Chapter 150-5 DENTAL HYGIENE
| (1) |
Persons of good
moral character, at least eighteen (18) years of age, who have been examined,
found qualified and issued licenses by the Georgia Board of Dentistry, may
practice as dental hygienists in this State under the terms and limitations set
forth in this Chapter. |
| (1) |
No persons shall be issued a license to
practice as a dental hygienist unless such person is a graduate of a school or
college for dental hygienists recognized by the board and accredited by the
Commission on Dental Accreditation of the American Dental Association or its
successor agency. Such school or college must conduct a course consisting of
not less than two (2) academic years for dental hygiene graduation. |
| (2) |
All applicants must show passage of all
sections with a score of 75 or higher on a clinical examination administered by
the board or a testing agency designated and approved by the board. The board
will only consider examination results from the Southern Regional Testing
Agency (SRTA) that were attained between February 22, 1993 and December 31,
2005. SRTA retake examination results will be accepted until December 31, 2006.
After December 31, 2005, the board will only consider the dental hygiene
examination as uniformly administered by the Central Regional Dental Testing
Service, Inc. (CRDTS) or any other testing agency designated and approved by
the board. Applicants must also pass a jurisprudence examination on the laws
and rules governing the practice of dental hygiene in the State of Georgia.
Such examinations shall be administered in the English language. The Board may
hold other examinations as may be required and necessary. |
| (3) |
Any candidate who fails any clinical
examination three times must take a remedial course of study designated and
pre-approved by the board.
| (a) |
Once the
candidate shows written proof of successful completion of the approved course
of study, the Board will grant the candidate one additional attempt at
successful passage of a clinical licensing examination approved by the
board. |
| (b) |
After a fourth failure
of any clinical examination, no further attempts will be authorized or scores
recognized by the board for licensure in Georgia. |
|
| (4) |
The applicant must provide the board with
a copy of his or her score showing passage of all sections with a score of 75
or higher on the National Board Examination. |
| (5) |
An applicant for dental hygiene licensure
must provide the board with the following items:
| (a) |
An official transcript under seal showing
the date of graduation and degree awarded from an accredited dental hygiene
school certified by the appropriate officials; |
| (b) |
A certified copy of the results of the
clinical examination given by the board or a testing agency designated and
approved by the board; |
| (c) |
Copies
of score of the National Board Examination; |
| (d) |
Proof of current CPR
certification; |
| (e) |
Copies of any
and all National Practitioner's Data Bank reports pertaining to the
applicant; |
| (f) |
Furnish a criminal
background check. The applicant shall be responsible for all fees associated
with the performance of a background check; and |
| (g) |
Verification of licensure from all states
where the applicant has ever held or currently holds a license to practice
dental hygiene. All such licenses shall be unencumbered by any past or present
disciplinary action. |
| (h) |
In
accordance with O.C.G.A. § 50-36-1, all applicants applying
for licensure must submit an Affidavit Regarding Citizenship and submit a copy
of secure and verifiable documentation supporting the Affidavit with his or her
application. |
|
| (1) |
Definitions.
| (a) |
"Authorizing dentist" shall
mean a dentist licensed to practice in Georgia who permits a dental hygienist
to practice under general supervision. |
| (b) |
"Dental hygiene duties" and "dental
hygiene services" shall mean those tasks which a dental hygienist may lawfully
perform under O.C.G.A. § 43-11-74 and this Rule |
| (c) |
"Dental hygienist" shall mean an
individual licensed to practice dental hygiene in Georgia. |
| (d) |
"Dental screening" shall mean a visual
assessment of the oral cavity without the use of x-rays, laboratory tests, or
diagnostic models to determine if it appears that a more thorough clinical
examination and diagnosis should be conducted by a licensed dentist. |
| (e) |
"Dentist" shall mean an individual
licensed to practice dentistry in Georgia. |
| (f) |
"Direct supervision" shall mean that a
licensed 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 dental hygienist, and before dismissal of the patient,
examines the patient. |
| (g) |
"General
supervision" shall mean that a licensed dentist has authorized the delegable
duties of a dental hygienist but does not require that a licensed dentist be
present when such duties are performed. |
|
| (2) |
No dentist shall be required to authorize
a dental hygienist to perform dental hygiene duties under general supervision,
and no part of this Rule shall be construed as to establish independent dental
hygiene practice. |
| (3) |
A dental
hygienist shall perform duties only under the direct supervision of a duly
licensed dentist who is licensed to practice in the State of Georgia, except
where otherwise provided in O.C.G.A. § 43-11-74 and this rule. |
| (4) |
The requirement of direct supervision
shall not apply to:
| (a) |
The educational
training of dental hygiene students at an institution approved by the Board and
the Commission on Dental Accreditation of the American Dental Association, or
its successor agency. |
| (b) |
The
performance of dental hygiene duties at approved dental facilities of the
Department of Public Health, county boards of health, or the Department of
Corrections, or the performance of dental hygiene duties by personnel of the
Department of Public Health or county boards of health at approved off-site
locations. |
| (c) |
The performance of
dental hygienists providing dental screenings in settings which include:
schools; hospitals; clinics; state, county, local, and federal public health
programs; federally qualified health centers; volunteer community health
settings; senior centers; family violence shelters, as defined in O.C.G.A.
§ 19-13-20; and free health clinics,
as defined in O.C.G.A. § 51-1-29.4. Other health fair
settings must be pre-approved by the board.
| 1. |
School settings.
| (i) |
School settings shall include only
schools that are Title I schools under the federal Elementary and Secondary
Education Act, schools in which at least 65% of the student population is
eligible for free or reduced price lunch under federal guidelines, Head Start
programs, and Georgia's Pre-K Program. |
| (ii) |
Dental hygienists may apply topical
fluoride and perform the application of sealants and oral prophylaxis under
general supervision, with written permission of the student's parent or
guardian. A dental hygienist may also, without prior written permission of the
student's parent or guardian, provide oral hygiene instruction and
counseling. |
| (iii) |
A dental
hygienist and the authorizing dentist shall maintain the confidentiality of any
records related to services provided to a student under subparagraph (4)(c) in
compliance with laws including without limitation the federal Family Education
Rights and Privacy Act of 1974,
20 U.S.C. Section
1232g. |
|
| 2. |
Hospitals; nursing homes; long-term care
facilities; rural health clinics; federally qualified health centers, health
facilities operated by federal, state, county or local governments; hospices;
family violence shelters, as defined in O.C.G.A. § 19-13-20; and free health clinics,
as defined in O.C.G.A. § 51-1-29.4.
| (i) |
Dental hygienists may apply topical
fluoride and perform the application of sealants and oral prophylaxis under
general supervision. |
|
| 3. |
A dental hygienist performing duties under subparagraphs (4)(c)(1.) or
(4)(c)(2.) shall:
| (i) |
Not perform any dental
hygiene services on a patient that has dental pain or clearly visible evidence
of widespread dental disease. The dental hygienist shall immediately refer such
patient to the authorizing dentist for clinical examination and treatment. The
dental hygienist shall notate such patient's file, and the patient shall not be
eligible to receive dental hygiene services under subparagraphs (4)(c)(1.) or
(4)(c)(2.) until a dentist provides written authorization that such services
may be performed on the patient. |
| (ii) |
Prior to providing any dental hygiene
services, obtain, study, and comprehend the school's or facility's protocols
and procedures regarding medical emergencies and implement and comply with such
protocols and procedures if a medical emergency arises during the provision of
dental hygiene services; and |
| (iii) |
Provide to each patient receiving such services written notice containing:
| (I) |
The name and license number of the dental
hygienist and the authorizing dentist; |
| (II) |
Any dental hygiene issues that the
dental hygienist identified during the performance of dental hygiene duties. If
dental hygiene services are not performed on a patient under subparagraph
(4)(c)(3.)(i), the written notice shall include a statement that the patient is
not eligible to receive dental hygiene services until a clinical examination is
performed by a dentist, and a dentist provides written authorization that
services may be performed; |
| (III) |
A
statement advising each patient who receives dental hygiene services to seek a
more thorough clinical examination by a dentist within 90 days, unless the
authorizing dentist performed a clinical examination of the patient. |
|
| (iv) |
Make all reasonable efforts
to provide such written notice as required in subparagraph (4)(c)(3.)(iii) to
parents or legal guardians of minors or incapacitated adults who receive dental
hygiene services and to the long-term care facility or nursing home for
residents of such facilities who receive dental hygiene services, as
applicable. |
| (v) |
Not charge a fee
for a dental screening provided under subparagraph (4)(c), except where
provided by an employee of the Department of Public Health or county boards of
health. However, these fees must be paid directly to the Department of Public
Health or that county board of health and not to the dental hygienist who
performed the screening. |
| (vi) |
Not
require a school or facility receiving dental hygiene services under
subparagraphs (4)(c)(1.) and (4)(c)(2.) to purchase any equipment. |
|
|
|
| (5) |
General
Supervision in a Private Office Setting.
| (a) |
A
dental hygienist may perform only the following functions under general
supervision:
| 1. |
Application of sealants and
oral prophylaxis and assessment; |
| 3. |
Oral hygiene
instruction and education; and |
| 4. |
Exposure and processing of radiographs if provided for by specific,
individualized standing orders of the authorizing dentist, including any
protocols regarding urgent dental issues that arise. |
|
| (b) |
A dentist in a private dental office
setting may authorize general supervision of a dental hygienist only upon
meeting the following criteria:
| 1. |
A new
patient of record must be clinically examined by the authorizing dentist during
the initial visit; |
| 2. |
A patient
must be examined by the authorizing dentist at a minimum of twelve-month
intervals; and |
| 3. |
A patient must be
notified in advance of the appointment that the patient will be treated by the
dental hygienist under general supervision without the authorizing dentist
being present or being examined by the authorizing dentist. |
|
|
| (6) |
A dental hygienist
performing dental hygiene services under general supervision shall have at
least two (2) years of experience in the practice of dental hygiene, shall be
in compliance with the continuing education requirements under O.C.G.A. § 43-11-73.1 and the cardiopulmonary
resuscitation certification requirements under O.C.G.A. § 43-11-73, shall be licensed in
good standing, and shall maintain coverage under a professional liability
occurrence or claims insurance policy with a policy limit minimum of
$1,000,000. |
| (7) |
In schools;
hospitals; clinics; state, county, local, and federal public health programs;
federally qualified health centers; volunteer community health settings; senior
centers; family violence shelters, as defined in O.C.G.A. § 19-13-20; and free health clinics,
as defined in O.C.G.A. § 51-1-29.4, it shall be in the sole
discretion of the authorizing dentist as to whether to require an initial
examination of the patient prior to the performance by a dental hygienist of
dental hygiene services under general supervision. |
| (8) |
A dentist may only authorize up to four
dental hygienists total to provide dental hygiene services in any setting or
number of settings at any one time. A dentist authorizing one or more dental
hygienists to provide dental hygiene services under (4)(c)(1.) and (4)(c)(2.)
shall practice dentistry and treat patients in a physical and operational
dental office located in this State within 50 miles of the setting in which the
dental hygiene services are to be provided under general supervision. |
| (9) |
Dental hygiene services provided by
dental hygienists in mobile dental vans shall always be provided under direct
supervision. |
| (10) |
In addition to
routine duties and the procedures of any of the operations or procedures
authorized in O.C.G.A. § 43-11-74, the following activities
may be performed by a dental hygienist working under the direct supervision of
a dentist:
| (a) |
All the duties that are usually
performed by a dental assistant pursuant to Title 43, Chapter 11, Article 4 of
the Official Code of Georgia Annotated and Chapter 150-9 of the Rules of the
Georgia Board of Dentistry, under the limitations and stipulations set forth in
Title 43, Chapter 11, Article 3 of the Official Code of Georgia Annotated and
Chapter 150-5 of the Rules of the Georgia Board of Dentistry. |
| (b) |
Take and mount oral x-rays; |
| (c) |
Apply medications and/or solutions
approved by the Board and prescribed by the dentist that can be applied by
methods approved by the Board, be that by irrigation, tray, or insertion of
bioresorbable materials; |
| (d) |
Remove
calcareous deposits, secretions, and stains from the surfaces of
teeth. Ultrasonic technologies are authorized for use by dental
hygienists; |
| (e) |
Utilize techniques
and materials necessary for the application of sealant(s) to pits of and
fissures of teeth; |
| (f) |
Perform root
planning and curettage with hand instruments; and |
| (g) |
Perform periodontal probing. |
|
| (11) |
Nothing in these rules shall
be construed as authorizing dental hygienists to utilize other techniques in
the course of the performance of their duties, otherwise authorized by these
rules. Only dentists licensed by the Georgia Board of Dentistry shall be
authorized to perform procedures involving laser technology which alters
tissue, creates thermal effect, or is intended to cut, coagulate,
photocoagulate, vaporize, or ablate essentially any soft or hard tissues of the
body. Additionally, only dentists licensed by the Board shall be authorized to
perform procedures utilizing air abrasive technology, which is normally
intended for cavity preparation or enamel removal. This is to be distinguished
from "micro etching" and "air polishing" technologies which are intended for
stain removal and roughening the surfaces of enamel to enhance bonding, similar
to acid etching, (i.e., Micro etching and air polishing are technologies
authorized for use by dental hygienists). |
Dental hygienists shall maintain at all times during licensure
and furnish to the Board, upon request, current certification in one and two
rescuer CPR and management of obstructed airway for adults, children and
infants as taught by the American Heart Association, the American Red Cross,
the American Safety and Health Institute, the National Safety Council, EMS
Safety Services, or other such agencies approved by the Board. Current
certification is a condition for license renewal. Failure to maintain current
CPR certification may serve as grounds to deny the renewal of a license and may
also result in disciplinary action against the licensee. In response to an
audit request, a dental hygienist shall be required to produce proof of CPR
certification during the biennium for which the audit is being
conducted.
| (1) |
Dental
hygienists licensed to practice in the state of Georgia shall maintain and
furnish to the Board, upon request, official documentation of having completed
a minimum of twenty-two (22) hours of continuing education during each
biennium. Official documentation shall be defined as documentation from an
approved provider that verifies a licensee's attendance at a particular
continuing education course. Official documentation of course attendance must
be maintained by a dental hygienist for at least three (3) years following the
end of the biennium during which the course was taken.
| (a) |
Compliance with all continuing education
requirements is a condition for license renewal. Failure to complete all hours
of mandatory continuing education shall serve as grounds to deny the renewal of
a license and may also result in disciplinary action being taken against a
licensee. |
| (b) |
Upon its own motion,
the Board may at any time randomly select a percentage of actively licensed
dental hygienists for the purpose of auditing their compliance with the
continuing education requirements of the Board. Those licensees selected for an
audit shall submit official documentation of their compliance within thirty
(30) days of receipt of the audit letter. Failure to respond to an audit
request in a timely manner shall be grounds for disciplinary action against a
licensee. |
| (c) |
The continuing
education requirements shall apply within the first biennium that a dental
hygienist is licensed in Georgia. However, in order to meet the continuing
education requirements during the first biennium, a newly licensed dental
hygienist may submit as their continuing education hours proof of dental
hygiene coursework taken within the previous two (2) years of the date of the
renewal application from a university or other institution accredited by the
Commission on Dental Accreditation of the American Dental Association.
Following the first biennium that a dental hygienist is licensed in Georgia
such licensees shall comply with the continuing education requirements set
forth in Rule
150-5-.05(2) and
(3). |
| (d) |
The continuing education requirements
shall not apply to dental hygienists who are on inactive status. |
| (e) |
The continuing education requirements for
dental hygienists holding volunteer licenses may be satisfied by compliance
with this rule, or they may alternatively be satisfied by compliance with Rule
150-3-.10. |
|
| (2) |
Coursework, including home study courses,
sponsored or approved by any organization recognized under Rule
150-3-.09(2) will be
accepted. |
| (3) |
Course content:
| (a) |
All courses must reflect the professional
needs of the hygienist providing quality dental health care to the
public; |
| (b) |
At least fifteen (15)
hours of the minimum requirement must be scientific courses in the actual
delivery of dental services to the patient or to the community; |
| (c) |
Four (4) credit hours for successful
completion of the CPR course required by Georgia law offered by the American
Heart Association, the American Red Cross, the American Safety and Health
Institute, the National Safety Council, EMS Safety Services, or other such
agencies approved by the Board may be used to satisfy continuing education
requirements per renewal period. |
| (d) |
Up to eight (8) hours of continuing
education per year may be obtained by assisting the Board with administering
the clinical licensing examination or by assisting the Board with
investigations of licensees. These hours shall be approved by the Continuing
Education Committee of the Georgia Board of Dentistry and need not be sponsored
by any agency or organization listed in
150-3-.09 (2). |
| (e) |
Up to five (5) hours of continuing
education per biennium may be obtained by teaching dental hygiene at any
ADA-approved educational facility. These hours shall be awarded, in writing, by
the course director at the facility and approved by the Continuing Education
Committee of the Georgia Board of Dentistry. |
| (f) |
Up to five (5) hours of continuing
education per biennium may be obtained by providing, uncompensated dental
hygiene care at a public agency or institution, not for profit agency, not for
profit institution, nonprofit corporation or not for profit association which
provides dental hygiene services to indigent patients. |
| (g) |
Up to ten (10) hours of continuing
education per biennium may be obtained by members of the Georgia Board of
Dentistry for member service, where one continuing education hour is credited
for each five hours of Board service provided. |
|
| (4) |
Criteria for receiving credit for
attending an approved continuing education course:
| (a) |
Credit hours are not retroactive or
cumulative. All credit hours must be received during the two (2) year period to
which they are applied; and |
| (b) |
One
credit hour for each hour of course attendance will be allowed; |
| (c) |
Only twelve hours of credit will be
accepted per calendar day; |
| (d) |
Effective January 1, 2008, at least eleven (11) of the required twenty-two (22)
hours of credit must be acquired in person at an on-site course or seminar; you
are not allowed to acquire all CE hours through on-line courses, electronic
means, journal studies, etc. |
|
| (5) |
Criteria for receiving credit for
teaching an approved continuing education course:
| (a) |
Credit hours for teaching an approved
course must be obtained and used during the biennium that the approved course
is taught; |
| (b) |
A dental hygienist
that teaches an approved continuing education course is eligible to receive two
(2) credit hours for each hour of coursework that he or she presents at a
particular course.
Credit will be given for teaching a particular course on one
occasion only. A maximum of five (5) credit hours per biennium may be obtained
by a dental hygienist by whom an approved continuing education course is
taught;
|
| (c) |
Only continuing
education course designated in Rule 150-5.05(2) as being sponsored or approved
by recognized organizations will be considered for credit pursuant to this
subsection of the rule. Courses taught by a dental hygienist prior to or a part
of the process of obtaining his or her R.D.H. shall not be eligible for
consideration pursuant to this provision of the rule; |
| (d) |
In the event that an audit is conducted
of the continuing education hours of a dental hygienist who has taught a course
approved by a recognized organization, the following shall be required to
document the dental hygienists role in presenting a continuing education
course:
| 1. |
Documentation from an approved
provider verifying that the dental hygienist presented an approved continuing
education course; |
| 2. |
Documentation
from an approved provider reflecting the content of the course; |
| 3. |
Documentation from an approved provider
specifying the list of materials used as part of the course; and |
| 4. |
Documentation from an approved provider
verifying the hours earned and the dates and times that the course in question
was given. |
|
| (e) |
In the
event that an approved continuing education course is taught by more than one
dental hygienist, continuing education credit will be given for those portions
of course work in which the dental hygienist is directly involved and primarily
responsible for the preparation and presentation thereof. Continuing education
credit will not be available to a dental hygienist whose participation in
preparing and presenting an approved course is not readily
identifiable. |
|
| (6) |
Criteria for receiving credit for providing uncompensated indigent dental
hygiene care.
| (a) |
Up to five (5) hours of
continuing education per biennium may be obtained by providing uncompensated
dental hygiene care at a public agency or institution, not for profit agency,
not for profit institution, nonprofit corporation or not for profit association
which provides dental hygiene services to indigent patients. |
| (b) |
Dental hygienists may receive one hour of
continuing education for every four hours of indigent dental hygiene care the
dental hygienist provides, up to five (5) hours. Such continuing education
credits will be applied toward the dental hygienist's clinical
courses. |
| (c) |
All credit hours must
be received during the two (2) year renewal period; |
| (d) |
Dental hygienists shall at all times be
required to meet the minimal standards of acceptable and prevailing practice in
Georgia; |
| (e) |
The Board shall have
the right to request the following:
| 1. |
Documentation from the organization indicating that the dental hygienist
provided the services; |
| 2. |
Documentation from the organization that it provided medical and/or dental
hygiene services to the indigent and/or those making up the underserved
populations; |
| 3. |
Notarized
verifications from the organization documenting the dental hygienist agreement
not to receive compensation for the services provided; |
| 4. |
Documentation from the organization
detailing the actual number of hours spent providing said services;
and |
| 5. |
Documentation from the
dental hygienist and/or organization verifying the services provided. |
|
|
| (1) |
An applicant applying for a temporary
permit must be currently licensed to practice as a dental hygienist in another
state and meet the conditions as specified in O.C.G.A. §§ 43-11-70 and
43-11-71. |
| (2) |
An application to take the required
examination must have been completed and on file before the Board will consider
an application for a temporary permit. |
| (3) |
A person requesting a temporary permit
must submit proof of current CPR certification in one and two rescuer and the
management of obstructed airway for infant, child and adult. |
| (4) |
It shall be the responsibility of the
dental hygienist to inform the Board of the name of the dentist/employer where
he/she will be practicing. |
| (5) |
A
temporary permit shall be valid from the date of issuance until the results of
the first examination scheduled for the applicant are released. |
| (6) |
If applicant fails the examination or
fails to appear at the examination, the temporary permit shall automatically
stand revoked, without a requirement of prior notice of such
revocation. |
| (7) |
No temporary permit
will be issued to an applicant who has previously failed the
examination. |
| (8) |
No temporary
permit shall be issued more than one time. |
| (9) |
A temporary permit shall be posted and
displayed in the place in which the dental hygienist is employed. |
| (10) |
All fees are due at the time of making
application. Fees are as shown in the schedule of fees adopted by the Board of
Dentistry. Fees are not refundable. |
