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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
HOUSE BILL 2921 By: Pittman
AS INTRODUCED
An Act relating to professions and occupations;
enacting the Dental Therapy Act; providing
definitions; providing education, licensing, and
examination requirements; limiting scope of practice;
providing supervision requirements; preserving health
care records; providing for codification; and
providing an effective date .
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 329 .1 of Title 59, unless there
is created a duplication in numbering, reads as follows:
As used in the Dental Therapy Act:
1. "Dental therapist" means an individual licensed by the Board
of Dentistry who engage s in the limited practice of dentistry ;
2. "Dental therapy" means the limited practice of dentistry,
consisting of the services, treatments, and procedures specified
under state law;
3. "Direct supervision" means that the dentist is present in
the dental office or other practice setting, personally diagnoses
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the condition to be treated, personally authorizes each procedure,
and, before dismissal of the patient, evaluates the performance o f
the allied dental personnel ;
4. "General supervision" means that the dentist is not present
in the dental office or other practice setting or on the premises at
the time tasks or procedures are being performed by the dental
therapist, but that the tasks or procedures performed by the dental
therapist are being performed with the prior knowledge and consent
of the dentist;
5. "Health care provider " means a dental therapist, dental
hygienist, physician assistant, nurse -midwife, or nurse
practitioner;
6. "Indirect supervision " means that the dentist is present in
the dental office or other practice setting, authorizes each
procedure, and remains in the office while the procedures are being
performed by the allied dental personnel ;
7. "Qualifying dentist" means a dentist who is licensed in this
state, who actively practices in this state; and
8. "Uninsured patient" means a patient who lacks dental health
coverage, either through a public health care program or private
insurance, and has an annual gross fa mily income equal to or less
than two hundred percent (200%) of the federal poverty guidelines.
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SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 329.1 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. The examining board shall gran t a license to practice dental
therapy to an individual who does all of the following:
1. Submits an application for the license to the Board of
Dentistry on a form provided by the department;
2. Pays the fee specified in state laws ;
3. Submits evidence satisfactory to the examining board that he
or she has done one of the following:
a. graduated from an accredited dental therapy education
program,
b. graduated from a dental th erapy education program that
was not accredited at the time of graduation, but that
satisfies all of the following:
(1) the program was approved by the Board of
Dentistry on or before the effective date of this
act,
(2) the program was accredited as of the date the
individual applies for a license under this
subsection,
c. graduated from a dental therapy education program
located in Oklahoma that, at the time of graduation,
was not fully accredited but had received initial
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accreditation. This subparagraph applies to a dental
therapy education program only during the four-year
period beginning after the program 's inception. After
those four (4) years have elapsed, an individual may
not qualify for a license under this subsection on the
basis of graduation f rom that program unless the
program has subsequently become accredited. The
examining board shall maintain a register of
individuals granted a license on the basis of
graduation from a program described in this
subparagraph;
4. Submits evidence satisfact ory to the examining board that he
or she has passed a national board dental t herapy examination and a
dental therapy clinical examination administered by a regional
testing service that has been approved by the examining board to
administer clinical exami nations for dental professionals. If a
national board examination or a regional testing service examination
for dental therapy does not exist , the examining board shall accept
evidence of passing an alternative examination administered by
another entity or testing service that is approved by the examining
board;
5. Passes an examination administered by the examining board on
the statutes and rules relating to dental therapy ;
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6. Submits evidence satisfactory to the examining board that he
or she has current proficiency in cardiopulmonary resuscitation,
including the use of an automated external defibrillator , achieved
through instruction provided by an individual, organization, or
institution of higher education approved by the state to provide
such instruction;
7. If the individual was licensed or is currently licensed in
another state or territory of the United States or in another
country, the individual submits information related to his or her
licensure in other jurisdictions as required by the examin ing board;
8. Completes any other requirements established by the
examining board by rule that are comparable to and no more
restrictive than the requirements established by the board for
dentists and dental hygienists.
B. The examining board may not ren ew a license to practice
dental therapy unless the applicant for renewal attes ts that he or
she has complied with state laws and regulations, that he or she has
current proficiency in cardiopulmonary resuscitation, and that he or
she has current proficienc y in the use of an automated external
defibrillator achieved through instruction provided by an
individual, organization, or institution of higher education
approved by the state to provide such instruction.
C. A person is not eligible for renewal of a li cense to
practice dental therapy unless the person has taught, prepared,
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attended, or otherwise completed, during the two-year period
immediately preceding the renewal date specified, twelve (12) credit
hours of continuing education relating to the clinica l practice of
dental therapy that is sponsored or recognized by a local, state,
regional, national, or international dental, dental therapy, dental
hygiene, dental assist ance, or medical-related professional
organization.
D. Continuing education may inclu de training in any of the
following:
1. Basic life support or cardiopulmonary resuscitation. Not
more than two (2) credit hours may be satisfied by such training ;
2. Infection control training. Not less than two (2) of the
credit hours required must be satisfied by such training.
E. After consultation with the Oklahoma Board of Dentistry , the
examining board may promulgate rules requiring that continuing
education credit hours include courses in specific clinical
subjects.
1. The credit hours required may be satisfied by independent
study, correspondence, or Internet program s or courses.
2. This section does not apply to an applicant for renewal of a
license that expires on the first renewal date after the date on
which the examining board initially g ranted the license.
3. A person may substitute credit hours of college level
courses related to the practice of dental therapy for the credit
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hours required. For purposes of this subsection, one (1) credit
hour of a college level course is equivalent to six (6) credit hours
of continuing education.
4. One (1) hour of teaching or preparing a continuing education
program is equivalent to one (1) credit hour of continuing
education, but a person who teaches or prepares a continuing
education program may obt ain credit for one program only once.
5. The examining board may require applicants for renewal of a
license to practice dental therapy to submit proof of compliance
with the requirements of this section.
SECTION 3. NEW LAW A new s ection of law to be codified
in the Oklahoma Statutes as Section 329.2 of Titl e 59, unless there
is created a duplication in numbering, reads as follows:
A. Dental therapists may provide dental therapy services only
as an employee of specified employers a nd only under the supervision
of a dentist who is either similarly employed or who directly
employs the dental therapist. The dental therapist must also have a
collaborative management agreement with a dentist that addresses
various aspects of the dental therapist's practice and supervision.
Dental therapists are, subject to the t erms of a collaborative
management agreement and what was covered in their dental therapy
education program, limited to providing services, treatments, and
specified procedures a s well as additional services, treatments, or
procedures specified by the board by rule.
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B. Dental therapists may initially provide dental therapy
services only under the direct or indirect supervision of a
qualifying dentist. Once a licensed dental therapist has provided
dental therapy services for at least two thousand (2,000) hours, the
dental therapist may provide services under the general supervision
of a qualifying dentist.
C. The level of supervision for a dental therapist may be
further limited under the terms of a collaborative management
agreement.
D. Dental therapists must also either:
1. Limit their practice to federally defined dental shortage
areas; or
2. Practice in settings where at least fifty percent (50%) of
their patient base consi sts of certain specified populations.
E. Dental therapists must complete twelve (12) hours of
continuing education each biennium.
F. Dental therapists are subject to and covered under various
other state laws.
G. No contract of employment entered into b etween a dentist or
dental therapist and any other party under which the dentist or
dental therapist renders dental services may require the dentist or
dental therapist to act in a manner that violates the professional
standards for dentistry or dental the rapy set forth in this act.
Nothing in this subsection limits the ability of the other party to
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control the operation of the dental practice in a manner in
accordance with the professional standards for dentistry or dental
therapy set for in this act.
H. No contract of employment entered into between a dental
therapist and any other party under which the dental therapist is
employed to practice dental therapy may require a dental therapist
to meet a minimum quota for the number of patients seen or the
number of procedures performed.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 329.3 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. A dental hygienist may practice dental hygiene or perform
remediable procedures only as authorized by a dentist or dental
therapist who is licensed to practice dentistry or dental therapy
under this chapter and who is present in the facility in which those
practices or procedures are performed.
B. A dental hygienist may practice dental hygiene or per form
remediable procedures if a dentist or dental therapist who is
licensed to practice dentistry or dental therapy under this chapter
is not present in the facility in which tho se practices or
procedures are performed only if all of the required conditions are
met.
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SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 329.4 of Title 59, unless there
is created a duplica tion in numbering, reads as follows:
A. The scope of practice of a dental the rapist shall, subject
to the terms of a collaborative management agreement, be limited to
providing the following services, treatments, and procedures:
1. Oral evaluation and as sessment of dental disease and
formulation of an individualized treatment plan ;
2. Identification of oral and systemic conditions requiring
evaluation or treatment by dentists, physicians, or other health
care providers and managing referrals ;
3. Comprehensive charting of the oral cavity ;
4. Oral health instruction and disease pr evention education,
including nutritional counseling and dietary analysis ;
5. Exposure and evaluation of radiographic images ;
6. Dental prophylaxis, including subgingival scali ng and
polishing procedures ;
7. Dispensing and administration via the oral or topical route
of nonnarcotic analgesic, anti -inflammatory, and antibiotic
medications as prescribed by a licensed health care provider ;
8. Application of topical preventative o r prophylactic agents,
including fluoride varnish, antimicrobial agents, carie s arresting
medicaments, and pit and fissure sealants ;
9. Pulp vitality testing ;
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10. Application of desensitizing medications or resins ;
11. Fabrication of athletic mouth guar ds and soft occlusal
guards;
12. Changing of periodontal dressings ;
13. Administration of local anesthetic and nitrous oxide ;
14. Simple extraction of erupted primary teeth ;
15. Nonsurgical extraction of periodontally diseased permanent
teeth with tooth mobility of +3 to +4 to the extent authorized in
the dental therapist 's collaborative management agreement, except
for the extraction of a tooth that is unerupted, impacted, or
fractured or that needs to be sectioned for removal ;
16. Emergency palliative treatment of dental pain limited to
the procedures in this subsection;
17. Preparation and placement of direct restoration in primary
and permanent teeth;
18. Fabrication and placement of single -tooth temporary crowns ;
19. Preparation and placement of preformed crowns on primary
teeth;
20. Indirect and direct capping on perman ent teeth;
21. Indirect pulp capping on primary teeth ;
22. Intraoral suture placement and removal ;
23. Minor adjustment and repair of removable prostheses ;
24. Placement and removal of space maintainers ;
25. Pulpotomy on primary teeth ;
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26. Tooth reimplantation and stabilization ;
27. Recementing of a permanent crown ;
28. Any additional services, treatments, or procedures
specified in state law.
B. A dental therapist shall, except as otherwise provided,
limit his or her practice of dental therapy to providing the
services, treatments, and procedures covered by his or her dental
therapy education program.
If any service, treatment, or procedure was not covered by a
dental therapist's dental therapy education program, the dental
therapist may provide that service, treatment, or procedure if the
dental therapist has subsequently received additional dental therapy
educational training to provide that service, treatment, or
procedure.
C. Except as otherwise provided, a dental therapist licensed
under this act may provide dental therapy services in this state
only under the direct supervision or indirect supervision of a
qualifying dentist with whom the dental therapist has entered into a
collaborative management agreement.
D. Once a dental therapist licensed under this act has provided
dental therapy services for at least five hundred (500) hours and up
to two thousand (2,000) hours under direct supervision or indirect
supervision, the dental therapist may provide dental therapy
services in this state under the general supervision of a qualifying
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dentist with whom the dental therapist has entered into a
collaborative management agreement.
E. For purposes of the hours required unde r subsection D of
this section, hours may include hours of providing dental therapy
services in this state under direct supervision or indirect
supervision of a qualifying dentist or hours of providing dental
therapy services under direct supervision or in direct supervision
while licensed as a dental therapist outside this state, bu t may not
include any hours completed prior to graduating from the dental
therapy education program.
F. The level of supervision for a dental therapist may be
further limited under the terms of a collaborative management
agreement.
G. A supervising dentist shall accept responsibility for all
services performed by a dental therapist pursuant to a collaborative
management agreement. If services needed by a patient are beyond
the dental therapist's scope of practice or authorization under the
collaborative management agreement, the dental therapist shall, to
the extent required under the collaborative management agreement,
consult with the supervising dentist as needed to arrange f or those
services to be provided by a dentist or another qualified health
care provider.
H. Prior to providing any dental therapy services, a dental
therapist shall enter into a written collaborative management
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agreement with a qualifying dentist who will serve as a supervising
dentist under subsection G of this section. The agreement must be
signed by the dental therapist and the qualifying dentist and
address all of the following:
1. The practice settings where services may be provided and the
patient populations that may be served ;
2. Consistent with and subject to state law, any conditions or
limitations on the services that may be provided by the dental
therapist, the level of supervision required, and any circumstances
requiring consultation prior to performing services ;
3. Age-specific and procedure -specific practice proto cols;
4. Dental record-keeping procedures;
5. A quality assurance plan for monitoring care provided by the
dental therapist;
6. Protocols for administering and dispensing medi cations;
7. Criteria or protocols relating to the provision of care to
patients with specific medical conditions, treatments, or
medications;
8. Policies relating to supervision of dental hygienists and
other staff;
9. A plan for the referral of patient s to other dental or
health care providers or clinics when services needed are beyond the
scope of practice or authorization of the dental therapist ;
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10. Whether and to what extent the dental therapist may perform
services described in the State Dental Ac t.
I. A collaborative management agreement shall be limited to
covering one qualifying dentist and one dental therapist.
J. A dental therapist may enter into multiple collaborative
management agreements. No dentist may have collaborative management
agreements with more than four dental therapists at any time. A
dental therapist may, subject to state law, provide dental therapy
services only as an employee of one or more of the following:
1. A dentist with whom the dental therapist has enter ed into a
collaborative management agreement ;
2. A dental practice;
3. A school district or the operator of a private school, or a
tribal school;
4. The operator of a school for the education of dentists or
dental hygienists;
5. A state or federal prison, a county jail, or other federal,
state, county, or municipal correctional or detention facility, or a
facility established to provide care for terminally ill patients ;
6. A local health department ;
7. A charitable institution open to the general public or to
members of a religious sect or order ;
8. A nonprofit home health care agency ;
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9. The operator of a nonprofit dental care program serving
primarily indigent, economically disadvantaged, or migrant worker
populations;
10. A health care employer, as defined b y state law.
K. A dentist may not enter into a collaborative management
agreement with a dental therapist unless the dentist directly
employs the dental therapist as provided in paragraph 1 of
subsection J of this section or the dentist is employed by or
contracts with the dental therapist 's employer described in
paragraphs 2 through 10 of s ubsection J of this section.
L. A dental therapist shall at all times comply with at least
one of the following:
1. Limit his or her practice to practicing in one or more
dental health shortage areas. If a dental therapist begins
practicing in a dental health shortage area and that area loses its
designation as a dental health shortage area while the dental
therapist continues to practice in that area, the dental ther apist
is considered to satisfy this paragraph as long as the dental
therapist continues to practice in that area ;
2. Practice in one or more settings in which at least fifty
percent (50%) of the total patient base of the dental therapist
consists of patients who are any of the following:
a. medical assistance patients ,
b. uninsured patients,
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c. patients receiving dental care at free and charitable
clinics,
d. patients receiving dental care at federally qualified
health centers,
e. patients who reside in lo ng-term care facilities ,
f. veterans,
g. patients who are members of a federally recognized
Indian tribe or band ,
h. patients receiving dental care at clinics or
facilities,
i. patients receiving dental care at clinics or
facilities located on tribal lands ,
j. patients with medical disabilities or chronic
conditions that create barr iers of access to dental
care.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 329.5 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. A person who manages or controls a business that offers
dental, dental therapy, or dental hygiene services, including
management or control of a business through which the person allows
another person to offer dental, dental therapy, or dental hygiene
services, shall preserve patient health care records for an amount
of time determined by the examining board by rule.
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B. A person who manages or controls a business that offers
dental, dental therap y, or dental hygiene services, including
management or control of a business through which the person allows
another person to offer dental, dental therapy, or dental hygiene
services, shall, upon request of a patient or person authorized by
the patient, transfer the patient health care records of the patient
to another person that the patient or person authorized by the
patient specifies to receive the patient health care records.
SECTION 7. NEW LAW A new section of law to be codifi ed
in the Oklahoma Statutes as Section 329.6 of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. A dentist or dental therapist who is licensed to practice
dentistry under this act may delegate to an individual who is not
licensed under this title only the performance of remediable
procedures, and only if all of the following conditions are met:
1. The unlicensed individual performs the remediable procedures
in accordance with a treatment plan approved by the dentist or
dental therapist;
2. The dentist or dental therapist is on the premises when the
unlicensed individual performs the remediable procedures ;
3. The unlicensed individual 's performance of the remediable
procedures is subject to inspection by the dentist or de ntal
therapist.
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B. Subject to the requirements of state law, a dentist or
dental therapist who is licensed to practice dentistry under this
act may delegate to a dental hygienist who is licensed to practice
dental hygiene under this act the performance of remediable
procedures and the administration of oral system premedication,
local anesthesia, nitrous oxide inhalation analgesia, and
subgingival sustained released chemotherapeutic agents, to the
extent the dentist or dental therapist has the authority to perform
the activity personally.
C. A dentist or dental therapist who delega tes to another
individual the performance of any practice or remediable procedure
is responsible for that individual 's performance of that delegated
practice or procedure.
D. The examining board may, without further notice or process,
limit, suspend, or revoke the license or certificate of any dentist,
dental therapist, or dental hygienist, or the registration of a
mobile dentistry program registrant, who fails, within sixty (60)
days after the mailing of written notice to the dentist 's, dental
therapist's, dental hygienist's, or registrant' last-known address,
to renew the license, certificate, or registration.
E. The examining board may make investigations and conduct
hearings in regard to any alleged action of any dentist, dental
therapist, dental hygienist, or expanded function dental auxiliary,
of a mobile dentistry program registrant, or of any other person it
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has reason to believe is engaged in or has engaged in the practic e
of dentistry, dental therapy, or dental hygiene, or the operation of
a mobile dentistry program, in this state, and may, on its own
motion, or upon complaint in writing, reprimand any dentist, dental
therapist, dental hygienist, or expanded function dent al auxiliary
who is licensed or certified under this act, or any mobile dentistry
program registrant, or deny, limit, suspend, or revoke his or her
license or certificate, or the registration of the mobile dentistry
program registrant, if it finds that the dentist, dental therapist,
dental hygienist, expanded function dental auxilia ry, or mobile
dentistry program registrant has done any of the following:
1. The health care provider having been convicted of a crime,
the circumstances of which substantially relate to the practice of
dentistry, dental therapy, or dental hygiene, the practice of an
expanded function dental auxiliary, or the operation of a mobile
dentistry program;
2. Violated this act or any federal or state statute or rule
that relates to the practice of dentistry, dental therapy, dental
hygiene, or an expanded functio n dental auxiliary, or the operation
of a mobile dentistry program;
3. Subject to state law, practiced dentistry, dental therapy,
or dental hygiene or as an expanded function de ntal auxiliary while
his or her ability was impaired by alcohol or other drugs;
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4. Engaged in conduct that indicates a lack of knowledge of, an
inability to apply, or the negligent application of principles or
skills of dentistry, dental therapy, or denta l hygiene or the
practice of an expanded function dental auxiliary. The examining
board shall immediately revoke the license to practice dental
therapy granted under State Dental Act of an individual who
qualified for the license on the basis of graduatio n from a dental
therapy education program if, upon the conclusion of the four-year
period the program is not accredited.
If the program subsequently becomes accredited, the examining
board may allow reinstatement of a revoked license described in this
subsection.
SECTION 8. This act shall become effective November 1 , 2025.
60-1-11317 TKR 01/15/25