RULES AND REGULATIONS
STATE BOARD OF DENTISTRY
[49 PA. CODE CH. 33]
Expanded Function Dental Assistants
[30 Pa.B. 2359] The State Board of Dentistry (Board) amends §§ 33.101--33.109, 33.201, 33.209, 33.211 and 33.212 and adds §§ 33.114 and 33.205a, to read as set forth in Annex A relating to expanded function dental assistants (EFDAs).
A. Description of Amendments
Substantive Amendments
§ 33.102(c) (relating to professional education)
Section 33.102(c) implements section 3(d.1)(1) of the Dental Law (act) (63 P. S. § 122(d.1)(1)). EFDAs are required to satisfy one of three educational pathways:
1. Graduate from an EFDA program at an accredited 2-year college or institution which offers an Associate Degree.
2. Graduate from an accredited dental hygiene school requiring the successful completion of at least 75 hours of clinical and didactic instruction in restorative functions.
3. Complete a certification program in EFDA of at least 200 hours of clinical and didactic instruction from an accredited dental assisting program.
In developing this rulemaking, the Board considered requiring accreditation by the Commission on Dental Accreditation of the American Dental Association (CODA) for each educational pathway, to parallel the requirements for dentists and dental hygienists. However, section 3(d.1)(1) of the act recognizes varying accrediting bodies. Therefore, under the Board's proposal, 2-year colleges, under subparagraph (i), would be accredited by an accrediting agency approved by the United States Department of Education Council on Postsecondary Accreditation. Dental hygiene schools, under subparagraph (ii), would receive CODA accreditation. Dental assisting programs, under subparagraph (iii), would be accredited by either CODA or an accredited agency approved by the United States Department of Education Council on Postsecondary Accreditation whose expanded function educational standards are approved by the Board.
§ 33.114 (relating to first certification examination)
Proposed § 33.114, which implements section 11.7(b) of the act (63 P. S. § 130h(b)), establishes the procedure for temporary permit holders to take the certification examination. Temporary permit holders are first required to take that examination. Those who fail are required to cease practicing and return their permits to the Board. Those who register for the examination and fail to appear are deemed to have failed the examination, unless they have received a waiver from the Board due to illness or bereavement. Those who pass will be permitted to continue practicing pending receipt of their certificate.
§ 33.205a (relating to practice as an expanded function dental assistant)
Section 33.205a, which implements section 2 of the act (63 P. S. § 121), delineates the scope of practice. Subsection (a) lists the procedures which expanded function dental assistants are statutorily authorized to perform. Each of these procedures may only be performed under the direct supervision of a dentist. Subsection (b) lists the procedures which expanded function dental assistants are statutorily prohibited from performing.
Technical Amendments
Sections 33.101--33.105, 33.107--33.109, 33.201, 33.209, 33.211 and 33.212 are amended to add provisions for expanded function dental assistants similar to those currently in existence for dentists and dental hygienists.
Notice of proposed rulemaking was published at 28 Pa.B. 3296 (July 11, 1998). Publication was followed by a 30-day public comment period during which the Board received comments from the House Professional Licensure Committee (HPLC), the Pennsylvania Dental Hygienists' Association (PDHA), Harcum College, a dentist and a dental hygienist. Following the close of the public comment period, the Board also received comments from the Independent Regulatory Review Commission (IRRC). The Senate Consumer Protection and Professional Licensure Committee offered no comments, suggestions or objections regarding the amendments.
The amendments reflected in Annex A are responsive to the comments and suggestions received by all commentators. In addition, the Board considered this rulemaking and its purpose under Executive Order 1996-1, Regulatory Review and Promulgation.
For ease of reference, the Board will address the comments in the order in which the amendments appear.
§ 33.102. Professional Education
IRRC proposed a revision of subsection (c)(1)(iii) to clarify the Board's approval process.
A public commentator also suggested that subsection (c)(1)(iii) delineate how the Board will conduct a review of these EFDA programs, by site visits or rubber-stamping a self-assessment document provided by the institution. Following additional public comment and considerable discussion, the Board has determined to retain the flexibility that this section provides.
A public commentator suggested that this section should reflect the duration of an EFDA program. The program content and duration are regulated by the accreditation process of the accrediting agency approved by the United States Department of Education Council on Post-Secondary Accreditation (§ 33.102(c)(1)(i)).
Subsection (c)(2) was revised to accommodate candidates from nonaccredited programs.
§ 33.102(c). Professional Education
IRRC suggested adding the exemption from the educational requirements contained in the 1994 revisions to the act. The Board has added paragraph (3) to meet this objective.
§ 33.102(c)(1)(iii)
IRRC proposed that this section be rewritten for clarity. The Board redrafted this section. The intent is to give guidance to the educational institutions that do not use CODA.
The citation reference under subsection (c)(1) has been corrected to 63 P. S. § 122(d)(1).
§ 33.103(d). Examinations
IRRC suggested that this section created a potential confusion because readers might believe a NERB examination is available for EFDAs. Although not adopting IRRC's suggested language, the Board has amended this section to meet IRRC's concern about potential confusion.
IRRC also recommended that the Board amend the second sentence of this section by inserting ''or certification'' after ''licensure'' to recognize that EFDAs are not licensed, but instead certified. The Board has deleted the words ''for licensure'' to achieve the same objective.
The HPLC suggested that the amendments to this section be postponed until there is an examination for EFDAs that can be identified. The Board has carefully considered this suggestion but has retained this section for the following reasons: (1) Section 33.103, pertaining to examinations, would need to be amended as part of the comprehensive coverage of the entire rulemaking package as it pertains to EFDAs. To leave this gap would be to cause more ambiguity than adding the new subsection (c). (2) The Northeast Regional Board Examination (NERB) is an examination developed and administered by a governing board composed of members of state licensing boards in the Northeast Region. In this regard, it is similar to the National Board Examination. Subsections (a) and (b) detail the NERB examination for dentists and dental hygienists. The EFDA examination will, in all likelihood, be similar to the radiologic procedure examination for auxiliary personnel in § 33.301, which is given by a third party testing administrator under contract with the Bureau. The proposed language is similar to that of existing § 33.301 and is more useful than identifying a particular contractor.
§ 33.107. Licensure and Certification by Criteria Approval
A public commentator recommended that the Board delete the sentence specifying that licensure and certification by criteria approval will be granted only to applicants whose licensing board confirms that it reciprocates with the Commonwealth. The Board has not deleted this provision as section 3(f) of the act requires that other states, territories or Canada recognize and endorse licenses issued by the Commonwealth.
§ 33.114. First certification examination
IRRC recommended that the Board amend the regulation to indicate the specific date on which a licensee must cease practicing. IRRC further suggested that the Board determine under what circumstances and when a waiver should be granted. The Board believes that this section can be simplified and IRRC's concerns met by revising the section as follows: (1) The Board will give notice to temporary permit holders of the date, time and location of the first expanded function dental assistant certification examination. A temporary permit holder will be required to register for and achieve a passing score on the examination. (2) Failure to register or to sit for the examination (unless the Board grants a waiver under subsection (c)) shall be deemed a failure of the examination. Upon notice from the Board of the failure of the examination, the temporary permit holder must immediately cease to practice as an EFDA and return the temporary permit to the Board. (3) The Board would grant a waiver to a temporary permit holder who has not been present at the examination, and who provides the Board with documentation acceptable to the Board that illness or bereavement prevented the applicant from taking the examination as scheduled. A request for a waiver would be filed with the Board within 10 days of the examination date. If a waiver is not granted, the temporary permit holder must, upon notice, immediately cease practicing as an EFDA and return the permit to the Board.
The HPLC suggested that the Board insert language in response to a public commentator to clarify that a temporary permit holder can retake the examination. The Board believes that this additional language is unnecessary and duplicative. The Legislature, in providing for EFDAs, provided for no limitation on the ability of anyone, whether a temporary permit holder or not, to take the examination as many times as the applicant chooses.
The HPLC also suggested that the word ''scheduled'' be inserted after the word ''examination.'' The Board has not adopted this suggestion because inserting this language presents a problem in the sense that if the examination is not held as scheduled, a literal reading may result in temporary permit holders having to cease practice and return their temporary permits, contrary to legislative intent.
§ 33.205a. Practice as an EFDA
IRRC recommended that the Board consider a recommendation of the PDHA to amend subsection (a)(1)(vii) to include the placing and finishing of sealant material as a restorative procedure. The Board has amended this subsection to reflect current practice of EFDAs, allowing the placement and finishing of composite restorations or sealant material, or both.
IRRC suggested that subsection (b) be amended to include the statutory prohibition against EFDAs taking impressions other than for study models or diagnostics. The Board has added this suggestion.
A public commentator objected to creation of § 33.205a, for practice as an EFDA, as a subsection to § 33.205, practice as a dental hygienist. The Board believes that each section, § 33.205 and § 33.205a, is separate and distinct, and it is helpful to have them placed contiguously.
Section 33.205a(b)(4) and (6) were amended to more clearly conform to the mandates of section 2 of the act.
B. Compliance with Executive Order 1996-1
The Board reviewed this rulemaking and considered its purpose and likely impact upon the public and the regulated population under Executive Order 1996-1, Regulatory Review and Promulgation. The final-form regulations address a compelling public interest as described in this Preamble and otherwise comply with Executive Order 1996-1.
C. Fiscal Impact and Paperwork Requirements
1. Commonwealth--The amendments will require the Board to assure compliance with the certification requirements for EFDAs. The costs associated with implementing these amendments, including an audit, will be borne by the general licensee/certificate holder population through biennial renewal fees which generate revenue for all Board activities. Additional paperwork will be incurred by the Board to amend renewal application forms.
2. Political subdivisions--There will be no adverse fiscal impact or paperwork requirements imposed.
3. Private sector--There will be no adverse fiscal impact or paperwork requirements imposed.
D. Statutory Authority
The amendments are promulgated under sections 2--5.1, 10--11.5 and 11.7 of the act (63 P. S. §§ 121--124.1, 129--129.1, 130, 130e and 130h).
E. Sunset Date
The Board continually monitors the effectiveness of its regulations through communications with the regulated population; accordingly, no sunset date has been set.
F. Regulatory Review
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on July 11, 1998, the Board submitted a copy of the notice of proposed rulemaking, published at 28 Pa.B. 3296 (July 11, 1998), to IRRC and the Chairpersons of the HPLC and the Senate Consumer Protection and Professional Licensure Committee for review and comment. In compliance with section 5(b.1) of the Regulatory Review Act, the Board also provided IRRC and the Committees with copies of the comments received, as well as other documentation.
In preparing these final-form regulations, the Board considered the comments received from IRRC and the public.
These final-form regulations were deemed approved by the House and Senate Committees on March 15, 2000. IRRC met on April 13, 2000, and deemed approved the final-form regulations in accordance with section 5.1(e) of the Regulatory Review Act (71 P. S. § 745.5a(e)).
G. Contact person
Further information may be obtained by contacting Lisa Burns, Board Administrator, State Board of Dentistry, P. O. Box 2649, Harrisburg, PA 17105-2649, (717) 783-7162.
H. Findings
(1) Public notice of rulemaking was given under sections 201 and 202 of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. §§ 1201 and 1202) and the regulations promulgated thereunder, at 1 Pa. Code §§ 7.1 and 7.2.
(2) A public comment period was provided as required by law and all comments were considered.
(3) These amendments do not enlarge the purpose of proposed rulemaking published at 28 Pa.B. 3296.
(4) These amendments are necessary and appropriate for administration and enforcement of the Board's authorizing statute.
Order
The Board, acting under its authorizing statute, orders that:
(a) The regulations of the Board, 49 Pa. Code Chapter 33, are amended by amending §§ 33.101--33.109, 33.201, 33.209, 33.211 and 33.212 and adding §§ 33.114 and 33.205a to read as set forth in Annex A.
(b) The Board shall submit this order and Annex A to the Office of General Counsel and to the Office of Attorney General as required by law.
(c) The Board shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(d) This order shall take effect upon publication in the Pennsylvania Bulletin.
NORBERT O. GANNON, D.D.S.,
Chairperson(Editor's Note: For the text of the order of the Independent Regulatory Review Commission, relating to this document, see 30 Pa.B. 2176 (April 29, 2000).)
Fiscal Note: Fiscal Note 16A-465 remains valid for the final adoption of the subject regulations.
Annex A
TITLE 49. PROFESSIONAL AND VOCATIONAL STANDARDS
PART I. DEPARTMENT OF STATE
Subpart A. PROFESSIONAL AND OCCUPATIONAL AFFAIRS
CHAPTER 33. STATE BOARD OF DENTISTRY
Subchapter B. LICENSURE OF DENTISTS AND DENTAL HYGIENISTS AND CERTIFICATION OF EXPANDED FUNCTION DENTAL ASSISTANTS § 33.101. General information.
(a) Only persons holding a current license issued by the Board may practice dentistry or may practice as a dental hygienist in this Commonwealth.
(b) Only persons holding a certificate issued by the Board may practice as an expanded function dental assistant in this Commonwealth.
(c) To secure a license or certificate, an applicant shall satisfy the requirements of the act and of this subchapter.
(d) Applications for licensure or certification shall be made on forms supplied by the Board and shall be accompanied by the application fee in § 33.3 (relating to fees).
§ 33.102. Professional education.
(a) Dentists.
(1) Candidates for licensure as dentists shall show compliance with section 3(c) of the act (63 P. S. § 122(c)) which requires a diploma from an ''approved institution or college,'' by submitting certification of graduation from a dental school accredited or provisionally accredited by the Commission on Accreditation of the American Dental Association.
(2) Candidates for licensure who received their professional education outside the United States in a nonaccredited school may satisfy the education requirement by submitting their credentials to an accredited or provisionally accredited school and obtaining additional preclinical and clinical training that will lead to the awarding of the D.M.D. or D.D.S. degree by that school.
(b) Dental hygienists.
(1) Candidates for licensure as dental hygienists shall show compliance with section 3(d) of the act by submitting certification of graduation from a dental hygiene school accredited or provisionally accredited by the Commission on Accreditation of the American Dental Association, if the school's dental hygiene course of study comprises a minimum of 2 years of at least 32 weeks of at least 30 hours each week or its equivalent.
(2) Candidates for licensure who received their professional education outside the United States in a nonaccredited school may satisfy the education requirement by submitting their credentials to an accredited or provisionally accredited school and obtaining additional training that will lead to the awarding of a degree in dental hygiene by that school.
(c) Expanded function dental assistants.
(1) Candidates for certification as expanded function dental assistants shall show compliance with 3(d.1) of the act by submitting verification of one of the following:
(i) Graduation from an expanded function dental assisting program at a 2-year college or other institution accredited or provisionally accredited by an accrediting agency approved by the United States Department of Education Council on Postsecondary Accreditation which offers an Associate Degree.
(ii) Graduation from a dental hygiene school which required the successful completion of at least 75 hours of clinical and didactic instruction in restorative functions accredited or provisionally accredited by the Commission on Accreditation of the American Dental Association.
(iii) Completion of a certification program in expanded function dental assisting of at least 200 hours of clinical and didactic instruction from a dental assisting program accredited by one of the following:
(A) The Commission on Dental Accreditation of the American Dental Association.
(B) An accrediting agency approved by the United States Department of Education Council on Postsecondary Accreditation whose expanded function educational standards are approved by the Board.
(2) Candidates for certification who receive their professional education outside the United States or from a nonaccredited program may satisfy the education requirement by submitting their credentials to a program listed in paragraph (1) and obtaining additional training that will lead to the awarding of a degree by that school.
(3) This subsection does not apply to persons who are not required to meet the educational requirements under section (3)(d.1)(2) of the act.
§ 33.103. Examinations.
(a) Dentists. Candidates for licensure shall pass the National Board Dental Examination (written examination) and the Northeast Regional Board (NERB) Dental Examination (clinical examination).
(b) Dental hygienists. Candidates for licensure shall pass the National Board Dental Hygiene Examination (written examination) and the NERB Dental Hygiene Examination (clinical examination).
(c) Expanded function dental assistants. Candidates for certification shall pass an examination comprised of both a written and a clinical component acceptable to the Board.
(d) Additional requirement. The Board will recognize successful completion of the NERB Dental Examination or NERB Dental Hygiene Examination or the expanded function dental assistant examination approved by the Board for up to 5 years from the date scores are reported to the Board. After 5 years, the Board will accept passing scores on the examinations only if the candidate has been engaged in postgraduate training or in the practice of dentistry, as a dental hygienist or as an expanded function dental assistant in another jurisdiction.
§ 33.104. Initial licensure; licensure documents.
(a) Each new licensee is issued a wall certificate indicating initial licensure and a registration packet including a biennial renewal certificate and a wallet-size license card that show the expiration date of the license. Licenses expire on March 31 of each odd-numbered year, regardless of the date of issuance.
(b) Each new certificate holder is issued a wall certificate indicating initial certification and a registration packet including a biennial renewal certificate and a wallet-size certification card that show the expiration date of the certificate. Certificates expire on March 31 of each odd-numbered year, regardless of the date of issuance.
(c) Fees as prescribed by the Bureau of Professional and Occupational Affairs Fee Act (63 P. S. §§ 1401-101--1401-501), shall be charged for duplicate wall certificates and biennial renewal documents. A duplicate will be issued only upon submission by the licensee or certificate holder of a notarized statement specifying why the original is unavailable and stating that the duplicate will be returned if the original is recovered.
§ 33.105. Biennial renewal of licenses and certificates.
(a) Licenses and certificates are renewable for a 2-year period beginning April 1 of each odd-numbered year. The fee for biennial renewal is set by the Board. See § 33.3 (relating to fees). Upon renewal, licensees and certificate holders receive new biennial renewal certificates and wallet-size license cards that show the next expiration date of the license or certificate. These documents are the only evidence of valid, current licensure or certification.
(b) Dentists, dental hygienists and expanded function dental assistants who fail to renew their licenses or certificates are prohibited from practicing their profession in this Commonwealth.
§ 33.106. Reactivation of licenses and certificates.
(a) Dentists, dental hygienists and expanded function dental assistants who have failed to renew their licenses or certificates may apply for reactivation of licensure or certification on forms prescribed by the Board. The applicant shall pay the current biennial renewal fee and shall submit a notarized affidavit identifying the period of time in which the applicant did not practice in this Commonwealth.
(b) An applicant for reactivation of licensure or certification who practiced in this Commonwealth without a current license or certificate shall pay a late renewal fee of $5 for each month or part of a month during which the unauthorized practice occurred, as provided in section 225 of the Bureau of Professional and Occupational Affairs Fee Act (63 P. S. § 1401-225). In addition, the applicant shall pay the biennial renewal fee for each biennium during which unauthorized practice occurred. The payment of late fees and biennial renewal fees does not preclude the Board from taking disciplinary action against a dentist, dental hygienist or expanded function dental assistant who practiced without a current license or certificate.
§ 33.107. Licensure and certification by criteria approval.
Dentists, dental hygienists and expanded function dental assistants who are currently licensed or certified in another state or territory or in Canada may be granted licensure or certification in this Commonwealth if the credentials submitted meet the requirements of the act and of this subchapter. Licensure and certification by criteria approval will be granted only to applicants whose licensing boards confirm that they reciprocate with the Commonwealth. An applicant shall cause the licensing authority of each state where the applicant has practiced to submit to the Board a letter of good standing. The Board may grant a personal interview to resolve questions concerning an applicant's qualifications.
§ 33.108. Transfers out-of-state.
Dentists, dental hygienists and expanded function dental assistants who wish their licensure, certification or grades certified to another state shall pay the fee in § 33.3 (relating to fees).
§ 33.109. Licensee's and certificate holder's change of name or address; service of process and legal papers.
(a) A licensee's or certificate holder's name on file with the Board shall be the name that appears on the license or certificate unless that name is legally changed, in which case the licensee or certificate holder shall report the change to the Board in writing within 10 days.
(b) A licensee or certificate holder who changes an address on file with the Board shall notify the Board in writing within 10 days. Licensees or certificate holders who do not comply with this subsection shall bear full responsibility for failure to receive correspondence, including biennial renewal notifications, from the Board or the Department.
(c) A licensee's or certificate holder's most recent name and address on file with the Board will be deemed the licensee's or certificate holder's official name and address for purposes of service of process and other legal papers.
§ 33.114. First certification examination.
(a) The Board will give notice to temporary permit holders of the date, time and location of the first expanded function dental assistant certification examination. A temporary permit holder is required to register for and achieve a passing score on the examination.
(b) Failure to register or to sit for the examination (unless the Board grants a waiver under subsection (c)) shall be deemed a failure of the examination. Upon notice from the Board of the failure of the examination, the temporary permit holder shall immediately cease to practice as an expanded function dental assistant and shall return the temporary permit to the Board.
(c) The Board will grant a waiver to a temporary permit holder who has not been present at the examination, who provides the Board with documentation acceptable to the Board that illness or bereavement prevented the applicant from taking the examination as scheduled. A request for a waiver shall be filed with the Board within 10 days of the examination date. If a waiver is not granted, the temporary permit holder shall, upon notice, immediately cease practicing as an expanded function dental assistant and return the permit to the Board.
Subchapter C. MINIMUM STANDARDS OF CONDUCT AND PRACTICE § 33.201. Use of titles and other designations.
(a) Dentists, dental hygienists and expanded function dental assistants may use only the following titles when formally holding themselves out to the public as members of their respective professions:
(1) Dentists.
(i) ''Doctor'' or ''Dr.'' if the licensee's name and a title permitted under subparagraph (ii) or (iii) follows immediately. The Board specifically prohibits the use of the word ''Doctor'' or its abbreviation except in combination with one of these titles.
(ii) ''Dentist,'' ''Doctor of Dental Surgery,'' ''Doctor of Dental Medicine,'' or a title such as ''Orthodontist,'' signifying a specialty recognized by the Board in which the dentist has advanced training in conformity with § 33.203(d)(1) (relating to advertising), when preceded by the licensee's name.
(iii) ''D.D.S.'' or ''D.M.D.,'' when preceded by the licensee's name.
(2) Dental hygienists.
(i) ''Dental Hygienist'' or ''D. H.,'' when preceded by the licensee's name.
(ii) ''Registered Dental Hygienist'' or ''R.D.H.,'' when preceded by the licensee's name.
(3) Expanded function dental assistants. ''Expanded function dental assistant'' or ''EFDA'' when preceded by the certificate holder's name.
(b) In addition to the titles approved under subsection (a), licensees may use, in conjunction with their names, designations of advanced degrees earned from accredited institutions and designations of advanced professional status--such as diplomate or fellow.
(c) References in this section to the licensee's or certificate holder's name shall be interpreted to mean the name appearing on the licensee's or certificate holder's current license or certificate but to allow for the use of initials preceding the licensee's or certificate holder's surname.
§ 33.205a. Practice as an expanded function dental assistant.
(a) Scope of professional practice.
(1) An expanded function dental assistant may offer to perform or perform the following services:
(i) Placing and removing rubber dams.
(ii) Placing and removing matrices.
(iii) Placing and removing wedges.
(iv) Applying cavity liners and bases.
(v) Placing and condensing amalgam restorations.
(vi) Carving and contouring amalgam restorations.
(vii) Placing and finishing composite resin restorations and/or sealant material or both.
(2) Each of the professional services identified in paragraph (1) shall be performed under the direct supervision of a dentist.
(b) Prohibitions. An expanded function dental assistant may not:
(1) Examine, diagnose or plan treatment.
(2) Cut hard or soft tissue.
(3) Prescribe drugs, medicaments or lab authorizations.
(4) Approve the final occlusion.
(5) Perform pulp capping, pulpotomy and other endodontic procedures.
(6) Perform final placement/cementation of fixed and removable prosthetic appliances.
(7) Administer local anesthesia, parenteral or inhalational sedation, nitrous oxide analgesia or general anesthesia.
(8) Take impressions other than for study models or diagnostic casts.
(c) Supervision. Expanded function dental assistants shall perform under the direct supervision of a dentist. Direct supervision means that a dentist is in the dental office or treatment facility, personally diagnoses the condition to be treated, personally authorizes the procedure and remains in the dental office or treatment facility while the procedure is being performed by the expanded function dental assistant, and, before dismissal of the patient, evaluates the work performed by the expanded function dental assistant.
§ 33.209. Preparing, maintaining and retaining patient records.
(a) A dentist shall maintain a dental record for each patient which accurately, legibly and completely reflects the evaluation and treatment of the patient. A patient dental record shall be prepared and maintained regardless of whether treatment is actually rendered or whether a fee is charged. The record shall include, at a minimum, the following:
(1) The name and address of the patient and, if the patient is a minor, the name of the patient's parents or legal guardian.
(2) The date of each patient visit.
(3) A description of the patient's complaint, symptoms and diagnosis.
(4) A description of the treatment or service rendered at each visit and the identity of the person rendering it.
(5) Information as required in § 33.208 (relating to prescribing, administering and dispensing medications) and this section with regard to controlled substances or other medications prescribed, administered or dispensed.
(6) The date and type of radiographs taken and orthodontic models made, as well as the radiographs and models themselves. Notwithstanding this requirement, the dentist may release orthodontic models to the patient. This transaction shall be memorialized on a form which is signed by the patient. The signed form shall become part of the patient's record.
(7) Information with regard to the administration of local anesthesia, nitrous oxide/oxygen analgesia, conscious sedation or general anesthesia.
(8) The date of each entry into the record and the identity of the person providing the service if not the dentist of record--for example, dental hygienist, expanded function dental assistant, dental assistant, and the like.
(b) A patient dental record shall be retained by a dentist for a minimum of 5 years from the date of the last dental entry.
(c) Within 30 days of receipt of a written request from a patient or a patient's parents or legal guardian if the patient is a minor, an exact copy of the patient's written dental record, along with copies of radiographs and orthodontic models, if requested, shall be furnished to the patient or to the patient's new dentist. This service shall be provided either gratuitously or for a fee reflecting the cost of reproduction.
(d) The obligation to transfer records under subsection (c) exists irrespective of a patient's unpaid balance for dental services or for the cost of reproducing the record.
(e) Dentists shall provide for the disposition of patient records in the event of the dentist's withdrawal from practice, incapacity or death in a manner that will ensure their availability under subsection (c).
(f) The components of a patient dental record that are prepared by a dentist or an agent and retained by a health care facility regulated by the Department of Health or the Department of Public Welfare shall be considered a part of the patient dental record required to be maintained by a dentist, but shall otherwise be exempt from subsections (a)--(e). The components of a patient dental record shall contain information required by applicable Department of Health and Department of Public Welfare regulations--see, for example, 28 Pa. Code § 141.26 (relating to patient dental records)--and health care facility bylaws.
(g) This section does not restrict or limit the applicability of recordkeeping requirements in § 33.207 (relating to prescribing, administering and dispensing controlled substances) and § 33.208.
(h) A dentist's failure to comply with this section will be considered unprofessional conduct and will subject the noncomplying dentist to disciplinary action as authorized in section 4.1(a)(8) of the act (63 P. S. § 123.1(a)(8)).
§ 33.211. Unprofessional conduct.
(a) Dentists. Unprofessional conduct, as defined in section 4.1(a)(8) of the act (63 P. S. § 123.1(a)(8)), includes the following conduct by a dentist:
(1) Knowingly or negligently employing as a dentist, dental hygienist or expanded function dental assistant a person whose license or certificate is not current or has been suspended or revoked.
(2) Failing to carry out supervisory responsibility with regard to auxiliary personnel or dental residents/interns.
(3) Delegating to a person duties that the dentist knows, or has reason to know, the person is not competent to perform or not authorized to perform.
(4) Withdrawing dental services after a dentist-patient relationship has been established so that the patient is unable to obtain necessary dental care in a timely manner.
(5) Physically, sexually or verbally abusing a patient.
(6) Unnecessarily exposing a patient to ionizing radiation.
(7) Failing to follow current infection-control recommendations issued by the Federal Centers for Disease Control or to ensure that auxiliary personnel and other supervisees follow these Federal guidelines.
(8) Failing to provide necessary dental care to a patent in a timely manner or to apprise the patient of the need for the care.
(9) Failing to make available to a patient, within 30 days of a request, information sufficient to enable the patient to complete an insurance form.
(b) Dental hygienists. Unprofessional conduct, as defined in section 4.1(a)(8) of the act includes the following conduct by a dental hygienist:
(1) Practicing as a dental hygienist without the supervision of a dentist.
(2) Performing a service that the dental hygienist knows, or has reason to know, the hygienist is not competent to perform or not authorized to perform.
(3) Physically, sexually or verbally abusing a patient.
(4) Failing to follow current infection-control recommendations issued by the Federal Centers for Disease Control.
(5) Unnecessarily exposing a patient to ionizing radiation.
(c) Expanded function dental assistants. Unprofessional conduct, as defined in section 4.1(a)(8) of the act includes the following conduct by an expanded function dental assistant:
(1) Practicing as an expanded function dental assistant without the direct supervision of a dentist.
(2) Performing a service that the expanded function dental assistant is not competent or not authorized to perform.
(3) Physically, sexually or verbally abusing a patient.
(4) Failing to follow current infection-control recommendations issued by the Federal Centers for Disease Control.
(5) Providing ionizing radiation in violation of § 33.302 (relating to auxiliary personnel performing radiologic procedures).
§ 33.212. Misleading, deceptive, untrue or fraudulent representations.
As used in section 4.1(a)(2) of the act (63 P. S. § 123.1(a)(2)), the phrase ''misleading, deceptive, untrue or fraudulent representations'' includes the following conduct by dentists, dental hygienists and expanded function dental assistants:
(1) Misrepresenting or concealing a material fact in obtaining, renewing or seeking reinstatement of a license or certificate.
(2) Misrepresenting or concealing a material fact in obtaining payment for dental services.
(3) Writing a prescription for a controlled substance or other medication in the name of a person other than for whom the controlled substance or other medication is intended under §§ 33.207 and 33.208 (relating to prescribing, administering and dispensing controlled substances; and prescribing, administering and dispensing medications).
(4) Falsifying a patient's record regarding treatment or the issuance of a controlled substance or other medication.
[Pa.B. Doc. No. 00-786. Filed for public inspection May 12, 2000, 9:00 a.m.]
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