MURIEL BOWSER
MAYOR
December 13, 2023
The Honorable Phil Mendelson
Chairman
Council of the District of Columbia
John A. Wilson Building
1350 Pennsylvania Avenue, N.W., Suite 504
Washington, D.C. 20004
Dear Chairman Mendelson:
Enclosed for consideration and approval by the Council is the Dental Specialties Licensure and
Scope of Practice Amendment Act of 2023. This legislation will amend the Health Occupations
Revision Act of 1985 to authorize the Board of Dentistry to license and regulate the practice of
and advertising of dental specialties in the District of Columbia, to define the practice of oral and
maxillofacial surgeons, and to amend the scope of practice of dentistry to authorize dentists to
administer immunizations and vaccinations when certified by the Board of Dentistry to do so, to
authorize dentists to use botulinum toxin or another neurotoxin approved by the Federal Food
and Drug Administration for dental-related procedures and to treat a diagnosed dental condition
when certified by the Board of Dentistry to do so, to further define and clarify what constitutes
the unlicensed practice of dentistry by managers, proprietors, operators, or conductors of a dental
office, and to authorize disciplinary action against a dental practitioner who enters into an
agreement or arrangement with a non-dentist or dentist not licensed under the Act that allows the
non-dentist or dentist not licensed under the Act to directly or indirectly usurp the dental
practitioner’s professional judgment and clinical treatment of patients through control or
ownership of the dental practitioner’s office, staff, equipment, patients, or patient records.
This legislation is necessary to ensure that dentists are appropriately qualified to practice dental
specialties and to hold themselves out to the public as specialists; to clearly delineate the line
between dentists and oral and maxillofacial surgeons; and to enable District of Columbia dentists
to keep up with the expansion of the practice of dentistry across the country and with what is
taught in dental schools.
During the public health emergency, dentists were authorized to administer Covid-19
vaccinations. This legislation will make that expansion of the practice of dentistry part of the
permanent scope of practice of dentists in the District of Columbia by allowing dentists who
want to administer vaccinations to receive a certification from the Board to do so. This
legislation will also expand the practice of dentists in the District of Columbia to be consistent with their counterparts in other states by allowing District of Columbia dentists to administer
Botox or another FDA approved neurotoxin for dental-related procedures and to treat diagnosed
dental conditions.
This legislation is also necessary to address a loophole in the current law by which non-dentists
have been circumventing the law that prohibits non-dentists from owning dental offices and
exercising control over dentists. The current law states that being a “manager,” “proprietor,”
“operator,” or “conductor” of a dental office is engaging in the practice of dentistry. Non-dentists
have been circumventing this prohibition by entering into agreements and arrangements with
dentists in which the non-dentist owns the office space, equipment, practice name, employs the
staff, and owns the patient roster and patient records. This legislation will close that loophole and
hold the dentists accountable for entering into these types of agreements and arrangements.
I urge the Council to take prompt and favorable action on the enclosed proposed legislation.
Sincerely,
Muriel Bowser 1
2
3
4
5
6
7
8
9
A BILL
airman Phil Mendelson
at the request
of the Mayor
10 IN THE COUNCIL OF THE DISTRICT OF COLUMBIA
11
12
13
14
15 To amend the Health Occupations Revision Act of 1985 to authorize the Board of Dentistry to
16 license and regulate the practice of and advertising of dental specialties in the District, to
17 define the practice of oral and maxillofacial surgery, to authorize dentists to administer
18 immunizations and vaccinations when certified by the Board of Dentistry to do so, to
19 authorize dentists to use botulinum toxin and other neurotoxins approved by the Food and
20 Drug Administration
to treat a diagnosed dental condition when certified by the Board of
21 Dentistry to do so, and to authorize disciplinary action against a dental practitioner who
22 enters into an agreement or arrangement with a non-dentist or dentist not licensed under
23 the act that allows the non-dentist or dentist not licensed under the act to control or own
24 the dental practitioner's office, staff, equipment, patients, or patient records.
25
26 BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this
27 act may be cited as the "Dental Specialties Licensure and Scope
of Practice Amendment Act of
28 2023".
29 Sec. 2. The District
of Columbia Health Occupations Revision Act of 1985, effective
30 March 25, 1986 (D.C. Law 6-99; D.C. Official
Code§ 3-1201.01 et seq.), is amended as follows:
31 (a) The table of contents is amended by adding a new section designation to read as
32 follows:
33 "Sec. 508c. Dental specialty licenses.".
34 (b) Section 102 (D.C. Official
Code§ 3-1201.02) is amended as follows:
35 (1) Paragraph (5) is amended as follows:
1 2
(A) Subparagraph (B) is amended by striking the phrase “tooth or teeth” 36
and inserting the phrase “tooth or teeth, or the placement or removal of dental implants” in its 37
place. 38
(B) Subparagraph (E) is amended by striking the phrase “properly trained 39
in the administration of the anesthetic agent” and inserting the phrase “properly trained in the 40
administration of the anesthetic agent and certified by the Board of Dentistry, if required 41
pursuant to section 201(g),” in its place. 42
(C) Subparagraph (J) is amended as follows: 43
(i) Sub-subparagraph (vii) is amended by striking the semicolon 44
and inserting the phrase “; and” in its place. 45
(ii) Sub-subparagraph (viii) is amended by striking the phrase “; 46
and” and inserting a period in its place. 47
(iii) Sub-subparagraph (ix) is repealed. 48
(D) New subparagraphs (K) and (L) are added to read as follows: 49
“(K) The prescription and administration of immunizations and 50
vaccinations when certified by the Board of Dentistry to do so; 51
“(L) The use of botulinum toxin or another neurotoxin approved by the 52
Food and Drug Administration, to treat a diagnosed dental condition approved by the Mayor 53
through rulemaking, when certified by the Board of Dentistry to do so.”. 54
(2) Paragraph (10A) is redesignated as paragraph (10B). 55
(3) A new paragraph (10A) is added to read as follows: 56
“(10A) “Practice of oral and maxillofacial surgery” means a specialty of the 57
practice of dentistry that includes the diagnosis, surgical, and adjunctive treatment of disease, 58 3
injuries and defects involving both the functional and aesthetic aspects of the hard and soft 59
tissues of the oral and maxillofacial region, including cosmetic and aesthetic procedures.”. 60
(c) Section 501 (D.C. Official Code § 3-1205.01) is amended by striking the word 61
“optometry” and inserting the phrase “optometry, oral and maxillofacial surgery” in its place. 62
(d) A new section 508c is added to read as follows: 63
“Sec. 508c. Dental specialty licenses. 64
“(a) A licensed dentist may not represent to the public that the licensee is a specialist in 65
any field of specialized dental practice, including oral and maxillofacial surgery, unless licensed 66
by the Board as a specialist in that dental specialty field. 67
“(b) The Board may approve any area of specialty recognized by the National 68
Commission on Recognition of Dental Specialties and Certifying Boards or its successor, or any 69
other entity approved by the Board that recognizes or certifies a field of specialized dental 70
practice. 71
“(c) A dentist shall be eligible for a license in a field of specialized dental practice if the 72
dentist establishes to the satisfaction of the Board that he or she: 73
“(1) Is licensed in good standing to practice dentistry in the District; 74
“(2)(A) Is a Diplomate of a specialty certifying board recognized by the American 75
Dental Association, is certified by a specialty certifying board recognized by the National 76
Commission on Recognition of Dental Specialties and Certifying Boards, or is certified by 77
another entity approved by the Board that that recognizes a field of specialized dental practice; or 78
“(B) Since a date before January 1, 1986, continuously held himself or 79
herself out to the public, in an ethical manner, as a specialist in a specialty recognized by the 80
Board, and 81 4
“(3) Meets any other requirements established by the Mayor by rule to assure that 82
the applicant has had the proper training, experience, and qualifications to be licensed in the 83
applicable field of specialized dental practice. 84
“(d) Notwithstanding subsection (a) of this section, for a period of one year following the 85
effective date of the Dental Specialties Licensure Amendment Act of 2023, a dentist licensed in 86
good standing by the Board, who is a Diplomate of a specialty certifying board recognized by the 87
American Dental Association, or certified by a specialty certifying board recognized by the 88
National Commission on Recognition of Dental Specialties and Certifying Boards, or certified 89
by another entity approved by the Board that recognizes a field of specialized dental practice, or 90
who is currently eligible for examination by a national specialty board recognized by the Board, 91
may continue to represent to the public that the dentist is a specialist in that specialty whether or 92
not that person holds a specialty license issued by the Board. 93
“(e) No dentist shall engage in the practice of oral and maxillofacial surgery unless the 94
dentist: 95
“(1) Has successfully completed an oral and maxillofacial residency program 96
approved by the Commission of Dental Accreditation of the American Dental Association or 97
another entity, approved by the Board, that approves oral and maxillofacial residency programs; 98
“(2)(A) Is a Diplomate of a national certifying board recognized by the American 99
Dental Association; or 100
“(B) Is a diplomate or the equivalent of a diplomate of another entity, 101
approved by the Board, that certifies diplomates or the equivalent a diplomate in oral and 102
maxillofacial surgery; and 103 5
“(3) Holds a valid dental specialty license in the field of oral and maxillofacial 104
surgery issued by the Board of Dentistry.”. 105
(e) Section 514(a) (D.C. Official Code § 3-1205.14(a)) is amended as follows: 106
(1) Paragraph (51) is amended by striking the phrase “; or” and inserting a 107
semicolon in its place. 108
(2) Paragraph (52) is amended by striking the period at the end and inserting the 109
phrase “; or” in its place. 110
(3) A new paragraph (53) is added to read as follows: 111
“(53) Enters into an agreement, arrangement, or relationship with an individual or 112
entity who is not licensed to practice dentistry under this act, or is not exempted from licensure 113
as a dentist under this act, in which the individual or entity that is not licensed to practice 114
dentistry under this act or is not exempted from licensure as a dentist under this act: 115
“(A) Retains ownership or control of dental office space, dental 116
equipment, or dental materials; 117
“(B) Employs or contracts with dentists, dental hygienists, or clinical 118
dental staff to provide dental services; or 119
“(C) Exercises control over the selection of a course of dental treatment 120
for a patient, or the dental procedures or materials to be used as part of such course of treatment, 121
or the manner in which such course of treatment is carried out by a dentist, dental hygienist, or 122
other dental staff member, or patient records.”. 123
Sec. 4. Fiscal impact statement. 124 6
The Council adopts the fiscal impact statement in the committee report as the fiscal 125
impact statement required by section 4a of the General Legislative Procedures Act of 1975, 126
approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-301.47a). 127
Sec. 5. Effective date. 128
This act shall take effect following approval by the Mayor (or in the event of veto by the 129
Mayor, action by the Council to override the veto), a 30-day period of Congressional review as 130
provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December 131
24, 1973 (87 Stat. 813; D.C. Official Code § 1-206.02(c)(1)), and publication in the District of 132
Columbia Register. 133 3
GOVERNMENT OF THE DISTRICT OF COLUMBIA
OFFICE OF THE ATTORNEY GENERAL
BRIANL.SCHWALB
ATTORNEYGENERALL
EGAL
C
OUNSEL
D
IVISION
MEMORANDUM
TO: Tommy Wells
Director
Office of Policy and Legislative Affairs
FROM: Megan D. Browder
Deputy Attorney General
Legal Counsel Division
DATE: February 17, 2023
SUBJECT: Legal Sufficiency ReviewofDraft Legislation, the “Dental Specialties Licensure and
Scope of Practice Amendment Act of 2023”
(AE-23-055)
________________________________________________________________________
This is to Certify that
this Office has reviewed the above-referenced
legislationand that we have found it to be legally sufficient. If you have any questions in this
regard, please do not hesitate to call me at 724-5524.
________________________________
Megan D. Browder Government of the District of Columbia
Office of the Chief Financial Officer
Glen Lee
Chief Financial Officer
1350 Pennsylvania Avenue, NW, Suite 203, Washington, DC 20004 (202)727-2476
www.cfo.dc.gov
MEMORANDUM
TO: The Honorable Phil Mendelson
Chairman, Council of the District of Columbia
FROM: Glen Lee
Chief Financial Officer
DATE: November 1, 2023
SUBJECT: Fiscal Impact Statement – Dental Specialties Licensure and Scope of
Practice Amendment Act of 2023
REFERENCE: Draft introduction as provided to the Office of Revenue Analysis on
October 27, 2023
Conclusion
Funds are sufficient in the fiscal year 2024 through fiscal year 2027 budget and financial plan to
implement the bill.
Background
The bill clarifies
1 and expands the scope of practice for dentists in the District of Columbia to allow
for the administration of immunizations and vaccinations when certified to do so by the Board of
Dentistry. The bill also authorizes dentists to use botulinum toxin and other neurotoxins that are
approved by the Food and Drug Administration to treat certain dental conditions.
The bill authorizes
2 the Board of Dentistry to license and regulate the practice and advertising of any
area of dental specialty recognized by the National Commission on Recognition of Dental Specialties
including the practice of oral and maxillofacial surgery.
3 In order to be licensed in a field of specialized
dental practice, dentists must be either licensed in good standing to practice dentistry in the District,
1
By amending The District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986
(D.C. Law 6-99; D.C. Official Code § 3-1201.01 et seq.).
2
Id.
3
The practice of oral and maxillofacial surgery includes the diagnosis, surgical, and adjunctive treatment of
disease, injuries, and defects involving both the functional and aesthetic aspects of the hard and soft tissues of
the oral and maxillofacial region, including cosmetic and aesthetic procedures. The Honorable Phil Mendelson
FIS: “Dental Specialties Licensure and Scope of Practice Amendment Act of 2023,” Draft introduction as
provided to the Office of Revenue Analysis on October 27, 2023
Page 2 of 2
be a diplomate of a specialty certifying board recognized by the American Dental Association, be
certified by a specialty certifying board recognized by the National Commission on Recognition of
Dental Specialties and Certifying Boards, or be certified by another entity approved by the Board that
recognizes a field of specialized dental practice. No dentists can engage in the practice of oral and
maxillofacial surgery unless the dentist has successfully completed an oral and maxillofacial
residency program, is a Diplomate of a national certifying board recognized by the American Dental
Association, or is a diplomate or the equivalent of a diplomate of another entity approved by the
Board of Dentistry.
The bill also authorizes
4 disciplinary action against dental practitioners who enter into agreements
or arrangements with non-dentists or dentists not licensed in the District to control or own the dental
practitioner’s office, staff, equipment, patients, or patient records.
Financial Plan Impact
Funds are sufficient in the fiscal year 2024 through fiscal year 2027 budget and financial plan to
implement the bill.
There is no cost to expanding the scope of the practice for dentists to include administering
vaccinations and to administer neurotoxins to treat certain dental conditions. The Board of Dentistry
already regulates the practice of dentistry in the District. Likewise, allowing for the licensing and
regulation of dental specialties does not have a cost. The Board of Dentistry estimates that fifty
individuals that are already licensed to practice dentistry in the District will apply for specialty
dentist licenses.
The Board of Dentistry is already authorized to take disciplinary action against practitioners that do
not comply with District law. Expanding the Board’s authority to take disciplinary action against
certain practitioners does not have a cost.
4
By amending D.C. Official Code § 3-1205.14(a).