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SENATE FLOOR VERSION
February 23, 2023
COMMITTEE SUBSTITUTE
FOR
SENATE BILL NO. 754 By: Paxton
An Act relating to the practice of dentistry;
amending 59 O.S. 2021, Section 328.3 , which relates
to definitions used in the S tate Dental Act;
modifying and adding definitions; amending 59 O.S.
2021, Section 328.21, as amended by Section 3,
Chapter 158, O.S.L. 2022 (59 O.S. Supp. 2022, Section
328.21), which relates to a pplication for licen se;
modifying allowed time period, type, and criter ia of
examinations; adding available advanced proce dures
for dental hygienist; specifying qualifications and
procedures for obtainment of advanced procedure
permit by credentials; amen ding 59 O.S. 2021, Section
328.22, which relates to specialty license; modifying
certain terminology and qualifications related to
specialty license; amending 59 O.S. 2021, Section
328.24, which relates to d ental assistant permits ;
adding expanded duty permits available to dental
assistants; broadening permitting provisions to apply
to oral maxillofacial surgery assistants; providing
for addition of expanded duties to licenses; amending
59 O.S. 2021, Section 328.32, as amended by Section
6, Chapter 158, O.S.L. 2022 (59 O.S. Supp. 2022,
Section 328.32), which relates to grounds for
penalties; modifying grounds for penalties; amending
59 O.S. 2021, Section 328.34 , which relates to
practice of dental hygiene under supervision of
dentist; requiring certain supervision for advanced
procedures; deleting certain definition; adding
references; modifying rulemaking authority of Board
of Dentistry for advanced procedures; authorizing
licensed dentist to allow tele dentistry treatment by
certain dental hygienists for patients in certain
long-term care settings; providing for application
for elder care and public health advanced procedure
permit; allowing treatment of patients by dental
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hygienist upon receipt of permit; requiring certain
documentation, recording, and maintenance of
recording by dental hygienist; requiring completion
of certain assessment; requiring supervising dentist
to maintain certain records; allowing certain dental
assistants to apply for public health and elder care
expanded duty permit; authorizing dental assistant
with permit to assist hygienist with treatment in
certain facilities; requiring patient records to list
dental assistant; updating statutory language;
providing for codification; providing an effective
date; and declaring an emergency.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 59 O.S. 202 1, Section 328.3, is
amended to read as follows:
Section 328.3. As used in the State Dental Act, the follow ing
words, phrases, or terms, unless the context otherwis e indicates,
shall have the follo wing meanings:
1. “Accredited dental college” means an institution whose
dental educational pro gram is accredited by the Commission on Dental
Accreditation of the Am erican Dental Association;
2. “Accredited dental hygie ne program” means a dental hygiene
educational program which is accredited by the Commission on Dental
Accreditation of the America n Dental Association;
3. “Accredited dental assisting program ” means a dental
assisting program which is accredited by the Commission on Dental
Accreditation of the American Dental Association;
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4. “Advanced procedure” means a dental procedure for which a
dental hygienist has received special training in a course of study
approved by the Board ;
5. “Board” means the Board of Dentistry;
5. 6. “Certified dental assistant” means a dental assistant who
has earned and maintains current certified dental assistant
certification from the Dental Assisting National Board (D ANB);
6. 7. “Coronal polishing” means a procedure limited to the
removal of plaque and stain from exposed tooth surfaces, utilizing a
slow speed hand piece with a prophy/polishing cup or brush and
polishing agent and is not prophylaxis. To be considered
prophylaxis, examination for calculus and scaling must be done by a
hygienist or dentist;
7. 8. “Deep sedation” means a drug-induced depression of
consciousness during which patients cannot be easily aro used but
respond purposefully following repeated or painfu l stimulation. The
ability to independently maintain ventilator fu nction may be
impaired. Patients may require assistance in maintaining a patent
airway, and spontaneous ventilation may be inadequ ate.
Cardiovascular function is usually maintained;
8. 9. “Dentistry” means the practice of dentistry in all of its
branches;
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9. 10. “Dentist” means a graduate of an accredited dental
college who has been issued a license by the Board to practice
dentistry as defined in Section 328.19 of this title;
10. 11. “Dental ambulatory surgical center (DASC) ” means a
facility that operates exclusively for the pur pose of furnishing
outpatient surgical services to patients. A DASC shall have the
same privileges and requirements as a dental office and additionally
must be an accredited facility by the appropriate entity;
11. 12. “Dental office” means an establishme nt owned and
operated by a dentist for the practice of dentistry, which may be
composed of reception r ooms, business offices, private offices,
laboratories, and den tal operating rooms where dental operations are
performed;
12. 13. “Dental hygiene” means the science and practice of the
promotion of oral health and prevention and treatment of oral
disease through the provision of educational, therapeutic, clinical ,
and preventive services ;
14. “Dental hygienist” means an individual who has fulfilled
the educational requirements and is a graduate of an accredited
dental hygiene program and who has pa ssed an examination and has
been issued a license by the Board and who is authorized to practice
dental hygiene as hereinafter define d;
13. 15. “Dental assistant or oral maxillofacial surgery
assistant” “Dental assistant” or “oral maxillofacial surgery
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assistant” means an individual working for a dentist, under the
dentist’s direct supervision or direct visual su pervision, and
performing duties in the dental office or a treatmen t facility
including the limited treatment of patients in accordance with the
provisions of the State Dental Act. A dental assistant or oral
maxillofacial surgery assistant may assist a d entist with the
patient; provided, this shall be done only under the direct
supervision or direct visual supervision and control of the dentist
and only in accordance with the educational requirements and rules
promulgated by the Board;
14. 16. “Dental laboratory” means a location, whether in a
dental office or not, where a dentist or a dental laboratory
technician performs dental laboratory technology;
15. 17. “Dental laboratory technician ” means an individual
whose name is duly filed in the official records of the Board, which
authorizes the technician, upon the laborat ory prescription of a
dentist, to perform dental laboratory technology, which services
must be rendered only to the prescribing dentist and not to t he
public;
16. 18. “Dental laboratory technology ” means using materials
and mechanical devices for the cons truction, reproduction or repair
of dental restorations, appliances or other devices to be worn in a
human mouth;
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17. 19. “Dental specialty” means a specialized practice of a
branch of dentistry, recogni zed by the Board, where the dental
college and specialty program are accredited by the Commissio n on
Dental Accreditation (CODA), or a dental specialty recognized by the
Board, requiring a minimum num ber of hours of approved education and
training and/or recognition by a nationally recognized association
or accreditation board;
18. 20. “Direct supervision” means the supervisory dentist is
in the dental office or treatment facility and, during the
appointment, personally examines the patient, diagnoses any
conditions to be treated, and authorizes the procedu res to be
performed by a dental hygienist, den tal assistant, or oral
maxillofacial surgery assistant. The supervising dentist is
continuously on-site and physically present in the dental office or
treatment facility while the procedures are being performe d and,
before dismissal of the patient, evalua tes the results of the dental
treatment;
19. 21. “Direct visual supervision ” means the supervisory
dentist has direct ongoing visual oversight which shall be
maintained at all times during any procedure author ized to be
performed by a dental assistant or an oral maxillofacial surgery
assistant;
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20. 22. “Expanded duty” means a dental procedure for which a
dental assistant has received special training in a course of study
approved by the Board ;
23. “Fellowship” means a program designed for post-residency
graduates to gain knowledge and experience in a specialized field;
21. 24. “General anesthesia” means a drug-induced loss of
consciousness during which patients a re not arousable, even b y
painful stimulation. The ability to independently maintain
ventilator function is often impaired. Patients often require
assistance in maintaining a patent airway, and positive pressure
ventilation may be required because of dep ressed spontaneous
ventilation or drug-induced depression of neuromuscular function.
Cardiovascular function may be impaired;
22. 25. “General supervision” means the supervisory dentist has
diagnosed any conditions to be treated within the past thirteen ( 13)
months, has personally authorized the procedures to be performed by
a dental hygienist, and will evaluate the results of the dental
treatment within a reasonab le time as determined by the na ture of
the procedures performed, the needs of the patient, an d the
professional judgment of the supervisory dentist. General
supervision may only be use d to supervise a hygienist and may not be
used to supervise an oral max illofacial surgery assistant or dental
assistant except as provided by Section 7 of this act;
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23. 26. “Indirect supervision ” means the supervisory dentist is
in the dental office or treatment facility and has personally
diagnosed any conditions to be treated, authorizes the procedures to
be performed by a dental hygienist, remains in the dental o ffice or
treatment facility while the procedur es are being performed, and
will evaluate the results of the dental treatment within a
reasonable time as determined by the nature of the procedures
performed, the needs of the patient, and the professional jud gment
of the supervisory dentist. Indirect su pervision may not be used
for an oral maxillofacial surgery assistant or a dental assistant;
24. 27. “Investigations” means an investigation procee ding,
authorized under Sections 328.15A and 328.43a of this ti tle, to
investigate alleged violations of the State Dental Act or the rules
of the Board;
25. 28. “Laboratory prescription” means a written description,
dated and signed by a dentist, of dental laboratory technology to be
performed by a dental laboratory technician;
26. 29. “Minimal sedation” means a minimally depressed level of
consciousness, produced by a pharmacological method, that retains
the patient’s ability to independently and continuou sly maintain an
airway and respond normally to tactile stimul ation and verbal
command. Although cognitive function and coordination may be
modestly impaired, ventilator and cardiovascular functions are
unaffected;
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27. 30. “Mobile dental anesthesia provid er” means a licensed
and anesthesia-permitted dentist, physi cian or certified registered
nurse anesthetist Certified Registered Nurse Anesthetist (CRNA) that
has a mobile dental unit and prov ides anesthesia in dental offices
and facilities in the state;
28. 31. “Mobile dental clinic” means a permitted motor vehicle
or trailer utilized as a dental clini c, and/or that contains dental
equipment and is used to provide dental s ervices to patients on-site
and shall not include a mobile dental anesthesia provider. A mobile
dental clinic shall also mean and include a volunteer mobile dental
facility that is directly affiliated with a church or religious
organization as defined by Section 501(c)(3) or 501(d) of the United
States Internal Revenue Code, the church or religious org anization
with which it is affiliated is clearly indicated on the exterior of
the mobile dental facility, and such facility does not receive any
form of payment either directly or indirectly for work provided to
patients other than donations through the af filiated church or
religious organization; provided, that the volunteer mobile dental
facility shall be exempt from any registration fee required under
the State Dental Act;
29. 32. “Moderate sedation” means a drug-induced depression of
consciousness during which patients respond purposefully to verbal
commands, either alone or accompanied by light tactile stimulation.
No interventions are required to maintain a patent airway, and
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spontaneous ventilation is adequate. Cardiovascular function is
usually maintained;
30. 33. “Prophylaxis” means the removal of any and all
calcareous deposits, stains, accretions or concretions from the
supragingival and subgingival surfa ces of human teeth, utilizing
instrumentation by scaler or periodontal curette on the crown and
root surfaces of human teeth including rotary or power-driven
instruments. This procedure may only be performed by a dentist or
dental hygienist;
31. 34. “Patient” or “patient of record” means an individual
who has given a medical history and has been examin ed and accepted
by a dentist for dental care;
32. 35. “Residencies” are programs designed for advanced
clinical and didactic training in general dentistry or other
specialties or other specialists at the post-doctoral level
recognized by the Commission on De ntal Accreditation (CODA) or the
Board;
33. 36. “Supervision” means direct supervision, direct visual
supervision, indirect supervision or general supervision;
34. 37. “Teledentistry” means the remote delivery of dental
patient care via telecommunications and other technology for the
exchange of clinical information and i mages for dental consultation,
preliminary treatment planning and patient monitoring; and
35. 38. “Treatment facility” means:
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a. a federal, tribal, state or local public health
facility,
b. a Federally Qualified Health Center (FQHC),
c. a private health facil ity,
d. a group home or residential care facility servin g the
elderly, handicapped or juveniles,
e. a hospital or dental ambulatory surgery center (DASC),
f. a nursing home,
g. a penal institution operated by or under contract with
the federal or state gov ernment,
h. a public or private school,
i. a patient of record’s private residence,
j. a mobile dental clinic,
k. a dental college, dental program, dental hygiene
program or dental assisting program accredited by the
Commission on Dental Accreditation, or
l. such other places as are authorized by the Board.
SECTION 2. AMENDATORY 59 O.S. 2021, Section 328.21, as
amended by Section 3, Chapter 158, O.S.L. 2022 (59 O.S. Supp. 2022,
Section 328.21), is amended to read as follows:
Section 328.21. A. No person shall practice dentistry or
dental hygiene without first applying for and obtaining a license
from the Board of Dentistry.
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B. Application shall be made to the Board in writing and shall
be accompanied by the fee established by the rules of the Board,
together with satisfactory proof that the applicant:
1. Is of good moral character;
2. Is twenty-one (21) years of age, or over, at the time of
making application to practice dentistry or eighteen (18) years of
age, or over, if the applicant is to practice dental hygiene;
3. Has passed a written theoretical examination and a clinical
examination approved by the Board within the previous five (5)
years; and
4. Has passed a written jurisprudence examination over the
rules and laws affecting dentistry in this state.
C. An application from a candidate who desires to secure a
license from the Board to practice dentistry or dental hygiene in
this state shall be accompanie d by satisfactory proof that the
applicant:
1. Is a graduate of an accredited dental college, if the
applicant is to practic e dentistry;
2. Is a graduate of an accredited dental hygiene program, if
the applicant is to pract ice dental hygiene; and
3. Has passed all portions of the National Board Dental
Examination or the National Board Dental Hygiene Examination.
D. Pursuant to Section 328.15 of this title, the Board may
affiliate as a member state, and accept regional ex ams from the
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Commission on Dental Competency Assessments (CDCA) or the Western
Regional Examining Board (WREB) (CDCA-WREB-CITA) if the following
requirements are included:
1. For dental licensing the following components on a live
patient or manikin:
a. a fixed prosthetic component of th e preparation of an
anterior all porcelain crown and the preparation of a
three-unit posterior bridge,
b. a periodontal component on a live patient or manikin,
c. an endodontic component,
d. an anterior class III and posterior class II
restorative componen t on a live patient or manikin,
e. a diagnosis and treatment planning section as approved
by the Board, as specif ied in Section 328.15 of this
title, and
f. the Board may determine equivalencies based on
components of other exams for the purpose of
credentialing; or
2. For dental hygienists licensing the following components on
a live patient or manikin:
a. clinical patient treatments with an evaluation of
specific clinical skills, and
b. evaluation of the candidate’s compliance with
professional standards during the treatment as
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approved by the Board in Section 328.15 of this title
and shall include:
(1) extra/intra oral assessment,
(2) periodontal probing, and
(3) scaling/subgingival calculus rem oval and
supragingival deposit removal.
E. When the applica nt and the accompanying proof are found
satisfactory, the Boa rd shall notify the applicant to appear for the
jurisprudence examination at the t ime and place to be fixed by the
Board. A dental stu dent or a dental hygiene student in the
student’s last semester of a dental or dental hygiene program,
having met all other requirements, may make application and take the
jurisprudence examination with a letter from the dean of the dental
school or director of th e hygiene program stating that the applicant
is a candidate for graduation within the next six (6) months.
F. The Board shall require every applicant for a license to
practice dentistry or dental hygiene to submit, for the files of the
Board, a copy of a dental degree or dental hygiene degree, an
official transcript, a recent photograph duly identified and
attested, and any other information as required by the Board.
G. Any applicant who fails to pass the jurisprudence
examination may apply for a second e xamination, in which case the
applicant shall pay a reexamination fee as established by the
statutes or rules of the State Dental Act.
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H. A dentist or dental hygienist currently licensed in another
state having met the qualifications in paragraphs 1 through 3 of
subsections B and C of this section may appl y for a license by
credentials upon meeting the following:
1. A dentist holding a general dentist license in good standing
and having practiced for at least five hundred (500) hours within
the previous five (5) years immediately prior to application and
having passed a regional examination substantially equivalent to the
requirements for this state may apply for licensur e by credentials;
2. A dental hygienist holding a dental hygiene license in good
standing and having practiced for at least four hundred twenty (420)
hours within the previous five (5) years immediately prior to
application and having passed a regional ex amination substantially
equivalent to the requirements for this state may apply for
licensure by credentials. Applicants for credentialin g must
include:
a. a letter of good standing from all states in which the
applicant has ever been licensed, and
b. any other requirements as set forth by the rules; and
3. An applicant applying for a dental or dental hygiene license
by credentials shall o nly be required to pass the jurisprudence
portion of the examination requirements as set forth in paragraph 4
of subsection B of this section; or
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4. A dental hygienist applying for credentialing for advanced
procedures by providing proof of passage of the advanced procedure
in a CDCA, WREB or CRDTS exam.
I. 1. There shall be two six types of advanced procedure
procedures available for dental hygienists upon completion of a
Commission on Dental Accreditation (CODA) approved program or,
course, or certification program that has been approved by the
Board:
1. Administration
a. administration of nitrous oxide; and,
2. Administration
b. administration of local anesthesia,
c. neuromodulator administration,
d. therapeutic use of lasers,
e. phlebotomy and venipuncture, and
f. elder care and public health pursuant to Section 7 of
this act.
2. A dental hygienist holding an advanced procedure permit or
credential in any other state for two (2) years shall be eligible
for the advanced procedure permit by credentials; provided, that
application for the advanced procedure permit by credentials for
administration of local anesthesia shall additionally require proof
of passage of such advanced procedure in a CDCA-WREB-CITA exam.
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3. For all advanced proce dures other than administration of
local anesthesia, a dental hygienist may apply b y filling out an
application with required documentation of train ing as required by
state law and rules of the Board.
4. All advanced procedures shall be added to the dental hygiene
license upon approval.
J. All licensees and permit holders shall display the current
permit or license in a visible place within the dental off ice or
treatment facility.
K. The Board shall have the authority to temporaril y change
requirements of an examination due to availability or changes in the
examination format, not to exceed one (1) year.
L. During a year in which governmental officials h ave declared
a health pandemic, a state or federal disaster, or other natural or
man-made disaster, the Board shall have the authority through a
resolution to change or ma ke allowances in requirements of all
candidates for licensure and issue temporary lic enses for extended
periods of time or as needed until the event passes. The r esolution
shall have a beginning and an end date and shall automatically
expire no less than thirty (30) days after the end of the disaster
is declared by governmental officials.
M. Every licensee or permit holder shall have an official
address and email address listed with the Board. Ever y licensee or
permit holder shall update the address with in thirty (30) calendar
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days of moving. Official notification of any action of the Board
adverse to a licensee or permit holder including but not limited to
notification of license or permit cancellation due to nonrenewal,
notice of a formal complaint, or a decision of the hearing panel or
board, shall be served to the license e or permit holder by
registered mail at the official address, in person, to the
licensee’s or permit holder’s attorney, by agreement of the
individual, by a process server, or by an Investigator investigator
of the Board pursuant to Section 2004 of Titl e 12 of the Oklahoma
Statutes.
SECTION 3. AMENDATORY 59 O.S. 2021, Section 328.22, is
amended to read as follows:
Section 328.22. A. 1. The Board of Dentistry may issue a
dental specialty license authorizing a dentist to represent himself
or herself to the public as a specia list, and to practice as a
specialist, in a dental specialty.
2. No dentist shall represent himself or herself t o the public
as a specialist or practice as a specialist as listed in this
paragraph, unless the individual:
a. has successfully completed an advanced dental
specialty educational program accredited by the
Commission on Dental Accreditation, or has met the
Board Certification board certification requirements
and is recognized as a current board certified member
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of a dental specialty organization or association
recognized by the National Commission on Recognition
of Dental Specialties and Certifying Boards ,
b. has passed the jurispruden ce examination covering the
State Dental Act, rules and state laws, and
c. has completed any additional requiremen ts set forth in
state law or rules and has been issued a dental
specialty license by the Board.
3. Specialty licenses recognized by the Board shall include:
a. dental public health,
b. endodontics,
c. oral and maxillofacial surgery,
d. oral and maxillofacial radiology,
e. orthodontics and dentofacial orthopedics,
f. pediatric dentistry,
g. periodontics,
h. prosthodontics,
i. oral and maxillofacial pathology,
j. dental anesthesiology,
k. oral medicine, and
l. orofacial pain.
B. 1. At the time of applicat ion, if the dentist has ever been
licensed in any other st ate, he or she shall provide a letter of
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good standing from such state before the Board may issue a sp ecialty
license.
2. In conducting an investigation of an applicant who has
applied for a dental specialty license pursuant to this subsection,
the Board shall require of the applicant disclosure of the same
background information as is required of an appl icant for a license
to practice dentistry in this state.
C. Any person holding an Oklahoma spec ialty license that does
not have an Oklahoma general den tistry license shall be limited to
practicing that special ty for which they hold a license.
D. The Board may use the American Dental Association National
Commission on Recognition of Dental Special ties and Certifying
Boards guidelines or the guidelines o f another nationally rec ognized
dental association or board for the purpose of defining a specialty
practice area not otherwise defined herein.
SECTION 4. AMENDATORY 59 O.S. 20 21, Section 328.24, is
amended to read as follows:
Section 328.24. A. No person shall practice as a dental
assistant or oral maxillofacial surgery assistant for more than one
(1) day in a calendar year without having applied for a permit as a
dental assistant or oral maxillofacial surgery assistant from the
Board of Dentistry within thirty (30) days of beginning empl oyment.
During this time period, the dental assistant shall work under the
direct visual supervision of a dentist at all times.
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B. The application shall be made to the Board in writing and
shall be accompanied by the fee established by the Board, togethe r
with satisfactory proof that the applicant passes a background check
with criteria established by the Board.
C. Beginning January 1, 2020, every dental assistant receiving
a permit shall complete a class on infe ction control as approved by
the Board within one (1) year from the date of receipt of the
permit. Any person holding a valid dental assistant permit prior to
January 1, 2020, shall complete an infection-control class as
approved by the Board before Decem ber 31, 2020. Failure to complete
the class shall be grounds for discipline pursuant to Section
328.29a of this title.
D. There shall be five seven types of expanded duty permits
available for dental assistants or oral maxillofacial surgery
assistants upon completion of a program approved by the Commission
on Dental Accreditation (CODA) o r a course that has been approved by
the Board:
1. Radiation safety;
2. Coronal polishing and t opical fluoride;
3. Sealants;
4. Assisting in the administration of nit rous oxide; or
5. Phlebotomy and venipuncture;
6. Elder care and public health; or
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7. Assisting a dentist who holds a parenteral or pediatric
anesthesia permit; provided, only the dentist may administer
anesthesia and assess the patient’s level of sedation.
All expanded duties shall be added to the dental assistant
license or oral maxillofacial surgery assistant license upon
approval.
E. The training requirements for all five expanded duty permits
shall be set forth by the Board. A program that is not CODA-
certified must meet the standards set forth and be approved by the
Board.
F. An applicant for a dental assistant permit who has graduated
from a dental assisting program ac credited by CODA and has passed
the jurisprudence test shall receive all five expanded duty permits
provided for in subs ection D of this section if the course mater ials
approved by the Board are covered in the program.
G. A dental assistant who holds an o ut-of-state dental
assistant permit with expanded duties may apply for credent ialing
and reciprocity for a dental assist ant permit including any expanded
duty by demonstrating the following:
1. The dental assistant has had a valid dental assistant permit
in another state for a minimum of two (2) years and is in good
standing;
2. The dental assistant has had a valid expand ed duty in
another state for a minimum of on e (1) year; and
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3. The dental assistant provides a certificate or proof of
completion of an educational class for the expanded duty and that
the dental assistant has bee n providing this treatment to dental
patients while working as a dental assistant in a dental office for
one (1) year.
H. Any person having served in the military as a dental
assistant shall receive credentialing and reciprocity for expanded
functions by demonstrating the following:
1. Proof of military service in excess of two (2) years with
any certifications or training in the expanded function areas; and
2. Verification fro m the commanding officer of the medical
program or the appropriate supervisor stating that the dental
assistant provided the expanded functions on patients in the
military dental facility for a minimum of one (1) year within the
past five (5) years.
SECTION 5. AMENDATORY 59 O.S. 2021, Section 328.32, as
amended by Section 6, Chapter 158, O.S.L. 202 2 (59 O.S. Supp. 2022,
Section 328.32), is amended to read as follows:
Section 328.32. A. The following acts or occurrences by a
dentist shall constitute grounds for which the penalties specified
in Section 328.44a of this title may be i mposed by order of the
Board of Dentistry or be the basi s for denying a new applicant any
license or permit issued by the Board:
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1. Pleading guilty or nolo contendere to, or being convicted
of, a felony, a misdemeanor inv olving moral turpitude, any crime in
which an individual would be required to be a registe red sex
offender under state law, any violent crime, Medicaid fraud,
insurance fraud, identity theft, embezzlement or a violation of
federal or state controlled dangerous substances laws;
2. Presenting to the B oard a false diploma, license, or
certificate, or one obtained by fraud or illegal means, or providing
other false information on an application or renewal;
3. Being, by reason of persistent inebriety or addiction to
drugs, incompetent to continue the pra ctice of dentistry;
4. Publishing a false, fraudulent, or misleading advertisement
or statement;
5. Authorizing or aiding an unlicensed person to practice
dentistry, to practice dental hygiene or to perform a function for
which a permit from the Board is required;
6. Authorizing or aiding a dent al hygienist to perform any
procedure prohibited by the State Dental Act or the rules of the
Board;
7. Authorizing or aiding a dental assistant or oral
maxillofacial surgery assistant to perform any procedure pro hibited
by the State Dental Act or the rule s of the Board;
8. Failing to pay fees as required by the State Dental Act or
the rules of the Board;
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9. Failing to complete continuing education requireme nts;
10. Representing himself or herself to the public as a
specialist in a dental specialty witho ut holding a dental specialty
license therefor as listed in Section 328.22 of thi s title;
11. Representing himself or herself to the public as a
specialist whose practice is li mited to a dental sp ecialty, when
such representation is false, fraudulent, or mis leading Practicing
below the basic standard of care of a patient which an ordinary
prudent dentist with similar training and experience within the
local area would have p rovided including, but not limited to,
failing to complete proper training and demonstrate proficiency for
any procedure delegated to a dental hygienist or dental assistant ;
12. Endangering the health of patients by reason of having a
highly communicable disease a nd continuing to practice dentistry
without taking appropriate safeguards;
13. Practicing dentistry in an unsafe or unsanitary manner or
place including but not limited to repeated failures to follow
Centers for Disease Control and Prevention (CDC) or Occ upational
Safety and Health Administration (OSHA) guidelines;
14. Being shown to be mentally unsound;
15. Being shown to be grossly immoral and that such condition
represents a threat to patient care or treatment;
16. Being incompetent to practice denti stry while delivering
care to a patient;
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17. Committing gross negl igence in the practice of dentistry;
18. Committing repeated acts of negligence in the practice of
dentistry;
19. Offering to effect or effecting a division of fees, or
agreeing to split or divide a fee for dental services with any
person, in exchange fo r the person bringing or referring a patient;
20. Being involuntarily committed to an i nstitution for
treatment for substance abuse, until recovery or remission;
21. Using or attempting t o use the services of a dental
laboratory or dental laboratory tech nician without issuing a
laboratory prescription, except as provided in subsection C of
Section 328.36 of this title;
22. Aiding, abetting, or encouraging a dental hygi enist
employed by the dentist to make use of an oral prophylaxis list, or
the calling by telephone or by use of letters transmitted through
the mail to solicit patronage from patients formerly served in the
office of any dentist formerly employing such hyg ienist;
23. Having more than the equivalent of three full-time dental
hygienists for each dentist actively practicing in the same dental
office;
24. Allowing a person not holding a permit or license issued by
the Board to assist in the treatment of a pat ient without having a
license or permit issued by the Board;
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25. Knowingly patronizing or using the services of a dental
laboratory or dental laboratory technician who has not complied with
the provisions of the State Dental Act and the rules of the Board ;
26. Authorizing or aiding a dental hygienist, dental assistant,
oral maxillofacial s urgery assistant, dental laboratory technician,
or holder of a permit to operate a dental laboratory to violate any
provision of the State Dental Act or the rules of the Board;
27. Willfully disclosing information protected by the Health
Information Portability and Accountability Act, P.L. 104-191;
28. Writing a false, unnecessary, or excessive prescription for
any drug or narcotic which is a controlled dangerous substa nce under
either federal or state law, or prescribing, dispensing or
administering opioid drugs in excess of the maximum limits
authorized in Section 2 -309I of Title 63 of the Oklahoma Statutes;
29. Prescribing or administering any drug or treatment witho ut
having established a valid dentist-patient relationship;
30. Using or administering nitrous oxide gas in a dental office
in an inappropriate or unauthorized manner;
31. Engaging in nonconsensual physical contact with a patient
which is sexual in natur e, or engaging in a verbal communication
which is intended to be sexually demeaning to a patient;
32. Practicing dentistry without displaying, at the dentist ’s
primary place of practice, the license issued to the dentist by the
Board to practice dentistry and the current renewal certificate;
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33. Being dishonest in a material way with a pat ient or during
the practice of dentistry;
34. Failing to retain all patient records for at least seven
(7) years from the date of the last treatment as provided by Section
328.31b of this title, except that the failure to retain records
shall not be a violation of the State Dental Act if the dentist
shows that the records were lost, destroyed , or removed by anothe r,
without the consent of the dentist;
35. Failing to retain the dentist’s copy of any laboratory
prescription for at least seven (7) years, except that the failure
to retain records shall not be a violation of the State Dental Act
if the dentist shows that the records were lost, destroyed, or
removed by another, without the consen t of the dentist;
36. Allowing any corporation, organization, group, person, or
other legal entity, except another dentist or a professional entity
that is in compliance with the registration requirements of
subsection B of Section 328.31 of this title, t o direct, control, or
interfere with the dentist’s clinical judgment. Clinical judgment
shall include, but not be limited to, such matters as selection of a
course of treatment, control of patient records, policies and
decisions relating to pricing, credi t, refunds, warranties and
advertising, and decisions relating to o ffice personnel and hours of
practice. Nothing in this paragraph shall be construed to:
a. limit a patient’s right of informed consent, or
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b. prohibit insurers, preferred provider organiza tions
and managed care plans from operating pursuant to the
applicable provisions of the Oklahoma Insurance Code
and the Oklahoma Public Health Code;
37. Violating the state dental act of another state resulting
in a plea of guilty or nolo contendere, conviction o r suspension or
revocation or other sanction by another state board , of the license
of the dentist under the laws of that state;
38. Violating or attemptin g to violate the provisions of the
State Dental Act or the rules of the Board, a state or federal
statute or rule relating to scheduled drugs, fraud, a violent crime
or any crime for which the penalty includes the requirement of
registration as a sex offen der in this state as a principal,
accessory or accomplice;
39. Failing to comply with the terms and conditions of an order
imposing suspension of a license or placeme nt on probation issued
pursuant to Section 328.44a of this title;
40. Failing to coopera te during an investig ation or providing
false information, verbally or in writing, to the Board, the Board’s
investigator or an agent of the Board;
41. Having multiple administrative or civil actions reported to
the National Practitioner Databank Data Bank;
42. Failing to complete an approved two-hour course on opioid
and scheduled drug prescribing within one (1) year of obtaining a
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license or a violation of a law related to controlled dangerous
substances including prescribing laws pursuant to Section 2 -309D of
Title 63 of the Oklahoma Statutes;
43. Falling below the basic standard of care of a lice nsed
dentist or dentist practicing in his or her specialty, a hygienist,
dental assistant, or other licensee or permit holder pursuant to the
State Dental Act and Section 20.1 of Title 76 of the Oklahoma
Statutes; or
44. Failing to provide patient records as provided by Sections
19 and 20 of Title 76 of the Oklahoma Statutes.
B. The provisions of the State Dental Act shall not be
construed to prohibit any dentist fr om displaying or otherwise
advertising that the dentist is also currently licensed, registered,
certified or otherwise credentialed pursuant to the laws of this
state or a nationally recognized credentialing board, if authorized
by the laws of the state o r credentialing board to display or
otherwise advertise as a licensed, registered, certified, or
credentialed dentist.
SECTION 6. AMENDATORY 59 O.S. 2021, Section 328.34, is
amended to read as follows:
Section 328.34. A. A dental hygienist may practice d ental
hygiene under the supervision of a dentist in a dental offic e or
treatment facility. A de ntist may employ not more than the
equivalent of three full-time dental hygienists for each dentist
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actively practicing in the same de ntal office. Employing th e
equivalent of three dental hygienists shall mean the employment or
any combination of full - or part-time dental hygienists not to
exceed one hundred twenty (120) hours per week per dentist.
B. 1. A dentist may delegate to a de ntal hygienist the
following procedures:
a. the duties and expanded duties authorized for de ntal
assistants by the State D ental Act or the rules of the
Board of Dentistry,
b. health history assessment pertaini ng to dental
hygiene,
c. dental hygiene examina tion and the charting of i ntra-
oral and extra-oral conditions, which include
periodontal charting, dental charting and cla ssifying
occlusion,
d. dental hygiene assess ment and treatment planning for
procedures authorized by the superv isory dentist,
e. prophylaxis, which means the re moval of any and all
calcareous deposits, stains, accretions, or
concretions from the supragingi val and subgingival
surfaces of human teeth, utilizing instrumentation by
scaler or periodontal curette on the crown and root
surfaces of human teeth, including rotary or power-
driven instruments. This paragraph shall not be
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construed to prohibit the use of a prophy/polishing
cup or brush on the cr owns of human teeth by a dental
assistant who holds a current expan ded duty permit for
Coronal Polishing/Topical Flu oride coronal polishing
and topical fluoride issued by the Board,
f. periodontal scaling and roo t planing,
g. dental hygiene nutritional and dietary evaluation,
h. placement of subgingival prescription drugs for
prevention and treatment of period ontal disease,
i. soft tissue curettage,
j. placement of temporary fillings,
k. removal of overhanging mar gins,
l. dental implant maintenance,
m. removal of periodontal packs,
n. polishing of amalgam restorations, and
o. other procedures authorized by the Board.
2. The procedures specified in subparagra phs b through o of
paragraph 1 of this subsection may be performed only by a dentist or
a dental hygienist.
3. Except as provided in subsections C and D of this section,
the procedures specified in paragrap h 1 of this subsection may be
performed by a dental hygienist only on a patient of record and only
under the supervision of a dentist. The advanced procedures of
administration of nitrous oxide , administration of local anesthesia ,
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neuromodulator administration, therapeutic use of lasers, and
phlebotomy and venipuncture shall be performed only under the direct
or indirect supervision of a dentist . The level of supervision,
whether direct, indirect , or general, for the advanced procedure of
elder care and public health pursuant to Section 7 of this act shall
be at the discretion of the super visory dentist. Authorization for
general supervision shall be limited to a maximum of thirteen (13)
months following an examination by the supervisory dentist of a
patient of record. For the purposes of this paragra ph, “patient of
record” means an individual who has given a medical history and has
been examined and accepted by a dentist for dental care .
C. 1. A dentist may authoriz e procedures to be performed by a
dental hygienist, without complying with the provis ions of paragraph
3 of subsection B of this section, if:
a. the dental hygienist has at least two (2) years years’
experience in the practice of dental hygiene,
b. the authorization to perform the procedures is in
writing and signed by the dentist, and
c. the procedures are performed during an initia l visit
to a person in a treatment facility, or pursuant to
Section 7 of this act.
2. The person upon whom the procedures are performed must be
referred to a dentist af ter completion of the procedures performed
pursuant to paragraph 1 of this subsection.
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3. A dental hygienist shall not perform a second set of
procedures on a person pursuant to this subsection until the person
has been examined and accepted for dental ca re by a dentist.
4. The treatment facility in wh ich any procedure is performed
by a dental hygienist pursuant to this subsection shall note eac h
such procedure in the medical records of the person upon whom the
procedure was performed and list the dentist that authorized the
hygienist to perform the pro cedures signed by the hygienist.
D. A treatment facility may employ dental hygienists whose
services shall be limited to the examination of teeth and the
teaching of dental hygiene or as otherwise authorize d by the Board.
E. The Board is authorized to :
1. Prescribe prescribe, by rule, the educational requirements
for advanced procedures that may be performed by a dental hygienist
who has satisfactorily completed a course of study regarding the
performance of such procedures upon receipt of the advanced
procedures designated on his or her license. The advance advanced
procedures shall include the administration of local anesthesia and,
the administration of nitrous oxide analgesia ;
2. Establish guidelines for courses of study necessary for a
dental hygienist to perform advanced procedures;
3. Issue authorization to perform advanced procedures to those
dental hygienists who meet the eligibility requirements; and
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4. Establish the level of supervision, wheth er direct, indirect
or general, under which the a dvanced procedures may be performed,
neuromodulator administration, therapeutic use of lasers, phlebotomy
and venipuncture, and elder care and public health pursuant to
Section 7 of this act .
F. A dental hygienist shall not own or op erate an independent
practice of dental hygiene.
G. Nothing in the State De ntal Act shall be construed to
prohibit a dentist from performing any of the procedures that may be
performed by a dental hygienist.
H. Nothing in the S tate Dental Act shall be co nstrued to allow
a dental assistant to work under the supervision of a denta l
hygienist while acting under direct, in direct or general
supervision, except as provided by Section 7 of this act.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 328.58 of Title 59, unless there
is created a duplication in numb ering, reads as follows:
A. A licensed dentist may allow a dental hygienist with a n
elder care advanced procedu re permit to treat patients unde r general
supervision by utilizing teledentistry on a patient in:
1. A nursing facility, specialized facility , or nursing care
component of a continuum of care facility licensed under or
otherwise subject to the Nursing Home Care Act, Section 1-1901 et
seq. of Title 63 of the Oklahoma Statutes;
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2. An assisted living center or continuum of care facility
licensed under the Continuum of Care and Assisted Living Act ,
Section 1-890.1 et seq. of Title 63 of the Oklahoma Statutes ;
3. A residential care home licensed under the Residential Care
Act, Section 1-819 et seq. of Title 63 of the Oklahoma Statutes;
4. An adult day care center or adult day care component of a
continuum of care facility licensed under or otherwise subject t o
the Adult Day Care Act, Section 1-870 et seq. of Title 63 of the
Oklahoma Statutes; or
5. Another healthcare facility or long-term care facility as
specifically approved by the B oard of Dentistry.
B. A dental hygienist with a minim um of two (2) years o f
licensed active hygiene practice may a pply to the Board for an
advanced procedure permit for elder care and public health.
C. Upon receipt of the advanced procedure permit, the dental
hygienist may provide hygiene treatments to a n ew or existing
patient in a facility listed in subsection A of this section,
utilizing mobile or other applicable dental equipment. In addition
to a written record and patient file, the hygienist shall complete a
visual recording of the patient ’s mouth through video or live
teledentistry to aid the dentist in completing an evaluation and
diagnosis of the patient. The video recording shall be maintained
as part of the patient record.
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D. A dentist shall complete an in-person, live, or recorded
teledentistry assessment, diagnosi s, and treatment plan for the
patient taking into consideration the needs, health, and physical
abilities of the patient a minimum of every thirteen (13) months.
E. The supervising dentist shall maintain all patient records
including teledentistry recordi ngs for a period of seven (7) years.
F. A dental assistant having a minimum of two (2) years of
active dental assisting practice may apply to the Board for an
expanded duty permit for elder care and public health. Upon receipt
of the expanded duty permit , the dental assistant may assist a
hygienist while providing treatment in a facility listed in
subsection A of this section under the general supervision of the
supervising dentist. The patient records shall list the dental
assistant providing treatment while assisting the dental hygienist.
SECTION 8. This act shall become e ffective July 1, 2023.
SECTION 9. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from a nd after its passage and approval.
COMMITTEE REPORT BY: COMMITTEE ON HEALTH AND HUMAN SERVICES
February 23, 2023 - DO PASS AS AMENDED BY CS