EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*sb0306*
SENATE BILL 306
J2 2lr1757
CF HB 219
By: Senator Lam
Introduced and read first time: January 20, 2022
Assigned to: Education, Health, and Environmental Affairs
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: February 26, 2022
CHAPTER ______
AN ACT concerning 1
Dental Hygienists – Consultation Requirements – Health Care Practitioners 2
FOR the purpose of altering the types of health care practitioners with whom a dental 3
hygienist must consult before providing certain treatment to a dental patient to 4
include a patient’s registered nurse practitioner, certified nurse midwife, or licensed 5
certified midwife; requiring that certain consultations by a dental hygienist be made 6
if there is a change in the patient’s medical condition; and generally relating to 7
dental hygienists and the provision of dental services. 8
BY repealing and reenacting, with amendments, 9
Article – Health Occupations 10
Section 4–308(k)(4)(vi) and (m)(1) and (5) 11
Annotated Code of Maryland 12
(2021 Replacement Volume) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Health Occupations 16
4–308. 17
(k) (4) A facility in which a dental hygienist is authorized to practice under the 18
general supervision of a licensed dentist in accordance with this subsection shall ensure 19
that: 20 2 SENATE BILL 306
(vi) A dental hygienist consults with the supervising dentist, OR the 1
patient’s dentist, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, 2
OR LICENSED CERTIFIE D MIDWIFE, or a AND THE treating physician, REGISTERED 3
NURSE PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D 4
MIDWIFE before proceeding with treatment if there is a change in the patient’s medical 5
history CONDITION; 6
(m) (1) (i) In this subsection the following words have the meanings 7
indicated. 8
(ii) “Assisted living program” has the meaning stated in § 19–1801 9
of the Health – General Article. 10
(III) “CLINICAL OFFICE ” MEANS AN OFFICE OF A LICENSED 11
PHYSICIAN, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, OR 12
LICENSED CERTIFIED M IDWIFE WHO PROVIDES PRENATAL, POSTPARTUM , OR 13
PRIMARY CARE AND IN WHICH THE SUPERVISING DENTIST AND DENTAL HYGIENIST 14
COMMUNICATE WITH THE LICENSED PHYSICIAN , CERTIFIED REGISTERED NURSE 15
PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D MIDWIFE IN 16
PROVIDING DENTAL HYG IENE SERVICES TO A P ATIENT. 17
[(iii)] (IV) “Facility” means: 18
1. A nursing home; 19
2. An assisted living program; 20
3. [Medical] CLINICAL offices; or 21
4. A group home or adult day care center. 22
[(iv)] (V) “General supervision” means supervision of a dental 23
hygienist by a dentist, where the dentist may or may not be present when the dental 24
hygienist performs the dental hygiene procedures. 25
[(v)] (VI) “Group home or adult day care center” means a group 26
home or adult day care center where the patient’s medical records are made available to 27
the dentist and the dental hygienist and that obtains the consent of the patient or the 28
patient’s guardian for dental hygiene services to be provided under this subsection. 29
[(vi) “Medical office” means an office of a licensed physician who 30
provides prenatal or primary medical care and in which the physician, supervising dentist, 31
and dental hygienist communicate in providing dental hygiene services to a patient.] 32
SENATE BILL 306 3
(vii) “Nursing home” has the meaning stated in § 19–1401 of the 1
Health – General Article. 2
(5) A dental hygienist practicing under the general supervision of a 3
licensed dentist in a facility and performing an authorized dental hygiene service for a 4
patient’s initial appointment shall: 5
(i) Ensure that, while the dental hygienist is performing the service, 6
the supervising dentist is available for consultation with the dental hygienist: 7
1. In person; 8
2. By telephone; or 9
3. Electronically; 10
(ii) Consult with the supervising dentist or a AND THE treating 11
physician OR THE PATIENT’S, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE 12
MIDWIFE, OR LICENSED CERTIFIE D MIDWIFE before proceeding with initial treatment 13
if there is a change in or concerns about a patient’s medical history CONDITION; 14
(iii) Assess the appropriate recall interval based on the needs of the 15
patient, or as otherwise recommended by the supervising dentist; 16
(iv) Limit dental hygiene tasks and procedures provided during the 17
initial appointment to: 18
1. Toothbrush prophylaxis; 19
2. Application of fluoride; 20
3. Dental hygiene instruction; 21
4. Full mouth debridement; 22
5. Assessing the patient’s apparent need for further 23
evaluation by a dentist in order to diagnose the presence of dental disease; and 24
6. Other duties as may be delegated, verbally or in writing, 25
by the supervising dentist; and 26
(v) Submit findings of the initial assessment to the supervising 27
dentist for a collaborative determination of future treatment based on the patient’s overall 28
health status. 29
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 30
October 1, 2022. 31