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Oklahoma House Bill HB2921

Oklahoma 2025 Regular Session

Oklahoma House Bill HB2921 Compare Versions

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2828 STATE OF OKLAHOMA
2929
3030 1st Session of the 60th Legislature (2025)
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3232 HOUSE BILL 2921 By: Pittman
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3838 AS INTRODUCED
3939
4040 An Act relating to professions and occupations;
4141 enacting the Dental Therapy Act; providing
4242 definitions; providing education, licensing, and
4343 examination requirements; limiting scope of practice;
4444 providing supervision requirements; preserving health
4545 care records; providing for codification; and
4646 providing an effective date .
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5252 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
5353 SECTION 1. NEW LAW A new section of law to be codified
5454 in the Oklahoma Statutes as Section 329 .1 of Title 59, unless there
5555 is created a duplication in numbering, reads as follows:
5656 As used in the Dental Therapy Act:
5757 1. "Dental therapist" means an individual licensed by the Board
5858 of Dentistry who engage s in the limited practice of dentistry ;
5959 2. "Dental therapy" means the limited practice of dentistry,
6060 consisting of the services, treatments, and procedures specified
6161 under state law;
6262 3. "Direct supervision" means that the dentist is present in
6363 the dental office or other practice setting, personally diagnoses
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9090 the condition to be treated, personally authorizes each procedure,
9191 and, before dismissal of the patient, evaluates the performance o f
9292 the allied dental personnel ;
9393 4. "General supervision" means that the dentist is not present
9494 in the dental office or other practice setting or on the premises at
9595 the time tasks or procedures are being performed by the dental
9696 therapist, but that the tasks or procedures performed by the dental
9797 therapist are being performed with the prior knowledge and consent
9898 of the dentist;
9999 5. "Health care provider " means a dental therapist, dental
100100 hygienist, physician assistant, nurse -midwife, or nurse
101101 practitioner;
102102 6. "Indirect supervision " means that the dentist is present in
103103 the dental office or other practice setting, authorizes each
104104 procedure, and remains in the office while the procedures are being
105105 performed by the allied dental personnel ;
106106 7. "Qualifying dentist" means a dentist who is licensed in this
107107 state, who actively practices in this state; and
108108 8. "Uninsured patient" means a patient who lacks dental health
109109 coverage, either through a public health care program or private
110110 insurance, and has an annual gross fa mily income equal to or less
111111 than two hundred percent (200%) of the federal poverty guidelines.
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138138 SECTION 2. NEW LAW A new section of law to be codified
139139 in the Oklahoma Statutes as Section 329.1 of Title 59, unless there
140140 is created a duplication in numbering, reads as follows:
141141 A. The examining board shall gran t a license to practice dental
142142 therapy to an individual who does all of the following:
143143 1. Submits an application for the license to the Board of
144144 Dentistry on a form provided by the department;
145145 2. Pays the fee specified in state laws ;
146146 3. Submits evidence satisfactory to the examining board that he
147147 or she has done one of the following:
148148 a. graduated from an accredited dental therapy education
149149 program,
150150 b. graduated from a dental th erapy education program that
151151 was not accredited at the time of graduation, but that
152152 satisfies all of the following:
153153 (1) the program was approved by the Board of
154154 Dentistry on or before the effective date of this
155155 act,
156156 (2) the program was accredited as of the date the
157157 individual applies for a license under this
158158 subsection,
159159 c. graduated from a dental therapy education program
160160 located in Oklahoma that, at the time of graduation,
161161 was not fully accredited but had received initial
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188188 accreditation. This subparagraph applies to a dental
189189 therapy education program only during the four-year
190190 period beginning after the program 's inception. After
191191 those four (4) years have elapsed, an individual may
192192 not qualify for a license under this subsection on the
193193 basis of graduation f rom that program unless the
194194 program has subsequently become accredited. The
195195 examining board shall maintain a register of
196196 individuals granted a license on the basis of
197197 graduation from a program described in this
198198 subparagraph;
199199 4. Submits evidence satisfact ory to the examining board that he
200200 or she has passed a national board dental t herapy examination and a
201201 dental therapy clinical examination administered by a regional
202202 testing service that has been approved by the examining board to
203203 administer clinical exami nations for dental professionals. If a
204204 national board examination or a regional testing service examination
205205 for dental therapy does not exist , the examining board shall accept
206206 evidence of passing an alternative examination administered by
207207 another entity or testing service that is approved by the examining
208208 board;
209209 5. Passes an examination administered by the examining board on
210210 the statutes and rules relating to dental therapy ;
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237237 6. Submits evidence satisfactory to the examining board that he
238238 or she has current proficiency in cardiopulmonary resuscitation,
239239 including the use of an automated external defibrillator , achieved
240240 through instruction provided by an individual, organization, or
241241 institution of higher education approved by the state to provide
242242 such instruction;
243243 7. If the individual was licensed or is currently licensed in
244244 another state or territory of the United States or in another
245245 country, the individual submits information related to his or her
246246 licensure in other jurisdictions as required by the examin ing board;
247247 8. Completes any other requirements established by the
248248 examining board by rule that are comparable to and no more
249249 restrictive than the requirements established by the board for
250250 dentists and dental hygienists.
251251 B. The examining board may not ren ew a license to practice
252252 dental therapy unless the applicant for renewal attes ts that he or
253253 she has complied with state laws and regulations, that he or she has
254254 current proficiency in cardiopulmonary resuscitation, and that he or
255255 she has current proficienc y in the use of an automated external
256256 defibrillator achieved through instruction provided by an
257257 individual, organization, or institution of higher education
258258 approved by the state to provide such instruction.
259259 C. A person is not eligible for renewal of a li cense to
260260 practice dental therapy unless the person has taught, prepared,
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287287 attended, or otherwise completed, during the two-year period
288288 immediately preceding the renewal date specified, twelve (12) credit
289289 hours of continuing education relating to the clinica l practice of
290290 dental therapy that is sponsored or recognized by a local, state,
291291 regional, national, or international dental, dental therapy, dental
292292 hygiene, dental assist ance, or medical-related professional
293293 organization.
294294 D. Continuing education may inclu de training in any of the
295295 following:
296296 1. Basic life support or cardiopulmonary resuscitation. Not
297297 more than two (2) credit hours may be satisfied by such training ;
298298 2. Infection control training. Not less than two (2) of the
299299 credit hours required must be satisfied by such training.
300300 E. After consultation with the Oklahoma Board of Dentistry , the
301301 examining board may promulgate rules requiring that continuing
302302 education credit hours include courses in specific clinical
303303 subjects.
304304 1. The credit hours required may be satisfied by independent
305305 study, correspondence, or Internet program s or courses.
306306 2. This section does not apply to an applicant for renewal of a
307307 license that expires on the first renewal date after the date on
308308 which the examining board initially g ranted the license.
309309 3. A person may substitute credit hours of college level
310310 courses related to the practice of dental therapy for the credit
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337337 hours required. For purposes of this subsection, one (1) credit
338338 hour of a college level course is equivalent to six (6) credit hours
339339 of continuing education.
340340 4. One (1) hour of teaching or preparing a continuing education
341341 program is equivalent to one (1) credit hour of continuing
342342 education, but a person who teaches or prepares a continuing
343343 education program may obt ain credit for one program only once.
344344 5. The examining board may require applicants for renewal of a
345345 license to practice dental therapy to submit proof of compliance
346346 with the requirements of this section.
347347 SECTION 3. NEW LAW A new s ection of law to be codified
348348 in the Oklahoma Statutes as Section 329.2 of Titl e 59, unless there
349349 is created a duplication in numbering, reads as follows:
350350 A. Dental therapists may provide dental therapy services only
351351 as an employee of specified employers a nd only under the supervision
352352 of a dentist who is either similarly employed or who directly
353353 employs the dental therapist. The dental therapist must also have a
354354 collaborative management agreement with a dentist that addresses
355355 various aspects of the dental therapist's practice and supervision.
356356 Dental therapists are, subject to the t erms of a collaborative
357357 management agreement and what was covered in their dental therapy
358358 education program, limited to providing services, treatments, and
359359 specified procedures a s well as additional services, treatments, or
360360 procedures specified by the board by rule.
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387387 B. Dental therapists may initially provide dental therapy
388388 services only under the direct or indirect supervision of a
389389 qualifying dentist. Once a licensed dental therapist has provided
390390 dental therapy services for at least two thousand (2,000) hours, the
391391 dental therapist may provide services under the general supervision
392392 of a qualifying dentist.
393393 C. The level of supervision for a dental therapist may be
394394 further limited under the terms of a collaborative management
395395 agreement.
396396 D. Dental therapists must also either:
397397 1. Limit their practice to federally defined dental shortage
398398 areas; or
399399 2. Practice in settings where at least fifty percent (50%) of
400400 their patient base consi sts of certain specified populations.
401401 E. Dental therapists must complete twelve (12) hours of
402402 continuing education each biennium.
403403 F. Dental therapists are subject to and covered under various
404404 other state laws.
405405 G. No contract of employment entered into b etween a dentist or
406406 dental therapist and any other party under which the dentist or
407407 dental therapist renders dental services may require the dentist or
408408 dental therapist to act in a manner that violates the professional
409409 standards for dentistry or dental the rapy set forth in this act.
410410 Nothing in this subsection limits the ability of the other party to
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437437 control the operation of the dental practice in a manner in
438438 accordance with the professional standards for dentistry or dental
439439 therapy set for in this act.
440440 H. No contract of employment entered into between a dental
441441 therapist and any other party under which the dental therapist is
442442 employed to practice dental therapy may require a dental therapist
443443 to meet a minimum quota for the number of patients seen or the
444444 number of procedures performed.
445445 SECTION 4. NEW LAW A new section of law to be codified
446446 in the Oklahoma Statutes as Section 329.3 of Title 59, unless there
447447 is created a duplication in numbering, reads as follows:
448448 A. A dental hygienist may practice dental hygiene or perform
449449 remediable procedures only as authorized by a dentist or dental
450450 therapist who is licensed to practice dentistry or dental therapy
451451 under this chapter and who is present in the facility in which those
452452 practices or procedures are performed.
453453 B. A dental hygienist may practice dental hygiene or per form
454454 remediable procedures if a dentist or dental therapist who is
455455 licensed to practice dentistry or dental therapy under this chapter
456456 is not present in the facility in which tho se practices or
457457 procedures are performed only if all of the required conditions are
458458 met.
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485485 SECTION 5. NEW LAW A new section of law to be codified
486486 in the Oklahoma Statutes as Section 329.4 of Title 59, unless there
487487 is created a duplica tion in numbering, reads as follows:
488488 A. The scope of practice of a dental the rapist shall, subject
489489 to the terms of a collaborative management agreement, be limited to
490490 providing the following services, treatments, and procedures:
491491 1. Oral evaluation and as sessment of dental disease and
492492 formulation of an individualized treatment plan ;
493493 2. Identification of oral and systemic conditions requiring
494494 evaluation or treatment by dentists, physicians, or other health
495495 care providers and managing referrals ;
496496 3. Comprehensive charting of the oral cavity ;
497497 4. Oral health instruction and disease pr evention education,
498498 including nutritional counseling and dietary analysis ;
499499 5. Exposure and evaluation of radiographic images ;
500500 6. Dental prophylaxis, including subgingival scali ng and
501501 polishing procedures ;
502502 7. Dispensing and administration via the oral or topical route
503503 of nonnarcotic analgesic, anti -inflammatory, and antibiotic
504504 medications as prescribed by a licensed health care provider ;
505505 8. Application of topical preventative o r prophylactic agents,
506506 including fluoride varnish, antimicrobial agents, carie s arresting
507507 medicaments, and pit and fissure sealants ;
508508 9. Pulp vitality testing ;
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535535 10. Application of desensitizing medications or resins ;
536536 11. Fabrication of athletic mouth guar ds and soft occlusal
537537 guards;
538538 12. Changing of periodontal dressings ;
539539 13. Administration of local anesthetic and nitrous oxide ;
540540 14. Simple extraction of erupted primary teeth ;
541541 15. Nonsurgical extraction of periodontally diseased permanent
542542 teeth with tooth mobility of +3 to +4 to the extent authorized in
543543 the dental therapist 's collaborative management agreement, except
544544 for the extraction of a tooth that is unerupted, impacted, or
545545 fractured or that needs to be sectioned for removal ;
546546 16. Emergency palliative treatment of dental pain limited to
547547 the procedures in this subsection;
548548 17. Preparation and placement of direct restoration in primary
549549 and permanent teeth;
550550 18. Fabrication and placement of single -tooth temporary crowns ;
551551 19. Preparation and placement of preformed crowns on primary
552552 teeth;
553553 20. Indirect and direct capping on perman ent teeth;
554554 21. Indirect pulp capping on primary teeth ;
555555 22. Intraoral suture placement and removal ;
556556 23. Minor adjustment and repair of removable prostheses ;
557557 24. Placement and removal of space maintainers ;
558558 25. Pulpotomy on primary teeth ;
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585585 26. Tooth reimplantation and stabilization ;
586586 27. Recementing of a permanent crown ;
587587 28. Any additional services, treatments, or procedures
588588 specified in state law.
589589 B. A dental therapist shall, except as otherwise provided,
590590 limit his or her practice of dental therapy to providing the
591591 services, treatments, and procedures covered by his or her dental
592592 therapy education program.
593593 If any service, treatment, or procedure was not covered by a
594594 dental therapist's dental therapy education program, the dental
595595 therapist may provide that service, treatment, or procedure if the
596596 dental therapist has subsequently received additional dental therapy
597597 educational training to provide that service, treatment, or
598598 procedure.
599599 C. Except as otherwise provided, a dental therapist licensed
600600 under this act may provide dental therapy services in this state
601601 only under the direct supervision or indirect supervision of a
602602 qualifying dentist with whom the dental therapist has entered into a
603603 collaborative management agreement.
604604 D. Once a dental therapist licensed under this act has provided
605605 dental therapy services for at least five hundred (500) hours and up
606606 to two thousand (2,000) hours under direct supervision or indirect
607607 supervision, the dental therapist may provide dental therapy
608608 services in this state under the general supervision of a qualifying
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635635 dentist with whom the dental therapist has entered into a
636636 collaborative management agreement.
637637 E. For purposes of the hours required unde r subsection D of
638638 this section, hours may include hours of providing dental therapy
639639 services in this state under direct supervision or indirect
640640 supervision of a qualifying dentist or hours of providing dental
641641 therapy services under direct supervision or in direct supervision
642642 while licensed as a dental therapist outside this state, bu t may not
643643 include any hours completed prior to graduating from the dental
644644 therapy education program.
645645 F. The level of supervision for a dental therapist may be
646646 further limited under the terms of a collaborative management
647647 agreement.
648648 G. A supervising dentist shall accept responsibility for all
649649 services performed by a dental therapist pursuant to a collaborative
650650 management agreement. If services needed by a patient are beyond
651651 the dental therapist's scope of practice or authorization under the
652652 collaborative management agreement, the dental therapist shall, to
653653 the extent required under the collaborative management agreement,
654654 consult with the supervising dentist as needed to arrange f or those
655655 services to be provided by a dentist or another qualified health
656656 care provider.
657657 H. Prior to providing any dental therapy services, a dental
658658 therapist shall enter into a written collaborative management
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685685 agreement with a qualifying dentist who will serve as a supervising
686686 dentist under subsection G of this section. The agreement must be
687687 signed by the dental therapist and the qualifying dentist and
688688 address all of the following:
689689 1. The practice settings where services may be provided and the
690690 patient populations that may be served ;
691691 2. Consistent with and subject to state law, any conditions or
692692 limitations on the services that may be provided by the dental
693693 therapist, the level of supervision required, and any circumstances
694694 requiring consultation prior to performing services ;
695695 3. Age-specific and procedure -specific practice proto cols;
696696 4. Dental record-keeping procedures;
697697 5. A quality assurance plan for monitoring care provided by the
698698 dental therapist;
699699 6. Protocols for administering and dispensing medi cations;
700700 7. Criteria or protocols relating to the provision of care to
701701 patients with specific medical conditions, treatments, or
702702 medications;
703703 8. Policies relating to supervision of dental hygienists and
704704 other staff;
705705 9. A plan for the referral of patient s to other dental or
706706 health care providers or clinics when services needed are beyond the
707707 scope of practice or authorization of the dental therapist ;
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734734 10. Whether and to what extent the dental therapist may perform
735735 services described in the State Dental Ac t.
736736 I. A collaborative management agreement shall be limited to
737737 covering one qualifying dentist and one dental therapist.
738738 J. A dental therapist may enter into multiple collaborative
739739 management agreements. No dentist may have collaborative management
740740 agreements with more than four dental therapists at any time. A
741741 dental therapist may, subject to state law, provide dental therapy
742742 services only as an employee of one or more of the following:
743743 1. A dentist with whom the dental therapist has enter ed into a
744744 collaborative management agreement ;
745745 2. A dental practice;
746746 3. A school district or the operator of a private school, or a
747747 tribal school;
748748 4. The operator of a school for the education of dentists or
749749 dental hygienists;
750750 5. A state or federal prison, a county jail, or other federal,
751751 state, county, or municipal correctional or detention facility, or a
752752 facility established to provide care for terminally ill patients ;
753753 6. A local health department ;
754754 7. A charitable institution open to the general public or to
755755 members of a religious sect or order ;
756756 8. A nonprofit home health care agency ;
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783783 9. The operator of a nonprofit dental care program serving
784784 primarily indigent, economically disadvantaged, or migrant worker
785785 populations;
786786 10. A health care employer, as defined b y state law.
787787 K. A dentist may not enter into a collaborative management
788788 agreement with a dental therapist unless the dentist directly
789789 employs the dental therapist as provided in paragraph 1 of
790790 subsection J of this section or the dentist is employed by or
791791 contracts with the dental therapist 's employer described in
792792 paragraphs 2 through 10 of s ubsection J of this section.
793793 L. A dental therapist shall at all times comply with at least
794794 one of the following:
795795 1. Limit his or her practice to practicing in one or more
796796 dental health shortage areas. If a dental therapist begins
797797 practicing in a dental health shortage area and that area loses its
798798 designation as a dental health shortage area while the dental
799799 therapist continues to practice in that area, the dental ther apist
800800 is considered to satisfy this paragraph as long as the dental
801801 therapist continues to practice in that area ;
802802 2. Practice in one or more settings in which at least fifty
803803 percent (50%) of the total patient base of the dental therapist
804804 consists of patients who are any of the following:
805805 a. medical assistance patients ,
806806 b. uninsured patients,
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833833 c. patients receiving dental care at free and charitable
834834 clinics,
835835 d. patients receiving dental care at federally qualified
836836 health centers,
837837 e. patients who reside in lo ng-term care facilities ,
838838 f. veterans,
839839 g. patients who are members of a federally recognized
840840 Indian tribe or band ,
841841 h. patients receiving dental care at clinics or
842842 facilities,
843843 i. patients receiving dental care at clinics or
844844 facilities located on tribal lands ,
845845 j. patients with medical disabilities or chronic
846846 conditions that create barr iers of access to dental
847847 care.
848848 SECTION 6. NEW LAW A new section of law to be codified
849849 in the Oklahoma Statutes as Section 329.5 of Title 59, unless there
850850 is created a duplication in numbering, reads as follows:
851851 A. A person who manages or controls a business that offers
852852 dental, dental therapy, or dental hygiene services, including
853853 management or control of a business through which the person allows
854854 another person to offer dental, dental therapy, or dental hygiene
855855 services, shall preserve patient health care records for an amount
856856 of time determined by the examining board by rule.
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883883 B. A person who manages or controls a business that offers
884884 dental, dental therap y, or dental hygiene services, including
885885 management or control of a business through which the person allows
886886 another person to offer dental, dental therapy, or dental hygiene
887887 services, shall, upon request of a patient or person authorized by
888888 the patient, transfer the patient health care records of the patient
889889 to another person that the patient or person authorized by the
890890 patient specifies to receive the patient health care records.
891891 SECTION 7. NEW LAW A new section of law to be codifi ed
892892 in the Oklahoma Statutes as Section 329.6 of Title 59, unless there
893893 is created a duplication in numbering, reads as follows:
894894 A. A dentist or dental therapist who is licensed to practice
895895 dentistry under this act may delegate to an individual who is not
896896 licensed under this title only the performance of remediable
897897 procedures, and only if all of the following conditions are met:
898898 1. The unlicensed individual performs the remediable procedures
899899 in accordance with a treatment plan approved by the dentist or
900900 dental therapist;
901901 2. The dentist or dental therapist is on the premises when the
902902 unlicensed individual performs the remediable procedures ;
903903 3. The unlicensed individual 's performance of the remediable
904904 procedures is subject to inspection by the dentist or de ntal
905905 therapist.
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932932 B. Subject to the requirements of state law, a dentist or
933933 dental therapist who is licensed to practice dentistry under this
934934 act may delegate to a dental hygienist who is licensed to practice
935935 dental hygiene under this act the performance of remediable
936936 procedures and the administration of oral system premedication,
937937 local anesthesia, nitrous oxide inhalation analgesia, and
938938 subgingival sustained released chemotherapeutic agents, to the
939939 extent the dentist or dental therapist has the authority to perform
940940 the activity personally.
941941 C. A dentist or dental therapist who delega tes to another
942942 individual the performance of any practice or remediable procedure
943943 is responsible for that individual 's performance of that delegated
944944 practice or procedure.
945945 D. The examining board may, without further notice or process,
946946 limit, suspend, or revoke the license or certificate of any dentist,
947947 dental therapist, or dental hygienist, or the registration of a
948948 mobile dentistry program registrant, who fails, within sixty (60)
949949 days after the mailing of written notice to the dentist 's, dental
950950 therapist's, dental hygienist's, or registrant' last-known address,
951951 to renew the license, certificate, or registration.
952952 E. The examining board may make investigations and conduct
953953 hearings in regard to any alleged action of any dentist, dental
954954 therapist, dental hygienist, or expanded function dental auxiliary,
955955 of a mobile dentistry program registrant, or of any other person it
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982982 has reason to believe is engaged in or has engaged in the practic e
983983 of dentistry, dental therapy, or dental hygiene, or the operation of
984984 a mobile dentistry program, in this state, and may, on its own
985985 motion, or upon complaint in writing, reprimand any dentist, dental
986986 therapist, dental hygienist, or expanded function dent al auxiliary
987987 who is licensed or certified under this act, or any mobile dentistry
988988 program registrant, or deny, limit, suspend, or revoke his or her
989989 license or certificate, or the registration of the mobile dentistry
990990 program registrant, if it finds that the dentist, dental therapist,
991991 dental hygienist, expanded function dental auxilia ry, or mobile
992992 dentistry program registrant has done any of the following:
993993 1. The health care provider having been convicted of a crime,
994994 the circumstances of which substantially relate to the practice of
995995 dentistry, dental therapy, or dental hygiene, the practice of an
996996 expanded function dental auxiliary, or the operation of a mobile
997997 dentistry program;
998998 2. Violated this act or any federal or state statute or rule
999999 that relates to the practice of dentistry, dental therapy, dental
10001000 hygiene, or an expanded functio n dental auxiliary, or the operation
10011001 of a mobile dentistry program;
10021002 3. Subject to state law, practiced dentistry, dental therapy,
10031003 or dental hygiene or as an expanded function de ntal auxiliary while
10041004 his or her ability was impaired by alcohol or other drugs;
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10311031 4. Engaged in conduct that indicates a lack of knowledge of, an
10321032 inability to apply, or the negligent application of principles or
10331033 skills of dentistry, dental therapy, or denta l hygiene or the
10341034 practice of an expanded function dental auxiliary. The examining
10351035 board shall immediately revoke the license to practice dental
10361036 therapy granted under State Dental Act of an individual who
10371037 qualified for the license on the basis of graduatio n from a dental
10381038 therapy education program if, upon the conclusion of the four-year
10391039 period the program is not accredited.
10401040 If the program subsequently becomes accredited, the examining
10411041 board may allow reinstatement of a revoked license described in this
10421042 subsection.
10431043 SECTION 8. This act shall become effective November 1 , 2025.
10441044
10451045 60-1-11317 TKR 01/15/25