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CALIFORNIA Dental Continuing Education
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Inside: Board-Approved CA Dental Practice Act CA Infection Control CA Schedule II Opioids
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What’s Inside
THE CALIFORNIA DENTAL PRACTICE ACT (MANDATORY) 1 [2 CE hours] Although its primary objective is to safeguard the public, the California Dental Practice Act is an excellent resource for dental professionals to ensure compliance with state law. The California Dental Practice Act is the body of laws in the California Business and Professions Code and the California Code of Regulations governing dental professionals, including dentists, oral and maxillofacial surgeons, orthodontists, dental assistants, and dental hygienists. The Act is intended to serve as a legal guideline for both professionals and the public regarding all aspects of dental practice. THIS COURSE SATISFIES THE CALIFORNIA DENTAL PRACTICE ACT REQUIREMENT INFECTION CONTROL FOR DENTAL PROFESSIONALS: THE CALIFORNIA REQUIREMENT (MANDATORY) 30 [2 CE hours] Effective infection control techniques are critical to reducing the incidence of infections in dental facilities. Antiseptic techniques and antibiotics will kill micro-organisms, while proper hand hygiene will block their transmission. Gloves, gowns, and masks remove dental professionals from the transmission cycle by protecting them from contact with micro- organisms. Contact Precautions and isolation techniques help patients avoid being vectors of transmission. Lastly, ensuring that dental professionals are immune or vaccinated can help decrease the availability of potential hosts. THIS COURSE SATISFIES THE INFECTION CONTROL REQUIREMENT CARIES-PRONE PATIENTS: PREVENTION, ASSESSMENT, AND INTERVENTION 49 [4 CE hours] The impact of nutrition on the caries process is known in the dental field, but dental professionals need to continue to convey the importance of this relationship to patients. Working as partners with patients, dental professionals can aid in the prevention of dental caries and help maintain patients’ overall health by offering nutritional counseling and behavior modification techniques. The incidence of caries in the United States could decrease significantly as dental professionals implement the advances available for early caries detection, recommend anticaries treatments, and offer nutritional analysis and counseling. HEALTHCARE-ASSOCIATED INFECTIONS 64 [15 CE hours] This course is structured to provide essential education regarding the epidemiology, prevention, diagnosis, and treatment of healthcare-associated infections (HAIs). The course begins with background information on the pathogenesis of bacterial infections, transmission of infection in the healthcare setting, and the development of drug resistance. The primary sources of HAIs related to the environment, patient factors, and iatrogenic factors are also discussed. The core of the course is a comprehensive description of the most common and costly HAIs: catheter-related urinary tract infections, surgical site infections, ventilator-associated pneumonia, intravascular device-related infections, and Clostridioides difficile infections. The overall incidences, related costs, risk factors, common pathogens, prevention, diagnosis, and treatment are presented for each of these infections, with the implications of drug-resistant infections also noted. An overview of the responsibilities of an infection control program in the healthcare setting is provided, with a discussion of surveillance, adherence to infection control guidelines, management of drug-resistant micro-organisms, precautions and isolation techniques, preparedness for outbreaks and epidemics, and education targeted to both healthcare workers and patients and families. RESPONSIBILITIES AND REQUIREMENTS OF PRESCRIBING SCHEDULE II OPIOID DRUGS (MANDATORY) 121 [2 CE hours] Opioid analgesic medications can bring substantial relief to patients suffering from pain. However, the inappropriate use, abuse, and diversion of prescription drugs in America, particularly prescription opioids, has increased dramatically in recent years and has been identified as a national public health epidemic. A set of clinical tools, guidelines, and recommendations are now available for prescribers who treat pain patients with opioids. By implementing these tools, clinicians can effectively address issues related to the clinical management of opioid prescribing, opioid risk management, regulations surrounding the prescribing of opioids, and problematic opioid use by patients. In doing so, healthcare professionals are more likely to achieve a balance between the benefits and risks of opioid prescribing, optimize patient attainment of therapeutic goals, and avoid the risk to patient outcome, public health, and viability of their own practice imposed by deficits in knowledge. THIS COURSE SATISFIES THE SCHEDULE II OPIOID REQUIREMENT
FINAL EXAM ANSWER SHEET
141
©2025: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Colibri Healthcare, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge in the areas covered. It is not meant to provide medical, legal or professional services advice. Colibri Healthcare, LLC recommends that you consult a medical, legal or professional services expert licensed in your state. Colibri Healthcare, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing, but does not represent or warrant that it will apply to your situation or circumstances and assumes no liability from reliance on these materials.
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DENTAL CONTINUING EDUCATION
Frequently Asked Questions
What are the requirements for license renewal? Licenses Expire CE Credit Hours
Mandatory Subjects
50 (25 hours may be completed by home study) A maximum of 8 hours of CE may be granted per day. Please record your completion dates on your Certificate(s) of Completion and retain for your records.
2 hours of CA Infection Control 2 hours of California Dental Practice Act 2 hours of responsibilities and requirements of prescribing Schedule II opioids 4 hours of basic life support (must include hands on demonstration from a certified instructor)
Licenses expire every two years on the last day of licensee’s birth month
How much will it cost?
Enter the code that corresponds to the online course listed below.
Course Title
Hours Price Course Code
DCA02CA
The California Dental Practice Act (Mandatory)
2
$18
Infection Control for Dental Professionals: The California Requirement (Mandatory)
DCA02IF
2
$18
DCA04CP
Caries-Prone Patients: Prevention, Assessment, and Intervention
4
$36
DCA15HA
Healthcare-Associated Infections
15
$135
Responsibilities and Requirements of Prescribing Schedule II Opioid Drugs (Mandatory)
DCA02OP
2
$18
Best Value - Save $75.00 - All 25 Hours
25
$150.00
How do I complete this course and receive my certificate of completion? See the following page for step-by-step instructions on how to complete and receive your certificate. Are you a California board-approved provider? NetCE is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada. org/cerp. NetCE is a National Approved PACE Program Provider for FAGD/MAGD credit. Approval does not imply acceptance by any regulatory authority for AGD endorsement. 10/1/2021 to 9/30/2027. Provider ID #217994. NetCE is a Registered Provider with the Dental Board of California. Provider Number RP3841. Are my hours reported to the California board? No. The board performs random audits at which time proof of continuing education must be provided. What information do I need to provide for course completion and certificate issuance? Please provide your license number on the test sheet to receive course credit. Your state may require additional information such as date of birth and/or last 4 of Social Security number; please provide these, if applicable. Is my information secure? Yes! We use SSL encryption, and we never share your information with third-parties. We are also rated A+ by the National Better Business Bureau.
What if I still have questions? What are your business hours?
No problem, we have several options for you to choose from! Online at EliteLearning.com/Dental you will see our robust FAQ section that answers many of your questions. Simply click FAQs at the top of the page, email us at office@elitelearning.com, or call us toll-free at 1-866-344-0972, Monday - Friday 9:00 am - 6:00 pm and Saturday 10:00 am - 4:00 pm EST. Important information for licensees Always check your state’s board website to determine the number of hours required for renewal, mandatory topics (as these are subject to change), and the amount that may be completed through home study. Also, make sure that you notify the board of any changes of address. It is important that your most current address is on file. Disclosures Resolution of conflict of interest Colibri Healthcare, LLC implemented mechanisms prior to the planning and implementation of the continuing education activity, to identify and resolve conflicts of interest for all individuals in a
position to control content of the course activity. Sponsorship/commercial support and non-endorsement
It is the policy of Colibri Healthcare, LLC not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners. Licensing board contact information: The Dental Board of California - Department of Consumer Affairs 2005 Evergreen Street, #1550 | Sacramento, CA 95815 Phone (916) 263-2300 | Fax (916) 263-2140 Website: https://www.dbc.ca.gov/
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DENTAL CONTINUING EDUCATION
Meet Your Substance Use Disorder DEA Requirement Get the training you need in a self-paced, convenient format with a course specifically
Prescribing Controlled Substances Safely - A DEA Requirement
designed for dentists to meet the Drug Enforcement Administration (DEA)’s new requirement under the Medication Access and Training Expansion (MATE) Act.
8 hours $79.95
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How To Complete This Book For Credit
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• Go to EliteLearning.com/Book and enter the code that corresponds to the course below, then click GO . Each course will need to be completed individually, and the specified course price will apply. • Proceed to your exam. If you already have an account, sign in with your username and password. If you do not have an account, you’ll be able to create one now. • Follow the online instructions to complete your exam and finalize your purchase. Upon completion, you’ll receive access to your completion certificate. ONLINE FASTEST AND EASIEST!
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Complete your CE
Course Title
Hours Price Course Code
The California Dental Practice Act (Mandatory)
2
$18 DCA02CA
DCA02IF
Infection Control for Dental Professionals: The California Requirement (Mandatory) 2
$18
DCA04CP
Caries-Prone Patients: Prevention, Assessment, and Intervention
4
$36
Healthcare-Associated Infections
15 $135 DCA15HA
Responsibilities and Requirements of Prescribing Schedule II Opioid Drugs (Mandatory)
DCA02OP
2
$18
Complete the answer sheet and evaluation found in the back of this book. Include your payment information and email address. Mail to: Elite Learning, PO Box 997432, Sacramento, CA 95899 BY MAIL Mailed completions will be processed within 2 business days of receipt, and certificates emailed to the address provided. Submissions without a valid email address will be mailed to the postal address provided.
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DENTAL CONTINUING EDUCATION
_____________________________________________________________ The California Dental Practice Act
DCA02CA — 2 CE HOURS
R elease D ate : 02/01/25
E xpiration D ate : 01/31/28
The California Dental Practice Act
Audience This course is designed for all California dentists, dental hygienists, and dental assistants in all practice settings. Course Objective The purpose of this course is to provide California dental professionals with a working knowledge of the contents of the California Dental Practice Act, ensuring that they practice legally and safely. Learning Outcomes Upon completion of this course, you should be able to: 1. Define the scope of practice of dental professionals in California.
Accreditations & Approvals NetCE is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp. NetCE Nationally Approved PACE Program Provider for FAGD/MAGD credit. Approval does not imply acceptance by any regulatory authority or AGD endorsement. NetCE is a Registered Provider with the Dental Board of Cali- fornia. Provider number RP3841. Completion of this course does not constitute authorization for the attendee to perform any services that he or she is not legally authorized to perform based on his or her permit type. Designations of Credit NetCE designates this activity for 2 continuing education credits. AGD Subject Code 010. This course meets the Dental Board of California’s require- ments for 2 units of continuing education. Dental Board of California course #02-3841-00450. Special Approval This course fulfills the California requirement for 2 hours of 10/1/2021 to 9/30/2027 Provider ID #217994.
2. Describe the standards of licensure of and medication prescription by dental professionals in California. 3. Identify possible victims of violence or neglect and outline the appropriate response. Faculty
Mark J. Szarejko, DDS, FAGD , received his dental degree from the State University of New York at Buffalo in 1985. He received fellowship from the Academy of General Dentistry in 1994. Faculty Disclosure Contributing faculty, Mark J. Szarejko, DDS, FAGD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned. Senior Director of Development and Academic Affairs Sarah Campbell Director Disclosure The director has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Mention of commercial products does not indicate endorsement.
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Dental Practice Act education. About the Sponsor
HOW TO RECEIVE CREDIT • Read the entire course online or in print. • Depending on your state requirements you will be asked to complete: ‒ A mandatory test (a passing score of 75 percent is required). Test questions link content to learning objectives as a method to enhance individualized learning and material retention. • Provide required personal information and payment information. • Complete the mandatory Course Evaluation. • A maximum of 8 hours of CE may be granted per day. Please record your completion dates on your Certificate(s) of Completion and retain for your records.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare. Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice. Disclosure Statement It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distrib- uting or providing access to this activity to learners.
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DENTISTS CBPC Section 1625. Dentistry is the diagnosis or treatment, by surgery or other method, of diseases and lesions and the cor- rection of malpositions of the human teeth, alveolar process, gums, jaws, or associated structures; and such diagnosis or treatment may include all necessary related procedures as well as the use of drugs, anesthetic agents, and physical evaluation. Without limiting the foregoing, a person practices dentistry within the meaning of this chapter who does any one or more of the following [24]: (a) By card, circular, pamphlet, newspaper, Internet website, social media, or in any other way advertises themselves or represents themselves to be a dentist. (b) Performs, or offers to perform, an operation or diagnosis of any kind, or treats diseases or lesions of the human teeth, alveolar process, gums, jaws, or associated struc- tures, or corrects malposed positions thereof. (c) In any way indicates that the person will perform by them- selves or their agents or servants any operation upon the human teeth, alveolar process, gums, jaws, or associated structures, or in any way indicates that the person will construct, alter, repair, or sell any bridge, crown, denture or other prosthetic appliance or orthodontic appliance. (d) Makes, or offers to make, an examination of, with the intent to perform or cause to be performed any opera- tion on the human teeth, alveolar process, gums, jaws, or associated structures. (e) Manages or conducts as manager, proprietor, conductor, lessor, or otherwise, a place where dental operations are performed. The Board requires that dentists ensure that each patient of record receives a copy of the Dental Materials Fact Sheet (pro- vided by the Board) prior to the placement of his or her first dental restoration [25]. The Dental Materials Fact Sheet details the comparative risks and benefits of available dental restor- ative materials. The patient must sign an acknowledgment of receipt of the fact sheet, and a copy of the acknowledgment must be placed in the patient’s record. DENTAL ASSISTANTS (UNLICENSED) Although unlicensed dental assistants are not Board approved, their duties and actions are governed by the Act and they are required to complete coursework in the Dental Practice Act, infection control, and basic life support. Failure to follow the regulations set forth by California law can result in fines and/ or imprisonment. As defined in CBPC Section 1750.(a), “A dental assistant is an individual who, without a license, may perform basic supportive dental procedures, as authorized by Section 1750.1 and by regulations adopted by the board, under
INTRODUCTION The California Dental Practice Act is the body of laws in the California Business and Professions Code (CBPC) and the California Code of Regulations (CCR) governing all dental professionals, including dentists, oral and maxillofacial sur- geons, orthodontists, unlicensed dental assistants, registered dental assistants, and dental hygienists. The Act is intended to serve as a legal guideline for both professionals and the public regarding all aspects of dental practice. As defined in Section 1016.(b)1 of the CCR, continuing education on the California Dental Practice Act is required and must include instruction on utilization, scope of practice, prescribing laws, violations, citations, fines, licensure, the identification of abuse, and mandatory abuse reporting [1]. Of course, the Act is a much larger volume, so much so that it is beyond the scope of this course to elucidate every section. The Dental Practice Act is not intended to replace professional oaths and codes of ethics but does define actions and omissions that may lead to legal action and revocation of a license to practice dentistry in the State of California, the laws of which are continually evolving. The Dental Board of California (a division of the California Department of Consumer Affairs), which consists of eight prac- ticing dentists, one registered dental hygienist, one registered dental assistant (each practicing for at least five years), and five public members, is responsible for licensure of qualified dental health professionals, enforcement of the California Dental Practice Act, and improving the education of consumers and licensees [19]. The Board’s highest priority is to protect the health and safety of the public. In addition, the practice of dental hygiene is regulated by the Dental Hygiene Board of California, the first of its kind in the United States [20].
DENTISTRY DEFINED: SCOPE OF PRACTICE
According to the American Dental Association, dentistry is defined as “the evaluation, diagnosis, prevention, and treat- ment of diseases, disorders, and conditions of the oral cavity, the craniomaxillofacial area and the adjacent structures and their impact on the human body. This care is provided by dentists within the scope of their education, training and experience in accordance with the ethics of the profession and applicable law” [2]. The CBPC and the CCR provide specific information regarding utilization and scope of practice for dentists, unlicensed dental assistants, registered dental assistants, and registered dental hygienists, as evidenced in the following sections [1].
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the supervision of a licensed dentist” [1]. Basic supportive dental procedures are those procedures that have technically elementary characteristics, are completely reversible, and are unlikely to precipitate potentially hazardous conditions for the patient being treated. A licensed dentist is responsible for assuring unlicensed dental assistants’ competence and ensuring that they complete required coursework (e.g., two-hour Dental Practice Act, eight-hour infection control, basic life support) and maintain certification in basic life support (if employed for longer than 120 days). Specific duties pertaining to dental assistant practice can be found in CCR Section 1085 [28]. General information regarding regulations pertaining to dental assistants is located in CBPC Sections 1740–1777; although these sections are not discussed in this course, they should be periodically reviewed to ensure self-compliance with the act. The CBPC may include additional duties for various dental assistant professions. CCR Section 1085. Dental Assistant Duties and Settings. (a) Unless specifically so provided by regulation, a dental assistant may not perform the following functions or any other activity which represents the practice of dentistry or requires the knowledge, skill and training of a licensed dentist: 1. Diagnosis and treatment planning; 2. Surgical or cutting procedures on hard or soft tissue; 3. Fitting and adjusting of correctional and prosth- odontic appliances; 4. Prescription of medicines; 5. Placement, condensation, carving or removal of permanent restorations, including final cementation procedures; 6. Irrigation and medication of canals, try-in cones, reaming, filing or filling of root canals; 7. Taking of impressions for prosthodontic appliances, bridges or any other structures which may be worn in the mouth; 8. Administration of injectable and/or general anes- thesia; 9. Oral prophylaxis procedures. (b) A dental assistant may perform such basic supportive dental procedures as the following under the general supervision of a licensed dentist: 1. Extra-oral duties or functions specified by the super- vising dentist; 2. Operation of dental radiographic equipment for the purpose of oral radiography if the dental assistant has complied with the requirements of section 1656 of the Code; 3. Examine orthodontic appliances.
(c) A dental assistant may perform such basic supportive dental procedures as the following under the direct super- vision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist. 1. Take impressions for diagnostic and opposing mod- els, bleaching trays, temporary crowns and bridges, and sports guards; 2. Apply non-aerosol and non-caustic topical agents; 3. Remove post-extraction and periodontal dressings; 4. Placement of elastic orthodontic separators; 5. Remove orthodontic separators; 6. Assist in the administration of nitrous oxide analge- sia or sedation; however, a dental assistant shall not start the administration of the gases and shall not adjust the flow of the gases unless instructed to do so by the dentist who shall be present at the patient’s chairside at the implementation of these instructions. This regulation shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency. 7. Hold anterior matrices; 8. Remove sutures; 9. Take intra-oral measurements for orthodontic pro- cedures; 10. Seat adjusted retainers or headgears, including appro- priate instructions; 11. Check for loose bands;
12. Remove arch wires; 13. Remove ligature ties;
14. Apply topical fluoride, after scaling and polishing by the supervising dentist or a registered dental hygienist; 15. Place and remove rubber dams; 16. Place, wedge and remove matrices; 17. Cure restorative or orthodontic materials in operative site with light-curing device. For the purpose of this section, a supervising licensed dentist is defined as a dentist whose patient is receiving the services of a dental assistant in the treatment facility and is under the direct control of said licensed dentist [1]. Direct supervision is defined as supervision of dental procedures based on instruc- tions given by a licensed dentist who must be physically present in the facility when the procedures are performed.
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_____________________________________________________________ The California Dental Practice Act
REGISTERED DENTAL ASSISTANTS Registered dental assistants (RDAs) are Board-licensed pro- fessionals who may perform a greater range of duties than unlicensed dental assistants. Specific information pertaining to RDAs’ scope of practice can be found in CCR Section 1086, and general information regarding regulations pertain- ing to RDAs is located in CBPC Sections 1740–1777, which should be reviewed periodically to ensure self-compliance with the act [28]. CCR Section 1086. RDA Duties and Settings. (a) Unless specifically so provided by regulation, the prohibi- tions contained in section 1085 of these regulations apply to registered dental assistants. (b) A registered dental assistant may perform all functions which may be performed by a dental assistant. (c) Under general supervision, a registered dental assistant may perform the following duties: 1. Mouth-mirror inspection of the oral cavity, to include charting of obvious lesions, existing restorations and missing teeth; 2. Placement and removal of temporary sedative dress- ings. (d) A registered dental assistant may perform the following procedures under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist. 1. Obtain endodontic cultures; 2. Dry canals, previously opened by the supervising dentist, with absorbent points; 3. Test pulp vitality; 4. Place bases and liners on sound dentin; 5. Remove excess cement from supragingival surfaces of teeth with a hand instrument or floss; 6. Size stainless steel crowns, temporary crowns and bands; 7. Fabrication of temporary crowns intra-orally; 8. Temporary cementation and removal of temporary crowns and removal of orthodontic bands; 9. Placement of orthodontic separators; 10. Placement and ligation of arch wires; 11. Placement of post-extraction and periodontal dress- ings; 12. Apply bleaching agents; 13. Activate bleaching agents with non-laser light-curing device;
14. Take bite registrations for diagnostic models for case study only; 15. Coronal polishing (Evidence of satisfactory comple- tion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof). This procedure shall not be intended or interpreted as a complete oral prophylaxis (a procedure which can be performed only by a licensed dentist or registered dental hygienist). A licensed dentist or registered dental hygienist shall determine that the teeth to be polished are free of calculus or other extraneous material prior to coronal polishing. 16. Removal of excess cement from coronal surfaces of teeth under orthodontic treatment by means of an ultrasonic scaler. (Evidence of satisfactory comple- tion of a board-approved course of instruction or equivalent instruction in an approved RDA program in this function must be submitted to the board prior to any performance thereof.) (e) Settings. Registered dental assistants may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or in an equivalent facility approved by the board. Registered Dental Assistants in Extended Functions Registered dental assistants in extended functions (RDAEFs) are Board-licensed dental professionals who have a greater breadth of permitted duties than RDAs. Specifics regarding these allowed duties can be found in CCR Section 1087 [28]. CCR Section 1087. RDAEF Duties and Settings. (a) Unless specifically so provided by regulation, the prohibi- tions contained in Section 1085 apply to RDAEFs. (b) An RDAEF may perform all duties assigned to dental assistants and registered dental assistants. (c) An RDAEF may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full profes- sional responsibility of the supervising dentist. Such pro- cedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist. 1. Cord retraction of gingivae for impression proce- dures; 2. Take impressions for cast restorations; 3. Take impressions for space maintainers, orthodontic appliances, and occlusal guards; 4. Prepare enamel by etching for bonding;
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Registered Dental Hygienists CCR Section 1088. RDH Duties and Settings.
5. Formulate indirect patterns for endodontic post and core castings; 6. Fit trial endodontic filling points; 7. Apply pit and fissure sealants; 8. Remove excess cement from subgingival tooth sur- faces with a hand instrument; 9. Apply etchant for bonding restorative materials. (d) Settings. Registered dental assistants in extended func- tions may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or in an equivalent facility approved by the board. In addition to the duties outlined in CCR section 1087, sec- tion 1753.5 of the CBPC states that RDAEFs may conduct preliminary evaluation of the patient’s oral health, including, but not limited to, charting, intraoral and extra-oral evaluation of soft tissue, classifying occlusion, and myofunctional evalu- ation, and perform oral health assessments in school-based, community health project settings under the direction of a dentist, registered dental hygienist, or registered dental hygien- ist in alternative practice [1]. RDAEFs may hold an orthodontic assistant permit, a dental sedation assistant permit, or both. DENTAL HYGIENISTS Registered dental hygienists (RDHs), registered dental hygien- ists in extended functions (RDHEFs), and registered dental hygienists in alternative practice (RDHAPs) are Board-licensed occupations administered by the Dental Hygiene Committee of California, and the California Dental Practice Act contains the main body of laws and regulations that govern their practice. The Dental Hygiene Committee of California was created by the Board and consists of seven governor-appointed positions: two public members, four dental hygienists, and one practicing dentist; in addition, there are two public members appointed by the Senate Committee on Rules and the Speaker of the Assembly, respectively [20]. Responsibilities of the Dental Hygiene Committee include adopting regulations; issuing, reviewing, and revoking licenses; developing and administering examinations; determining fees; and updating continuing edu- cation requirements for all dental hygiene licensure categories. The Act contains specific information regarding the permitted duties and settings of RDH practice (CCR Section 1088), RDHEF practice (CCR Section 1089), and RDHAP practice (CCR Section 1090) [28]. Additional laws and regulations pertaining specifically to dental hygiene practice are located in CBPC Sections 1900–1966.6. These sections should be periodically reviewed to ensure self-compliance with the Act.
(a) Unless specifically so provided by regulation, the prohibi- tion contained in Section 1085(a), subsections (1) through (8) of these regulations shall apply to duties performed by a registered dental hygienist. (b) A registered dental hygienist may perform all duties assigned to dental assistants and registered dental assis- tants, under the supervision of a licensed dentist as specified in these regulations. (c) Under general supervision, a registered dental hygienist may perform the following duties in addition to those provided by Section 1760(b) of the Code: 1. Root planing; 2. Polish and contour restorations; 3. Oral exfoliative cytology; 4. Apply pit and fissure sealants; 5. Preliminary examination, including but not limited to: A. Periodontal charting; B. Intra and extra-oral examination of soft tissue; C. Charting of lesions, existing restorations and missing teeth; D. Classifying occlusion; E. Myofunctional evaluation. 6. Irrigate sub-gingivally with an antimicrobial and/or antibiotic liquid solution(s). 7. The following direct supervision duties of dental assistants and registered dental assistants: A. Dental Assistant. 1. Taking impressions for diagnostic and opposing models; 2. Applying non-aerosol and non-caustic topi- cal agents; 3. Removing post-extraction and periodontal dressings; 4. Removing sutures; 5. Taking intra-oral measurements for orth- odontic procedures; 6. Checking for loose bands;
7. Removing ligature ties; 8. Applying topical fluoride; 9. Placing elastic separators.
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_____________________________________________________________ The California Dental Practice Act
B. Registered Dental Assistant 1. Test pulp vitality;
6. Public institutions, including but not limited to fed- eral, state and local penal and correctional facilities; 7. Mobile units operated by a public or governmental agency or a nonprofit and charitable organization approved by the board; provided, however, that the mobile unit meets the statutory and regulatory requirements for mobile units; 8. Home of a non-ambulatory patient, provided there is a written note from a physician or registered nurse stating that the patient is unable to visit a dental office; 9. Health fairs or similar non-profit community activi- ties. Each such fair or activity shall be approved by the board. Any other facility must be approved by the board. Registered Dental Hygienists in Extended Functions CCR Section 1089. RDHEF Duties and Settings. (a) Unless specifically provided by regulation, the prohibi- tions contained in Section 1085(a) (1) through (8) shall apply to RDHEFs. (b) An RDHEF may perform all duties assigned to dental assistants, registered dental assistants and registered dental hygienists. (c) An RDHEF may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full profes- sional responsibility of the supervising dentist. Such pro- cedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist. 1. Cord retraction of gingivae for impression proce- dures; 2. Take impressions for cast restorations; 3. Take impressions for space maintainers, orthodontic appliances and guards; 4. Prepare enamel by etching for bonding; 5. Formulate indirect patterns for endodontic post and core castings; 6. Fit trial endodontic filling points; 7. Apply etchant for bonding restorative materials. (d) Settings. Registered dental hygienists in extended func- tions may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or an equivalent facil- ity approved by the Board.
2. Removing excess cement from supragingival surfaces of teeth; 3. Sizing stainless steel crowns, temporary crowns and bands; 4. Temporary cementation and removal of temporary crowns and removal of orth- odontic bands; 5. Placing post-extraction and periodontal dressings.
(d) A registered dental hygienist may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist. 1. Placement of antimicrobial or antibiotic medica- ments which do not later have to be removed; 2. All duties so assigned to a dental assistant or a reg- istered dental assistant, unless otherwise indicated; 3. Periodontal soft tissue curettage (Evidence of satis- factory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof); 4. Administration of local anesthetic agents, infiltration and conductive, limited to the oral cavity (Evidence of satisfactory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof); 5. Administration of nitrous oxide and oxygen when used as an analgesic, utilizing fail-safe type machines containing no other general anesthetic agents. (Evi- dence of satisfactory completion of a board-approved course of instruction in this function must be submit- ted to the board prior to any performance thereof.) (e) A registered dental hygienist may undertake the duties authorized by this section in the following settings, pro- vided the appropriate supervision requirements are met: 1. The treatment facility of a licensed dentist; 2. Licensed health facilities as defined in Section 1250 of the Health and Safety Code; 3. Licensed clinics as defined in Section 1203 of the Health and Safety Code; 4. Licensed community care facilities as defined in Sec- tion 1502 of the Health and Safety Code; 5. Schools of any grade level whether public or private;
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The California Dental Practice Act _ ____________________________________________________________
Registered Dental Hygienists in Alternative Practice CCR Section 1090. RDHAP Duties and Settings. (a) Unless specifically so provided by regulation, an RDHAP may not perform the following functions or any activity which represents the practice of dentistry or requires knowledge, skill and training of a licensed dentist: 1. Diagnosing and treatment planning; 2. Surgical or cutting procedures on hard or soft tissue; 3. Fitting and adjusting of correctional and prosth- odontic appliances; 4. Prescribing medication; 5. Placing, condensing, carving or removal of per- manent restorations, including final cementation procedures; 6. Irrigating and medicating canals, try-in cones, ream- ing, filing or filling of root canals; 7. Taking of impressions for prosthodontic appliances, bridges, or any other devices which may be worn in the mouth; 8. Administering local or general anesthesia, oral or parental conscious sedation. (b) Under the supervision of a licensed dentist, an RDHAP may perform the duties assigned to registered dental hygienists by Section 1088, under the same levels of supervision and in the same settings as specified in that section, in addition to those duties permitted by Section 1768(b)(3). (c) Independently and without the supervision of a licensed dentist, an RDHAP may, upon the prescription of a dentist or a physician and surgeon licensed in California, perform the duties assigned to a registered dental hygienist by Section 1088(c). 1. All prescriptions shall contain the following informa- tion: A. The pre-printed name, address, license number, and signature of the prescribing dentist or physi- cian and surgeon. B. The name, address and phone number of the patient. C. The date the services are prescribed and the
Prior to the establishment of an independent practice, an RDHAP shall provide to the board documentation of an existing relationship with at least one dentist for referral, consultation, and emergency services [1].
LICENSURE All individuals practicing dentistry in California, with the exception of unlicensed dental assistants, must hold a current, valid license issued by the Board; California does not grant reciprocity with other states or nations. The Act requires that dental professionals meet certain education requirements, submit the correct applications and fees, pass the appropriate examinations, and submit a set of fingerprints. Fingerprinting is also required for license renewal if not previously conducted by the California Department of Justice (DOJ) or if records no longer exist [21]. Fingerprinting within California must be conducted using the DOJ Live Scan system; fingerprint records from other institutions (e.g., Department of Motor Vehicles) are not suitable, although ink-on-card fingerprints made at a law enforcement agency are acceptable if unable to travel to California. The required fingerprint cards must be requested from the Dental Board by phone or email [21]. The fingerprints will be used to conduct a criminal history record check and a state and federal level criminal offender record information search. Issuance, review, and revocation of RDH/RDHEF/RDHAP licenses and the development and administration of license examinations for these auxiliaries are handled by the Dental Hygiene Board of California. All other licensure, including that for RDAs/RDAEFs, is handled by the Dental Board (despite the existence of the Dental Assisting Council, whose purpose is to consider matters related to dental assisting practice and make recommendations to the board). Complaints, investigations, and enforcement are handled by either the Dental Hygiene Board or the Dental Board, according to profession, but the governing regulations and laws set forth in the California Dental Practice Act pertain to all dental professionals. Infor- mation about application for licensure to practice as a dentist or dental auxiliary can be found in CCR Section 1028 and CCR Sections 1076–1079.3, respectively. Specific information about the licensure application requirements and process for dentists and dental assistants can be found at https://www. dbc.ca.gov/applicants and for hygienists at https://www.dhbc. ca.gov/applicants. Effective July 2012, application for licensure may be denied based on delinquent state tax payments [1]. Similarly, current licenses/certifications/registrations may be revoked for failure to pay taxes.
expiration date of the prescription. The pre- scription shall be for dental hygiene services and, if necessary, include special instructions for the care of that patient.
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_____________________________________________________________ The California Dental Practice Act
LICENSE RENEWAL Licenses for all dental professions must be renewed every two years before the last day of the professional’s birth month. Practicing without renewing after this date is considered practicing without a license [1]. It is required that dentists have completed 50 hours of continuing education and dental auxiliaries (excluding RDHAPs) have completed 25 hours of continuing education (maximum of 25 hours and 12.5 hours of home study, respectively) upon renewal submission. The continuing education requirement is 35 hours for RDHAPs. Coursework regarding the Dental Practice Act, infection control, and basic life support is mandatory every two years for all licensees. To receive credit, all courses must be from Board-approved providers. In addition, the Board has identi- fied topics that may only constitute a portion of the full con- tinuing education requirement or that are not acceptable at all. A complete listing of allowable and non-allowable courses is available on the Board website. Links to information regarding license renewal for dentists and dental assistants can be found at https://www.dbc.ca.gov/ licensees, and renewal information for hygienists can be found at https://www.dhbc.ca.gov/licensees/renewals.
According to CBPC Section 1670.1, conviction of crimes committed by dental professionals outside of the workplace may also be grounds for Board discipline and can impact licensure status if the crime is “substantially related to the quali- fications, functions, or duties of a dentist or dental assistant licensed under this chapter” [1]. These vary considerably on a case-by-case basis. Various lesser convictions, for example, driving under the influence (DUI), illicit drug possession, and prescription drug diversion, may not necessarily lead to license revocation provided the proper steps are taken toward remediation (e.g., entering the Board diversion program, sub- mitting to periodic drug testing) [23]. In general, convictions for assaults, sex crimes, multiple misdemeanors (e.g., second DUI/controlled substance charge), and other egregious viola- tions constitute a basis for denial or revocation of licenses or certifications. In addition to violations outside the workplace, unprofessional conduct, in its many forms, is grounds for Board Enforcement action. Acts and omissions that character- ize unprofessional conduct are covered extensively in CBPC Sections 1680, 1681, and 1682 and CCR Section 1018.05. CBPC Section 1680. Unprofessional conduct by a person licensed under this chapter is defined as, but is not limited to, any one of the following: (a) The obtaining of any fee by fraud or misrepresentation. (b) The employment directly or indirectly of any student or suspended or unlicensed dentist to practice dentistry as defined in this chapter. (c) The aiding or abetting of any unlicensed person to prac- tice dentistry. (d) The aiding or abetting of a licensed person to practice dentistry unlawfully. (e) The committing of any act or acts of sexual abuse, mis- conduct, or relations with a patient that are substantially related to the practice of dentistry. (f) The use of any false, assumed, or fictitious name, either as an individual, firm, corporation, or otherwise, or any name other than the name under which the person is licensed to practice, in advertising or in any other manner indicating that the person is practicing or will practice dentistry, except that name as is specified in a valid permit issued pursuant to Section 1701.5. (g) The practice of accepting or receiving any commission or the rebating in any form or manner of fees for professional services, radiograms, prescriptions, or other services or articles supplied to patients. (h) The making use by the licensee or any agent of the licensee of any advertising statements of a character tending to deceive or mislead the public.
ACTS LEADING TO SUSPENSION OF A LICENSE AND IN VIOLATION OF THE DENTAL PRACTICE ACT
Violations of the Act by Board licensees are grounds for suspen- sion of a license/certification and are handled by the Board’s Enforcement Program, which is composed of five sections: Complaint and Compliance Unit; Inspections/Probation Section; Investigation Unit: Sworn Investigators; Investiga- tion Analysis Unit; and Discipline Coordination Unit [22]. Complaints originate from many sources, including dental professionals, healthcare providers, insurance companies, law enforcement agencies, and patients. Complaint intake specialists route these to the appropriate section; for example, an allegation of an unsafe or unsanitary office condition is routed to the inspection section, whereby Board enforcement inspectors may be sent out and are authorized to issue citations and fines. In addition to Board enforcement action, other law enforcement or regulatory agencies are involved when indicated [1]. Dental professionals placed on probation status by the Board for violations of the Act are monitored by the Enforcement Program’s Probation Unit. The Board’s Enforce- ment Unit may be contacted by phone at (916) 263-2300 or by e-mail at DentalBoardComplaints@dca.ca,gov. Violations of the Act by hygienists are handled by the Hygiene Board’s Complaint Unit, which operates in a similar manner and can be contacted at (866) 810-9899 or by email at DHBCEnforce- ment@dca.ca.gov [20].
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