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1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 5. The Illinois Dental Practice Act is amended by
5 changing Sections 4, 17, 18, and 18.1 and by adding Sections
6 13.2 and 13.4 as follows:
7 (225 ILCS 25/4)
8 (Section scheduled to be repealed on January 1, 2026)
9 Sec. 4. Definitions. As used in this Act:
10 "Address of record" means the designated address recorded
11 by the Department in the applicant's or licensee's application
12 file or license file as maintained by the Department's
13 licensure maintenance unit. It is the duty of the applicant or
14 licensee to inform the Department of any change of address and
15 those changes must be made either through the Department's
16 website or by contacting the Department.
17 "Department" means the Department of Financial and
18 Professional Regulation.
19 "Secretary" means the Secretary of Financial and
20 Professional Regulation.
21 "Board" means the Board of Dentistry.
22 "Dentist" means a person who has received a general
23 license pursuant to subsection paragraph (a) of Section 11 of
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1 this Act and who may perform any intraoral and extraoral
2 procedure required in the practice of dentistry and to whom is
3 reserved the responsibilities specified in Section 17.
4 "Dental hygienist" means a person who holds a license
5 under this Act to perform dental services as authorized by
6 Section 18.
7 "Dental assistant" means an appropriately trained person
8 who, under the supervision of a dentist, provides dental
9 services as authorized by Section 17.
10 "Expanded function dental assistant" means a dental
11 assistant who has completed the training required by Section
12 17.1 of this Act.
13 "Dental laboratory" means a person, firm, or corporation
14 which:
15 (i) engages in making, providing, repairing, or
16 altering dental prosthetic appliances and other artificial
17 materials and devices which are returned to a dentist for
18 insertion into the human oral cavity or which come in
19 contact with its adjacent structures and tissues; and
20 (ii) utilizes or employs a dental technician to
21 provide such services; and
22 (iii) performs such functions only for a dentist or
23 dentists.
24 "Supervision" means supervision of a dental hygienist or a
25 dental assistant requiring that a dentist authorize the
26 procedure, remain in the dental facility while the procedure
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1 is performed, and approve the work performed by the dental
2 hygienist or dental assistant before dismissal of the patient,
3 but does not mean that the dentist must be present at all times
4 in the treatment room.
5 "General supervision" means supervision of a dental
6 hygienist requiring that the patient be a patient of record,
7 that the dentist examine the patient in accordance with
8 Section 18 prior to treatment by the dental hygienist, and
9 that the dentist authorize the procedures which are being
10 carried out by a notation in the patient's record, but not
11 requiring that a dentist be present when the authorized
12 procedures are being performed. The issuance of a prescription
13 to a dental laboratory by a dentist does not constitute
14 general supervision.
15 "Public member" means a person who is not a health
16 professional. For purposes of board membership, any person
17 with a significant financial interest in a health service or
18 profession is not a public member.
19 "Dentistry" means the healing art which is concerned with
20 the examination, diagnosis, treatment planning, and care of
21 conditions within the human oral cavity and its adjacent
22 tissues and structures, as further specified in Section 17.
23 "Branches of dentistry" means the various specialties of
24 dentistry which, for purposes of this Act, shall be limited to
25 the following: endodontics, oral and maxillofacial surgery,
26 orthodontics and dentofacial orthopedics, pediatric dentistry,
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1 periodontics, prosthodontics, oral and maxillofacial
2 radiology, and dental anesthesiology, oral and maxillofacial
3 pathology, dental public health, oral medicine, and orofacial
4 pain.
5 "Specialist" means a dentist who has received a specialty
6 license pursuant to subsection (b) of Section 11 11(b).
7 "Dental technician" means a person who owns, operates, or
8 is employed by a dental laboratory and engages in making,
9 providing, repairing, or altering dental prosthetic appliances
10 and other artificial materials and devices which are returned
11 to a dentist for insertion into the human oral cavity or which
12 come in contact with its adjacent structures and tissues.
13 "Informed consent" means legally valid consent that is
14 given by a patient or legal guardian, that is recorded in
15 writing or digitally, that authorizes intervention or
16 treatment services from the treating dentist, and that
17 documents agreement to participate in those services and
18 knowledge of the risks, benefits, and alternatives, including
19 the decision to withdraw from or decline treatment.
20 "Impaired dentist" or "impaired dental hygienist" means a
21 dentist or dental hygienist who is unable to practice with
22 reasonable skill and safety because of a physical or mental
23 disability as evidenced by a written determination or written
24 consent based on clinical evidence, including deterioration
25 through the aging process, loss of motor skills, abuse of
26 drugs or alcohol, or a psychiatric disorder, of sufficient
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1 degree to diminish the person's ability to deliver competent
2 patient care.
3 "Nurse" means a registered professional nurse, a certified
4 registered nurse anesthetist licensed as an advanced practice
5 registered nurse, or a licensed practical nurse licensed under
6 the Nurse Practice Act.
7 "Patient of record", except as provided in Section 17.2,
8 means a patient for whom the patient's most recent dentist has
9 obtained a relevant medical and dental history and on whom the
10 dentist has performed a physical examination within the last
11 year and evaluated the condition to be treated, including a
12 review of the patient's most recent x-rays.
13 "Dental responder" means a dentist or dental hygienist who
14 is appropriately certified in disaster preparedness,
15 immunizations, and dental humanitarian medical response
16 consistent with the Society of Disaster Medicine and Public
17 Health and training certified by the National Incident
18 Management System or the National Disaster Life Support
19 Foundation.
20 "Mobile dental van or portable dental unit" means any
21 self-contained or portable dental unit in which dentistry is
22 practiced that can be moved, towed, or transported from one
23 location to another in order to establish a location where
24 dental services can be provided.
25 "Public health dental hygienist" means a hygienist who
26 holds a valid license to practice in the State, has 2 years of
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1 full-time clinical experience or an equivalent of 4,000 hours
2 of clinical experience, and has completed at least 42 clock
3 hours of additional structured courses in dental education in
4 advanced areas specific to public health dentistry.
5 "Public health setting" means a federally qualified health
6 center; a federal, State, or local public health facility;
7 Head Start; a special supplemental nutrition program for
8 Women, Infants, and Children (WIC) facility; a certified
9 school-based health center or school-based oral health
10 program; a prison; or a long-term care facility.
11 "Public health supervision" means the supervision of a
12 public health dental hygienist by a licensed dentist who has a
13 written public health supervision agreement with that public
14 health dental hygienist while working in an approved facility
15 or program that allows the public health dental hygienist to
16 treat patients, without a dentist first examining the patient
17 and being present in the facility during treatment, (1) who
18 are eligible for Medicaid or (2) who are uninsured or whose
19 household income is not greater than 300% of the federal
20 poverty level.
21 "Teledentistry" means the use of telehealth systems and
22 methodologies in dentistry and includes patient diagnosis,
23 treatment planning, care, and education delivery for a patient
24 of record using synchronous and asynchronous communications
25 under an Illinois licensed dentist's authority as provided
26 under this Act.
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1 "Moderate sedation" means a drug-induced depression of
2 consciousness during which: (1) patients respond purposefully
3 to verbal commands, either alone or accompanied by light
4 tactile stimulation; (2) no interventions are required to
5 maintain a patient's airway and spontaneous ventilation is
6 adequate; and (3) cardiovascular function is usually
7 maintained.
8 "Deep sedation" means a drug-induced depression of
9 consciousness during which: (1) patients cannot be easily
10 aroused, but respond purposefully following repeated or
11 painful stimulation; (2) the ability to independently maintain
12 ventilatory function may be impaired; (3) patients may require
13 assistance in maintaining airways and spontaneous ventilation
14 may be inadequate; and (4) cardiovascular function is usually
15 maintained.
16 "General anesthesia" means a drug-induced loss of
17 consciousness during which: (1) patients are not arousable,
18 even by painful stimulation; (2) the ability to independently
19 maintain ventilatory function is often impaired; (3) patients
20 often require assistance in maintaining airways and positive
21 pressure ventilation may be required because of depressed
22 spontaneous ventilation or drug-induced depression of
23 neuromuscular function; and (4) cardiovascular function may be
24 impaired.
25 "Venipuncture" means the puncture of a vein as part of a
26 medical procedure, typically to withdraw a blood sample or for
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1 an intravenous catheter for the administration of medication
2 or fluids.
3 "Enteral route of administration" means administration of
4 a drug that is absorbed through the gastrointestinal tract or
5 through oral, rectal, or sublingual mucosa.
6 "Parenteral route of administration" means administration
7 of a drug by which the drug bypasses the gastrointestinal
8 tract through intramuscular, intravenous, intranasal,
9 submucosal, subcutaneous, or intraosseous methods.
10 (Source: P.A. 102-93, eff. 1-1-22; 102-588, eff. 8-20-21;
11 102-936, eff. 1-1-23; 103-425, eff. 1-1-24; 103-431, eff.
12 1-1-24; 103-605, eff. 7-1-24; 103-628, eff. 7-1-24; 103-902,
13 eff. 8-9-24; revised 10-10-24.)
14 (225 ILCS 25/13.2 new)
15 Sec. 13.2. Practice of license-pending general dentists.
16 (a) An applicant for licensure as general dentist under
17 this Act may obtain employment as a license-pending general
18 dentist and practice under the delegation of a licensed
19 general dentist. An applicant may be employed as a
20 license-pending general dentist if all of the following
21 criteria are met:
22 (1) the applicant has completed and passed the
23 Department-approved licensure examination and presents to
24 the employer an official written notification indicating
25 successful passage of the licensure examination;
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1 (2) the applicant has completed and submitted to the
2 Department an application for a general dentist license
3 under this Act; and
4 (3) the applicant has submitted the required licensure
5 fee.
6 (b) An applicant's authorization to practice under this
7 Section shall terminate upon the occurrence of any of the
8 following:
9 (1) receipt of a general dentist license from the
10 Department;
11 (2) notification from the Department that the
12 applicant's application for licensure has been denied;
13 (3) a request by the Department that the applicant
14 terminate practicing as a license-pending general dentist
15 until an official decision is made by the Department to
16 grant or deny a general dentist license to the applicant;
17 or
18 (4) 6 months elapsing since the official date of the
19 applicant's passage of the licensure examination, as
20 specified on the formal written notification provided to
21 the applicant upon passage of the examination. The 6-month
22 period may be extended by the Department by rule.
23 (225 ILCS 25/13.4 new)
24 Sec. 13.4. Practice of license-pending dental hygienists.
25 (a) An applicant for licensure as a dental hygienist under
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1 this Act may obtain employment as a license-pending dental
2 hygienist and practice under the delegation of a licensed
3 general dentist. An individual may be employed as a
4 license-pending dental hygienist if all of the following
5 criteria are met:
6 (1) the applicant has completed and passed the
7 Department-approved licensure examination and presents to
8 the employer an official written notification indicating
9 successful passage of the licensure examination;
10 (2) the applicant has completed and submitted to the
11 Department an application for a dental hygienist license
12 under this Act; and
13 (3) the applicant has submitted the required licensure
14 fee.
15 (b) An applicant's authorization to practice under this
16 Section shall terminate upon the occurrence of any of the
17 following:
18 (1) receipt of a dental hygienist license from the
19 Department;
20 (2) notification from the Department that the
21 applicant's application for licensure has been denied;
22 (3) a request by the Department that the applicant
23 terminate practicing as a license-pending dental hygienist
24 until an official decision is made by the Department to
25 grant or deny a dental hygienist license to the applicant;
26 or
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1 (4) 6 months elapsing since the official date of the
2 applicant's passage of the licensure examination, as
3 specified on the formal written notification provided to
4 the applicant upon passage of the examination. The 6-month
5 period may be extended by the Department by rule.
6 (225 ILCS 25/17)
7 (Section scheduled to be repealed on January 1, 2026)
8 Sec. 17. Acts constituting the practice of dentistry. A
9 person practices dentistry, within the meaning of this Act:
10 (1) Who represents himself or herself as being able to
11 diagnose or diagnoses, treats, prescribes, or operates for
12 any disease, pain, deformity, deficiency, injury, or
13 physical condition of the human tooth, teeth, alveolar
14 process, gums, or jaw; or
15 (2) Who is a manager, proprietor, operator, or
16 conductor of a business where dental operations are
17 performed; or
18 (3) Who performs dental operations of any kind; or
19 (4) Who uses an X-Ray machine or X-Ray films for
20 dental diagnostic purposes; or
21 (5) Who extracts a human tooth or teeth, or corrects
22 or attempts to correct malpositions of the human teeth or
23 jaws; or
24 (6) Who offers or undertakes, by any means or method,
25 to diagnose, treat, or remove stains, calculus, and
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1 bonding materials from human teeth or jaws; or
2 (7) Who uses or administers local or general
3 anesthetics in the treatment of dental or oral diseases or
4 in any preparation incident to a dental operation of any
5 kind or character; or
6 (8) Who takes material or digital scans for final
7 impressions of the human tooth, teeth, or jaws or performs
8 any phase of any operation incident to the replacement of
9 a part of a tooth, a tooth, teeth, or associated tissues by
10 means of a filling, a crown, a bridge, a denture, or other
11 appliance; or
12 (9) Who offers to furnish, supply, construct,
13 reproduce, or repair, or who furnishes, supplies,
14 constructs, reproduces, or repairs, prosthetic dentures,
15 bridges, or other substitutes for natural teeth to the
16 user or prospective user thereof; or
17 (10) Who instructs students on clinical matters or
18 performs any clinical operation included in the curricula
19 of recognized dental schools and colleges; or
20 (11) Who takes material or digital scans for final
21 impressions of human teeth or places his or her hands in
22 the mouth of any person for the purpose of applying teeth
23 whitening materials, or who takes impressions of human
24 teeth or places his or her hands in the mouth of any person
25 for the purpose of assisting in the application of teeth
26 whitening materials. A person does not practice dentistry
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1 when he or she discloses to the consumer that he or she is
2 not licensed as a dentist under this Act and (i) discusses
3 the use of teeth whitening materials with a consumer
4 purchasing these materials; (ii) provides instruction on
5 the use of teeth whitening materials with a consumer
6 purchasing these materials; or (iii) provides appropriate
7 equipment on-site to the consumer for the consumer to
8 self-apply teeth whitening materials.
9 The fact that any person engages in or performs, or offers
10 to engage in or perform, any of the practices, acts, or
11 operations set forth in this Section, shall be prima facie
12 evidence that such person is engaged in the practice of
13 dentistry.
14 The following practices, acts, and operations, however,
15 are exempt from the operation of this Act:
16 (a) The rendering of dental relief in emergency cases
17 in the practice of his or her profession by a physician or
18 surgeon, licensed as such under the laws of this State,
19 unless he or she undertakes to reproduce or reproduces
20 lost parts of the human teeth in the mouth or to restore or
21 replace lost or missing teeth in the mouth; or
22 (b) The practice of dentistry in the discharge of
23 their official duties by dentists in any branch of the
24 Armed Services of the United States, the United States
25 Public Health Service, or the United States Veterans
26 Administration; or
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1 (c) The practice of dentistry by students in their
2 course of study in dental schools or colleges approved by
3 the Department, when acting under the direction and
4 supervision of dentists acting as instructors; or
5 (d) The practice of dentistry by clinical instructors
6 in the course of their teaching duties in dental schools
7 or colleges approved by the Department:
8 (i) when acting under the direction and
9 supervision of dentists, provided that such clinical
10 instructors have instructed continuously in this State
11 since January 1, 1986; or
12 (ii) when holding the rank of full professor at
13 such approved dental school or college and possessing
14 a current valid license or authorization to practice
15 dentistry in another country; or
16 (e) The practice of dentistry by licensed dentists of
17 other states or countries at meetings of the Illinois
18 State Dental Society or component parts thereof, alumni
19 meetings of dental colleges, or any other like dental
20 organizations, while appearing as clinicians; or
21 (f) The use of X-Ray machines for exposing X-Ray films
22 of dental or oral tissues by dental hygienists or dental
23 assistants; or
24 (g) The performance of any dental service by a dental
25 assistant, if such service is performed under the
26 supervision and full responsibility of a dentist. In
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1 addition, after being authorized by a dentist, a dental
2 assistant may, for the purpose of eliminating pain or
3 discomfort, remove loose, broken, or irritating
4 orthodontic appliances on a patient of record.
5 For purposes of this paragraph (g), "dental service"
6 is defined to mean any intraoral procedure or act which
7 shall be prescribed by rule or regulation of the
8 Department. "Dental service", however, shall not include:
9 (1) Any and all diagnosis of or prescription for
10 treatment of disease, pain, deformity, deficiency,
11 injury, or physical condition of the human teeth or
12 jaws, or adjacent structures.
13 (2) Removal of, restoration of, or addition to the
14 hard or soft tissues of the oral cavity, except for the
15 placing, carving, and finishing of amalgam
16 restorations and placing, packing, and finishing
17 composite restorations by dental assistants who have
18 had additional formal education and certification.
19 A dental assistant may place, carve, and finish
20 amalgam restorations, place, pack, and finish
21 composite restorations, and place interim restorations
22 if he or she (A) has successfully completed a
23 structured training program as described in item (2)
24 of subsection (g) provided by an educational
25 institution accredited by the Commission on Dental
26 Accreditation, such as a dental school or dental
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1 hygiene or dental assistant program, or (B) has at
2 least 4,000 hours of direct clinical patient care
3 experience and has successfully completed a structured
4 training program as described in item (2) of
5 subsection (g) provided by a statewide dental
6 association, approved by the Department to provide
7 continuing education, that has developed and conducted
8 training programs for expanded functions for dental
9 assistants or hygienists. The training program must:
10 (i) include a minimum of 16 hours of didactic study and
11 14 hours of clinical manikin instruction; all training
12 programs shall include areas of study in nomenclature,
13 caries classifications, oral anatomy, periodontium,
14 basic occlusion, instrumentations, pulp protection
15 liners and bases, dental materials, matrix and wedge
16 techniques, amalgam placement and carving, rubber dam
17 clamp placement, and rubber dam placement and removal;
18 (ii) include an outcome assessment examination that
19 demonstrates competency; (iii) require the supervising
20 dentist to observe and approve the completion of 8
21 amalgam or composite restorations; and (iv) issue a
22 certificate of completion of the training program,
23 which must be kept on file at the dental office and be
24 made available to the Department upon request. A
25 dental assistant must have successfully completed an
26 approved coronal polishing and dental sealant course
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1 prior to taking the amalgam and composite restoration
2 course.
3 A dentist utilizing dental assistants shall not
4 supervise more than 4 dental assistants at any one
5 time for placing, carving, and finishing of amalgam
6 restorations or for placing, packing, and finishing
7 composite restorations.
8 (3) Any and all correction of malformation of
9 teeth or of the jaws.
10 (4) Administration of anesthetics, except for
11 monitoring of nitrous oxide, moderate sedation, deep
12 sedation, and general anesthetic as provided in
13 Section 8.1 of this Act, that may be performed only
14 after successful completion of a training program
15 approved by the Department. A dentist utilizing dental
16 assistants shall not supervise more than 4 dental
17 assistants at any one time for the monitoring of
18 nitrous oxide.
19 (5) Removal of calculus from human teeth.
20 (6) Taking of material or digital scans for final
21 impressions for the fabrication of prosthetic
22 appliances, crowns, bridges, inlays, onlays, or other
23 restorative or replacement dentistry.
24 (7) The operative procedure of dental hygiene
25 consisting of oral prophylactic procedures, except for
26 coronal polishing and pit and fissure sealants, which
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1 may be performed by a dental assistant who has
2 successfully completed a training program approved by
3 the Department. Dental assistants may perform coronal
4 polishing under the following circumstances: (i) the
5 coronal polishing shall be limited to polishing the
6 clinical crown of the tooth and existing restorations,
7 supragingivally; (ii) the dental assistant performing
8 the coronal polishing shall be limited to the use of
9 rotary instruments using a rubber cup or brush
10 polishing method (air polishing is not permitted); and
11 (iii) the supervising dentist shall not supervise more
12 than 4 dental assistants at any one time for the task
13 of coronal polishing or pit and fissure sealants.
14 In addition to coronal polishing and pit and
15 fissure sealants as described in this item (7), a
16 dental assistant who has at least 2,000 hours of
17 direct clinical patient care experience and who has
18 successfully completed a structured training program
19 provided by (1) an educational institution including,
20 but not limited to, a dental school or dental hygiene
21 or dental assistant program, (2) a continuing
22 education provider approved by the Department, or (3)
23 a statewide dental or dental hygienist association
24 that has developed and conducted a training program
25 for expanded functions for dental assistants or
26 hygienists may perform: (A) coronal scaling above the
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1 gum line, supragingivally, on the clinical crown of
2 the tooth only on patients 17 years of age or younger
3 who have an absence of periodontal disease and who are
4 not medically compromised or individuals with special
5 needs and (B) intracoronal temporization of a tooth.
6 The training program must: (I) include a minimum of 32
7 hours of instruction in both didactic and clinical
8 manikin or human subject instruction; all training
9 programs shall include areas of study in dental
10 anatomy, public health dentistry, medical history,
11 dental emergencies, and managing the pediatric
12 patient; (II) include an outcome assessment
13 examination that demonstrates competency; (III)
14 require the supervising dentist to observe and approve
15 the completion of 6 full mouth supragingival scaling
16 procedures unless the training was received as part of
17 a Commission on Dental Accreditation approved dental
18 assistant program; and (IV) issue a certificate of
19 completion of the training program, which must be kept
20 on file at the dental office and be made available to
21 the Department upon request. A dental assistant must
22 have successfully completed an approved coronal
23 polishing course prior to taking the coronal scaling
24 course. A dental assistant performing these functions
25 shall be limited to the use of hand instruments only.
26 In addition, coronal scaling as described in this
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1 paragraph shall only be utilized on patients who are
2 eligible for Medicaid, who are uninsured, or whose
3 household income is not greater than 300% of the
4 federal poverty level. A dentist may not supervise
5 more than 2 dental assistants at any one time for the
6 task of coronal scaling. This paragraph is inoperative
7 on and after January 1, 2026.
8 The limitations on the number of dental assistants a
9 dentist may supervise contained in items (2), (4), and (7)
10 of this paragraph (g) mean a limit of 4 total dental
11 assistants or dental hygienists doing expanded functions
12 covered by these Sections being supervised by one dentist;
13 or
14 (h) The practice of dentistry by an individual who:
15 (i) has applied in writing to the Department, in
16 form and substance satisfactory to the Department, for
17 a general dental license and has complied with all
18 provisions of Section 9 of this Act, except for the
19 passage of the examination specified in subsection (e)
20 of Section 9 of this Act; or
21 (ii) has applied in writing to the Department, in
22 form and substance satisfactory to the Department, for
23 a temporary dental license and has complied with all
24 provisions of subsection (c) of Section 11 of this
25 Act; and
26 (iii) has been accepted or appointed for specialty
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1 or residency training by a hospital situated in this
2 State; or
3 (iv) has been accepted or appointed for specialty
4 training in an approved dental program situated in
5 this State; or
6 (v) has been accepted or appointed for specialty
7 training in a dental public health agency situated in
8 this State.
9 The applicant shall be permitted to practice dentistry
10 for a period of 3 months from the starting date of the
11 program, unless authorized in writing by the Department to
12 continue such practice for a period specified in writing
13 by the Department.
14 The applicant shall only be entitled to perform such
15 acts as may be prescribed by and incidental to his or her
16 program of residency or specialty training and shall not
17 otherwise engage in the practice of dentistry in this
18 State.
19 The authority to practice shall terminate immediately
20 upon:
21 (1) the decision of the Department that the
22 applicant has failed the examination; or
23 (2) denial of licensure by the Department; or
24 (3) withdrawal of the application.
25 (Source: P.A. 102-558, eff. 8-20-21; 102-936, eff. 1-1-23;
26 103-425, eff. 1-1-24; 103-431, eff. 1-1-24; 103-605, eff.
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1 7-1-24; 103-628, eff. 7-1-24.)
2 (225 ILCS 25/18) (from Ch. 111, par. 2318)
3 (Section scheduled to be repealed on January 1, 2026)
4 Sec. 18. Acts constituting the practice of dental hygiene;
5 limitations.
6 (a) A person practices dental hygiene within the meaning
7 of this Act when he or she performs the following acts under
8 the supervision of a dentist:
9 (i) the operative procedure of dental hygiene,
10 consisting of oral prophylactic procedures;
11 (ii) the exposure and processing of X-Ray films of the
12 teeth and surrounding structures;
13 (iii) the application to the surfaces of the teeth or
14 gums of chemical compounds designed to be desensitizing
15 agents or effective agents in the prevention of dental
16 caries or periodontal disease;
17 (iv) all services which may be performed by a dental
18 assistant as specified by rule pursuant to Section 17, and
19 a dental hygienist may engage in the placing, carving, and
20 finishing of amalgam restorations only after obtaining
21 formal education and certification as determined by the
22 Department;
23 (v) administration and monitoring of nitrous oxide
24 upon successful completion of a training program approved
25 by the Department;
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1 (vi) administration of local anesthetics upon
2 successful completion of a training program approved by
3 the Department; and
4 (vii) such other procedures and acts as shall be
5 prescribed by rule or regulation of the Department.
6 (b) A dental hygienist may be employed or engaged only:
7 (1) by a dentist;
8 (2) by a federal, State, county, or municipal agency
9 or institution;
10 (3) by a public or private school; or
11 (4) by a public clinic operating under the direction
12 of a hospital or federal, State, county, municipal, or
13 other public agency or institution.
14 (c) When employed or engaged in the office of a dentist, a
15 dental hygienist may perform, under general supervision, those
16 procedures found in items (i) through (iv) of subsection (a)
17 of this Section, provided the patient has been examined by the
18 dentist within one year of the provision of dental hygiene
19 services, the dentist has approved the dental hygiene services
20 by a notation in the patient's record and the patient has been
21 notified that the dentist may be out of the office during the
22 provision of dental hygiene services.
23 (d) If a patient of record is unable to travel to a dental
24 office because of illness, infirmity, or imprisonment, a
25 dental hygienist may perform, under the general supervision of
26 a dentist, those procedures found in items (i) through (iv) of
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1 subsection (a) of this Section, provided the patient is
2 located in a long-term care facility licensed by the State of
3 Illinois, a mental health or developmental disability
4 facility, or a State or federal prison. The dentist shall
5 either personally examine and diagnose the patient or utilize
6 approved teledentistry communication methods and determine
7 which services are necessary to be performed, which shall be
8 contained in an order to the hygienist and a notation in the
9 patient's record. Such order must be implemented within 45
10 days of its issuance; except when a patient is located within a
11 State or federal prison, then the order must be implemented
12 within 180 days of its issuance, and an updated medical
13 history and observation of oral conditions must be performed
14 by the hygienist immediately prior to beginning the procedures
15 to ensure that the patient's health has not changed in any
16 manner to warrant a reexamination by the dentist.
17 (e) School-based oral health care, consisting of and
18 limited to oral prophylactic procedures, sealants, and
19 fluoride treatments, may be provided by a dental hygienist
20 under the general supervision of a dentist. A dental hygienist
21 may not provide other dental hygiene treatment in a
22 school-based setting, including but not limited to
23 administration or monitoring of nitrous oxide or
24 administration of local anesthetics. The school-based
25 procedures may be performed provided the patient is located at
26 a public or private school and the program is being conducted
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1 by a State, county or local public health department
2 initiative or in conjunction with a dental school or dental
3 hygiene program. The dentist shall personally examine and
4 diagnose the patient and determine which services are
5 necessary to be performed, which shall be contained in an
6 order to the hygienist and a notation in the patient's record.
7 Any such order for sealants must be implemented within 120
8 days after its issuance. Any such order for oral prophylactic
9 procedures or fluoride treatments must be implemented within
10 180 days after its issuance. An updated medical history and
11 observation of oral conditions must be performed by the
12 hygienist immediately prior to beginning the procedures to
13 ensure that the patient's health has not changed in any manner
14 to warrant a reexamination by the dentist.
15 (f) Without the supervision of a dentist, a dental
16 hygienist may perform dental health education functions,
17 including instruction in proper oral health care and dental
18 hygiene in, for example, a school setting, a long-term care
19 facility, and a health fair. In addition, a dental hygienist
20 may record case histories and oral conditions observed at any
21 time prior to a clinical exam by a dentist.
22 (g) The number of dental hygienists practicing in a dental
23 office shall not exceed, at any one time, 4 times the number of
24 dentists practicing in the office at the time.
25 (h) A dental hygienist who is certified as a public health
26 dental hygienist may provide services to patients: (1) who are
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1 eligible for Medicaid or (2) who are uninsured and whose
2 household income is not greater than 300% of the federal
3 poverty level. A public health dental hygienist may perform
4 oral assessments, perform screenings, and provide educational
5 and preventative services as provided in subsection (b) of
6 Section 18.1 of this Act. The public health dental hygienist
7 may not administer local anesthesia or nitrous oxide, or
8 place, carve, or finish amalgam restorations or provide
9 periodontal therapy under this exception. Each patient must
10 sign a consent form that acknowledges that the care received
11 does not take the place of a regular dental examination. The
12 public health dental hygienist must provide the patient or
13 guardian a written referral to a dentist for assessment of the
14 need for further dental care at the time of treatment. Any
15 indication or observation of a condition that could warrant
16 the need for urgent attention must be reported immediately to
17 the supervising dentist for appropriate assessment and
18 treatment.
19 This subsection (h) is inoperative on and after January 1,
20 2026.
21 (i) A dental hygienist performing procedures listed in
22 paragraphs (1) through (4) of subsection (a) of Section 17.1
23 must be under the supervision of a dentist, requiring the
24 dentist authorizes the procedure, remains in the dental
25 facility while the procedure is performed, and approves the
26 work performed by the dental hygienist before dismissal of the
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1 patient, but the dentist is not required to be present at all
2 times in the treatment room.
3 (j) A dental hygienist may perform actions described in
4 paragraph (5) of subsection (a) of Section 17.1 under the
5 general supervision of a dentist as described in this Section.
6 (Source: P.A. 102-936, eff. 1-1-23; 103-431, eff. 1-1-24.)
7 (225 ILCS 25/18.1)
8 (Section scheduled to be repealed on January 1, 2026)
9 Sec. 18.1. Public health dental supervision
10 responsibilities.
11 (a) When working together in a public health supervision
12 relationship, dentists and public health dental hygienists
13 shall enter into a public health supervision agreement. The
14 dentist providing public health supervision must:
15 (1) be available to provide an appropriate level of
16 contact, communication, collaboration, and consultation
17 with the public health dental hygienist and must meet
18 in-person with the public health dental hygienist at least
19 quarterly for review and consultation;
20 (2) have specific standing orders or policy guidelines
21 for procedures that are to be carried out for each
22 location or program, although the dentist need not be
23 present when the procedures are being performed;
24 (3) provide for the patient's additional necessary
25 care in consultation with the public health dental
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1 hygienist;
2 (4) file agreements and notifications as required; and
3 (5) include procedures for creating and maintaining
4 dental records, including protocols for transmission of
5 all records between the public health dental hygienist and
6 the dentist following each treatment, which shall include
7 a notation regarding procedures authorized by the dentist
8 and performed by the public health dental hygienist and
9 the location where those records are to be kept.
10 Each dentist and hygienist who enters into a public health
11 supervision agreement must document and maintain a copy of any
12 change or termination of that agreement.
13 Dental records shall be owned and maintained by the
14 supervising dentist for all patients treated under public
15 health supervision, unless the supervising dentist is an
16 employee of a public health clinic or federally qualified
17 health center, in which case the public health clinic or
18 federally qualified health center shall maintain the records.
19 If a dentist ceases to be employed or contracted by the
20 facility, the dentist shall notify the facility administrator
21 that the public health supervision agreement is no longer in
22 effect. A new public health supervision agreement is required
23 for the public health dental hygienist to continue treating
24 patients under public health supervision.
25 A dentist entering into an agreement under this Section
26 may supervise and enter into agreements for public health
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1 supervision with 4 public health dental hygienists. This shall
2 be in addition to the limit of 4 dental hygienists per dentist
3 set forth in subsection (g) of Section 18 of this Act.
4 (b) A public health dental hygienist providing services
5 under public health supervision may perform only those duties
6 within the accepted scope of practice of dental hygiene, as
7 follows:
8 (1) the operative procedures of dental hygiene,
9 consisting of oral prophylactic procedures, including
10 prophylactic cleanings, application of fluoride, and
11 placement of sealants;
12 (2) the exposure and processing of x-ray films of the
13 teeth and surrounding structures; and
14 (3) such other procedures and acts as shall be
15 prescribed by rule of the Department.
16 Any patient treated under this subsection (b) must be
17 examined by a dentist before additional services can be
18 provided by a public health dental hygienist. However, if the
19 supervising dentist, after consultation with the public health
20 hygienist, determines that time is needed to complete an
21 approved treatment plan on a patient eligible under this
22 Section, then the dentist may instruct the hygienist to
23 complete the remaining services prior to an oral examination
24 by the dentist. Such instruction by the dentist to the
25 hygienist shall be noted in the patient's records. Any
26 services performed under this exception must be scheduled in a
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1 timely manner and shall not occur more than 30 days after the
2 first appointment date.
3 (c) A public health dental hygienist providing services
4 under public health supervision must:
5 (1) provide to the patient, parent, or guardian a
6 written plan for referral or an agreement for follow-up
7 that records all conditions observed that should be called
8 to the attention of a dentist for proper diagnosis;
9 (2) have each patient sign a permission slip or
10 consent form that informs them that the service to be
11 received does not take the place of regular dental
12 checkups at a dental office and is meant for people who
13 otherwise would not have access to the service;
14 (3) inform each patient who may require further dental
15 services of that need;
16 (4) maintain an appropriate level of contact and
17 communication with the dentist providing public health
18 supervision; and
19 (5) complete an additional 4 hours of continuing
20 education in areas specific to public health dentistry
21 yearly.
22 (d) Each public health dental hygienist who has rendered
23 services under subsections (c), (d), and (e) of this Section
24 must complete a summary report at the completion of a program
25 or, in the case of an ongoing program, at least annually. The
26 report must be completed in the manner specified by the
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1 Department of Public Health Oral Health Section including
2 information about each location where the public health dental
3 hygienist has rendered these services. The public health
4 dental hygienist must submit the form to the dentist providing
5 supervision for his or her signature before sending it to the
6 Division. The Department of Public Health Oral Health Section
7 shall compile and publicize public health dental hygienist
8 service data annually.
9 (e) Public health dental hygienists providing services
10 under public health supervision may be compensated for their
11 work by salary, honoraria, and other mechanisms by the
12 employing or sponsoring entity. Nothing in this Act shall
13 preclude the entity that employs or sponsors a public health
14 dental hygienist from seeking payment, reimbursement, or other
15 source of funding for the services provided.
16 (e-5) A patient who is provided services under a
17 supervision agreement by a public health dental hygienist as
18 described in this Section does not need to receive a physical
19 examination from a dentist prior to treatment if the public
20 health dental hygienist consults with the supervising dentist
21 prior to performing the teledentistry service.
22 (f) This Section is repealed on January 1, 2026.
23 (Source: P.A. 103-431, eff. 1-1-24; 103-902, eff. 8-9-24.)
24 Section 99. Effective date. This Act takes effect upon
25 becoming law.
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