First Regular Session
Seventy-fifth General Assembly
STATE OF COLORADO
ENGROSSED
This Version Includes All Amendments Adopted
on Second Reading in the House of Introduction
LLS NO. 25-0401.03 Kristen Forrestal x4217
SENATE BILL 25-194
Senate Committees House Committees
Health & Human Services
Appropriations
A BILL FOR AN ACT
C
ONCERNING THE CONTINUATION OF THE "DENTAL PRACTICE ACT".101
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Sunset Process - Senate Health and Human Services
Committee. The bill makes changes to the "Dental Practice Act" (act) by:
! Continuing the act for 9 years, until 2034;
! Updating and adding definitions;
! Changing the makeup of the Colorado dental board
(board);
! Requiring the attorney general, in addition to counseling
the board, to counsel and advise the board's consultants;
SENATE
Amended 2nd Reading
April 15, 2025
SENATE SPONSORSHIP
Michaelson Jenet and Mullica, Cutter, Frizell
HOUSE SPONSORSHIP
Duran and Hartsook,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. ! Adding and updating the grounds for which the board may
take disciplinary action against an applicant for licensure or
a licensee;
! Allowing a licensee's submission to a mental or physical
examination to satisfy the requirement to notify the board
of a condition that would impair the licensee's ability to
practice;
! Adding as exemptions to the act the volunteer practice of
dentistry and dental hygiene under specific conditions;
! Repealing the exceptions that allow a dental therapist,
dental hygienist, or dental assistant to perform certain
dentistry practices and including additional tasks to the list
of items included in the practice of dentistry;
! Clarifying that a dental assistant, dental hygienist, and
dental therapist may perform tasks consistent with rules
adopted by the board;
! Requiring providers who perform itinerant surgery to
develop and maintain protocols for emergency follow-up
care;
! Authorizing licensed dentists to prescribe orders
electronically;
! Requiring a peer health assistance program selected as a
designated provider for the dentist peer health assistance
program to provide training and calibration to dentists who
practice monitoring services;
! Authorizing dentists to self-refer to participate in a peer
health assistance program or be referred by the board;
! Requiring an applicant for dental, dental hygienist, or
dental therapy licensure to pass a jurisprudence
examination that tests the applicant's knowledge of the act;
! Removing a requirement that dental education schools and
programs must be accredited or approved by a specific
entity;
! Requiring the board to adopt rules that allow for expedited,
temporary licensure during a public health emergency;
! Repealing specific tasks that are currently authorized to be
performed by a dental therapist;
! Updating procedures for the construction of dental devices
by an unlicensed technician;
! Updating the list of practices that are considered to be the
practice of unsupervised dental hygiene;
! Repealing the specific dosages of certain drugs that a
dental hygienist may prescribe;
! Authorizing the board to adopt rules that identify safe
prescribing alternatives to silver diamine fluoride as a
194
-2- treatment for strengthening teeth and preventing tooth
decay;
! Identifying tasks that are deemed to be practicing
supervised dental hygiene;
! Requiring a dental hygienist performing an interim
therapeutic restoration to confirm a referral for follow-up
care with a dentist;
! Limiting the number of dental hygienists that a dentist may
supervise; and
! Authorizing a dental therapist to perform specific tasks.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 12-220-104, amend2
(1), (4), (9)(a), and (10)(a); add (5.2), (10.5),
and (14.5); and add with3
amended and relocated provisions (5.3) as follows:4
12-220-104. Definitions - rules. As used in this article 220, unless5
the context otherwise requires:6
(1) "Accredited" means a program that is nationally recognized for7
specialized accrediting for dental, dental therapy, dental hygiene, and8
dental auxiliary programs by
THE COMMISSION ON DENTAL9
A
CCREDITATION OR A SPECIALTY ACCREDITING ORGANIZATION10
RECOGNIZED BY the United States department of education OR BY A11
SUCCESSOR ORGANIZATION OF THE COMMISSION .
12
(4) "Dental hygiene" means the delivery of preventive,13
educational, and clinical services supporting total health for the control14
of oral disease;
THE IMPACT OF THE DISEASE, DISORDER, OR CONDITION ON15
THE HUMAN BODY; and the promotion of oral health provided by a dental16
hygienist within the scope of the dental hygienist's education, training,17
and experience and in accordance with applicable law.18
(5.2) "D
ENTAL HYGIENE LABORATORY WORK ORDER " MEANS THE
19
DOCUMENTED ORDER OF A DENTAL HYGIENIST LICENSED IN THIS STATE20
194-3- AUTHORIZING ANOTHER PERSON TO CONSTRUCT , REPRODUCE, OR REPAIR1
AN ORAL MEDICAMENT CARRIER .2
(5.3) [Formerly 12-220-104 (11)] "D
ENTAL laboratory work
3
order" means the written instructions DOCUMENTED ORDER of a dentist4
licensed in Colorado authorizing another person to construct, reproduce,5
or repair any prosthetic denture, bridge, appliance, or other structure to6
function in the oral cavity, maxillofacial area, or adjacent and associated7
regions.8
(9) (a) (I) "Indirect supervision" means the supervision of those9
tasks or procedures that do not require the presence of the dentist in the10
office or on the premises at the time the tasks or procedures are being11
performed but do require that the tasks be performed with the prior12
knowledge and consent of the dentist.13
(II) F
OR PROCEDURES PERFORMED UNDER INDIRECT SUPERVISION ,
14
IF FOLLOW-UP CARE IS INDICATED, THE TREATING PROVIDER SHALL15
PROVIDE AN APPROPRIATE REFERRAL FOR RECOMMENDED FOLLOW -UP16
CARE.17
(III) A DENTIST WHO PROVIDES INDIRECT SUPERVISION MUST HAVE18
AN ACTIVE COLORADO LICENSE IN GOOD STANDING .19
(10) (a) "Interim therapeutic restoration" or "ITR" means a direct20
provisional restoration placed to stabilize a tooth until a licensed dentist21
OR DENTAL THERAPIST can assess the need for further definitive treatment.22
(10.5) "ITINERANT SURGERY" MEANS THE PROVISION OF23
ELECTIVE SURGICAL PROCEDURES BY A PROVIDER WHO TRAVELS BETWEEN24
MULTIPLE TREATMENT FACILITIES RATHER THAN OPERATING FROM A25
SINGLE, ESTABLISHED SURGICAL LOCATION WHERE THE PROVIDER IS NOT26
EMPLOYED OR DOES NOT HOLD OWNERSHIP OR A LONG -TERM LEASE.27
194
-4- "ITINERANT SURGERY" INCLUDES SPECIALTY-LEVEL SURGICAL CARE1
PERFORMED IN A FACILITY BY A PROVIDER WHO IS NOT A GRADUATE OF AN2
ACCREDITED SURGICAL TRAINING PROGRAM FOR THAT SPECIALTY .3
(14.5) "TELEDENTISTRY" MEANS TELEHEALTH METHODOLOGIES4
AND SYSTEMS THAT ARE USED IN A MANNER THAT IS COMPLIANT WITH THE5
FEDERAL "HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT6
OF 1996", 42 U.S.C. SECS. 1320d TO 1320d-9, AS AMENDED, TO DELIVER7
ORAL HEALTH SERVICES IN DENTISTRY, INCLUDING INFORMATIONAL AND8
ELECTRONIC COMMUNICATION TECHNOLOGIES , REMOTE MONITORING9
TECHNOLOGIES, AND STORE-AND-FORWARD TRANSFERS, TO FACILITATE10
THE ASSESSMENT, DIAGNOSIS, CONSULTATION, COUNSELING, AND11
EDUCATION OF, OR TREATMENT PLANNING FOR , A PATIENT WHILE THE12
PATIENT IS LOCATED AT AN ORIGINATING SITE WITHOUT A DENTAL13
PRACTITIONER, AND THE DENTAL PRACTITIONER PROVIDING THE SERVICE14
IS AT A DISTANT SITE.15
16
SECTION 2. In Colorado Revised Statutes, 12-220-105, amend17
(1)(b)(II)(A) and (5) as follows:18
12-220-105. Colorado dental board - qualifications of board19
members - quorum - panel - rules - review of functions - repeal of20
article - repeal. (1) (b) (II) (A) Effective July 1, 2031, the board consists21
of seven dentist members, two ONE OF WHOM IS AN ORAL AND22
MAXILLOFACIAL SURGEON UNLESS AN ORAL AND MAXILLOFACIAL23
SURGEON IS NOT AVAILABLE; ONE dental therapist members, two MEMBER;24
THREE dental hygienist members; and two members from the public at25
large;
EXCEPT THAT THE DENTAL THERAPIST SEAT SHALL REMAIN OPEN
26
AND A DENTAL THERAPIST MEMBER SHALL NOT BE APPOINTED UNTIL27
194
-5- THERE ARE AT LEAST ONE HUNDRED DENTAL THERAPISTS ACTIVELY1
ENGAGED IN CLINICAL PRACTICE IN THIS STATE . The governor shall2
appoint each member for a term of four years, and each member must3
have the qualifications provided in this article 220. A member shall not4
serve more than two consecutive terms of four years. Each board member5
holds office until the member's term expires or until the governor6
appoints a successor.7
(5) (a) THIS ARTICLE 220 IS REPEALED, EFFECTIVE SEPTEMBER 1,8
2034. Before the repeal, of this article 220 pursuant to subsection (5)(b)9
of this section, all functions of the board are scheduled for review in10
accordance with section 24-34-104.11
(b) This article 220 is repealed, effective September 1, 2025.12
SECTION 3. In Colorado Revised Statutes, 12-220-106, amend13
(1)(a) introductory portion and (2); and add (1)(a)(VI) and (1)(a)(VII) as14
follows:15
12-220-106. Powers and duties of board - rules - limitation on16
authority. (1) The board shall exercise, in accordance with this article17
220, the following powers and duties:18
(a) Make ADOPT, publish, declare, and periodically review19
reasonable rules pursuant to section 12-20-204, including rules regarding:20
(VI) R
EQUIREMENTS FOR JURISPRUDENCE EDUCATION PRIOR TO
21
INITIAL LICENSURE;22
(VII) D
EFINITIONS FOR THE TERMS "IN GOOD STANDING" AND
23
"
PATIENT REPRESENTATIVE" FOR THE PURPOSES OF THIS ARTICLE 220;
24
(2) The board may recognize those dental specialties defined by25
the American Dental Association NATIONAL COMMISSION ON26
R
ECOGNITION OF DENTAL SPECIALTIES AND CERTIFYING BOARDS OR THE27
194
-6- UNITED STATES DEPARTMENT OF EDUCATION .1
SECTION 4. In Colorado Revised Statutes, amend 12-220-1082
as follows:3
12-220-108. Attorney general shall represent board and4
members. (1) The attorney general of the state of Colorado shall counsel5
with and advise the board in connection with its THE BOARD'S duties6
and responsibilities under DESCRIBED IN this article 220. If litigation is7
brought against the board or any of its individual members in8
connection with actions taken by the board or any of its members under9
this article 220 and the actions are free of malice, fraud, or willful neglect10
of duty, the attorney general shall defend the litigation without cost to the11
board or to any individual member of the board.12
(2) A
WITNESS OR CONSULTANT APPEARING OR TESTIFYING BEFORE
13
THE BOARD, OR PROVIDING EXPERT CONSULTATION TO THE BOARD , HAS14
THE SAME IMMUNITY AND IS SUBJECT TO THE SAME C ONDITIONS FOR15
IMMUNITY AS SPECIFIED IN SECTION 12-20-402.16
SECTION 5. In Colorado Revised Statutes, 12-220-201, amend17
(1)(n), (1)(s), (1)(ii), and (1)(oo); and add (1)(qq) and (1)(rr) as follows:18
12-220-201. Grounds for disciplinary action - definition.19
(1) The board may take disciplinary action against an applicant or20
licensee in accordance with sections 12-20-404 and 12-220-202 for any21
of the following causes:22
(n) Refusing to make patient records available to a patient,23
PATIENT REPRESENTATIVE , OR PREVIOUS OR CURRENT TREATMENT24
PROVIDER WITHIN SEVEN CALENDAR DAYS AFTER A WRITTEN REQUEST25
pursuant to a written authorization request under section 25-1-802;26
(s) Failing to furnish unlicensed persons with
DENTAL laboratory27
194
-7- work orders pursuant to section 12-220-502;1
(ii) Advertising or otherwise holding oneself out to the public as2
practicing a dental specialty in which the dentist has not successfully3
completed the education specified for the dental specialty as defined by4
the American Dental Association NATIONAL COMMISSION ON5
R
ECOGNITION OF DENTAL SPECIALTIES AND CERTIFYING BOARDS OR THE6
U
NITED STATES DEPARTMENT OF EDUCATION ;7
(oo) Failing to comply with sections 12-220-501 (1)(a)(II)(C) and
8
12-220-503 (1)(g) SECTION 12-220-503 (1)(g) and rules adopted pursuant9
to those sections THAT SECTION regarding the application of silver10
diamine fluoride; or11
(qq) P
RACTICING OUTSIDE THE SCOPE OF AN ARTICULATED PLAN12
DEVELOPED IN ACCORDANCE WITH SECTION 12-220-503 (1)(g)(V) OR
13
12-220-508 (1)(b), (1)(c)(VII),
OR (2);
OR14
(rr) T
HE FAILURE OF THE PROVIDER PERFORMING ITINERANT
15
SURGERY TO PROVIDE NECESSARY FOLLOW -UP CARE, INCLUDING THE16
FAILURE TO PROVIDE A POST -PROCEDURE CARE PLAN OUTLINING17
FOLLOW-UP CARE IN A FACILITY OR TO BE PERFORMED BY A LICENSED18
SURGICAL SPECIALIST WHO IS LOCATED WITHIN A REASONABLE DISTANCE19
FROM THE OFFICE WHERE THE INITIAL CARE WAS PROVIDED IF THE20
ORIGINAL ITINERANT CARE PROVIDER IS UNAVAILABLE TO PROVIDE THE21
NECESSARY FOLLOW-UP CARE. THE POST-PROCEDURE CARE PLAN SHALL22
IDENTIFY AN URGENT CARE CENTER OR A HOSPITAL EMERGENCY23
DEPARTMENT AS THE PROVIDER OR THE TREATMENT FACILITY FOR24
FOLLOW-UP CARE.25
SECTION 6. In Colorado Revised Statutes, 12-220-206, add (4)26
and (5) as follows:27
194
-8- 12-220-206. Mental and physical examinations. (4) A1
LICENSEE'S VOLUNTARY SUBMISSION TO A MENTAL OR PHYSICAL2
EXAMINATION AND COMPLETION OF ANY REQUIREMENTS GIVEN BY THE3
QUALIFIED PROFESSIONAL DESIGNATED BY THE BOARD SATISFIES ANY4
REQUIREMENT TO NOTIFY THE BOARD OF A PHYSICAL OR MENTAL HEALTH5
CONDITION THAT MAY IMPACT THE LICENSEE 'S ABILITY TO PRACTICE WITH6
REASONABLE SKILL AND SAFETY PURSUANT TO SECTION 12-30-108 (1),7
12-220-201 (1)(j)(I),
OR 12-220-310 (3), UNLESS THE QUALIFIED
8
PROFESSIONAL NOTIFIES THE LICENSEE THAT THE LICENSEE MUST NOTIFY9
THE BOARD OF THE CONDITION.10
(5) N
OTIFICATION REQUIREMENTS DESCRIBED IN SECTION11
12-30-108
(1), 12-220-201 (1)(j)(I), OR 12-220-310 (3) BEGIN UPON12
DISCHARGE OF A LICENSEE ENROLLED IN INPATIENT TREATMENT FOR A13
SERIOUS MENTAL HEALTH OR PHYSICAL CONDITION .14
SECTION 7. In Colorado Revised Statutes, 12-220-302, amend15
(1)(b), (1)(f), (1)(g), and (1)(j); and add (1)(k) and (1)(l) as follows:16
12-220-302. Persons exempt from operation of this article.17
(1) This article 220 does not apply to the following practices, acts, and18
operations:19
(b) The administration of an anesthetic
FOR A DENTAL OPERATION20
by a qualified anesthetist
LICENSED PURSUANT TO ARTICLE 240 OF THIS21
TITLE 12 or registered
A nurse for a dental operation LICENSED OR22
REGISTERED PURSUANT TO ARTICLE 255 OF THIS TITLE 12;23
(f) The practice of dentistry, dental therapy, or dental hygiene by24
dentists, dental therapists, or dental hygienists licensed in good standing25
by other states or countries while appearing in
ACCREDITED OR26
BOARD-APPROVED programs of dental education or research, at the27
194
-9- invitation of any group of licensed dentists, dental therapists, or dental1
hygienists in this state who are in good standing, so long as the practice2
is limited to five consecutive days in a twelve-month period and the name3
of each person engaging in the practice is submitted to the board, in4
writing and on a form A FORMAT approved by the board, at least ten days5
before the person performs the practice;6
(g) The filling of
DENTAL laboratory work orders of a licensed7
dentist, as provided by section 12-220-502, by any person, association,8
corporation, or other entity for the construction, reproduction, or repair9
of prosthetic dentures, bridges, plates, or appliances to be used or worn10
as substitutes for natural teeth or for restoration of natural teeth, or11
replacement of structures relating to the jaws, maxillofacial area, or12
adjacent and associated structures;13
(j) The practice of dentistry dental therapy, or dental hygiene
by14
dentists dental therapists, or dental hygienists licensed in good standing15
by other states while providing care as a volunteer, at the invitation of any16
group of licensed dentists, dental therapists, or dental hygienists in this17
state who are in good standing, so long as the practice is limited to five18
consecutive days in a twelve-month period and the name of each person19
engaging in the practice is submitted to the board, in writing and on a20
form A FORMAT approved by the board, at least ten days before the person21
performs the practice;22
(k) T
HE PRACTICE OF DENTAL THERAPY BY DENTAL THERAPISTS23
LICENSED IN GOOD STANDING BY OTHER STATES WHILE PROVIDING CARE24
AS A VOLUNTEER, AT THE INVITATION OF ANY GROUP OF LICENSED25
DENTISTS, DENTAL THERAPISTS, OR DENTAL HYGIENISTS IN THIS STATE26
WHO ARE IN GOOD STANDING , SO LONG AS THE PRACTICE IS LIMITED TO27
194
-10- FIVE CONSECUTIVE DAYS IN A TWELVE-MONTH PERIOD AND THE NAME OF1
EACH PERSON ENGAGING IN THE PRACTICE IS SUBMITTED TO THE BOARD ,2
IN A FORMAT APPROVED BY THE BOARD , AT LEAST TEN DAYS BEFORE THE3
PERSON PERFORMS THE PRACTICE , AND THE DENTAL THERAPISTS TREAT4
PATIENTS ONLY UNDER DIRECT SUPERVISION OF A LICENSED DENTIST IN5
COMPLIANCE WITH SECTION 12-220-508; OR6
(l) T
HE PRACTICE OF DENTAL HYGIENE BY DENTAL HYGIENISTS7
LICENSED IN GOOD STANDING BY OTHER STATES WHILE PROVIDING CARE8
AS A VOLUNTEER, AT THE INVITATION OF ANY GROUP OF LICENSED9
DENTISTS, DENTAL THERAPISTS, OR DENTAL HYGIENISTS IN THIS STATE10
WHO ARE IN GOOD STANDING , SO LONG AS THE PRACTICE IS LIMITED TO11
FIVE CONSECUTIVE DAYS IN A TWELVE-MONTH PERIOD AND THE NAME OF12
EACH PERSON ENGAGING IN THE PRACTICE IS SUBMITTED TO THE BOARD ,13
IN A FORMAT APPROVED BY THE BOARD , AT LEAST TEN DAYS BEFORE THE14
PERSON PERFORMS THE PRACTICE , AND THE DENTAL HYGIENISTS TREAT15
PATIENTS ONLY UNDER DIRECT SUPERVISION OF A LICENSED DENTIST .16
SECTION 8. In Colorado Revised Statutes, 12-220-303, amend17
(2)(a) and (3)(d) as follows:18
12-220-303. Ownership of dental or dental hygiene practice -19
information to be posted - heir to serve as temporary proprietor -20
limitations - definitions. (2) (a) The name, license number, ownership21
percentage, and other information, as required by the board, of each22
proprietor of a dental or dental hygiene practice, including an unlicensed23
heir who is the temporary proprietor of the practice, as specified in24
subsection (3) of this section, must be
IMMEDIATELY AND PUBLICLY25
available at the reception desk of the
dental or dental hygiene practice26
during the practice's hours of operation. The information required by this27
194
-11- subsection (2)(a) must be available in a format approved by the board.1
(3) (d) The temporary proprietorship of a dental or dental hygiene2
practice by an unlicensed heir does MUST not affect the exercise of the3
independent professional judgment of the licensed dentist or dental4
hygienist providing care to patients on behalf of the practice.5
SECTION 9. In Colorado Revised Statutes, 12-220-304, amend6
(3) as follows:7
12-220-304. Names and status under which dental practice8
may be conducted. (3) The practice of dentistry, dental therapy, or9
dental hygiene by a
PROFESSIONAL SERVICE CORPORATION , limited10
liability company of licensees, or by a
limited liability partnership of11
licensees is permitted subject to the limitations and requirements, insofar12
as are applicable, set forth in section 12-240-138 relating to a13
PROFESSIONAL SERVICE CORPORATION , limited liability company, or14
limited liability partnership for the practice of medicine.15
SECTION 10. In Colorado Revised Statutes, 12-220-305, amend16
(1)(a), (1)(b), (1)(c), (1)(d),
(1)(j), (1)(k), (1)(l), (1)(m), (1)(n), (1)(p),17
(1)(q), (1)(r), and (2); and add (1)(s), (1)(t), (1)(u), and (3) as follows:18
12-220-305. What constitutes practicing dentistry - rules.19
(1) A person is practicing dentistry if the person:20
(a) Performs or attempts or professes to perform any dental21
operation, oral surgery, or dental diagnostic or therapeutic services of any22
kind; except that nothing in this subsection (1)(a) prohibits a dental23
therapist, dental hygienist, or dental assistant from providing preventive24
dental or nutritional counseling, education, or instruction services;25
(b) Is a proprietor of a place where dental operation, oral surgery,26
or dental diagnostic or therapeutic services are performed; except that27
194
-12- nothing in this subsection (1)(b) prohibits a dental therapist, dental1
hygienist, or dental assistant from performing those tasks and procedures2
consistent with section 12-220-501;3
(c) Directly or indirectly, by any means or method, takes
A4
PHYSICAL OR DIGITAL impression OR SCAN of the human tooth, teeth,5
jaws, maxillofacial area, or adjacent and associated structures; performs6
any phase of any operation incident to the replacement of a part of a7
tooth; or supplies artificial substitutes for the natural teeth, jaws, or8
adjacent and associated structures; except that nothing in this subsection
9
(1)(c) prohibits a dental therapist, dental hygienist, or dental assistant10
from performing tasks and procedures consistent with sections11
12-220-501 (3)(b)(III), 12-220-503 (1)(d), and 12-220-508;12
(d) Furnishes, supplies, constructs, reproduces, or repairs any A13
prosthetic denture, bridge, appliance, or other structure to be worn in the14
human mouth or upon the jaws, maxillofacial area, or adjacent and15
associated structures other than on the written DENTAL laboratory work16
order of a duly licensed and practicing dentist;17
(j) Extracts or attempts to extract human teeth or corrects, or18
attempts to correct, malformations of human teeth or jaws; except that19
this subsection (1)(j) does not prohibit a dental therapist from performing20
tasks and procedures consistent with section 12-220-508;21
(k) Repairs or fills cavities in human teeth; except that this22
subsection (1)(k) does not prohibit a dental therapist from performing23
tasks and procedures consistent with section 12-220-508;24
(l) Prescribes ionizing radiation or the use of an X ray for the25
purpose of taking dental X rays; or roentgenograms; except that nothing26
in this subsection (1)(l) prohibits these procedures from being delegated27
194
-13- to appropriately trained personnel in accordance with this article 220 and1
rules of the board;2
(m) Gives or professes to give interpretations or readings of dental3
X rays, or roentgenograms, CT scans, or other diagnostic methodologies;4
except that nothing in this subsection (1)(m) prohibits a dental hygienist5
from performing tasks and procedures consistent with sections6
12-220-503 and 12-220-504 or a dental therapist from performing tasks7
consistent with section 12-220-508;8
(n) Represents himself or herself THEMSELF to an individual or the9
general public as practicing dentistry by using the words "dentist" or10
"dental surgeon" or by using the letters "D.D.S.", "D.M.D.",11
"D.D.S./M.D.", or "D.M.D./M.D."; Nothing in this subsection (1)(n)12
prohibits a dental therapist, dental hygienist, or dental assistant from13
performing tasks and procedures consistent with section 12-220-501 (2),14
(2.5), or (3)(b).15
(p) Prescribes drugs or medications and administers local16
anesthesia, analgesia including nitrous oxide/oxygen inhalation,17
medication prescribed or administered for the relief of anxiety or18
apprehension, minimal sedation, moderate sedation, deep sedation, or19
general anesthesia as necessary for the proper practice of dentistry; except20
that nothing in this subsection (1)(p) prohibits:21
(I) A dental hygienist from performing those tasks and procedures22
consistent with sections 12-220-501, 12-220-503 (1)(e) and (1)(g), and23
12-220-504 (1)(c), and in accordance with rules promulgated by the24
board; or25
(II) A dental therapist from performing those tasks and procedures26
consistent with sections 12-220-501 (2.5) and 12-220-508 and in27
194
-14- accordance with rules promulgated by the board.1
(q) Prescribes, induces, and sets dosage levels for inhalation2
anesthesia; except that nothing in this subsection (1)(q) prohibits the3
delegation of monitoring and administration to
DENTAL HYGIENISTS AND4
appropriately trained
UNLICENSED personnel in accordance with this5
article 220 and rules of the board,
INCLUDING REQUIRING TRAINING;6
(r) Gives or professes to give interpretations or readings of dental7
charts or records or gives treatment plans or interpretations of treatment8
plans derived from examinations, patient records,
OR dental X rays; or
9
roentgenograms; except that nothing in this subsection (1)(r) prohibits a10
dental therapist, dental hygienist, or dental assistant from performing11
tasks and procedures consistent with sections 12-220-501 (2), (2.5) and12
(3), 12-220-503, 12-220-504, and 12-220-508;13
(s) M
AINTAINS PATIENT CLINICAL RECORDS , DENTAL CHARTS,14
IMAGES, TREATMENT PLANS , INTERPRETATIONS , OR OTHER15
DOCUMENTATION, EXCEPT WHEN UNDERGOING A TRANSITION IN PRACTICE16
OWNERSHIP AS PERMITTED IN SECTION 12-220-303 (2);17
(t) (I) P
URSUANT TO RULES ADOPTED BY THE BOARD , ORDERS AND
18
ADMINISTERS IMMUNIZATIONS TO PATIENTS SIX YEARS OF AGE OR OLDER .19
T
HE BOARD SHALL ADOPT RULES REGARDING DELEGATION OF
20
IMMUNIZATION ADMINISTRATION BY A LICENSED DENTIST TO A DENTAL21
THERAPIST OR DENTAL HYGIENIST AND MAY ADOPT RULES SPECIFYING THE22
MINIMUM TRAINING REQUIREMENTS FOR DENTISTS TO ADMINISTER23
IMMUNIZATIONS.24
(II) A
DENTIST WHO ADMINISTERS IMMUNIZATIONS SHALL :
25
(A) N
OT PROVIDE MEDICAL OR NONMEDICAL EXEMPTIONS FOR ANY
26
REQUIRED IMMUNIZATIONS;27
194
-15- (B) ENTER ALL IMMUNIZATION -RELATED ADMINISTRATION1
INFORMATION INTO THE COLORADO IMMUNIZATION INFORMATION SYSTEM2
CREATED PURSUANT TO PART 24 OF ARTICLE 4 OF TITLE 25;3
(C) D
ISCLOSE THEIR MEDICAL TRAINING RELATED TO PEDIATRIC
4
ADMINISTRATION, INCLUDING THE ABILITY TO MANAGE SIDE EFFECTS OR5
ADVERSE OUTCOMES, TO PATIENTS AS PART OF THE PATIENT CONSENT6
PROCESS;7
(D) A
DMINISTER ONLY RESPIRATORY AND ORAL HEALTH ,
8
INCLUDING HUMAN PAPILLOMAVIRUS , IMMUNIZATIONS; AND9
(E) D
ISTRIBUTE IMMUNIZATION EDUCATIONAL MATERIALS AND
10
RECOMMENDATIONS DEVELOPED BY THE DEPARTMENT OF PUBLIC HEALTH11
AND ENVIRONMENT TO THEIR PATIENTS .12
(u) O
RDERS AND ADMINISTERS NEUROMODULATORS AND DERMAL13
FILLERS TO DENTAL PATIENTS OF RECORD FOR THERAPEUTIC AND14
COSMETIC PURPOSES PURSUANT TO RULES ADOPTED BY THE BOARD15
REGARDING REQUIRED TRAINING , ONGOING COMPETENCY , RECORD16
KEEPING, AND DELEGATION TO DENTAL HYGIENISTS .17
(2) A licensed dentist may prescribe orders electronically.
THIS18
SECTION DOES NOT PROHIBIT:19
(a) A
DENTAL ASSISTANT FROM PERFORMING TASKS AND20
PROCEDURES CONSISTENT WITH SECTION 12-220-501 AND IN ACCORDANCE21
WITH RULES ADOPTED BY THE BOARD ;22
(b) A
DENTAL HYGIENIST FROM PERFORMING TASKS AND23
PROCEDURES CONSISTENT WITH SECTIONS 12-220-501, 12-220-503, AND24
12-220-504
AND IN ACCORDANCE WITH RULES ADOPTED BY THE BOARD ;25
OR26
(c) A
DENTAL THERAPIST FROM PERFORMING TASKS AND27
194
-16- PROCEDURES CONSISTENT WITH SECTIONS 12-220-501 AND 12-220-5081
AND IN ACCORDANCE WITH RULES ADOPTED BY THE BOARD .2
(3) A
PROVIDER PERFORMING ITINERANT SURGERY SHALL DEVELOP3
AND MAINTAIN A WRITTEN PROTOCOL FOR EMERGENCY FOLLOW -UP CARE4
WITH APPROPRIATELY TRAINED PRACTITIONERS FOR ALL PATIENTS5
TREATED. THE PLAN SHALL BE PROVIDED TO EACH PATIENT UNDERGOING6
TREATMENT AND MUST BE AVAILABLE IMMEDIATELY AT THE REQUEST OF7
THE BOARD. THE WRITTEN PROTOCOL MUST INCLUDE A PROVISION THAT8
REQUIRES THE PROVIDER TO INCLUDE IN A PLAN OF CARE FOLLOW -UP9
TREATMENT IN A PERMANENTLY ESTABLISHED TREATMENT FACILITY10
WITHIN A REASONABLE PROXIMITY OF THE LOCATION WHERE ITINERANT11
SURGICAL TREATMENT WAS PERFORMED . THIS FOLLOW-UP TREATMENT12
SHALL BE PROVIDED BY THE ITINERANT SURGICAL TREATMENT OPERATOR13
OR AN APPROPRIATELY TRAINED PRACTITIONER WHO HAS AGREED IN14
WRITING TO PARTICIPATE IN THE EMERGENCY FOLLOW -UP CARE PLAN FOR15
THE ITINERANT SURGICAL TREATMENT OPERATOR . THE APPROPRIATELY16
TRAINED PRACTITIONER MUST BE AVAILABLE WHEN THE ITINERANT17
SURGICAL OPERATOR IS NOT AVAILABLE .18
SECTION 11. In Colorado Revised Statutes, 12-220-306, amend19
(1)(a)(III) and (1)(b); and add (3) and (4)
as follows:20
12-220-306. Dentists may prescribe drugs - surgical operations21
- anesthesia - limits on prescriptions - rules. (1) (a) A licensed dentist22
is authorized to:23
(III) Administer, pursuant to
A PERMIT REQUIRED BY SECTION24
12-220-411
AND PURSUANT TO board rules, local anesthesia, analgesia25
including nitrous oxide/oxygen inhalation, medication prescribed or26
administered for the relief of anxiety or apprehension, minimal sedation,27
194
-17- moderate sedation, deep sedation, or general anesthesia; and1
(b) A dentist shall not prescribe, distribute, or give to any person,2
including the dentist THEMSELF, any habit-forming drug or any controlled3
substance, as defined in section 18-18-102 (5) or as contained in schedule4
II of 21 U.S.C. sec. 812, other than in the course of legitimate dental5
practice and pursuant to the rules promulgated ADOPTED by the board6
regarding controlled substance record keeping
AND IN COMPLIANCE WITH7
THE ELECTRONIC PRESCRIBING OF CONTROLLED SUBSTANCES AS REQUIRED8
BY SECTION 12-30-111.9
(3) A
LICENSED DENTIST MAY PRESCRIBE ORDERS10
ELECTRONICALLY.11
(4) A
LICENSED DENTIST IS STRONGLY ENCOURAGED TO PURCHASE
12
OR UTILIZE AN ELECTRONIC HEALTH PRODUCT THAT INCLUDES13
INTEGRATION OF A TOOL THAT FACILITATES DENTISTS ' COMPLIANCE WITH14
PRESCRIPTION DRUG MONITORING STANDARDS REQUIRED BY SECTION15
12-30-114 (1)(a)(IV).16
SECTION 12. In Colorado Revised Statutes, 12-220-310, amend17
(1)(a), (1)(b) introductory portion, (1)(b)(IV), (2)(b), and (5); and add18
(2)(d) as follows:19
12-220-310. Dentist peer health assistance program - fees -20
rules. (1) (a) Effective July 1, 2004, as a condition of renewal in this21
state, every AN APPLICANT FOR A DENTIST LICENSE OR A dentist applying22
to renew
OR REINSTATE
the dentist's license must, AT THE TIME OF23
APPLICATION, pay to the administering entity that has been selected by the24
board pursuant to subsection (1)(b) of this section an amount A FEE not to25
exceed fifty-nine dollars per year, which maximum amount may be26
adjusted on January 1, 2005, and annually thereafter by the board to27
194
-18- reflect changes in the United States department of labor, LABOR'S bureau1
of labor statistics consumer price index,
OR A SUCCESSOR INDEX, for2
Denver-Aurora-Lakewood for all urban consumers or goods. or its
3
successor index. The fee shall be used to support designated providers4
that have been selected by the board to provide assistance to dentists5
needing help in dealing with physical, emotional, or psychological6
problems that may be detrimental to their ability to practice dentistry. The7
fee shall MUST not exceed one hundred dollars per year per licensee.8
(b) The board shall select one or more peer health assistance9
programs as designated providers. T
HE BOARD OR THE DEPARTMENT MUST
10
PROVIDE PUBLIC NOTICE WHEN A PEER HEALTH ASSISTANCE PROGRAM IS11
BEING CONSIDERED FOR SELECTION AS A DESIGNATED PROVIDER AND12
SHALL PROVIDE A PROCESS FOR STAKEHOLDERS AND THE PUBLIC TO13
PROVIDE INPUT TO THE BOARD REGARDING THE SELECTION OF A14
DESIGNATED PROVIDER. To be eligible for designation by the board, a peer15
health assistance program must:16
(IV) Monitor the status of a dentist who has been referred for17
treatment,
INCLUDING PROVIDING TRAINING
TO DENTISTS PROVIDING18
PRACTICE MONITORING SERVICES;19
(2) (b) Notwithstanding sections 12-220-201 and 24-4-104, the20
board may immediately suspend the license of any A dentist who is21
referred to a peer health assistance program by the board and who fails to22
attend or complete the program. If the dentist objects to the suspension,23
the dentist may submit a written request to the board, IN A FORMAT24
APPROVED BY THE BOARD, for a formal hearing on the suspension within25
ten days after receiving notice of the suspension, and the board shall grant26
the request. In the hearing, the dentist bears the burden of proving that the27
194
-19- dentist's license should not be suspended.1
(d) A
DENTIST MAY SELF-REFER TO PARTICIPATE IN THE PEER2
HEALTH ASSISTANCE PROGRAM OR MAY BE REFERRED BY THE BOARD . A3
DENTIST WHO SELF-REFERS TO THE PEER HEALTH ASSISTANCE PROGRAM4
MAY DO SO CONFIDENTIALLY AND WITHOUT DIRECT NOTIFICATION TO THE5
BOARD. SUCH SELF-REFERRAL TO THE PEER HEALTH ASSISTANCE PROGRAM6
SATISFIES BOARD NOTIFICATION REQUIREMENTS SET FORTH IN SECTION7
12-220-207
AND SUBSECTION (3) OF THIS SECTION; EXCEPT THAT THE PEER8
HEALTH ASSISTANCE PROGRAM SHALL REPORT KNOWLEDGE OF A9
DENTIST'S VIOLATION OF THIS ARTICLE 220 OR RULES OF THE BOARD,10
EXCLUDING KNOWLEDGE OF
VIOLATIONS OF SECTION 12-220-201 (1)(e) OR11
(1)(f).12
13
(5) The board is authorized to promulgate MAY ADOPT rules14
necessary to implement this section.15
SECTION 13. In Colorado Revised Statutes, 12-220-402, amend16
(1)(a) as follows:17
12-220-402. Dentist academic license. (1) (a) A dentist who is18
employed at an accredited school or college of dentistry in this state and19
who practices dentistry in the course of the dentist's employment20
responsibilities must either make written FILE AN application to the board21
for an academic license in accordance with this section,
IN A FORMAT22
APPROVED BY THE BOARD , or otherwise become licensed pursuant to23
sections 12-220-401 and 12-220-403, as applicable.24
25
SECTION 14. In Colorado Revised Statutes, 12-220-405, amend26
(1)(a) introductory portion as follows:27
194
-20- 12-220-405. Application for dental hygienist license - fee.1
(1) Every person who desires to qualify for practice as a dental hygienist2
within this state must file with the board:3
(a) A written AN application for a license, IN A FORMAT APPROVED4
BY THE BOARD, on which application the applicant shall list:5
6
SECTION 15. In Colorado Revised Statutes, 12-220-407.2,7
amend (1)(a) introductory portion and (1)(b) as follows:8
12-220-407.2. Application for dental therapist license - fee -9
rules. (1) Effective May 1, 2023, every person who desires to qualify for10
practice as a dental therapist within this state must file with the board:11
(a) A written AN application for a license, IN A FORMAT APPROVED12
BY THE BOARD, on which application the applicant must list:13
(b) Satisfactory proof that the applicant:14
(I) Graduated from a school of dental therapy that, at the time of15
the applicant's graduation, was accredited; by the American Dental16
Association's commission on dental accreditation or its successor17
organization; or18
(II) Graduated from a dental therapy education program developed19
prior to February 6, 2015, that, at the time of the applicant's graduation,20
was accredited RECOGNIZED by the Minnesota board of dentistry or21
certified by the Alaska community health aide program certification22
board.23
24
SECTION 16. In Colorado Revised Statutes, 12-220-409, add (6)25
as follows:26
12-220-409. Inactive dental, dental therapist, or dental27
194
-21- hygienist license - rules. (6) T HE BOARD SHALL ADOPT RULES THAT1
ALLOW AN EXPEDITED, TEMPORARY LICENSURE DURING PUBLIC HEALTH2
EMERGENCIES AND ACUTE WORKFORCE SHORTAGES FOR A DENTIST ,3
DENTAL HYGIENIST, OR DENTAL THERAPIST WHO HAS MAINTAINED A4
LICENSE IN GOOD STANDING WITH NO PAST DISCIPLINARY HISTORY PRIOR5
TO OBTAINING AN INACTIVE LICENSE. THE RULES MUST ADDRESS:6
(a) S
UPERVISION OR PRACTICE MONITORING REQUIREMENTS ;7
(b) L
IABILITY COVERAGE REQUIREMENTS ;8
(c) O
THER CONDITIONS OF OR LIMITATION ON PRACTICE ; AND9
(d) T
EMPORARY LICENSE TERMS , ADMINISTRATIVE APPROVALS ,10
TIMELINES, AND RENEWAL OPTIONS.11
SECTION 17.
In Colorado Revised Statutes, 12-220-410, add (7)12
as follows:13
12-220-410. Retired dental, dental therapist, and dental14
hygienist licenses - rules. (7) T
HE BOARD SHALL ADOPT RULES THAT15
ALLOW EXPEDITED, TEMPORARY LICENSURE DURING A DISASTER
16
EMERGENCY DECLARED PURSUANT TO SECTION 24-33.5-704 (4) FOR A17
DENTIST, DENTAL HYGIENIST , OR DENTAL THERAPIST WHO HAS18
MAINTAINED A LICENSE IN GOOD STANDING WITH NO PAST DISCIPLINARY19
HISTORY PRIOR TO OBTAINING AN INACTIVE LICENSE . THE RULES MUST20
ADDRESS:21
(a) S
UPERVISION OR PRACTICE MONITORING REQUIREMENTS ;22
(b) L
IABILITY COVERAGE REQUIREMENTS ;23
(c) O
THER CONDITIONS OF OR LIMITATION ON PRACTICE ; AND24
(d) T
EMPORARY LICENSE TERMS , ADMINISTRATIVE APPROVALS ,25
TIMELINES, AND RENEWAL OPTIONS.26
SECTION
18. In Colorado Revised Statutes, 12-220-411, amend27
194
-22- (1) and (5)(a) as follows:1
12-220-411. Anesthesia and sedation permits - dentists, dental2
therapists, and dental hygienists - training and experience3
requirements - office inspections - rules. (1) (a) Upon application in a4
form and manner determined by the board and payment of the applicable5
fees established by the board, the board may issue an anesthesia or6
sedation permit to a licensed dentist or a local anesthesia permit to a7
dental therapist or dental hygienist in accordance with this section.8
(b) T
HE BOARD SHALL DESIGN AND IMPLEMENT AN EXPEDITED
9
APPLICATION AND PERMITTING PROCESS FOR A DENTIST WHO HAS10
COMPLETED AN ACCREDITED RESI DENCY PROGRAM IN GENERAL11
ANESTHESIA OR A POSTDOCTORAL TRAINING PROGRAM THAT PROVIDES12
COMPREHENSIVE AND APPROPRIATE TRAINING NECESSARY TO ADMINISTER13
AND MANAGE MODERATE SEDATION OR DEEP SEDATION AND GENERAL14
ANESTHESIA ACCORDING TO INDUSTRY -ACCEPTED STANDARDS.15
(5) The board shall establish, by rule, criteria and procedures for16
an office inspection program to be completed upon application and17
renewal of anesthesia or sedation permits, which must include:18
(a) Designation of qualified
ANESTHESIA inspectors who are
19
experts in dental outpatient deep sedation/general anesthesia and20
moderate sedation; HAVE MORE THAN FIVE YEARS OF EXPERIENCE21
PROVIDING ANESTHESIA SERVICES AND HOLD AN ACTIVE ANESTHESIA22
PERMIT TO PROVIDE EITHER DENTAL OUTPATIENT DEEP23
SEDATION/GENERAL ANESTHESIA OR MODERATE SEDATION . AN24
ANESTHESIA INSPECTOR WHO HOLDS AN ACTIVE ANESTHESIA PERMIT TO25
PROVIDE MODERATE SEDATION MAY ONLY PROVIDE OFFICE ANESTHESIA26
INSPECTIONS FOR PROVIDERS WHO REQUEST MODERATE SEDATION27
194
-23- PRIVILEGES FOR BOTH INITIAL AND RENEWAL PERMIT APPLICATIONS . AN1
ANESTHESIA INSPECTOR WHO HOLDS AN ACTIVE ANESTHESIA PERMIT TO2
PROVIDE DEEP SEDATION/GENERAL ANESTHESIA MAY PROVIDE OFFICE3
ANESTHESIA INSPECTIONS FOR ANY LEVEL OF SEDATION FOR BOTH INITIAL4
AND RENEWAL PERMIT APPLICATIONS . AN ANESTHESIA INSPECTOR SHALL5
COMPLETE AN ANESTHESIA INSPECTOR CALIBRATION PROGRAM CREATED6
AND UPDATED BY THE BOARD ONCE EVERY FIVE YEARS . THE ANESTHESIA7
INSPECTOR RECERTIFICATION MAY BE COMPLETED IN CONJUNCTION WITH8
AN ANESTHESIA PERMIT RENEWAL .9
SECTION 19. In Colorado Revised Statutes, 12-220-412, amend10
(1) as follows:11
12-220-412. Change of address - duplicate licenses and12
certificates. (1) Every A person licensed under this article 220, upon13
changing the licensee's place of business
OR CONTACT INFORMATION, shall14
furnish to the board the licensee's new mailing address
AND EMAIL15
ADDRESS within thirty days after the change.16
SECTION 20.
In Colorado Revised Statutes, 12-220-501, amend17
(1)(a), (3)(a)(VI), (3)(b) introductory portion, and (3)(b)(III); and repeal18
(2) as follows:19
12-220-501. Tasks authorized to be performed by dental20
therapists, dental hygienists, or dental assistants - rules.21
(1) (a) (I) Except as provided in subsection (1)(a)(II) of this section, The22
responsibility for dental diagnosis, dental treatment planning, or the23
prescription of therapeutic measures in the practice of dentistry remains24
with a licensed dentist and may not be assigned to any A dental therapist,25
or dental hygienist, OR DENTAL ASSISTANT.26
(II) A dental hygienist may:27
194
-24- (A) Perform dental hygiene assessment, dental hygiene diagnosis,1
and dental hygiene treatment planning for dental hygiene services2
pursuant to section 12-220-503 (1)(f);3
(B) Identify dental abnormalities for immediate referral to a4
dentist as described in section 12-220-503 (1)(f); and5
(C) In collaboration with a licensed dentist, prescribe, administer,6
and dispense, as described in section 12-220-503 (1)(g): Fluoride,7
fluoride varnish, silver diamine fluoride, antimicrobial solutions for8
mouth rinsing, other nonsystemic antimicrobial agents, and resorbable9
antimicrobial agents pursuant to rules of the board.10
(D) Repealed.11
(2) Except as provided in subsection (1) of this section, a dental12
hygienist may perform any dental task or procedure assigned to the13
hygienist by a licensed dentist that does not require the professional skill14
of a licensed dentist; except that the dental hygienist may perform the task15
or procedure only under the indirect supervision of a licensed dentist or16
as authorized in sections 12-220-503 and 12-220-504.17
(3) (a) A dental assistant shall not perform the following tasks:18
(VI) Scaling (supra and sub-gingival); as it pertains to the practice19
of dental hygiene;20
(b) A dental assistant may perform the following tasks under the21
indirect supervision of a licensed dentist
OR THE DIRECT SUPERVISION OF
22
A LICENSED DENTAL THERAPIST OR A LICENSED DENTAL HYGIENIST :23
(III) Gathering and assembling information, including but not24
limited to fact-finding and patient history, oral inspection, and25
RECORDING OF dental and periodontal charting AS DICTATED BY A26
LICENSEE;27
194
-25- SECTION 21. In Colorado Revised Statutes, amend 12-220-5021
as follows:2
12-220-502. Construction of dental devices by unlicensed3
technician. (1) (a) A licensed dentist who uses the services of an4
unlicensed technician for the purpose of constructing, altering, repairing,5
or duplicating any denture, bridge, splint, or orthodontic or prosthetic6
appliance A LABORATORY-FABRICATED INTRAORAL OR MAXILLOFACIAL7
DENTAL PROSTHESIS, PRODUCT, OR APPLIANCE shall furnish the unlicensed8
technician with a written or electronic DENTAL laboratory work order in9
a form approved by THAT COMPLIES WITH RULES OF the board, which form10
shall be dated and signed by the dentist for each separate and individual11
piece of work. The dentist shall make the
DENTAL laboratory work order12
in a reproducible
DOCUMENTED form, and the dentist and the unlicensed13
technician shall each retain a copy in a permanent file for two years AS A14
PERMANENT PART OF THE PATIENT RECORD . THE LABORATORY15
TECHNICIAN SHALL RETAIN A COPY OF THE DENTAL LABORATORY WORK16
ORDER IN A FILE FOR A MINIMUM OF TWO YEARS . The permanent files of17
the licensed dentist and the unlicensed technician must be open to18
inspection at any reasonable time by the board or its duly constituted19
agent. The licensed dentist that furnishes the
DENTAL laboratory work20
order must have appropriate training, education, and experience related21
to the prescribed treatment and is responsible for directly supervising all22
intraoral treatment rendered to the patient.23
(b) I
F A PATIENT'S CARE REQUIRES THAT MULTIPLE24
LABORATORY-FABRICATED INTRAORAL OR MAXILLOFACIAL DENTAL25
PROSTHESES OR APPLIANCES BE FABRICATED AT THE SAME TIME , IT IS26
PERMISSIBLE TO INCORPORATE THOSE PRODUCTS OR APPLIANCES INTO A27
194
-26- SINGLE DENTAL LABORATORY WORK ORDER .1
(b) (c) An unlicensed technician that possesses a valid DENTAL2
laboratory work order may provide extraoral construction, manufacture,3
fabrication, supply, or repair of identified dental and orthodontic devices4
but shall not provide intraoral service in a human mouth except under the5
direct supervision of a licensed dentist in accordance with section6
12-220-501 (3)(d).7
(2) If the dentist fails to keep permanent records of
DENTAL8
laboratory work orders as required in subsection (1)(a) of this section, the9
dentist is subject to disciplinary action as deemed appropriate by the10
board.11
(3) If an unlicensed technician fails to have in the technician's12
possession a
DENTAL laboratory work order signed by a licensed dentist13
with each denture, bridge, splint, or orthodontic or prosthetic appliance14
in the technician's possession, the absence of the
DENTAL laboratory work15
order is prima facie evidence of a violation of this section and constitutes16
the practice of dentistry without an active license in violation of, and17
subject to the penalties specified in, section 12-220-211. 18
SECTION 22.
In Colorado Revised Statutes, 12-220-503, amend19
(1) introductory portion, (1)(d)(II), (1)(d)(IV), (1)(d)(V), (1)(f), (1)(g)(I),20
(1)(g)(III)(A), (1)(g)(III)(B), (1)(g)(III)(C), (1)(g)(IV) introductory21
portion, (2), and (4); repeal (1)(g)(II)(A); and add (1)(d)(VI), (1)(e.5),22
(1)(g)(V), and (1)(h) as follows:23
12-220-503. What constitutes practicing unsupervised dental24
hygiene - rules. (1) N
OTWITHSTANDING SUBSECTION (3) OF THIS25
SECTION, unless licensed to practice dentistry, a person
AN INDIVIDUAL is26
deemed to be practicing unsupervised dental hygiene when the person27
194
-27- INDIVIDUAL, within the scope of the person's INDIVIDUAL'S education,1
training, and experience:2
(d) Gathers and assembles information, including but not limited3
to:4
(II) Preparation PROVISION of study casts for the purpose of5
fabricating a permanent record of the patient's present condition; as a6
visual aid for patient education, dental hygiene diagnosis, and dental7
hygiene treatment planning; and to provide assistance during forensic8
examination OR DIGITAL SCANS;9
(IV) Dental
CHARTING and periodontal PROBING AND charting; and
10
(V) Radiographic and X-ray survey for the purpose of assessing11
and diagnosing dental hygiene-related conditions for treatment planning12
for dental hygiene services as described in this section and identifying13
dental
HARD AND SOFT TISSUE abnormalities for immediate
referral to a14
dentist
OR APPROPRIATE SPECIALIST; AND15
(VI) A
DDITIONAL SCREENING OR SCREENING TESTS FOR FURTHER16
INVESTIGATION OF ANY ORAL OR SYSTEMIC HEALTH -RELATED CONCERN
17
PERTINENT TO THE SCOPE OF PRACTICE FOR DENTAL HYGIENE ; AND18
(e.5) A
DMINISTERS LOCAL ANESTHESIA IN COMPLIANCE WITH19
SECTION 12-220-411 AND RULES ADOPTED BY THE BOARD , INCLUDING20
MINIMUM EDUCATION REQUIREMENTS AND PROCEDURES FOR LOCAL21
ANESTHESIA ADMINISTRATION ;22
(f) Performs dental hygiene assessment, dental hygiene diagnosis,23
and dental hygiene treatment planning
FOR HARD AND SOFT TISSUE for24
dental hygiene services as described in this section and identifies dental25
abnormalities for immediate
referral to a dentist OR APPROPRIATE26
SPECIALIST; or27
194
-28- (g) (I) Prescribes, administers, and dispenses fluoride, fluoride1
varnish, silver diamine fluoride FLUORIDES in accordance with subsection2
(1)(g)(IV) of this section, antimicrobial solutions for mouth rinsing, other3
nonsystemic antimicrobial agents, and related emergency drugs and4
reversal agents. in collaboration with a licensed dentist. The board, by5
rule, may further define the permissible and appropriate emergency drugs6
and reversal agents. An articulated plan with a collaborating dentist for7
dental hygiene prescribing must describe any protocols, restrictions or8
limitations, follow-up and referral mechanisms, notification and9
disclosure requirements, and any other requirements established by the10
board by rule. Dental hygienists shall maintain clear documentation in the11
patient record of the drug or agent prescribed, administered, or dispensed;12
the date of the action; and the rationale for prescribing, administering, or13
dispensing the drug or agent.14
(II) A dental hygienist shall not prescribe, administer, or dispense15
the following:16
(A) Drugs whose primary effect is systemic, with the exception of17
fluoride supplements permitted under subsection (1)(g)(III)(A) of this18
section; and19
(III) A dental hygienist may prescribe the following:20
(A) Fluoride supplements; as follows, all using sodium fluoride:21
Tablets: 0.5 mg, 1.1 mg, or 2.2 mg; lozenges: 2.21 mg; and drops: 1.122
mL;23
(B) Topical anti-caries treatments, as follows, all using sodium24
fluoride unless otherwise indicated: Toothpastes: 1.1% or less (or25
stannous fluoride 0.4%); topical gels: 1.1% or less (or stannous fluoride26
0.4%); oral rinses: 0.05%, 0.2%, 0.44%, or 0.5%; oral rinse concentrate27
194
-29- used in periodontal disease: 0.63% stannous fluoride; fluoride varnish:1
5%; silver diamine fluoride: 38%; and prophy pastes containing2
approximately 1.23% sodium fluoride and used for polishing procedures3
as part of professional dental prophylaxis treatment INCLUDING SODIUM4
FLUORIDE, STANNOUS FLUORIDE, SILVER DIAMINE FLUORIDE , OTHER5
SILVER FLUORIDES, HYDROXYAPATITE REGENERATION MEDICAMENTS6
USED FOR REPAIRING CAVITIES, AND ALTERNATIVES FOR STRENGTHENING7
TEETH AND PREVENTING AND ARRESTING TOOTH DECAY . THE BOARD MAY8
ADOPT RULES THAT IDENTIFY SAFE PRESCRIBING ALTERNATIVES TO SILVER9
DIAMINE FLUORIDE AS A TREATMENT FOR STRENGTHENING TEETH AND10
PREVENTING TOOTH DECAY .11
(C) Topical anti-infectives, as follows: Chlorhexidine gluconate12
rinses: 0.12%; chlorhexidine gluconate periodontal chips for subgingival13
insertion into a periodontal pocket/sulcus; tetracycline impregnated fibers,14
inserted subgingivally into a periodontal pocket/sulcus; doxycycline15
hyclate periodontal gel, inserted subgingivally into a periodontal16
pocket/sulcus; and minocycline hydrochloride periodontal powder,17
inserted subgingivally into a periodontal pocket/sulcus INCLUDING18
CHLORHEXIDINE GLUCONATE RINSE , PERIODONTAL CHIPS, PERIODONTAL19
GELS, PERIODONTAL POWDERS , AND IMPREGNATED FIBERS FOR20
PERIODONTAL TREATMENT ; and21
(IV) A dental hygienist may prescribe and apply silver diamine22
fluoride
AND OTHER SILVER FLUORIDES upon completion of a23
postsecondary course or continuing education course developed at the24
postsecondary level that satisfies the requirements established by the25
board and provides instructions on the use and limitations of applying26
silver diamine fluoride. A dental hygienist may complete the course27
194
-30- described in this subsection (1)(g)(IV) through:1
(V) A
DENTAL HYGIENIST MAY PRESCRIBE , DISPENSE, AND
2
ADMINISTER NONNARCOTIC ANALGESICS , ANTI-INFLAMMATORIES, AND3
ANTIBIOTICS WITHIN THE PARAMETERS OF A WRI TTEN ARTICULATED PLAN ,4
WITH THE AUTHORIZATION OF THE SUPERVISING DENTIST , AND UPON5
COMPLETION OF A POSTSECONDARY C OURSE OR CONTINUING EDUCATION6
COURSE DEVELOPED AT THE POSTSECONDARY LEVEL THAT SATISFIES THE7
REQUIREMENTS ESTABLISHED BY THE BOARD AND THAT PROVIDES8
INSTRUCTION ON THE USE AND LIMITATIONS OF NONNARCOTIC9
ANALGESICS, ANTI-INFLAMMATORIES, AND ANTIBIOTICS.10
(h) D
IRECTS DENTAL ASSISTANTS TO ASSIST IN ACTIVITIES THAT11
ARE WITHIN THE SCOPE OF PRACTICE FOR A DENTAL HYGIENIST UNDER12
DIRECT SUPERVISION OF A DENTAL HYGIENIST ONLY; EXCEPT THAT DENTAL13
ASSISTANTS SHALL NOT PERFORM ACTIVITIES DISALLOWED UNDER SECTION14
12-220-501 (3)(a).15
(2) A dental hygienist shall state in writing and require a patient16
to acknowledge by signature that any diagnosis or assessment is for the17
purpose of determining necessary dental hygiene services only. and that
18
it is recommended by the American Dental Association, or any successor19
organizations, that a thorough dental examination be performed by a20
dentist twice each year.21
(4) (a) Notwithstanding section 12-220-104 (13) or 12-220-30522
(1)(b),
AND CONSISTENT WITH SECTION 12-220-303, a dental hygienist23
may be the proprietor of a place where supervised or unsupervised dental24
hygiene is performed and may purchase, own, or lease equipment,25
DENTAL MATERIALS, AND SUPPLIES necessary to perform supervised or26
unsupervised dental hygiene.27
194
-31- (b) A dental hygienist proprietor, or a professional corporation,1
LIMITED LIABILITY PARTNERSHIP , or professional limited liability2
corporation of dental hygienists, in addition to providing dental hygiene3
services, may enter into an agreement with one or more dentists for the4
lease or rental of equipment or office space in the same physical location5
as the dental hygiene practice, but only if the determination of necessary6
dental services provided by the dentist and professional responsibility for7
those services, including but not limited to dental records, appropriate8
medication, and patient payment, remain with the treating dentist. It is the9
responsibility of the dental hygienist to inform the patient as to whether10
there is a supervisory relationship between the dentist and the dental11
hygienist. An agreement under this subsection (4)(b) does not constitute12
employment and does not constitute cause for discipline pursuant to13
section 12-220-201 (1)(h). 14
SECTION 23. In Colorado Revised Statutes, amend 12-220-504,15
as follows:16
12-220-504. What constitutes practicing supervised dental17
hygiene - rules. (1) N
OTWITHSTANDING SECTION 12-220-501 (3), unless18
licensed to practice dentistry, a person who performs any of the following19
tasks under the supervision of a licensed dentist is deemed to be20
practicing supervised dental hygiene:21
(a) Performing a task described in section 12-220-503 (1);
22
(b) Preparing study casts;23
(c) Administering local anesthesia under the indirect supervision24
of a licensed dentist pursuant to rules of the board, including minimum25
education requirements and procedures for local anesthesia26
administration; or27
194
-32- (d) Placing interim therapeutic restorations pursuant to section1
12-220-505.2
(e) Repealed.3
(b) ADMINISTERING AND MONITORING INHALATION ANESTHESIA4
UNDER THE INDIRECT SUPERVISION OF A DENTIST CONSISTENT WITH5
SECTION 12-220-305 (1)(q) AND PURSUANT TO THE RULES OF THE BOARD6
REGARDING TRAINING AND MINIMUM EDUCATION REQUIREMENTS ;7
(c) UTILIZING A LASER FOR DENTAL HYGIENE PURPOSES WITHIN8
DEFINED SCOPES OF PRACTICE IN ACCORDANCE WITH RULES OF THE BOARD ;9
(d) (I) P
URSUANT TO RULES ADOPTED BY THE BOARD ,
10
ADMINISTERING IMMUNIZATIONS , UNDER THE DIRECT SUPERVISION OF A11
LICENSED DENTIST OR THE DELEGATION OF A LICENSED PROFESSIONAL12
WHO IS AUTHORIZED TO ADMINISTER IMMUNIZATIONS AND DELEGATE13
TASKS UNDER THIS TITLE 12, TO PATIENTS SIX YEARS OF AGE OR OLDER.14
T
HE BOARD MAY ADOPT RULES SPECIFYING THE MINIMUM TRAINING
15
REQUIREMENTS FOR DENTIST HYGIENISTS TO ADMINISTER IMMUNIZATIONS .16
(II) A
DENTIST HYGIENIST WHO ADMINISTERS IMMUNIZATIONS
17
SHALL:18
(A) N
OT PROVIDE MEDICAL OR NONMEDICAL EXEMPTIONS FOR ANY
19
REQUIRED IMMUNIZATIONS;20
(B) E
NTER ALL IMMUNIZATION -RELATED ADMINISTRATION
21
INFORMATION INTO THE COLORADO IMMUNIZATION INFORMATION SYSTEM22
CREATED PURSUANT TO PART 24 OF ARTICLE 4 OF TITLE 25;23
(C) D
ISCLOSE THEIR MEDICAL TRAINING RELATED TO PEDIATRIC
24
ADMINISTRATION, INCLUDING THE ABILITY TO MANAGE SIDE EFFECTS OR25
ADVERSE OUTCOMES , TO PATIENTS AS PART OF THE PATIENT CONSENT26
PROCESS;27
194
-33- (D) ADMINISTER ONLY RESPIRATORY AND ORAL HEALTH ,1
INCLUDING HUMAN PAPILLOMAVIRUS , IMMUNIZATIONS; AND2
(E) D
ISTRIBUTE IMMUNIZATION EDUCATIONAL MATERIALS AND
3
RECOMMENDATIONS DEVELOPED BY THE DEPARTMENT OF PUBLIC HEALTH4
AND ENVIRONMENT TO THEIR PATIENTS .5
(e) ADMINISTERING NEUROMODULATORS AND DERMAL FILLERS6
FOR THERAPEUTIC AND COSMETIC PURPOSES UNDER THE DIRECT7
SUPERVISION OF A LICENSED DENTIST, OR THE DELEGATION OF A LICENSED8
PHYSICIAN OR OTHER DELEGATED PROFESSIONAL , PURSUANT TO RULES9
ADOPTED BY THE BOARD. THE BOARD SHALL ADOPT RULES REGARDING10
THE APPROPRIATE EDUCATION AND TRAINING , AS APPLICABLE.11
12
(f) P
LACING INTERIM THERAPEUTIC RESTORATIONS PURSUANT TO
13
SECTION 12-220-505.14
(2) A
DENTAL HYGIENIST MAY PERFORM ANY DENTAL TASK OR15
PROCEDURE ASSIGNED TO THE DENTAL HYGIENIST BY A LICENSED DENTIST16
THAT DOES NOT REQUIRE THE PROFESSIONAL SKILL OF A LICENSED17
DENTIST; EXCEPT THAT THE DENTAL HYGIENIST MAY PERFORM THE TASK18
OR PROCEDURE ONLY UNDER THE INDIRECT SUPERVISION OF A LICENSED19
DENTIST OR AS AUTHORIZED IN SECTIONS 12-220-503 AND 12-220-504.20
SECTION 24.
In Colorado Revised Statutes, 12-220-505, amend21
(1)(b), (1)(d), and (6)(a); and add (6)(c) as follows:22
12-220-505. Interim therapeutic restorations by dental23
hygienists - permitting process - rules - subject to review. (1) Upon24
application, accompanied by a fee in an amount determined by the25
director, the board shall grant a permit to place interim therapeutic26
restorations to any dental hygienist applicant who:27
194
-34- (b) Has completed a course developed at the postsecondary1
educational level that complies with the rules adopted by the board. The2
course must be offered under the direct supervision of a member of the3
faculty of a AN ACCREDITED Colorado dental or dental hygiene school.4
accredited by the Commission on Dental Accreditation or its successor5
agency. All faculty responsible for clinical evaluation of students must be6
dentists with a faculty appointment at an accredited Colorado dental or7
dental hygiene school.8
(d) Furnishes, supplies, constructs, reproduces, or repairs any9
prosthetic denture, bridge, appliance, or other structure to be worn in the10
human mouth or upon the jaws, maxillofacial area, or adjacent and11
associated structures other than on the written
DENTAL laboratory work12
order of a duly licensed and practicing dentist;13
(6) (a) A dentist shall not supervise more than five full-time14
equivalent dental hygienists who place interim therapeutic restorations15
under telehealth supervision unless granted a waiver by the board16
pursuant to subsection (6)(b) of this section. For purposes of patient
17
referral for follow-up care, A dentist who supervises a dental hygienist18
who provides interim therapeutic restorations under telehealth supervision19
must have an active license in good standing issued by the board. and a20
physical practice location in Colorado or within reasonable proximity of21
the location where the interim therapeutic restoration is placed BEFORE22
PROVIDING INTERIM THERAPEUTIC RESTORATIONS , A DENTAL HYGIENIST23
SHALL CONFIRM IN COMMUNICATION TO THE SUPERVISING DENTIST A24
REFERRAL FOR FOLLOW -UP CARE TO A LICENSED DENTIST WITHIN25
REASONABLE PHYSICAL PROXIMITY TO THE LOCATION WHERE THE INTERIM26
THERAPEUTIC RESTORATION IS PLACED .27
194
-35- (c) A DENTIST SHALL NOT SUPERVISE, IN AGGREGATE, MORE THAN1
FIVE FULL-TIME EQUIVALENT DENTAL HYGIENISTS OR DENTAL THERAPISTS2
PERFORMING PROCEDURES PURSUANT TO SUBSECTION (6)(a) OF THIS3
SECTION AND SECTION 12-220-508, AND LIMITS ON SUPERVISION OF4
DENTAL THERAPISTS MUST REMAIN CONSISTENT WITH SECTION 12-220-5085
(3).6
SECTION 25. In Colorado Revised Statutes, 12-220-508, amend7
(1)(a) introductory portion, (1)(a)(VIII), (2)(a)(VI), and (3)(a); and add8
(1)(c)(IX) and (3)(d) as follows:9
12-220-508. Practice of dental therapy - supervision10
requirement - rules. (1) (a) A dental therapist may perform the11
following tasks and procedures under the direct supervision of a licensed12
dentist
WITH AN ACTIVE LICENSE IN GOOD STANDING :13
(VIII) Repair defective
prosthetic devices.14
(c) A dental therapist licensed pursuant to this article 220 may15
perform the following tasks under the indirect supervision of a licensed16
dentist, regardless of the number of hours the dental therapist has17
practiced:18
(IX) D
IRECTING DENTAL ASSISTANTS TO ASSIST IN ACTIVITIES19
THAT ARE WITHIN THE SCOPE OF PRACTICE FOR A DENTAL THERAPIST20
UNDER DIRECT AND INDIRECT SUPERVISION OF THE DENTAL THERAPIST21
ONLY; EXCEPT THAT DENTAL ASSISTANTS SHALL NOT PERFORM ACTIVITIES22
DISALLOWED UNDER SECTION 12-220-501 (3)(a).23
(2) (a) An articulated plan between a dental therapist and a dentist24
must include:25
(VI) C
ONSISTENT WITH DENTAL ASSISTANTS ' SCOPE OF PRACTICE,26
policies for supervising dental assistants and working with dental27
194
-36- hygienists and other dental practitioners and staff.1
(3) (a) Except as provided in subsection (3)(b), or (3)(c), OR (3)(d)2
of this section, a dentist may not simultaneously supervise more than3
three full-time or full-time-equivalent dental therapists.4
(d) A
DENTIST SHALL NOT SUPERVISE IN AGGREGATE MORE THAN5
FIVE FULL-TIME EQUIVALENT DENTAL HYGIENISTS OR DENTAL THERAPISTS6
PURSUANT TO THIS SECTION AND SECTION 12-220-505 (6)(a), AND LIMITS7
ON SUPERVISION OF DENTAL THERAPISTS MUST REMAIN CONSISTENT WITH8
THIS SUBSECTION (3).9
SECTION 26.
In Colorado Revised Statutes, 24-34-104, repeal10
(26)(a)(I); and add (35)(a)(VI) as follows:11
24-34-104. General assembly review of regulatory agencies12
and functions for repeal, continuation, or reestablishment - legislative13
declaration - repeal. (26) (a) The following agencies, functions, or both,14
are scheduled for repeal on September 1, 2025:15
(I) The Colorado dental board created in article 220 of title 12;16
(35) (a) The following agencies, functions, or both, are scheduled17
for repeal on September 1, 2034:18
(VI) T
HE COLORADO DENTAL BOARD CREATED IN ARTICLE 220 OF19
TITLE 12.20
SECTION 27.
Repeal of relocated provisions. In Colorado21
Revised Statutes, repeal 12-220-104 (11).22
SECTION 28. Act subject to petition - effective date. This act23
takes effect at 12:01 a.m. on the day following the expiration of the24
ninety-day period after final adjournment of the general assembly; except25
that, if a referendum petition is filed pursuant to section 1 (3) of article V26
of the state constitution against this act or an item, section, or part of this27
194
-37- act within such period, then the act, item, section, or part will not take1
effect unless approved by the people at the general election to be held in2
November 2026 and, in such case, will take effect on the date of the3
official declaration of the vote thereon by the governor.4
194
-38-