234CMR: BOARD OFREGISTRATION INDENTISTRY
234 CMR 2.00:PURPOSE, AUTHORITY,DEFINITIONS
Section
2.01: Purpose
2.02: Authority
2.03: Definitions
2.04: Severability
2.01: Purpose
234CMR2.00governsthelicensureandpracticeofdentistry,dentalhygieneanddentalassistinginMassachusettsbyestablishingtheeligibilityandlicensurerequirementsandbyestablishingthestandardsforthepracticeofdentistry,dentalhygieneanddentalassistingintheCommonwealth.
2.02: Authority
The Board of Registration in Dentistry adopts 234 CMR 2.00 under authority of M.G.L.c.13,§§9,19andM.G.L.c.112,§§43through53,andpursuanttoM.G.L.c.30A,§3.
2.03: Definitions
The followingdefinitionsapplytoallpartsof234CMR.
ADAmeans the AmericanDental Association.
ADAAmeans the American Dental Assistants Association.
ADHAmeans the American Dental Hygienists’ Association.
Address ofRecordmeanstheaddress ofanindividual licensed,registeredor permitted bytheBoardasprovidedbytheapplicant or /licenseeandmaintainedbytheBoardandwheretheBoardwillsendswrittencommunication(s)totheindividual.
AdjudicatoryHearingmeansanadministrativehearingheld in accordance with M.G.L. c. 30A and 801 CMR 1.00heldbytheBoardtodeterminethetruthandvalidityoftheallegationscontainedinacomplaintfiledagainstalicensee,registrantorpermitholderoftheBoard.ThehearingisheldinaccordancewithM.G.L.c.30A,theStateAdministrativeProcedureAct,and801CMR1.00:StandardAdjudicatoryRulesofPracticeandProcedure.
AdvancedCardiacLifeSupport(ACLS)Certificationmeansthatanindividualhassuccessfullycompletedanadvancedcardiaclifesupportcourseofferedbythe AmericanHeartAssociationor other Board-approvedentityapproved bythe Board.
Advertisingmeansarepresentationorothernoticegiventothepublicormembersthereof,directlyorindirectly,byadentistor public health dental hygienist onbehalfofhimselforherself,hisorherfacility,hisorherpartnerorassociate,oranydentistaffiliatedwiththedentistorhisorherfacilitybyanymeansormethodforthepurposeofinducingpurchase,saleoruseofdentalmethods,services,treatments,operations,proceduresorproductsortopromotecontinuedorincreaseduseofsuchdentalmethods,treatments,operations,proceduresorproducts.
BasicLifeSupport(BLS)Certificationmeanscertification in Basic Life Support for the Healthcare Provider obtained through a course that follows the guidelines of the American Heart Association for BLS or guidelines of the American Red Cross. thatanindividualhassuccessfullycompleteda courseinbasiclifesupportforhealthcareprovidersofferedbytheAmericanHeartAssociationor other entityapproved bythe Board.
BoardmeanstheBoardofRegistrationinDentistry oranyof its committeesorsubcommitteesthereofestablishedintheMassachusettsDepartmentofPublicHealthpursuanttotheprovisionsofM.G.L. c. 13, §§ 9 and, 19, c. 112, §§ 43 through 53 and c. 30A.
CardiopulmonaryResuscitation/AutomatedExternalDefibrillation(CPR/AED)Certificationmeanscertification in Cardiopulmonary Resuscitation/Automated External Defibrillation for Professional Rescuers and Health Care Providers obtained through a course that follows the guidelines of the American Red Cross for CPR/AED.thatanindividualhassuccessfullycompletedacardiopulmonaryresuscitationcourseforprofessionalrescuersofferedbytheAmericanRedCrossorotherentityapprovedbytheBoard.
CDCA means the Commission on Dental Competency Assessments, successor to the North East Regional Board of Dental Examiners (NERB), which administers qualifying examinations for dentists and dental hygienists.
CDCGuidelinesmeansthe GuidelinesforInfectionControlinDentalHealth-CareSettings-2003,United States Centers forDisease Control and Prevention.
Chapters69-and74-approvedProgrammeansaprogramthathasobtainedtheapproval,pursuanttoM.G.L.c.69andc.74,forspecificsecondaryorvocational-technicalprogramsbythe Commissioner of theMassachusettsDepartment of Elementaryand SecondaryEducation.
Chapter112-approvedProgrammeansaprogramthathasobtainedtheapproval,pursuantto M.G.L.c.112,§263forspecificprivateoccupationalschoolprogramsby theMassachusettsDivision of Professional Licensure.
CMRmeanstheCodeofMassachusettsRegulationspublishedbytheState Publications and RegulationsDivisionofthe MassachusettsOfficeof the Secretaryof the Commonwealth.
CODAmeans the ADA’s Commission on Dental Accreditation of the AmericanDental Association.
CollaborativeAgreementmeansawrittenagreementthatcomplieswith234CMR5.08:WrittenCollaborativeAgreement(WCA)withaPublicHealthDentalHygienistandisbetweenapublichealth dentalhygienist and a local or state governmentagencyor institution or with a licenseddentistwhoholdsavalidlicenseissuedpursuanttoM.G.L.c.112,§45whoagreestoprovidetheappropriatelevelofcommunicationandconsultationwiththepublichealthdentalhygienistto ensure patienthealthandsafety.
CommunityHealthCentermeansanon-profitagencylicensedbytheDepartmentofPublicHealth under M.G.L. c. 111, § 51.
Complaintmeansacommunicationto,orotherinformationobtainedby,theBoardortheDivisionofHealthProfessionsLicensurewhichthatallegesthatanindividual,personorentitysubjecttoregulationbythe Board hasengagedinconductthatviolatesanylaw or ,regulation,orboth, related to dentistryand/or dentalpractice.
ConsentAgreementmeansalegallybindingdocumentreflectingtheagreement,includingspecifiedtermsandconditions,enteredintobyanindividuallicensed,registeredorpermittedbythe Boardand the Board in resolution of anycomplaint against such licensee.
ContinuingEducationUnit(CEU)meanscontinuing education unit and means aminimumof50minutesofeducationand/orexperience assetforthin234CMR8.00:Continuing Education.
Convictionshallincludeanyguiltyverdictorfinding ofguiltandanyadmissiontoorfindingofsufficientfactstowarrantafindingofguilt,acontinuancewithoutafinding,andanypleaofguiltyornolocontenderewhichhasbeenacceptedbythecourt,whetherornotsentencehasbeenimposed.AconvictionofanypersonlicensedbytheBoardlicenseeshallbeconclusiveevidenceofthecommissionof thatcrime inanydisciplinaryproceeding institutedagainstthatlicenseebasedupon the conviction.
DentalAssistantmeansan individualpersonqualifiedbyeducation,trainingorexperiencewho,underthesupervisionofalicenseddentist,aidsorassiststhedentistintheperformanceofproceduresordutiesrelatedtotheprovisionofdentalcareinaccordancewiththeprovisionsin234CMR2.00.Adentalassistantmaybeclassifiedinone of fourcategories:
(a)CertifiedAssistant(CA)meansan individualpersoncertifiedbytheDentalAssistingNationalBoard,Inc., orotherBoard-approved,certifyingbody,asadentalassistant.
(b)DentalAssistantTrainedonthejob(OJT)meansan individualpersontrainedonthejobbyadentistlicensedtopracticedentistryintheCommonwealthwhohascompletedthetrainingpursuantto M.G.L. c. 112, § 51½.
(c)ExpandedFunctionDentalAssistant(EFDA)meansan individual personwhoiscurrentlycertifiedbytheDentalAssistingNationalBoard,Inc.,orotherBoard-approved,certifyingbody,andhascompletedaformalprograminexpandedfunctionsthatprovides,ataminimum,traininginthedelegabledutiespursuantto234CMR5.11:DelegableProcedures,ataCODA-accredited programaccredited bythe CODA.
(d)FormallyTrainedDentalAssistant(FTDA)meansan individualpersonwhoisagraduateofaschool or program that meetsrequirements for licensurepursuant to 234 CMR 4.11(3).
DANBmeans the Dental Assisting NationalBoard,Inc.
DANB-RHS means the DANBRadiation Health and SafetyExamination.
DANB-ICEmeans the DANBInfection Control Examination.
DentalAuxiliaryPersonnelmeans a dentalhygienistora dentalassistant.
Dentistmeans an individual nypersonlicensed underthe provisions of M.G.L. c. 112, § 45 or § 45A.
Dentistryhas the same meaning as set forth in M.G.L. c. 112, §50.Apersonshallbedeemedtobepracticingdentistryifheorsheholdshimselforherselfoutasbeingabletodiagnose,treat,operateorprescribeforanydisease,pain,injury,deficiency,deformityorotherconditionofthehumanteeth,alveolarprocess,gumsorjaws,andassociatedparts,intra-orallyorextra-orally,orifhe/sheeitheroffersorundertakesbyanymethodtodiagnose,treat,operateorprescribeforanydisease,pain,injury,deficiency,deformityorotherconditionofthesame;orifhe/she,exceptonthewrittenprescriptionofaregistereddentistandbytheuseofimpressionsmadebyaregistereddentist,directlyorindirectlybymail,carrier,personalagent,orbyanyothermethod,supplies,constructs,reproduces,relines,repairs,addsordirectstheapplicationofanysubstance,ofadurablenature,todentures,bridges,appliances or other structures tobe usedand wornas substitutes for natural teeth or solicits oradvertises,exceptaspermittedinM.G.L.c.112§52A,tosupply,construct,reproduce,repair,reline,addor directtheapplicationof anysubstance, ofa durablenature, to dentures,bridges,appliancesorotherstructurestobeusedandwornassubstitutesfornaturalteeth;ofifheorsheplacessuchsubstitutesinthemouthoradjuststhesame;orif heorshe,exceptonthewrittenprescriptionofaregistereddentist,observesapatient'snaturaldentitionforpurposesofmatchingcolorationorotheraestheticcharacteristictoaidinthefabricationorrepairofaprescribedrestorativeappliance.
Facultymeansanindividualappointedtothefaculty ofaCODA-accrediteddentalcollege,dentalhygiene,ordentalassistingprogram.Facultymayincludefullorpart-timeassistantorassociateclinicalinstructors,adjunctinstructors,assistantorassociateprofessors,teachers,post-doctoralfellows,visitinglecturersandgraduateassistants.
FinalDecisionandOrdermeansthewrittenfindingsoffact,conclusionsoflaw,andorderforsanction or otherdisposition issued to alicenseebythe Boardfollowing the final adjudicationofa complaint.
GoodMoralCharactermeansthosevirtuesofan individualapersonwhicharegenerallyrecognizedasbeneficial to the public health, safetyand welfare.
HIPDBmeansthe HealthcareIntegrityand Protection Data Bank.
Homeboundmeansanindividual“confinedtohisorherhome”iftheindividualhasacondition,duetoanillnessorinjury,thatrestrictstheabilityoftheindividualtoleavehisorherhomeexceptwiththeassistanceofanotherindividualortheaidofasupportivedevice(suchascrutches,acane,awheelchair,orawalker),oriftheindividualhasaconditionsuchthatleavinghisorherhomeismedicallycontraindicated.Whileanindividualdoesnothavetobebedriddentobeconsidered“confinedtohishome”,theconditionoftheindividualshouldbesuchthatthereexistsanormalinabilitytoleavehomeandthatleavinghomerequiresaconsiderableandtaxingeffortbytheindividual.Anyabsenceofanindividualfromthehomeattributabletotheneedtoreceivehealthcaretreatment,includingregularabsencesforthepurposeofparticipatingintherapeutic,psychosocial,ormedicaltreatmentinanadultday-careprogramthatislicensedor certifiedbyastate,oraccredited,tofurnishadultdaycareservicesinthestateshallnotdisqualifyanindividualfrombeingconsideredtobe“confinedtohisorherhome”.Anyotherabsenceofanindividualfromthehomeshallnotsodisqualifyanindividualiftheabsenceisofinfrequentorofrelativelyshortduration.Forpurposesoftheprecedingsentence,anyabsencefor the purpose of attending areligious serviceshall be deemed to be an absenceof infrequentor short duration. [42 USC 1395n(a)(2)(F)]
Impairedmeanstheinabilitytopracticedentistry,dentalhygiene,ordentalassistingwithreasonablejudgment,skill,andsafetybyreasonofalcoholordrugabuse,useofothersubstances, aphysical or mental illness or condition, or byanycombination of the foregoing.
InstitutionalFacilitymeansanyentitythathostsanMDForPDOincluding,butnotlimitedtoaschool,longtermcarefacility, residentialhome, residentialtreatmentfacilityorcorrectionalinstitution.
Jurisdictionmeans anymunicipality,state,territoryor country,includingtheCommonwealthofMassachusetts.
LegalRepresentativemeansanindividualwhohaseitherbeenappointedbyacourt or whoisnamedunderawrittenagreementwiththepatienttoserveasthepatient'srepresentative,including, but not limited to, guardian,conservator,healthcare agent, or power ofattorney.
Licenseasusedin234CMRissynonymouswithregistration,permitand ortherighttorenewsaidalicense,registrationorpermit.
Licensed Dentist means a dentist licensed pursuant to M.G.L. c. 112, § 45.
Licenseemeans an individual personregistered as holding or havingheld anytype of license,registration,and/orpermitissuedpursuanttoM.G.L.c.112,§§43through53and234CMR,whetherornotsuch licenseis expired, surrendered,suspended, or revoked.
LimitedLicenseemeans an individualpersonlicensed to practicedentistryundertheprovisionsof M.G.L. c.112,§45A.Alimitedlicenseemaybeadentalinternorafull-timefacultymember.
(a)LimitedLicenseDentalInternmeansanindividualgrantedalimitedlicensetopracticedentistryintheCommonwealth,pursuanttoM.G.L.c.112,§45A,whohasgraduatedfromareputabledentalcollege,pursuanttoM.G.L.c.112,§46,andwhopracticesinahospitalorotherinstitutionmaintainedbythestate,acountyormunicipality,orhospitalordentalinfirmaryincorporatedunderthelawsoftheCommonwealth.Alimitedlicensedentalinternshallnotpracticedentistry inaprivatedentalofficeorprivatedentalclinicandmay onlypracticeatinstitution(s)specifiedinthedentalintern'slicenseapplication.Apersonwhohasbeenissuedalimitedlicenseshallworkunderthedirectionofaregisteredlicenseddentistwhoislicensed bythe Board,pursuant to M.G.L. c. 112, § 45, and isemployedbythe institution.
(b)LimitedLicenseFacultymeansanindividualgrantedalimitedlicensetopracticedentistryintheCommonwealth,pursuanttoM.G.L.c.112,§45A,whohasgraduatedfromareputabledentalcollege,pursuantto M.G.L. c. 112,§46,whois employed as afull-timememberofthefacultyofaCODA-accrediteddentalcollegeandwhoworksunderthedirectionofaregisteredlicenseddentistwhoislicensedbytheBoard,pursuanttoM.G.L.c.112,§45andisemployedbysaiddentalcollege.Apersonwhohasbeenissuedalimitedlicensefacultymember licenseshall not practicedentistryin aprivate dental officeor privatedental clinic. A,exceptthatafull-timefacultymembermayparticipateinanintramuralgrouppracticewhichisoperated,managedandphysically locatedwithinanonprofitdentaleducationalorresearch institutionandtheiritsaffiliatedhospitalsinwhichwhere thelimitedlicensefull-timefacultymemberis employed.
MassHealthmeans the Medical assistance program known as MassHealth administered by the Executive Office of Health and Human Services pursuant to M.G.L. c. 118E and Title XIX of the Social Security Act.
MDForPDODirectormeansa licenseddentistwhoiscurrentlylicensedtopracticedentistryintheCommonwealthpursuanttoM.G.L.c.112,§45,orapublic health dentalhygienistpracticingpursuanttoM.G.L.c.112,§51,forthepurposesofprovidingdentalhygieneservicesinpublichealthsettings , who is responsible for dentalservices provided bythe MDFor PDO.
MDForPDOPermitHoldermeansalicensed dentistwhoiscurrentlylicensedtopracticedentistryintheCommonwealthpursuanttoM.G.L.c.112,§45,orapublichealthdentalhygienistinwhosenametheMDFand/orPDOFacilityPermitisissued.WheretheMDForPDOisnotwhollyownedby a licensed dentist(s)ora publichealthdentalhygienistlicensedtopracticeintheCommonwealth,theowner(s)shallapplyforalicensetooperateasaclinicpursuantto M.G.L.c.111,§51,unlesstheentityisexemptfromsuchlicensurepursuanttoM.G.L.c.111, § 52.
M.G.L.means the MassachusettsGeneralLaws.
MobileDentalFacility(MDF)meansanyself-containedfacilitywheredentistrywillisbepracticed,whichmaybedriven,moved,towed,ortransportedfromonelocationtoanother.Seerelateddefinition under Portable DentalOperation.
NERBmeanstheNortheastRegionalBoardofDentalExaminers,Inc.qualifyingexaminationsfordentistsanddentalhygienists.
NPDBmeansthe National Practitioner DataBank.
OrdertoShowCausemeansanoticeissuedbytheBoardtoalicenseeoftheBoardcontainingallegationsthatthelicensee’s acts or omissionsengagedinconductthatviolatedsanya laworregulation,orbothrelatedtothepracticeofdentistry,ordentalhygiene or dental assisting.TheOrdertoShowCausemayalsoorderthelicenseetoappearatanadjudicatoryhearingheldbytheBoardto“showcause”whytheBoardshouldnottakedisciplinaryactionagainstalicenseortherighttorenewsuchlicense.See801 CMR 1.01(6)(a).
OSHAStandardsmeansGeneralIndustryStandardsat29CFR, the UnitedStatesOccupationalSafetyandHealth Administration’s General Industry Standards at 29 CFR.
Patient, includes a parent or legalrepresentative.
PortableDentalOperation(PDO)meansanynon-facilitywheredentalequipmentutilizedusedinthepracticeofdentistry,istransportedtoandused tilizedonatemporarybasisatanout-of-officelocation.Seerelateddefinitionsunder 234 CMR 2.03: Mobile Dental Facility(MDF).
PublicHealthDentalHygienist(PHDH)meansaregistereddentalhygienistwhoholdsavalidlicensetopracticeintheCommonwealthissuedpursuanttoM.G.L.c.112,§51,whohasthreeyearsoffull-timeoranequivalent4,500hoursofclinicalexperienceandhastheappropriatetrainingpursuantto234CMR5.07(2):EducationalRequirementsforPublicHealthDentalHygienePractice andwhoworksinapublichealthsetting pursuanttoawrittencollaborativeagreementwithalocalorstategovernmentagencyorinstitutionoralicenseddentistwhoholdsa valid licenseissued pursuant to M.G.L. c. 112, § 45.
PublicHealthSettingincludes,butisnotlimitedto,residencesofthehomebound,schools,HeadStart programs, nursing homes and long-term care facilities licensed pursuant to M.G.L.c.111,§71,clinics,communityhealthcenters,andhospitalslicensedpursuantto M.G.L.c.111,§51,medicalfacilities,prisons,residentialtreatmentfacilities,federal,stateorlocalpublichealthprograms,mobiledentalfacilitiesandportabledentalprogramswhicharepermittedbytheBoardpursuantto234CMR7.00:MobileandPortableDentistryorlicensedorcertifiedbytheDepartmentpursuanttoM.G.L.c.111,§51,andotherfacilitiesorprogramsdeemedappropriatebytheBoardandtheDepartment.
Reactivationmeanstherenewalofanexpiredlicense topractice dentistry,dentalhygiene,ordentalassisting.
RegisteredDentalHygienist(RDH)orDentalHygienistmeansan individualpersonwhohasbeensuccessfullyexaminedbytheBoardoritsdesigneeandwhohasbeenlicensedbytheBoardtopracticedental hygiene in the Commonwealth pursuant to M.G.L. c. 112, § 51.
Reinstatementmeanstheissuanceofalicensetopracticedentistry,dentalhygiene,ordentalassisting whichthathas been suspended, surrendered orrevoked.
SubstanceAbuUseDisordermeansadysfunctionalpatternofhumanresponsecharacterizedbyexcessive,inappropriate, or unhealthyuse of chemicalsubstances includingalcohol or drugs.
Supervisionincludesthree typesofsupervisionasfollows:
(a)GeneralSupervisionmeanssupervisionofdentalproceduresbasedoninstructionsgivenbyalicenseddentistbutnotrequiringthephysicalpresenceofasupervisingdentistduringtheperformanceofthoseprocedures.Apublichealthdentalhygienistmayperformalldelegateddutiespermittedundergeneralsupervisionasdescribed in234CMR5.00:RequirementsforthePracticeofDentistry, andDentalHygiene and Dental AssistingprovidedthepublichealthdentalhygienisthasenteredintoacollaborativeagreementWCA withalicensed dentistwhoholdsavalidlicenseissuedpursuanttoM.G.L.c.112,§45orwithanappropriate municipalorstate agencyor institution to ensure thepublic healthandsafety.
(b)DirectSupervisionmeanssupervisionofdentalproceduresbasedoninstructionsgivenbyalicenseddentistwhoremainsinthedentalfacilitywhiletheproceduresarebeingperformed bytheauxiliary.
(c)ImmediateSupervisionmeansthesupervisionofdentalproceduresbyalicenseddentist,whoremainsinthedentalfacility,personallydiagnosestheconditiontobetreated,personallyauthorizestheprocedures,andbeforedismissalofthepatient,evaluatesthetreatmentrendered.
ValidLicensemeansa licensetoengageinthepractice of dentistry, dentalhygiene,or dentalassistingintheCommonwealthproperlyissuedtoalicenseebytheBoardonthebasisoftruthfulinformationrelatedtoqualificationsforlicensureandwhichlicenseisnotexpired,surrendered,suspended, orrevoked.
WrittenCollaborativeAgreement(WCA)meansawrittenagreementthatcomplieswith234CMR5.08:WrittenCollaborativeAgreement(WCA)withaPublicHealthDentalHygienist.andisbetweenapublichealthdentalhygienistandalocalorstategovernmentagencyorinstitutionorwithalicenseddentistwhoholdsavalidlicenseissuedpursuanttoM.G.L.c.112, §45whoagreestoprovidetheappropriatelevelofcommunicationandconsultationwiththepublic healthdentalhygienist to ensure patienthealthandsafety.
2.04: Severability
The provisions of 245 CMR et. seq. are severable. If any provision therein is declared unconstitutional or invalid by a court of competent jurisdiction, the validity of the remaining portions shall not be affected.
REGULATORYAUTHORITY
234 CMR 2.00: M.G.L. c. 13, § 19; c. 112, §§ 43 through 53 and 61.
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