LAWRENCE J. HOGAN, JR., Governor Ch. 678
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Chapter 678
(Senate Bill 306)
AN ACT concerning
Dental Hygienists – Consultation Requirements – Health Care Practitioners
FOR the purpose of altering the types of health care practitioners with whom a dental
hygienist must consult before providing certain treatment to a dental patient to
include a patient’s registered nurse practitioner, certified nurse midwife, or licensed
certified midwife; requiring that certain consultations by a dental hygienist be made
if there is a change in the patient’s medical condition; and generally relating to
dental hygienists and the provision of dental services.
BY repealing and reenacting, with amendments,
Article – Health Occupations
Section 4–308(k)(4)(vi) and (m)(1) and (5)
Annotated Code of Maryland
(2021 Replacement Volume)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health Occupations
4–308.
(k) (4) A facility in which a dental hygienist is authorized to practice under the
general supervision of a licensed dentist in accordance with this subsection shall ensure
that:
(vi) A dental hygienist consults with the supervising dentist, OR the
patient’s dentist, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE,
OR LICENSED CERTIFIE D MIDWIFE, or a AND THE treating physician, REGISTERED
NURSE PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D
MIDWIFE before proceeding with treatment if there is a change in the patient’s medical
history CONDITION;
(m) (1) (i) In this subsection the following words have the meanings
indicated.
(ii) “Assisted living program” has the meaning stated in § 19–1801
of the Health – General Article.
Ch. 678 2022 LAWS OF MARYLAND
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(III) “CLINICAL OFFICE ” MEANS AN OFFICE OF A LICENSED
PHYSICIAN, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE MIDW IFE, OR
LICENSED CERTIFIED M IDWIFE WHO PROVIDES PRENATAL, POSTPARTUM , OR
PRIMARY CARE AND IN WHICH THE SUPERVISING DENTIST AND DENTAL HYGIENIST
COMMUNICATE WITH THE LICENSED PHYSICIAN , CERTIFIED REGISTERED NURSE
PRACTITIONER , CERTIFIED NURSE MIDW IFE, OR LICENSED CERTIFIE D MIDWIFE IN
PROVIDING DENTAL HYG IENE SERVICES TO A P ATIENT.
[(iii)] (IV) “Facility” means:
1. A nursing home;
2. An assisted living program;
3. [Medical] CLINICAL offices; or
4. A group home or adult day care center.
[(iv)] (V) “General supervision” means supervision of a dental
hygienist by a dentist, where the dentist may or may not be present when the dental
hygienist performs the dental hygiene procedures.
[(v)] (VI) “Group home or adult day care center” means a group
home or adult day care center where the patient’s medical records are made available to
the dentist and the dental hygienist and that obtains the consent of the patient or the
patient’s guardian for dental hygiene services to be provided under this subsection.
[(vi) “Medical office” means an office of a licensed physician who
provides prenatal or primary medical care and in which the physician, supervising dentist,
and dental hygienist communicate in providing dental hygiene services to a patient.]
(vii) “Nursing home” has the meaning stated in § 19–1401 of the
Health – General Article.
(5) A dental hygienist practicing under the general supervision of a
licensed dentist in a facility and performing an authorized dental hygiene service for a
patient’s initial appointment shall:
(i) Ensure that, while the dental hygienist is performing the service,
the supervising dentist is available for consultation with the dental hygienist:
1. In person;
2. By telephone; or
LAWRENCE J. HOGAN, JR., Governor Ch. 678
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3. Electronically;
(ii) Consult with the supervising dentist or a AND THE treating
physician OR THE PATIENT’S, REGISTERED NURSE PRA CTITIONER, CERTIFIED NURSE
MIDWIFE, OR LICENSED CERTIFIE D MIDWIFE before proceeding with initial treatment
if there is a change in or concerns about a patient’s medical history CONDITION;
(iii) Assess the appropriate recall interval based on the needs of the
patient, or as otherwise recommended by the supervising dentist;
(iv) Limit dental hygiene tasks and procedures provided during the
initial appointment to:
1. Toothbrush prophylaxis;
2. Application of fluoride;
3. Dental hygiene instruction;
4. Full mouth debridement;
5. Assessing the patient’s apparent need for further
evaluation by a dentist in order to diagnose the presence of dental disease; and
6. Other duties as may be delegated, verbally or in writing,
by the supervising dentist; and
(v) Submit findings of the initial assessment to the supervising
dentist for a collaborative determination of future treatment based on the patient’s overall
health status.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2022.
Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.