§ 90-233. Practice of dental hygiene.
§ 90‑233. Practice ofdental hygiene.
(a) A dental hygienistmay practice only under the supervision of one or more licensed dentists. Thissubsection shall be deemed to be complied with in the case of dental hygienistsemployed by or under contract with a local health department or Stategovernment dental public health program and especially trained by the DentalHealth Section of the Department of Health and Human Services as public healthhygienists, while performing their duties for the persons officially served bythe local health department or State government program under the direction ofa duly licensed dentist employed by that program or by the Dental HealthSection of the Department of Health and Human Services.
(a1) A dental hygienistwho has three years of experience in clinical dental hygiene or a minimum of2,000 hours performing primarily prophylaxis or periodontal debridement underthe supervision of a licensed dentist, who completes annual CPR certification,who completes six hours each year of Board‑approved continuing educationin medical emergencies in addition to the requirements of G.S. 90‑225.1,and who is designated by the employing dentist as being capable of performingclinical hygiene procedures without the direct supervision of the dentist, mayperform one or more dental hygiene functions as described in G.S. 90‑221(a)without a licensed dentist being physically present if all of the followingconditions are met:
(1) A licensed dentistdirects in writing the hygienist to perform the dental hygiene functions.
(2) The licensed dentisthas personally conducted an evaluation of the patient which shall include acomplete oral examination of the patient, a thorough analysis of the patient'shealth history, a diagnosis of the patient's condition, and a specific writtenplan for treatment.
(3) The dental hygienefunctions directed to be performed in accordance with this subsection shall beconducted within 120 days of the dentist's evaluation.
(4) The services areperformed in nursing homes; rest homes; long‑term care facilities; ruraland community clinics operated by Board‑approved nonprofits; rural andcommunity clinics operated by federal, State, county, or local governments; andany other facilities identified by the Office of Rural Health and approved bythe Board as serving dental access shortage areas.
(a2) A dental hygienistshall not establish or operate a separate care facility that exclusivelyrenders dental hygiene services.
(a3) A dental hygienistwho has been disciplined by the Board may not practice outside the directsupervision of a dentist under G.S. 90‑233(a1). A dentist who has beendisciplined by the Board may not allow a hygienist to work outside of thatdentist's direct supervision under G.S. 90‑233(a1).
(a4) Each dentist whochooses to order dental hygiene services under G.S. 90‑233(a1) shallreport annually to the Board the number of patients who were treated outsidethe direct supervision of the dentist, the location in which the services wereperformed by the hygienist, and a description of any adverse circumstanceswhich occurred during or after the treatment, if any. The dentist's reportshall not identify hygienists or patients by name or any other identifier.
(a5) Clinical dentalhygiene services shall be provided in compliance with both CDC and OSHAstandards for infection control and patient treatment.
(b) A dentist inprivate practice may not employ more than two dental hygienists at one and thesame time who are employed in clinical dental hygiene positions.
(c) Dental hygiene maybe practiced only by the holder of a license or provisional license currentlyin effect and duly issued by the Board. The following acts, practices,functions or operations, however, shall not constitute the practice of dentalhygiene within the meaning of this Article:
(1) The teaching ofdental hygiene in a school or college approved by the Board in a board‑approvedprogram by an individual licensed as a dental hygienist in any state in theUnited States.
(2) Activity which wouldotherwise be considered the practice of dental hygiene performed by studentsenrolled in a school or college approved by the Board in a board‑approveddental hygiene program under the direct supervision of a dental hygienist or adentist duly licensed in North Carolina or qualified for the teaching ofdentistry pursuant to the provisions of G.S. 90‑29(c)(3), acting as aninstructor.
(3) Any act or actsperformed by an assistant to a dentist licensed to practice in this State whensaid act or acts are authorized and permitted by and performed in accordancewith rules and regulations promulgated by the Board.
(4) Dental assisting andrelated functions as a part of their instructions by students enrolled in acourse in dental assisting conducted in this State and approved by the Board,when such functions are performed under the supervision of a dentist acting asa teacher or instructor who is either duly licensed in North Carolina orqualified for the teaching of dentistry pursuant to the provisions of G.S. 90‑29(c)(3).(1945, c. 639,s. 12; 1971, c. 756, s. 13; 1973, c. 476, s. 128; 1981, c. 824, ss. 2, 3; 1989,c. 727, s. 219(6a); 1997‑443, s. 11A.23; 1999‑237, s. 11.65; 2007‑124,s. 2.)