annually. The
report must be completed in the manner specified by the
Division of Oral Health in the Department of Public Health
including information about each location where the public
health dental hygienist has rendered these services. The public
health dental hygienist must submit the form to the dentist
providing supervision for his or her signature before sending
it to the Division.
(e) Public health dental hygienists providing services
under public health supervision may be compensated for their
work by salary, honoraria, and other mechanisms by the
employing or sponsoring entity. Nothing in this Act shall
preclude the entity that employs or sponsors a public health
dental hygienist from seeking payment, reimbursement, or other
source of funding for the services provided.
(f) This Section is repealed on January 1, 2026 2021.
(Source: P.A. 99-492, eff. 12-31-15; 99-680, eff. 1-1-17.)

(225 ILCS 25/38.2)
(Section scheduled to be repealed on January 1, 2026)
Sec. 38.2. Death or incapacitation of dentist.
(a) The executor or administrator of a dentist's estate or
the legal guardian or authorized representative of a dentist
who has become incapacitated may contract with another dentist
or dentists to continue the operations of the deceased or
incapacitated dentist's practice (if the practice of the
deceased or incapacitated dentist is a sole proprietorship, a
corporation where the deceased or incapacitated dentist is the
sole shareholder, or a limited liability company where the
deceased or incapacitated dentist is the sole member) for a
period of no more than one year from the time of death or
incapacitation of the dentist or until the practice is sold,
whichever occurs first, if all the following conditions are
met:
(1) The executor, administrator, guardian, or
authorized representative executes and files with the
Department a notification of death or incapacitation on a
form provided by the Department, which notification shall
include the following:
(A) the name and license number of the deceased or
incapacitated dentist;
(B) the name and address of the dental practice;
(C) the name, address, and tax identification
number of the estate;

(D) the name and license number of each dentist who
will operate the dental practice; and
(E) an affirmation, under penalty of perjury, that
the information provided is true and correct and that
the executor, administrator, guardian, or authorized
representative understands that any interference by
the executor, administrator, guardian, or authorized
representative or any agent or assignee of the
executor, administrator, guardian, or authorized
representative with the contracting dentist's or
dentists' practice of dentistry or professional
judgment or any other violation of this Section is
grounds for an immediate termination of the operations
of the dental practice.
(2) Within 30 days after the death or incapacitation of
a dentist, the executor, administrator, guardian, or
authorized representative shall send notification of the
death or incapacitation by mail to the last known address
of each patient of record that has seen the deceased or
incapacitated dentist within the previous 12 months, with
an explanation of how copies of the practitioner's records
may be obtained. This notice may also contain any other
relevant information concerning the continuation of the
dental practice.
Continuation of the operations of the dental practice of a
deceased or incapacitated dentist shall not begin until the

provisions of this subsection (a) have been met.
If the practice is not sold within the initial one-year
period, the provision described in subsection (a) may be
extended for additional 12-month periods by the Department.
However, if the extension is approved, the extension shall not
exceed 3 additional 12-month periods. Each extension must be
granted prior to the expiration date of the prior extension and
must be accompanied by a petition detailing the reasons for the
extension that must be kept on file by the Department.
(b) The Secretary may terminate the operations of a dental
practice operating pursuant to this Section if the Department
has evidence of a violation of this Section or Section 23 or 24
of this Act. The Secretary must conduct a hearing before
terminating the operations of a dental practice operating
pursuant to this Section. At least 15 days before the hearing
date, the Department (i) must notify, in writing, the executor,
administrator, guardian, or authorized representative at the
address provided, pursuant to item (C) of subdivision (1) of
subsection (a) of this Section, and to the contracting dentist
or dentists at the address of the dental practice provided
pursuant to item (B) of subdivision (1) of subsection (a) of
this Section, of any charges made and of the time and place of
the hearing on the charges before the Secretary or hearing
officer, as provided in Section 30 of this Act, (ii) direct the
executor, administrator, guardian, or authorized
representative to file his or her written answer to such

charges with the Secretary under oath within 10 days after the
service on the executor, administrator, guardian, or
authorized representative of the notice, and (iii) inform the
executor, administrator, guardian, or authorized
representative that if he or she fails to file such answer, a
default judgment will be entered against him or her and the
operations of the dental practice shall be terminated.
(c) If the Secretary finds that evidence in his or her
possession indicates that a violation of this Section or
Section 23 or 24 of this Act constitutes an immediate threat to
the public health, safety, or welfare, the Secretary may
immediately terminate the operations of the dental practice
without a hearing. Upon service by certified mail to the
executor, administrator, guardian, or authorized
representative, at the address provided pursuant to item (C) of
subdivision (1) of subsection (a) of this Section, and the
contracting dentist or dentists, at the address of the dental
practice provided pursuant to item (B) of subdivision (1) of
subsection (a) of this Section, of notice of an order
immediately terminating the operations of the dental practice,
the executor, administrator, guardian, or authorized
representative may petition the Department within 30 days for a
hearing to take place within 30 days after the petition is
filed.
(d) The Department may require, by rule, the submission to
the Department of any additional information necessary for the

administration of this Section.
(Source: P.A. 94-1028, eff. 1-1-07.)
(225 ILCS 25/54.3)
(Section scheduled to be repealed on January 1, 2020)
Sec. 54.3. Vaccinations.
(a) Notwithstanding Section 54.2 of this Act, a dentist may
administer vaccinations upon completion of appropriate
training set forth by rule and approved by the Department on
appropriate vaccine storage, proper administration, and
addressing contraindications and adverse reactions.
Vaccinations shall be limited to patients 18 years of age and
older pursuant to a valid prescription or standing order by a
physician licensed to practice medicine in all its branches
who, in the course of professional practice, administers
vaccines to patients. Methods of communication shall be
established for consultation with the physician in person or by
telecommunications.
(b) Vaccinations administered by a dentist shall be limited
to influenza (inactivated influenza vaccine and live
attenuated influenza intranasal vaccine). Vaccines shall only
be administered by the dentist and shall not be delegated to an
assistant or any other person. Vaccination of a patient by a
dentist shall be documented in the patient's dental record and
the record shall be retained in accordance with current dental
recordkeeping standards. The dentist shall notify the

patient's primary care physician of each dose of vaccine
administered to the patient and shall enter all patient level
data or update the patient's current record. The dentist may
provide this notice to the patient's physician electronically.
In addition, the dentist shall enter all patient level data on
vaccines administered in the immunization data registry
maintained by the Department of Public Health.
(c) A dentist shall only provide vaccinations under this
Section if contracted with and credentialed by the patient's
health insurance, health maintenance organization, or other
health plan to specifically provide the vaccinations allowed
under this Section. Persons enrolled in Medicare or Medicaid
may only receive the vaccinations allowed for under this
Section from dentists who are authorized to do so by the
federal Centers for Medicare and Medicaid Services or the
Department of Healthcare and Family Services.
(d) The Department shall adopt any rules necessary to
implement this Section.
(e) This Section is repealed on January 1, 2026 2020.
(Source: P.A. 98-665, eff. 6-23-14.)
Section 99. Effective date. This Act takes effect upon
becoming law.
INDEX
Statutes amended in order of appearance