Bill Text: IL HB2267 | 2023-2024 | 103rd General Assembly | Chaptered

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Bill Title: Amends the Illinois Dental Practice Act. Changes the definition of "public health supervision". Provides that without the supervision of a dentist, a dental hygienist may perform dental health education functions, including instruction in proper oral health care and dental hygiene in, for example, a school setting, a long-term care facility, and a health fair (rather than just either a school setting and a long-term care facility). Provides that a dental hygienist may record case (rather than care) histories and oral conditions. Provides that a dentist may enter into an agreement for public health supervision with 4 (rather than 2) public health dental hygienists. Provides that the Department of Public Health Oral Health Section shall compile and publicize public health dental hygienist service data annually. Makes other changes.

Spectrum: Partisan Bill (Democrat 5-0)

Status: (Passed) 2023-08-04 - Public Act . . . . . . . . . 103-0431 [HB2267 Detail]

Download: Illinois-2023-HB2267-Chaptered.html

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Public Act 103-0431
HB2267 Enrolled LRB103 30203 AMQ 56631 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Dental Practice Act is amended by
changing Sections 4, 17, 18, and 18.1 as follows:
(225 ILCS 25/4) (from Ch. 111, par. 2304)
(Section scheduled to be repealed on January 1, 2026)
Sec. 4. Definitions. As used in this Act:
"Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application
file or license file as maintained by the Department's
licensure maintenance unit. It is the duty of the applicant or
licensee to inform the Department of any change of address and
those changes must be made either through the Department's
website or by contacting the Department.
"Department" means the Department of Financial and
Professional Regulation.
"Secretary" means the Secretary of Financial and
Professional Regulation.
"Board" means the Board of Dentistry.
"Dentist" means a person who has received a general
license pursuant to paragraph (a) of Section 11 of this Act and
who may perform any intraoral and extraoral procedure required

in the practice of dentistry and to whom is reserved the
responsibilities specified in Section 17.
"Dental hygienist" means a person who holds a license
under this Act to perform dental services as authorized by
Section 18.
"Dental assistant" means an appropriately trained person
who, under the supervision of a dentist, provides dental
services as authorized by Section 17.
"Expanded function dental assistant" means a dental
assistant who has completed the training required by Section
17.1 of this Act.
"Dental laboratory" means a person, firm or corporation
which:
(i) engages in making, providing, repairing or
altering dental prosthetic appliances and other artificial
materials and devices which are returned to a dentist for
insertion into the human oral cavity or which come in
contact with its adjacent structures and tissues; and
(ii) utilizes or employs a dental technician to
provide such services; and
(iii) performs such functions only for a dentist or
dentists.
"Supervision" means supervision of a dental hygienist or a
dental assistant requiring that a dentist authorize the
procedure, remain in the dental facility while the procedure
is performed, and approve the work performed by the dental

hygienist or dental assistant before dismissal of the patient,
but does not mean that the dentist must be present at all times
in the treatment room.
"General supervision" means supervision of a dental
hygienist requiring that the patient be a patient of record,
that the dentist examine the patient in accordance with
Section 18 prior to treatment by the dental hygienist, and
that the dentist authorize the procedures which are being
carried out by a notation in the patient's record, but not
requiring that a dentist be present when the authorized
procedures are being performed. The issuance of a prescription
to a dental laboratory by a dentist does not constitute
general supervision.
"Public member" means a person who is not a health
professional. For purposes of board membership, any person
with a significant financial interest in a health service or
profession is not a public member.
"Dentistry" means the healing art which is concerned with
the examination, diagnosis, treatment planning and care of
conditions within the human oral cavity and its adjacent
tissues and structures, as further specified in Section 17.
"Branches of dentistry" means the various specialties of
dentistry which, for purposes of this Act, shall be limited to
the following: endodontics, oral and maxillofacial surgery,
orthodontics and dentofacial orthopedics, pediatric dentistry,
periodontics, prosthodontics, oral and maxillofacial

radiology, and dental anesthesiology.
"Specialist" means a dentist who has received a specialty
license pursuant to Section 11(b).
"Dental technician" means a person who owns, operates or
is employed by a dental laboratory and engages in making,
providing, repairing or altering dental prosthetic appliances
and other artificial materials and devices which are returned
to a dentist for insertion into the human oral cavity or which
come in contact with its adjacent structures and tissues.
"Impaired dentist" or "impaired dental hygienist" means a
dentist or dental hygienist who is unable to practice with
reasonable skill and safety because of a physical or mental
disability as evidenced by a written determination or written
consent based on clinical evidence, including deterioration
through the aging process, loss of motor skills, abuse of
drugs or alcohol, or a psychiatric disorder, of sufficient
degree to diminish the person's ability to deliver competent
patient care.
"Nurse" means a registered professional nurse, a certified
registered nurse anesthetist licensed as an advanced practice
registered nurse, or a licensed practical nurse licensed under
the Nurse Practice Act.
"Patient of record" means a patient for whom the patient's
most recent dentist has obtained a relevant medical and dental
history and on whom the dentist has performed an examination
and evaluated the condition to be treated.

"Dental responder" means a dentist or dental hygienist who
is appropriately certified in disaster preparedness,
immunizations, and dental humanitarian medical response
consistent with the Society of Disaster Medicine and Public
Health and training certified by the National Incident
Management System or the National Disaster Life Support
Foundation.
"Mobile dental van or portable dental unit" means any
self-contained or portable dental unit in which dentistry is
practiced that can be moved, towed, or transported from one
location to another in order to establish a location where
dental services can be provided.
"Public health dental hygienist" means a hygienist who
holds a valid license to practice in the State, has 2 years of
full-time clinical experience or an equivalent of 4,000 hours
of clinical experience and has completed at least 42 clock
hours of additional structured courses in dental education in
advanced areas specific to public health dentistry.
"Public health setting" means a federally qualified health
center; a federal, State, or local public health facility;
Head Start; a special supplemental nutrition program for
Women, Infants, and Children (WIC) facility; a certified
school-based health center or school-based oral health
program; a prison; or a long-term care facility.
"Public health supervision" means the supervision of a
public health dental hygienist by a licensed dentist who has a

written public health supervision agreement with that public
health dental hygienist while working in an approved facility
or program that allows the public health dental hygienist to
treat patients, without a dentist first examining the patient
and being present in the facility during treatment, (1) who
are eligible for Medicaid or (2) who are uninsured or and whose
household income is not greater than 300% 200% of the federal
poverty level.
"Teledentistry" means the use of telehealth systems and
methodologies in dentistry and includes patient care and
education delivery using synchronous and asynchronous
communications under a dentist's authority as provided under
this Act.
(Source: P.A. 101-64, eff. 7-12-19; 101-162, eff. 7-26-19;
102-93, eff. 1-1-22; 102-588, eff. 8-20-21; 102-936, eff.
1-1-23.)
(225 ILCS 25/17) (from Ch. 111, par. 2317)
(Section scheduled to be repealed on January 1, 2026)
Sec. 17. Acts constituting the practice of dentistry. A
person practices dentistry, within the meaning of this Act:
(1) Who represents himself or herself as being able to
diagnose or diagnoses, treats, prescribes, or operates for
any disease, pain, deformity, deficiency, injury, or
physical condition of the human tooth, teeth, alveolar
process, gums or jaw; or

(2) Who is a manager, proprietor, operator or
conductor of a business where dental operations are
performed; or
(3) Who performs dental operations of any kind; or
(4) Who uses an X-Ray machine or X-Ray films for
dental diagnostic purposes; or
(5) Who extracts a human tooth or teeth, or corrects
or attempts to correct malpositions of the human teeth or
jaws; or
(6) Who offers or undertakes, by any means or method,
to diagnose, treat or remove stains, calculus, and bonding
materials from human teeth or jaws; or
(7) Who uses or administers local or general
anesthetics in the treatment of dental or oral diseases or
in any preparation incident to a dental operation of any
kind or character; or
(8) Who takes material or digital scans for final
impressions of the human tooth, teeth, or jaws or performs
any phase of any operation incident to the replacement of
a part of a tooth, a tooth, teeth or associated tissues by
means of a filling, crown, a bridge, a denture or other
appliance; or
(9) Who offers to furnish, supply, construct,
reproduce or repair, or who furnishes, supplies,
constructs, reproduces or repairs, prosthetic dentures,
bridges or other substitutes for natural teeth, to the

user or prospective user thereof; or
(10) Who instructs students on clinical matters or
performs any clinical operation included in the curricula
of recognized dental schools and colleges; or
(11) Who takes material or digital scans for final
impressions of human teeth or places his or her hands in
the mouth of any person for the purpose of applying teeth
whitening materials, or who takes impressions of human
teeth or places his or her hands in the mouth of any person
for the purpose of assisting in the application of teeth
whitening materials. A person does not practice dentistry
when he or she discloses to the consumer that he or she is
not licensed as a dentist under this Act and (i) discusses
the use of teeth whitening materials with a consumer
purchasing these materials; (ii) provides instruction on
the use of teeth whitening materials with a consumer
purchasing these materials; or (iii) provides appropriate
equipment on-site to the consumer for the consumer to
self-apply teeth whitening materials.
The fact that any person engages in or performs, or offers
to engage in or perform, any of the practices, acts, or
operations set forth in this Section, shall be prima facie
evidence that such person is engaged in the practice of
dentistry.
The following practices, acts, and operations, however,
are exempt from the operation of this Act:

(a) The rendering of dental relief in emergency cases
in the practice of his or her profession by a physician or
surgeon, licensed as such under the laws of this State,
unless he or she undertakes to reproduce or reproduces
lost parts of the human teeth in the mouth or to restore or
replace lost or missing teeth in the mouth; or
(b) The practice of dentistry in the discharge of
their official duties by dentists in any branch of the
Armed Services of the United States, the United States
Public Health Service, or the United States Veterans
Administration; or
(c) The practice of dentistry by students in their
course of study in dental schools or colleges approved by
the Department, when acting under the direction and
supervision of dentists acting as instructors; or
(d) The practice of dentistry by clinical instructors
in the course of their teaching duties in dental schools
or colleges approved by the Department:
(i) when acting under the direction and
supervision of dentists, provided that such clinical
instructors have instructed continuously in this State
since January 1, 1986; or
(ii) when holding the rank of full professor at
such approved dental school or college and possessing
a current valid license or authorization to practice
dentistry in another country; or

(e) The practice of dentistry by licensed dentists of
other states or countries at meetings of the Illinois
State Dental Society or component parts thereof, alumni
meetings of dental colleges, or any other like dental
organizations, while appearing as clinicians; or
(f) The use of X-Ray machines for exposing X-Ray films
of dental or oral tissues by dental hygienists or dental
assistants; or
(g) The performance of any dental service by a dental
assistant, if such service is performed under the
supervision and full responsibility of a dentist. In
addition, after being authorized by a dentist, a dental
assistant may, for the purpose of eliminating pain or
discomfort, remove loose, broken, or irritating
orthodontic appliances on a patient of record.
For purposes of this paragraph (g), "dental service"
is defined to mean any intraoral procedure or act which
shall be prescribed by rule or regulation of the
Department. Dental service, however, shall not include:
(1) Any and all diagnosis of or prescription for
treatment of disease, pain, deformity, deficiency,
injury or physical condition of the human teeth or
jaws, or adjacent structures.
(2) Removal of, or restoration of, or addition to
the hard or soft tissues of the oral cavity, except for
the placing, carving, and finishing of amalgam

restorations and placing, packing, and finishing
composite restorations by dental assistants who have
had additional formal education and certification.
A dental assistant may place, carve, and finish
amalgam restorations, place, pack, and finish
composite restorations, and place interim restorations
if he or she (A) has successfully completed a
structured training program as described in item (2)
of subsection (g) provided by an educational
institution accredited by the Commission on Dental
Accreditation, such as a dental school or dental
hygiene or dental assistant program, or (B) has at
least 4,000 hours of direct clinical patient care
experience and has successfully completed a structured
training program as described in item (2) of
subsection (g) provided by a statewide dental
association, approved by the Department to provide
continuing education, that has developed and conducted
training programs for expanded functions for dental
assistants or hygienists. The training program must:
(i) include a minimum of 16 hours of didactic study and
14 hours of clinical manikin instruction; all training
programs shall include areas of study in nomenclature,
caries classifications, oral anatomy, periodontium,
basic occlusion, instrumentations, pulp protection
liners and bases, dental materials, matrix and wedge

techniques, amalgam placement and carving, rubber dam
clamp placement, and rubber dam placement and removal;
(ii) include an outcome assessment examination that
demonstrates competency; (iii) require the supervising
dentist to observe and approve the completion of 8
amalgam or composite restorations; and (iv) issue a
certificate of completion of the training program,
which must be kept on file at the dental office and be
made available to the Department upon request. A
dental assistant must have successfully completed an
approved coronal polishing and dental sealant course
prior to taking the amalgam and composite restoration
course.
A dentist utilizing dental assistants shall not
supervise more than 4 dental assistants at any one
time for placing, carving, and finishing of amalgam
restorations or for placing, packing, and finishing
composite restorations.
(3) Any and all correction of malformation of
teeth or of the jaws.
(4) Administration of anesthetics, except for
monitoring of nitrous oxide, conscious sedation, deep
sedation, and general anesthetic as provided in
Section 8.1 of this Act, that may be performed only
after successful completion of a training program
approved by the Department. A dentist utilizing dental

assistants shall not supervise more than 4 dental
assistants at any one time for the monitoring of
nitrous oxide.
(5) Removal of calculus from human teeth.
(6) Taking of material or digital scans for final
impressions for the fabrication of prosthetic
appliances, crowns, bridges, inlays, onlays, or other
restorative or replacement dentistry.
(7) The operative procedure of dental hygiene
consisting of oral prophylactic procedures, except for
coronal polishing and pit and fissure sealants, which
may be performed by a dental assistant who has
successfully completed a training program approved by
the Department. Dental assistants may perform coronal
polishing under the following circumstances: (i) the
coronal polishing shall be limited to polishing the
clinical crown of the tooth and existing restorations,
supragingivally; (ii) the dental assistant performing
the coronal polishing shall be limited to the use of
rotary instruments using a rubber cup or brush
polishing method (air polishing is not permitted); and
(iii) the supervising dentist shall not supervise more
than 4 dental assistants at any one time for the task
of coronal polishing or pit and fissure sealants.
In addition to coronal polishing and pit and
fissure sealants as described in this item (7), a

dental assistant who has at least 2,000 hours of
direct clinical patient care experience and who has
successfully completed a structured training program
provided by (1) an educational institution including,
but not limited to, a dental school or dental hygiene
or dental assistant program, or (2) a continuing
education provider approved by the Department, or (3)
a statewide dental or dental hygienist association,
approved by the Department on or before January 1,
2017 (the effective date of Public Act 99-680), that
has developed and conducted a training program for
expanded functions for dental assistants or hygienists
may perform: (A) coronal scaling above the gum line,
supragingivally, on the clinical crown of the tooth
only on patients 17 years of age or younger who have an
absence of periodontal disease and who are not
medically compromised or individuals with special
needs and (B) intracoronal temporization of a tooth.
The training program must: (I) include a minimum of 32
hours of instruction in both didactic and clinical
manikin or human subject instruction; all training
programs shall include areas of study in dental
anatomy, public health dentistry, medical history,
dental emergencies, and managing the pediatric
patient; (II) include an outcome assessment
examination that demonstrates competency; (III)

require the supervising dentist to observe and approve
the completion of 6 full mouth supragingival scaling
procedures unless the training was received as part of
a Commission on Dental Accreditation approved dental
assistant program; and (IV) issue a certificate of
completion of the training program, which must be kept
on file at the dental office and be made available to
the Department upon request. A dental assistant must
have successfully completed an approved coronal
polishing course prior to taking the coronal scaling
course. A dental assistant performing these functions
shall be limited to the use of hand instruments only.
In addition, coronal scaling as described in this
paragraph shall only be utilized on patients who are
eligible for Medicaid, who are uninsured, or whose
household income is not greater than 300% of the
federal poverty level. A dentist may not supervise
more than 2 dental assistants at any one time for the
task of coronal scaling. This paragraph is inoperative
on and after January 1, 2026.
The limitations on the number of dental assistants a
dentist may supervise contained in items (2), (4), and (7)
of this paragraph (g) mean a limit of 4 total dental
assistants or dental hygienists doing expanded functions
covered by these Sections being supervised by one dentist;
or

(h) The practice of dentistry by an individual who:
(i) has applied in writing to the Department, in
form and substance satisfactory to the Department, for
a general dental license and has complied with all
provisions of Section 9 of this Act, except for the
passage of the examination specified in subsection (e)
of Section 9 of this Act; or
(ii) has applied in writing to the Department, in
form and substance satisfactory to the Department, for
a temporary dental license and has complied with all
provisions of subsection (c) of Section 11 of this
Act; and
(iii) has been accepted or appointed for specialty
or residency training by a hospital situated in this
State; or
(iv) has been accepted or appointed for specialty
training in an approved dental program situated in
this State; or
(v) has been accepted or appointed for specialty
training in a dental public health agency situated in
this State.
The applicant shall be permitted to practice dentistry
for a period of 3 months from the starting date of the
program, unless authorized in writing by the Department to
continue such practice for a period specified in writing
by the Department.

The applicant shall only be entitled to perform such
acts as may be prescribed by and incidental to his or her
program of residency or specialty training and shall not
otherwise engage in the practice of dentistry in this
State.
The authority to practice shall terminate immediately
upon:
(1) the decision of the Department that the
applicant has failed the examination; or
(2) denial of licensure by the Department; or
(3) withdrawal of the application.
(Source: P.A. 101-162, eff. 7-26-19; 102-558, eff. 8-20-21;
102-936, eff. 1-1-23.)
(225 ILCS 25/18) (from Ch. 111, par. 2318)
(Section scheduled to be repealed on January 1, 2026)
Sec. 18. Acts constituting the practice of dental hygiene;
limitations.
(a) A person practices dental hygiene within the meaning
of this Act when he or she performs the following acts under
the supervision of a dentist:
(i) the operative procedure of dental hygiene,
consisting of oral prophylactic procedures;
(ii) the exposure and processing of X-Ray films of the
teeth and surrounding structures;
(iii) the application to the surfaces of the teeth or

gums of chemical compounds designed to be desensitizing
agents or effective agents in the prevention of dental
caries or periodontal disease;
(iv) all services which may be performed by a dental
assistant as specified by rule pursuant to Section 17, and
a dental hygienist may engage in the placing, carving, and
finishing of amalgam restorations only after obtaining
formal education and certification as determined by the
Department;
(v) administration and monitoring of nitrous oxide
upon successful completion of a training program approved
by the Department;
(vi) administration of local anesthetics upon
successful completion of a training program approved by
the Department; and
(vii) such other procedures and acts as shall be
prescribed by rule or regulation of the Department.
(b) A dental hygienist may be employed or engaged only:
(1) by a dentist;
(2) by a federal, State, county, or municipal agency
or institution;
(3) by a public or private school; or
(4) by a public clinic operating under the direction
of a hospital or federal, State, county, municipal, or
other public agency or institution.
(c) When employed or engaged in the office of a dentist, a

dental hygienist may perform, under general supervision, those
procedures found in items (i) through (iv) of subsection (a)
of this Section, provided the patient has been examined by the
dentist within one year of the provision of dental hygiene
services, the dentist has approved the dental hygiene services
by a notation in the patient's record and the patient has been
notified that the dentist may be out of the office during the
provision of dental hygiene services.
(d) If a patient of record is unable to travel to a dental
office because of illness, infirmity, or imprisonment, a
dental hygienist may perform, under the general supervision of
a dentist, those procedures found in items (i) through (iv) of
subsection (a) of this Section, provided the patient is
located in a long-term care facility licensed by the State of
Illinois, a mental health or developmental disability
facility, or a State or federal prison. The dentist shall
either personally examine and diagnose the patient or utilize
approved teledentistry communication methods and determine
which services are necessary to be performed, which shall be
contained in an order to the hygienist and a notation in the
patient's record. Such order must be implemented within 45
days of its issuance, and an updated medical history and
observation of oral conditions must be performed by the
hygienist immediately prior to beginning the procedures to
ensure that the patient's health has not changed in any manner
to warrant a reexamination by the dentist.

(e) School-based oral health care, consisting of and
limited to oral prophylactic procedures, sealants, and
fluoride treatments, may be provided by a dental hygienist
under the general supervision of a dentist. A dental hygienist
may not provide other dental hygiene treatment in a
school-based setting, including but not limited to
administration or monitoring of nitrous oxide or
administration of local anesthetics. The school-based
procedures may be performed provided the patient is located at
a public or private school and the program is being conducted
by a State, county or local public health department
initiative or in conjunction with a dental school or dental
hygiene program. The dentist shall personally examine and
diagnose the patient and determine which services are
necessary to be performed, which shall be contained in an
order to the hygienist and a notation in the patient's record.
Any such order for sealants must be implemented within 120
days after its issuance. Any such order for oral prophylactic
procedures or fluoride treatments must be implemented within
180 days after its issuance. An updated medical history and
observation of oral conditions must be performed by the
hygienist immediately prior to beginning the procedures to
ensure that the patient's health has not changed in any manner
to warrant a reexamination by the dentist.
(f) Without the supervision of a dentist, a dental
hygienist may perform dental health education functions,

including instruction in proper oral health care and dental
hygiene in, for example, either a school setting, a or
long-term care facility, and a health fair. In addition, a
dental hygienist may record case care histories and oral
conditions observed at any time prior to a clinical exam by a
dentist.
(g) The number of dental hygienists practicing in a dental
office shall not exceed, at any one time, 4 times the number of
dentists practicing in the office at the time.
(h) A dental hygienist who is certified as a public health
dental hygienist may provide services to patients: (1) who are
eligible for Medicaid or (2) who are uninsured and whose
household income is not greater than 300% of the federal
poverty level. A public health dental hygienist may perform
oral assessments, perform screenings, and provide educational
and preventative services as provided in subsection (b) of
Section 18.1 of this Act. The public health dental hygienist
may not administer local anesthesia or nitrous oxide, or
place, carve, or finish amalgam restorations or provide
periodontal therapy under this exception. Each patient must
sign a consent form that acknowledges that the care received
does not take the place of a regular dental examination. The
public health dental hygienist must provide the patient or
guardian a written referral to a dentist for assessment of the
need for further dental care at the time of treatment. Any
indication or observation of a condition that could warrant

the need for urgent attention must be reported immediately to
the supervising dentist for appropriate assessment and
treatment.
This subsection (h) is inoperative on and after January 1,
2026.
(i) A dental hygienist performing procedures listed in
paragraphs (1) through (4) of subsection (a) of Section 17.1
must be under the supervision of a dentist, requiring the
dentist authorizes the procedure, remains in the dental
facility while the procedure is performed, and approves the
work performed by the dental hygienist before dismissal of the
patient, but the dentist is not required to be present at all
times in the treatment room.
(j) A dental hygienist may perform actions described in
paragraph (5) of subsection (a) of Section 17.1 under the
general supervision of a dentist as described in this Section.
(Source: P.A. 101-162, eff. 7-26-19; 102-936, eff. 1-1-23.)
(225 ILCS 25/18.1)
(Section scheduled to be repealed on January 1, 2026)
Sec. 18.1. Public health dental supervision
responsibilities.
(a) When working together in a public health supervision
relationship, dentists and public health dental hygienists
shall enter into a public health supervision agreement. The
dentist providing public health supervision must:

(1) be available to provide an appropriate level of
contact, communication, collaboration, and consultation
with the public health dental hygienist and must meet
in-person with the public health dental hygienist at least
quarterly for review and consultation;
(2) have specific standing orders or policy guidelines
for procedures that are to be carried out for each
location or program, although the dentist need not be
present when the procedures are being performed;
(3) provide for the patient's additional necessary
care in consultation with the public health dental
hygienist;
(4) file agreements and notifications as required; and
(5) include procedures for creating and maintaining
dental records, including protocols for transmission of
all records between the public health dental hygienist and
the dentist following each treatment, which shall include
a notation regarding procedures authorized by the dentist
and performed by the public health dental hygienist and
the location where those records are to be kept.
Each dentist and hygienist who enters into a public health
supervision agreement must document and maintain a copy of any
change or termination of that agreement.
Dental records shall be owned and maintained by the
supervising dentist for all patients treated under public
health supervision, unless the supervising dentist is an

employee of a public health clinic or federally qualified
health center, in which case the public health clinic or
federally qualified health center shall maintain the records.
If a dentist ceases to be employed or contracted by the
facility, the dentist shall notify the facility administrator
that the public health supervision agreement is no longer in
effect. A new public health supervision agreement is required
for the public health dental hygienist to continue treating
patients under public health supervision.
A dentist entering into an agreement under this Section
may supervise and enter into agreements for public health
supervision with 4 2 public health dental hygienists. This
shall be in addition to the limit of 4 dental hygienists per
dentist set forth in subsection (g) of Section 18 of this Act.
(b) A public health dental hygienist providing services
under public health supervision may perform only those duties
within the accepted scope of practice of dental hygiene, as
follows:
(1) the operative procedures of dental hygiene,
consisting of oral prophylactic procedures, including
prophylactic cleanings, application of fluoride, and
placement of sealants;
(2) the exposure and processing of x-ray films of the
teeth and surrounding structures; and
(3) such other procedures and acts as shall be
prescribed by rule of the Department.

Any patient treated under this subsection (b) must be
examined by a dentist before additional services can be
provided by a public health dental hygienist. However, if the
supervising dentist, after consultation with the public health
hygienist, determines that time is needed to complete an
approved treatment plan on a patient eligible under this
Section, then the dentist may instruct the hygienist to
complete the remaining services prior to an oral examination
by the dentist. Such instruction by the dentist to the
hygienist shall be noted in the patient's records. Any
services performed under this exception must be scheduled in a
timely manner and shall not occur more than 30 days after the
first appointment date.
(c) A public health dental hygienist providing services
under public health supervision must:
(1) provide to the patient, parent, or guardian a
written plan for referral or an agreement for follow-up
that records all conditions observed that should be called
to the attention of a dentist for proper diagnosis;
(2) have each patient sign a permission slip or
consent form that informs them that the service to be
received does not take the place of regular dental
checkups at a dental office and is meant for people who
otherwise would not have access to the service;
(3) inform each patient who may require further dental
services of that need;

(4) maintain an appropriate level of contact and
communication with the dentist providing public health
supervision; and
(5) complete an additional 4 hours of continuing
education in areas specific to public health dentistry
yearly.
(d) Each public health dental hygienist who has rendered
services under subsections (c), (d), and (e) of this Section
must complete a summary report at the completion of a program
or, in the case of an ongoing program, at least annually. The
report must be completed in the manner specified by the
Division of Oral Health in the Department of Public Health
Oral Health Section including information about each location
where the public health dental hygienist has rendered these
services. The public health dental hygienist must submit the
form to the dentist providing supervision for his or her
signature before sending it to the Division. The Department of
Public Health Oral Health Section shall compile and publicize
public health dental hygienist service data annually.
(e) Public health dental hygienists providing services
under public health supervision may be compensated for their
work by salary, honoraria, and other mechanisms by the
employing or sponsoring entity. Nothing in this Act shall
preclude the entity that employs or sponsors a public health
dental hygienist from seeking payment, reimbursement, or other
source of funding for the services provided.

(f) This Section is repealed on January 1, 2026.
(Source: P.A. 101-162, eff. 7-26-19.)