AS Title 8, Chapter 32: Dental Hygienists and Assistants

Article 1. Examination and Licensing of Dental Hygienists. Chapter 32. Dental Hygienists and Assistants. Sec. 08.32.010. License required. Except as provided in AS 08.32.095 , a person may not practice, offer or attempt to practice, or advertise or announce as being prepared or qualified to practice dental hygiene without a license. Sec. 08.32.014. Qualifications for license. (a) An applicant for a license to practice dental hygiene shall (1) provide evidence to the board that the applicant (A) has successfully completed an academic program in dental hygiene of at least two years duration that, at the time of graduation, is accredited by the Commission on Dental Accreditation of the American Dental Association and is approved by the board; (B) has passed a written theory examination of the American Dental Association Joint Commission on National Dental Examinations or an equivalent examination approved by the board; (C) has successfully passed a state or regional dental hygiene clinical examination approved by the board; (D) has not had a license to practice dental hygiene revoked, suspended, or voluntarily surrendered in this state or another state; (E) is not the subject of an adverse decision based on a complaint, investigation, review procedure, or other disciplinary proceeding within the five years immediately preceding application or of an unresolved complaint, investigation, review procedure, or other disciplinary proceeding undertaken by a state, territorial, local, or federal dental licensing jurisdiction; (F) is not the subject of an unresolved or adverse decision based on a complaint, investigation, review procedure, or other disciplinary proceeding undertaken by a state, territorial, local, or federal dental licensing jurisdiction or law enforcement agency that relates to criminal or fraudulent activity, dental malpractice, or negligent dental care and that adversely reflects on the applicant's ability or competence to practice as a dental hygienist or on the safety or well-being of patients; (G) is not the subject of an adverse report from the National Practitioner Data Bank or the American Association of Dental Boards Clearinghouse for Board Actions that relates to criminal or fraudulent activity or dental malpractice; (H) is not impaired to an extent that affects the applicant's ability to practice as a dental hygienist; (I) has not been convicted of a crime that adversely reflects on the applicant's ability or competency to practice as a dental hygienist or that jeopardizes the safety or well-being of a patient; and (2) meet the other qualifications for a license established by the board by regulation. (b) An applicant for a license to practice dental hygiene may be interviewed in person by the board or a designee of the board. The interview must be recorded. If the application is denied on the basis of the interview, the denial shall be stated in writing, with the reasons for it, and the record shall be preserved. Sec. 08.32.015. Malpractice insurance. [Repealed, § 40 ch 177 SLA 1978.] Sec. 08.32.020. Examination required. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.030. Licensure by credentials. The board may provide for the licensing without examination of a dental hygienist who (1) meets the criteria of AS 08.32.014 ; (2) submits proof of continued competence as specified in regulations adopted by the board; (3) is currently licensed to practice dental hygiene in another state or territory of the United States; and (4) pays the fees established under AS 08.01.065 . Sec. 08.32.035. Temporary license. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.040. Application and fee. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.050. Disposition of fees. [Repealed, § 54 ch 37 SLA 1985.] Sec. 08.32.060. Frequency and content of examination. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.070. Licensing of dental hygienists. The board shall issue each successful applicant a license upon payment of all required fees. Sec. 08.32.071. Renewal of license. At least 60 days before expiration of a dental hygienist's license, the Department of Commerce, Community, and Economic Development shall notify the licensed dental hygienist. Each licensee who wishes to renew a dental hygienist's license shall submit a completed license renewal form, the appropriate fee, and evidence of continued professional competence as required by the board. The Department of Commerce, Community, and Economic Development shall, as soon as practicable, issue a dental hygienist license valid for a stated number of years. Failure to receive notification from the department under this section does not exempt a licensee from renewing the licensee's dental hygienist license. Sec. 08.32.080. Lapse and reinstatement of license. [Repealed, § 7 ch 94 SLA 1968.] Sec. 08.32.081. Lapse and reinstatement of license. A licensed dental hygienist who does not pay the renewal fee under AS 08.32.071 forfeits the hygienist's license. The board may reinstate the license without examination within two years of the date on which payment was due upon written application, proof of continued professional competence, and payment of all unpaid renewal fees and any penalty fee established under AS 08.01.100 (b). Sec. 08.32.085. Restorative function license endorsement. (a) The board shall issue a restorative function endorsement to a licensed dental hygienist if the licensee furnishes evidence satisfactory to the board that the licensee has (1) successfully completed a course offered by or under the auspices of a program accredited by the Commission on Dental Accreditation of the American Dental Association or other equivalent course or program approved by the board; and (2) passed the Western Regional Examining Board's restorative examination or other equivalent examination approved by the board within the five years preceding the licensee's endorsement application, or the licensee is licensed, certified, or otherwise permitted in another state or United States territory to perform restorative functions. (b) An endorsement issued under this section authorizes a licensed dental hygienist under the direct supervision of a licensed dentist to place restorations into a cavity prepared by the licensed dentist and thereafter carve, contour, and adjust contacts and occlusion of the restoration. (c) The board may by regulation establish renewal and continuing education requirements for an endorsement under this section. Sec. 08.32.090. Temporary license. [Repealed, § 15 ch 59 SLA 1978.] Sec. 08.32.095. Exemption from license requirement. (a) A person enrolled as a student in an accredited dental hygiene program may perform dental hygiene procedures as part of a course of study without a license if (1) the procedures are performed under the (A) general supervision of a member of the faculty who is licensed under AS 08.36 , and under the direct or indirect supervision of a member of the faculty who is licensed under this chapter; or (B) direct or indirect supervision of a member of the faculty who is licensed under AS 08.36 ; and (2) the clinical program has received written approval from the board. (b) A person practicing dental hygiene under (a) of this section is subject to all other provisions of this chapter and laws and regulations that apply to the practice of dental hygiene by a licensed dental hygienist. Sec. 08.32.097. Fees. [Repealed, § 40 ch 53 SLA 2012.] Article 2. Regulation of Dental Hygienists. Sec. 08.32.100. Employment of dental hygienists. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.110. Scope of practice of dental hygienists. (a) The role of the dental hygienist is to assist members of the dental profession in providing oral health care to the public. A person licensed to practice the profession of dental hygiene in the state may, (1) under the general supervision of a licensed dentist, (A) perform preliminary charting and triage to formulate a dental hygiene assessment and dental hygiene treatment plan; (B) remove calcareous deposits, accretions, and stains from the exposed surfaces of the teeth beginning at the epithelial attachment by scaling and polishing techniques; (C) remove marginal overhangs; (D) use local periodontal therapeutic agents; (E) perform nonsurgical periodontal therapy; (F) perform other dental operations and services delegated by a licensed dentist if the dental operations and services are not prohibited by (c) of this section; (G) if certified by the board, administer local anesthetic agents; and (2) if certified by the board and under the direct or indirect supervision of a licensed dentist, administer and monitor nitrous oxide-oxygen conscious sedation. (b) The board shall specify by regulation those additional functions that may be performed by a licensed dental hygienist only upon successful completion of a formal course of instruction approved by the board. The board shall adopt regulations specifying the education requirements, evaluation procedures, and degree of supervision required for each function. (c) This section does not authorize delegation of (1) dental diagnosis, comprehensive treatment planning, and writing (A) prescriptions for drugs; (B) authorizations for restorative, prosthetic, or orthodontic appliances; (2) operative or surgical procedures on hard or soft tissues; or (3) other procedures that require the professional competence and skill of a dentist. (d) [Repealed, § 8 ch 111 SLA 2008.] (e) This section does not prohibit a licensed dental hygienist (1) with an endorsement issued under AS 08.32.085 from performing the activities authorized under AS 08.32.085 ; (2) who holds an advanced practice permit issued by the board under AS 08.32.125 or has entered into a collaborative agreement approved by the board under AS 08.32.115 from performing the activities authorized under the permit or collaborative agreement; or (3) from performing a dental operation, procedure, or service a dentist may delegate to a dental assistant under AS 08.36.346 or that a licensed dental hygienist who holds an advanced practice permit issued by the board under AS 08.32.125 may delegate to a dental assistant under AS 08.36.346 (c). Sec. 08.32.115. Collaborative agreements. (a) If the collaborative agreement is approved by the board under (d) of this section, a licensed dental hygienist with a minimum of 4,000 documented hours of clinical experience within the five years preceding application for the board's approval may enter into a collaborative agreement with a licensed dentist in which the licensed dentist authorizes the licensed dental hygienist to perform one or more of the following: (1) oral health promotion and disease prevention education; (2) removal of calcareous deposits, accretions, and stains from the surfaces of teeth; (3) application of topical preventive or prophylactic agents, including fluoride varnishes and pit and fissure sealants; (4) polishing and smoothing restorations; (5) removal of marginal overhangs; (6) preliminary charting and triage to formulate a dental hygiene assessment and dental hygiene treatment plan; (7) the exposure and development of radiographs; (8) use of local periodontal therapeutic agents; and (9) performance of nonsurgical periodontal therapy, with or without the administration of local anesthesia, subsequent to a licensed dentist's authorization or diagnosis as specified in the licensed hygienist's collaborative agreement. (b) The services described in (a) of this section may be performed under a collaborative agreement approved by the board (1) without the presence of the licensed dentist; (2) in a setting other than the usual place of practice of the licensed dentist; and (3) without the dentist's diagnosis and treatment plan unless otherwise specified in the collaborative agreement or in (a) of this section. (c) The board shall adopt regulations regarding approval of collaborative agreements between licensed dental hygienists and licensed dentists. (d) The board may approve a collaborative agreement between a licensed dentist and a licensed dental hygienist. However, the board may not approve more than five collaborative agreements with a licensed dentist, not including any collaborative agreements that have been terminated. A licensed dental hygienist shall notify the board of the termination of a collaborative agreement with a licensed dentist. Sec. 08.32.120. Place of employment. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.125. Advanced practice permits. (a) The board may issue an advanced practice permit to a licensed dental hygienist with a minimum of 4,000 documented hours of clinical experience. A licensed dental hygienist holding an advanced practice permit may (1) promote oral health and provide disease prevention education and oral systemic health education; (2) remove calcareous deposits, accretions, and stains from the surfaces of the teeth beginning at the epithelial attachment by scaling and polishing techniques; (3) apply topical preventive or prophylactic agents, including silver diamine fluoride, fluoride varnishes, and pit and fissure sealants; (4) remove marginal overhangs; (5) perform preliminary charting and triage to formulate a dental hygiene assessment and dental hygiene treatment plan; (6) expose and develop radiographs; (7) use local periodontal therapeutic agents; (8) perform nonsurgical periodontal therapy; (9) screen for oral cancer; (10) if certified by the board, administer local anesthetic agents; (11) prescribe (A) fluoride that is applied or provided to a patient; and (B) chlorhexidine or a similar antibacterial rinse; and (12) delegate dental operations and services to a dental assistant as provided in AS 08.36.346 . (b) A licensed dental hygienist holding an advanced practice permit may provide the services described in (a) of this section to a patient who is unable to access dental treatment because of age, infirmity, or disability and is (1) a resident in a senior center, including a hospital, long-term care facility, adult foster home, residential care facility, or adult congregate living facility; (2) a resident in a health care facility, including a mental health residential program or facility for individuals with developmental or other disabilities; (3) held in a local correctional facility for juveniles or adults; (4) enrolled in a nursery school, day care program, vocational training facility, primary school, secondary school, private school, or public charter school; (5) entitled to benefits under 42 U.S.C. 1786 (Special Supplemental Nutrition Program for Women, Infants, and Children); (6) homebound; or (7) a resident of a dental health professional shortage area designated under 42 U.S.C. 254e. (c) A licensed dental hygienist holding an advanced practice permit may provide the services described in (a) of this section to a patient described in (b) of this section without (1) the physical presence, authorization, or supervision of a licensed dentist; (2) a licensed dentist's examination of the patient. (d) A licensed dental hygienist who provides services under an advanced practice permit shall maintain professional liability insurance and provide the patient, or the parent or legal guardian of the patient, with (1) a written notice that the treatment provided will be limited to services permitted under (a) of this section; (2) a written recommendation that the patient be examined by a licensed dentist for comprehensive oral health care services; and (3) assistance in obtaining a referral to a licensed dentist for further dental planning and treatment, including a written description of methods for obtaining a referral and a list of licensed dentists in the patient's community or other resources for finding a licensed dentist. (e) An advanced practice permit is valid until the expiration of the dental hygienist's license to practice. A licensed dental hygienist may renew an advanced practice permit at the time of license renewal under AS 08.32.071 . Sec. 08.32.130. Information required. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.140. Supervision required. [Repealed, § 40 ch 53 SLA 2012.] Sec. 08.32.150. Revocation of dentist's license. [Repealed, § 32 ch 49 SLA 1980. For current law, see AS 08.36.315 .] Sec. 08.32.160. Grounds for discipline, suspension, or revocation of license. The board may revoke or suspend the license of a dental hygienist, or may reprimand, censure, or discipline a licensee, if, after a hearing, the board finds that the licensee (1) used or knowingly cooperated in deceit, fraud, or intentional misrepresentation to obtain a license, certificate, or endorsement; (2) engaged in deceit, fraud, or intentional misrepresentation in the course of providing or billing for professional services or engaging in professional activities; (3) advertised professional services in a false or misleading manner; (4) has been convicted of a felony or other crime that affects the licensee's ability to continue to practice competently and safely; (5) failed to comply with this chapter, with a regulation adopted under this chapter or under AS 08.36 , or with an order of the board; (6) continued to practice after becoming unfit due to (A) professional incompetence; (B) addiction or dependence on alcohol or other drugs that impairs the licensee's ability to practice safely; (C) physical or mental disability; (7) engaged in lewd or immoral conduct in connection with the delivery of professional service to patients; (8) except as permitted under an advanced practice permit under AS 08.32.125 , performed clinical procedures without being under the supervision of a licensed dentist; (9) did not conform to professional standards in delivering dental hygiene services to patients regardless of whether actual injury to the patient occurred; (10) permitted a dental assistant employed by an advanced practice dental hygienist or working under the supervision of a dental hygienist to perform a dental procedure in violation of AS 08.32.110 or AS 08.36.346 ; (11) falsified or destroyed a patient or facility record, or failed to maintain a patient or facility record for at least seven years after the date the record was created. Sec. 08.32.165. Limits or conditions on license; discipline. (a) In addition to action under AS 08.32.160 , upon a finding that by reason of demonstrated problems of competence, experience, education or health the authority to practice dental hygiene should be limited or conditioned or the practitioner disciplined, the board may reprimand, censure, place on probation, restrict practice by specialty, procedure or facility, require additional education or training, or revoke or suspend a license. (b) [Repealed by § 15 ch 59 SLA 1978.] Sec. 08.32.170. Procedure followed. [Repealed, § 15 ch 59 SLA 1978.] Sec. 08.32.171. Disciplinary sanctions. (a) [Repealed, § 49 ch 94 SLA 1987.] (b) [Repealed, § 49 ch 94 SLA 1987.] (c) The board may summarily suspend the license of a licensee who refuses to submit to a physical or mental examination under AS 08.36.070 (b)(1). A person whose license is suspended under this section is entitled to a hearing conducted by the office of administrative hearings ( AS 44.64.010 ) within seven days after the effective date of the order. If, after a hearing, the board upholds the suspension, the licensee may appeal the suspension to a court of competent jurisdiction. (d) [Repealed, § 49 ch 94 SLA 1987.] (e) [Repealed, § 49 ch 94 SLA 1987.] Sec. 08.32.180. Penalty for violations. (a) A person who violates a provision of this chapter or a regulation adopted under this chapter for which a penalty is not otherwise provided is guilty of a class B misdemeanor. (b) Notwithstanding AS 08.01.075 (a)(8), the board may impose a civil fine not to exceed $25,000 for each violation of this chapter or a regulation adopted under this chapter. Article 3. General Provisions. Sec. 08.32.185. Application of Administrative Procedure Act. AS 44.62 (Administrative Procedure Act) applies to any action taken by the board under this chapter. Sec. 08.32.187. Application of chapter. (a) This chapter applies to a person who practices, or offers or attempts to practice, as a dental hygienist in the state except (1) a dental hygienist in the military service in the discharge of official duties; (2) a dental hygienist in the employ of the United States Public Health Service, United States Department of Veterans Affairs, United States Indian Health Service, or another agency of the federal government, in the discharge of official duties; (3) a dental hygienist licensed in another state or jurisdiction who is teaching or demonstrating clinical techniques at a meeting, seminar, or limited course of instruction sponsored by a dental or dental auxiliary society or association or by an accredited dental or dental auxiliary educational institution; (4) a dental hygienist employed in the state by an Indian health program, as that term is defined in 25 U.S.C. 1603, while providing dental hygiene services to a person the Indian health program is entitled to serve under 25 U.S.C. 450 et seq. (Indian Self-Determination and Education Assistance Act), as amended, and 25 U.S.C. 1601 et seq. (Indian Health Care Improvement Act), as amended. (b) A person excepted from this chapter under (a) of this section shall be held to the same standard of care as a person covered by this chapter. Sec. 08.32.190. Definitions. In this chapter, (1) “board” means the Board of Dental Examiners; (2) “direct supervision” means the dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient evaluates the performance of the dental hygienist; (3) “general supervision” means the dentist has authorized the procedures and they are being carried out in accordance with the dentist's diagnosis and treatment plan; (4) “indirect supervision” means a licensed dentist is in the dental facility, authorizes the procedures, and remains in the dental facility while the procedures are being performed by the dental hygienist; (5) “licensed dental hygienist” means a dental hygienist licensed under this chapter; (6) “licensed dentist” means a dentist licensed under AS 08.36 .