234 Cmr: Board of Registration in Dentistry
234 CMR: BOARD OF REGISTRATION IN DENTISTRY
234CMR5.00: / REQUIREMENTSFORTHEPRACTICEOF DENTISTRY, DENTALHYGIENE,AND DENTALASSISTING
Section
5.01: Purpose
5.02: GeneralRequirements for the Conduct of aDental Practice
5.03: Dental Specialties
5.04: Posting ofLicenses and Permits, and Identification of Personnel
5.05: InfectionControl,OccupationalSafetyandHealthStandards, andRadiationControlRequirements5.06: Controlled Substances
5.07: Dental HygienePracticeand Public Health DentalHygienist Practice
5.08: WrittenCollaborative Agreement(WCA)withaPublicHealthDentalHygienist
5.09: RequirementsforTrainingin Radiology
5.10: Delegation of Duties
5.11: DelegableProcedures
5.12: Non-delegableDental Duties
5.13: PatientRecords:Content,Confidentiality,Retention,andAvailability
5.14: Content of Patient Records
5.15: EmergencyProtocol
5.16: Reporting ofPatient Deaths in DentalFacilities
5.17: Inspection of Facilities and Requirements for CorrectiveAction
5.18: Advertising
5.19: Principles of Ethics and Code ofProfessional Conduct
5.20: Prohibited Practices
5.01: Purpose
The purposeof 234 CMR 5.00is to set forth the standards and requirements that licenseesof the Board must complywith in the practiceof dentistry, dental hygieneand dental assistingin the Commonwealth.
5.02: GeneralRequirements for the Conduct of aDental Practice
(1)An individualypersonwhoowns,leases,maintains,oroperatesadentalpracticeinanyfacilityorroom(s)wheredentalservicesareprovided,ordirectlyorindirectlyisdirector,proprietororconductorofsame,isrequiredtoconductsuchdentalpracticeinaccordancewithM.G.L.c.112, §§43through53and234CMR.
(2)Adentalpracticenotwhollyownedbyalicensed dentistordentistslicensedtopracticedentistryintheCommonwealthshallbelicensedasadentalclinicorhospitalpursuanttoM.G.L.c.111, § 51 unless it is exempt from such licensurepursuant to M.G.L. c. 111, § 52.
(3)Theowner(s)ofadentalpracticewhereanynon-ownerdentistpracticesdentistryshalldesignateadentistwhoholdsavalidlicenseissuedpursuanttoM.G.L.c.112,§45toactasDentalDirector.TheappointmentofaDentalDirectorshallnotabsolveanyownerlicensee orotherlicenseepracticingatthesitefromensuringthatthedentalpracticeisestablished,maintainedandoperatedinaccordancewithM.G.L.c.112,§§43through53,61and234CMRandanyrule,advisoryorwrittenpolicyadoptedbytheBoardrelatedtothepracticeofdentistry,dentalhygiene,ordentalassisting.Anon-ownerdentistincludes,butis notlimitedto,adentistwhoworks full-time, part-time, or on a temporarybasis or as anindependentcontractor.
(a)ThenameoftheDentalDirectorandatleastoneoftheownerswith a valid whoisadentalistlicensedtopracticedentistryintheCommonwealth shallbepostedateachpracticesiteina publicplacewhere a patient can observesuch notice.
(b)TheDentalDirectorshall,ataminimum,beresponsibleforimplementingpoliciesandprocedurestoensurecompliancewithlocalordinancesandstateandfederalstatutesandregulationsgoverningthe practice ofdentistryin areasincluding, but not limited to:
1.Licensure andqualifications ofdentistsanddentalauxiliaries;
2.Delegation of duties to dental auxiliaries pursuant to 234 CMR 5.10 and 5.11;
3.Anesthesia administration as permitted bythe Board;
4.State and federal controlled substances rules and regulations;
5.CDC Gguidelines, including weekly spore testing;
6.OSHA standards;
7.Radiation control requirements;
8.Posting dental licenses in the practice;
9.Advertising dental services or fees;
10.Scheduleofequipmentanddrugstoensuretimelyinspections,maintenanceandcurrentdrugs; and
11.Compliancewithapplicablelocal,stateandfederalregulationsandstatutes,including,butnotlimitedto,occupancycodes,firesafetycodes,anddisposalofhazardous waste.
5.03: Dental Specialties
(1)Adentistmayholdhim/herselfoutadvertiseasanADA specialistinaparticularareaofpracticeonlyif hethe dentist/she:
(a)HascCompletedaspecialtyeducationprogramapprovedbytheAmericanDentalAssociation(ADA)andtheCommissiononDentalAccreditationortheCommissiononDental Accreditation of Canada; and one of the following:
(b)Iseligible for examination bya national specialtyboard recognized bythe ADA; or
(c)Is a diplomate of anational specialtyboard recognized bythe ADA.
(2)Adentistisprohibitedshall notfromholdinghimself or /herselfoutindirectories,listingsorotherwrittenorelectronicpublicationsasapractitionerinanyspecialtyrecognizedbytheADAunlesshisorherthe dentist’spractice islimitedonlytothespecialtyarea(s)thatisbeingadvertised,listed,orotherwisenoted or published.
5.04: Posting ofLicenses and Permits and Identification of Personnel
(1)Alicenseeshallposthisorherthe licensee’snameandcurrentlicense,orcopyofsaidlicensepublically ineachlocation of practice in aplacewhere it can beobserved bythe public.
(2)Alicensee shallposthisorherthe licensee’sindividualanesthesiaandFacilityPermit,ifasapplicable,publically ineachpractice site in a placewheretheycan beobserved bythe public.
(3)Alllicenseesanddentalauxiliariesprovidingdentalservicestoapatient,orassistingadentistinthedirectcareortreatmentofapatient,shallwearanametagwiththeindividual'slicensee’sname,andprofessional title and function.
5.05: InfectionControl,OccupationalSafetyandHealthStandards,andRadiationControl Requirements
(1)InfectionControlPractices.AllpersonslicensedbytheBoardlicenseesandallpracticesprovidingdentalservicesarerequiredtoshalloperateincompliance withthecurrent RecommendedInfectionControlinDentalHealth-CareSettings-2003,CentersforDiseaseControlandPrevention(CDC), U.S. Department of Health and Human Services,Atlanta.
(2)OccupationalHealthandSafetyPractices.AllpersonslicenseesdbytheBoardandallpracticesprovidingdentalservicesarerequiredtooperateincompliancewith OSHA StandardstheOccupationalSafetyandHealthAdministrationStandardsat29CFR: OSHA Standards.
(3)RadiationControl.Allpersonslicensedby theBoardlicenseesandalldentalpracticesprovidingdentalservicesusingutilizingradiologicalequipmentarerequiredtoshalloperateandmaintainsuchequipmentincompliancewithMassachusettsRadiationControlProgramstatutesandregulations.
5.06: Controlled Substances
(1)Dentistsregisteredtodispense,administerandprescribeanycontrolledsubstancesshallonly dosoinaccordancewith M.G.L. c. 94Cand105CMR700.00:ImplementationofM.G.L.c.94Candallapplicablestateandfederalstatutesandregulationspertainingtocontrolledsubstances.
(2)Dentistsshall only arelimitedtowriteingprescriptionsforcontrolledsubstancesforlegitimatedentalpurposesintheusualcourseofpracticeandshall not areprohibitedfromprescribeingcontrolledsubstances in Schedules IIthroughIV for personal use.
(3)Exceptinanemergency,adentistisprohibitedfromshall notprescribingeScheduleIIcontrolledsubstancestoamemberofhisorherimmediatefamilyincludingaspouse(orequivalent),parent,child,sibling,parent-in-law,sonordaughter-in-law,brotherorsister-in-law,step-parent,step-child,step-sibling,orotherrelativepermanentlyresidinginthesameresidenceasthelicensee.
(4)Priortoprescribingahydrocodone-onlyextendedreleasemedicationthatisnotinanabusedeterrentform,alicensee must:
(a)Thoroughlyassessthepatient,includinganevaluationofthepatient'sriskfactors,substanceabusehistory,presentingcondition(s),currentmedication(s),adeterminationthatotherpainmanagementtreatmentsareinadequate,andacheckofthepatient'sdatathroughtheonline PrescriptionMonitoringProgram;
(b)Discussthe risksandbenefitsofthemedicationwiththepatient;
(c)EnterintoaPainManagementTreatmentAgreementwiththepatientthatshallappropriatelyaddressdrugscreening,pillcounts,safestorageanddisposalandotherrequirementsbasedonthepatient'sdiagnoses,treatmentplan,andriskassessmentunlessaPainManagementTreatmentAgreementisnotclinicallyindicatedduetotheseverityofthepatient's medical condition;
(d)SupplyaLetterofMedicalNecessityasrequiredbytheBoardofRegistrationinPharmacypursuant to 247 CMR 9.04(8)(c); and
(e)Document 234 CMR 5.06(4)(a)through (d) in the patient'smedicaldentalrecord.
Thepurposeof234CMR5.06(4)istoenhancethepublichealthandwelfarebypromotingoptimumtherapeuticoutcomes,avoidingpatientinjuryandeliminatingmedicationerrors.Nothingin234CMR5.06(4)shallalterthestandardofcarealicenseemustusewhenprescribinganySchedule II,IIIor IV controlled substance.
5.07: Dental HygienePracticeand Public Health DentalHygienist Practice
(1)Adentalhygienistmayshall onlyprovidedentalserviceswhichareeducational,therapeutic,prophylacticandpreventive innatureasmaybe authorizedbythe Board andmayperformalltasksperformedbyadentalassistantunderthespecifictypeofsupervisionsetforthin234CMR5.11.Adentalhygienistorpublichealthdentalhygienistmayshallnotperformactsorserviceswhichrequirediagnosisandtreatmentplanningfornon-dentalhygieneservices,surgicalorcuttingproceduresonhardorsofttissue,and/ortheprescriptionofmedications,unlessspecificallyauthorized in 234 CMR 5.07 and 5.12.
(2)EducationalRequirements for Public Health Dental HygienePractice.
(a)Priortopracticingasapublichealthdentalhygienist pursuant to 234 CMR2.03:Definitionsand5.08,adentalhygienistshallsuccessfullycompleteaminimumoftenhoursofcontinuingeducationasfollows:
1.Aminimumofsixhoursofhands-onexperienceinapublichealthsetting.AdentalhygienistwhohasdocumentationdemonstratingaminimumofsixhoursofhandsonexperienceinapublichealthsettingbetweenJanuary1,2005andAugust20,2010shallbedeemedtohavefulfilledthisrequirement.
2.Successfulcompletion,within24monthspriortocommencementofpracticeasapublic healthdentalhygienist,ofcontinuingeducationineachofthefollowingareas:
a.CDCGuidelines(234CMR2.00: Purpose, Authority, Definitions);
b.Risk Management forpractice in a public health setting; and
c.Managementofmedicalemergencies.
(b)The publichealth dentalhygienist shallpermanentlyretain documentationdemonstratingcompliancewith 234 CMR5.07(2)(a)and 5.08.
(3)Apublichealthdentalhygienistpracticinginapublichealthsettingmayshall onlyperformin a public health setting thosedentalserviceswhichareauthorizedbytheBoardpursuanttoM.G.L.c.112,§51,tobeprovidedinapublichealthsetting,and pursuanttoawritten collaborative agreement(WCA)thatcomplieswithrequirementsdescribedinat234CMR5.08,includingasignedaffidavitthatconfirms successful completion of the continuingeducationrequired in 234 CMR5.07(2).
(4)Aregistereddentalhygienistpracticinginapublichealthsettingmayprovidedentalhygieneservices,includingplacementofsealants,withoutfirsthavingadentistexaminethepatient,eitherpursuanttoawrittencollaborativeagreement(WCA)thatcomplieswithrequirementsdescribedin234CMR5.08,orpursuanttoastandingorderunderthegeneralsupervision of a dentistlicensed pursuant to M.G.L. c. 112, § 45licensed dentist.
5.08: WrittenCollaborative Agreement (WCA)with aPublicHealthDentalHygienist
A public healthdentalhygienistwhoholds avalid license to practicedentalhygiene in theCommonwealthissuedpursuanttoM.G.L.c.112,§51,andwhohascompletedtheappropriatetrainingrequiredbytheBoardandhaseitherthreeyearsoffull-timeoranequivalent4,500hoursofclinicalexperienceshallpracticeinaccordancewithBoardstatutesandregulationsandshallenterintoawrittencollaborativeagreement(WCA)withadentistwhoholdsavalidlicenseissuedpursuanttoM.G.L.c.112,§45orwiththeappropriatelocalorstategovernmentagencyorinstitutionpursuanttoM.G.L.c.112,§51,wherealicensed dentistlicensedpursuanttoM.G.L.c.112,§45, isavailabletoprovide the appropriate levelofcommunicationandconsultationwiththepublic health dentalhygienist to ensure patienthealthandsafety.
(1)EachApublic healthdentalhygienistshall:
(a)Enterintoawrittencollaborativeagreement(WCA)whichcomplieswiththerequirementsat234CMR5.08beforerenderingtreatment,advertising,orsolicitingpatientspatients or toprovidingeanydentalhygieneservicesina public healthsettingpursuanttothe WCAcollaborative agreement;
(b)Maintaincontactanddocumentcommunicationwiththedentistwithwhomthepublichealth dentalhygienist has entered into a writtencollaborativeagreement (WCA);
(c) Obtain and practice public health dental hygiene under a PDO Permit pursuant to 234 CMR 7.00 (Mobile andPortableDentistry)
(cd) Practice inaccordance withBoardrulesandregulations;
(de) Practiceinaccordancewithsystems,policiesandproceduresestablishedpursuanttoBoardstatute andregulations;
(ef) Obtainwritten,signedinformedconsentofthepatientorlegalrepresentativewhichcomplieswithBoardregulationscontainedin234CMR5.08,informsthepatientorlegalrepresentativethattheservicesprovidedbythepublichealthdentalhygienistarenotasubstituteforadentalexaminationbyadentistandinformsthepatientthatthepatientorlegalrepresentativethatthepatientshouldobtain,orshouldhavehadadentalexaminationbya dentistwithin90days;
(fg) ProvideeachpatientwithawrittenInformationSheetattheconclusionofthepatient'svisit, which shall be part of the dental record. SaidTheInformationSheetshall,ataminimum, includethefollowing:
1.Results of the dental hygieneevaluation;
2.Thename(s)ofthepublichealthdentalhygienistsandanylicenseddentistandotherdentalauxiliarieswhoprovidedservices;
3.A description of the treatmentrenderedincluding, but not limited to, billed servicecodes andfeesassociated with treatment, and tooth numbers when as appropriate;
4.Informationonhowtocontactthepublichealthdentalhygienist or,dentalhealthservicesprogramdirector,mobiledentalfacilityorportabledentaloperationpermitholder(See234CMR7.00:Mobile andPortableDentistry);
5.Ifnecessary,provide a referralforemergencyassessmentbyadentist;
6.Whenareferralismade,thepublic health dental hygienist shall refer the patientorlegalrepresentativeshallbereferredtothepatient'sregulardentistifoneisidentified.Ifnoneisidentified,thenthepublic health dental hygienist shall provide the patientorlegalrepresentativemustbeprovidedwiththenamesofdentist(s),communityhealthcenter(s)ordentalschoolclinic(s)locatedwithinareasonablegeographicdistancefromthepatient'shomeandwithwhomthepublichealthdentalhygienistordentalhealthservicesprogramhadcommunicatedwithregardingtheregarding accepting ance ofreferrals;
7.The name and signatureof the public health dental hygienist; and
8.Ifthepatientorlegalrepresentativehasgivenconsentforaninstitutionalfacility(e.g.school,nursinghome)toaccessthepatient'sdentalhealthrecords,thenthedentalhygienistshallalsoprovidetheinstitutionwithacopyoftheinformationsheet.
(2)Alicensed dentistenteringintoawrittencollaborativeagreement(WCA)withsupervisingapublichealthdentalhygienist,may,butisnotrequiredto, providesubsequentdentaltreatmenttopatientsservedunderthe WCAsaidagreement.
(3)WrittenCollaborativeAgreement(WCA).Acollaborativeagreementbetweenapublichealthdentalhygienistandamunicipalityorstateagencyorinstitution,orwithalicenseddentistwhoholds a validlicense issuedpursuant toM.G.L.c.112,§45shall, ata minimum,addressall ofthefollowing:
(a)Names(s) of Identifybyname(s)thedentist(s)whoshallbeavailabletoprovidetheappropriatelevelofcommunicationandconsultationwiththepublichealthdentalhygienisttoensurepatienthealthandsafety;
(b)Specifically Ddescribe,withspecificity,including the frequency of and arrangements for back-up coverage,howthe communicationandconsultationbetweenthelicensed dentistandpublichealthdentalhygienistwillconsult and communicate to ensure patient health and safetybeaccomplished,includingthefrequencyandarrangementsforback-upcoveragewhenthedentistisnotaccessibletoprovidecommunication and consultation(e.g., duringvacation, illness);
(c)ProvidetThenames,licensenumbers,addresses,telephoneandfacsimilenumbers,andemergencycontactinformationforthedentist(s)andpublic healthdentalhygienist;
(d)IncludeThe public health dental hygienist’sanattestationfromthepublichealthdentalhygienistwhichissignedunderthepainsandpenaltiesofperjurythatdescribingesthepublichealthdentalhygienistlicensee'squalificationstopracticeasapublic healthdentalhygienistandexplicitlystatesthatthedentalhygienisthasaminimumofthreeyearsoffull-timeoranequivalentof4,500hoursofclinicalexperienceasaregistereddentalhygienistandhascompletedalltrainingrequiredbytheBoard;
(e)IdentifyTheentity(ies)andgeographicarea(s)wherepublichealthdentalhygienistserviceswillbe providedpursuanttothe WCAcollaborative agreement;
(f)SpecifytThespecific dentalhygieneprocedurestobeprovidedandthepopulationstobeservedpursuanttothe collaborative agreementWCA;
(g)Specifyand describe How patient records will be created, maintained, stored and kept confidentialresponsibilitiesforcreating,maintaining,storing,retrievingandprovidingfortheconfidentialityofpatientrecords;
(h)SpecifyanddescriberesponsibilitiesforestablishingThe systems,policiesandprocedures developedtoensurecompliancewithBoardregulations,includingbutnotlimitedtorequirementsof234CMR5.00and7.00: Mobile andPortableDentistryas maybe applicable;
(i)Specifyanddescriberesponsibilitiesfordeveloping,implementing,andmaintainingTheemergencymedicalprotocolsandfortheprovisionofperiodicreviewandtrainingonsame;
(j)Include anycConsiderationsfor age- orprocedure-specificprotocols as the dentist or public health dental hygienist determines to maybe deemednecessarybythedentistorpublichealthdentalhygienist;
(k)IncludeanycConsiderationsformedically-compromisedpatientsasthe dentist or public health dental hygienist determines to maybedeemednecessarybythedentistorpublichealthdentalhygienist;
(l)OutlineHow and what services the public health dental hygienist will responsibilitiesforbillingandreimbursementforservicesrenderedbythedentalhygienist in the public health setting, ifindicatedfor;
(m)Identify aprocessfortheHow thepublichealthdentalhygienistwill tolegallyobtainprescriptionproducts(e.g.chemotherapeutics,fluoridevarnish)pertinenttotheprovisionofdentalhygieneservicesandwhicharetobeutilizedwhenrenderingservicesinapublichealthsetting; and
(n)Term of the collaborativeagreementWCA, if applicable.
(4)Thelicensed dentistandpublichealthdentalhygienistshallreviewandupdatetheWCAwrittencollaborative agreementatleastannually.
(5)Thelicensed dentistandpublic healthdentalhygienistshallimmediatelynotifyeachotherand,ifapplicable,themunicipality,stateagencyorinstitutioninvolvedinthecollaborativeagreementWCAof anydisciplinaryactionimposedbytheBoardoranyother governmentalagencyagainsthisor herlicense to practicedentistryor dentalhygiene in the Commonwealth.
(6)The municipality, state agency, institution or licensed dentist and the public health dental hygienist shall maintain AacopyoftheWCAwrittencollaborativeagreementshallbemaintainedbythemunicipality,stateagencyorinstitution,licenseddentist,andthepublichealthdentalhygienist.Uponwrittenrequest,the saidagreementWCAshallbemadeavailabletotheBoard,ortoapatientwhoreceivedtreatmentpursuant under the WCAto the agreement or the patient’s his or herlegalrepresentative.
(7)Eachpublichealthdentalhygienistshallmaintain and report thefollowingdatatobereportedtotheMassachusettsDepartmentofPublicHealth'sOfficeofOralHealthonformsandinaccordancewith proceduresand timelines established bythat office:
(a)Thedatesofeachsessionwithnameandaddressofthesitewherepublichealthdentalhygieneservices wereprovided; and
(b)Thenumberofpatientsservedandthetype(s)andquantity(ies)ofeachserviceprovided.
5.09: RequirementsforTrainingin Radiology
(1)ARegisteredDentalHygienist(RDH),PublicHealthDentalHygienist(PHDH),ExpandedFunctionDentalAssistant(EFDA),CertifiedAssistant(CA)oraFormally-trainedDentalAssistant(FTDA)maytakedentalradiographsonlyunderthesupervisionofadentistprovidedthatthedentalauxiliary hassuccessfully completedacoursewithacurriculumthatcomplieswithCODA-standardsfor radiologicaltechniquesandsafeguards in dentistry.
(2)AnOn-the-jobTrainedDentalAssistant(OJT)maytakeradiographsonlyunderthesupervisionofadentistandmusthavecompletedacourseinradiologicaltechniquesandsafeguardsandsuccessfullypassedtheDANBRadiationHealthandSafetyExamination(RHS),or other examination as approved bythe Board,within one yearof the coursecompletion.
5.10: Delegation of Duties
(1)AdentistlicensedtopracticedentistryintheCommonwealthpursuanttoM.G.L.c.112,
§45A dentist maydelegatecertaindentaldutiessetforthinthissectiontoadentalauxiliarywhoisproperlyeducated,trained,andqualifiedasspecifiedinM.G.L.c112,§§43through53,61and234CMRandanyrule,advisoryorwritten policyadoptedbytheBoardrelatedtothepracticeofdentistry,dentalhygiene,ordentalassisting.
(2)Thesupervisingdentistshallberesponsibleforalldelegatedactsandproceduresperformedbythedentalauxiliary.Anydentistwhodelegatesaproceduretoanauxiliarywhodoesnotmeettherequirementsnecessarytoperformthatproceduremaybesubjecttodisciplinearyactionbythe Board.
5.11: DelegableProcedures
RegisteredDentalHygienists(RDH),PublicHealthDentalHygienist(PHDH),ExpandedFunctionDentalAssistant(EFDA),CertifiedAssistant(CA),Formally-trainedDentalAssistant(FTDA),andDentalAssistantTrainedontheJob(OJT)andmayperformthefollowingdentalprocedurespursuanttothedesignatedlevelofsupervisionordirection:GeneralSupervision(G),WrittenCollaborativeAgreement(WCA),DirectSupervision(D),ImmediateSupervision(I)or Delegation Not Allowed (N/A).
DELEGATEDDUTY / RDH / PHDH / EFDA / CA / FTDA / OJT(1) / Reviewmedicalanddentalhistoryandconsultwhen
necessarywithmedicalpractitioner / G / WCA / G / G / G / G
(2) / Performpreliminaryevaluationtodetermineneeded
dentalhygieneservices / G / WCA / N/A / N/A / N/A / N/A
(3) / Makereferralstodentists,physicians,andother
practitionersinconsultationwithadentist / G / WCA / N/A / N/A / N/A / N/A
(4) / Provideoralhealthinstruction / G / WCA / G / G / G / D
(5) / Performdietaryscreeningfordentaldisease
preventionandcontrol / G / WCA / G / G / G / N/A
(6) / Conductdentalscreenings / G / WCA / N/A / N/A / N/A / N/A
(7) / Recorddentalscreenings / G / WCA / D / D / D / D
(8) / Exposeradiographs / G / WCA / G / G / G / G
(9) / Evaluateradiographsforprovisionofdentalhygiene
services / G / WCA / N/A / N/A / N/A / N/A
DELEGATEDDUTY / RDH / PHDH / EFDA / CA / FTDA / OJT
(10) / Takeintra-oralphotographs / G / WCA / G / G / G / G
(11) / Performandrecordchartingoftheoralcavityandsurroundingstructures,includingbutnotlimitedto,existingdentalrestorations,lesionsandperiodontal
probingdepths / G / WCA / N/A / N/A / N/A / N/A
(12) / Recordchartingoftheoralcavityandsurroundingstructures,includingbutnotlimitedto,dental
restorations,lesionsandperiodontalprobingdepths / G / WCA / D / D / D / D
(13) / Takeandrecordvitalsigns / G / WCA / G / G / G / G
(14) / Performminoremergencydentureadjustmentsto
eliminatepainanddiscomfortinnursinghomesandotherresidentialorlongtermcarefacilities / G / WCA / N/A / N/A / N/A / N/A
(15) / Performpulptesting / D / N/A / N/A / N/A / N/A / N/A
(16) / Applyanti-cariogenicagents,includingfluoride
varnish / G / WCA / G / G / G / D
(17) / Applytopicalanestheticagents / G / WCA / G / G / G / D
(18) / Applyandadjustdentalsealants / G / WCA / G / D / D / N/A
(19) / Takeimpressionsforstudycasts,biteregistrations,includingforidentificationpurposes,nightguards,
andcustomfluorideandbleachingtrayspursuanttoa
dentist’sprescriptionororder / G / WCA / G / G / G / I
(20) / Takeimpressionsforathleticmouthguards / G / WCA / G / G / G / I
(21) / Retractlips,cheek,tongueandotheroraltissueparts / G / WCA / G / G / G / G
(22) / Irrigateandaspiratetheoralcavity / G / WCA / G / G / G / G
(23) / Re-cementandadjustintacttemporaryrestorations
intra-orally / G / WCA / G / G / G / N/A
(24) / Placetemporaryrestorations(notincluding
temporizationofinlays,on-lays,crowns,andbridges)toprovidepalliativetreatment / G / WCA / G / G / G / I
(25) / Assistormonitornitrousoxideanalgesia / I / I / I / I / I / I
(26) / Placeandremovegingivalretractionmaterials / D / D / D / D / D / D
(27) / Applycavityvarnish,liner(s)andbondingagents / I / I / I / I / I / I
(28) / Applydesensitizingagents / G / WCA / G / D / D / D
(29) / Placerestorativematerialsintoothforcondensation
andfinishingbythedentist / I / I / I / I / I / I
(30) / Removetemporaryrestorationswithhandinstruments / G / WCA / G / I / I / N/A
(31) / Placeandremovewedges / G / WCA / G / D / D / I
(32) / Placeandremovematrixbands / G / WCA / G / D / D / I
(33) / Placeandremovedentaldams / G / WCA / G / G / G / D
(34) / Placeandremoveperiodontaldressings / G / WCA / G / G / G / N/A
(35) / Removesutures / G / WCA / G / G / G / D
(36) / Removalofimplanthealingcaps/coverscrewsfor
restorativeprocedures / I / I / I / I / I / I
(37) / Dryrootcanalswithpaperpoints / I / I / I / N/A / N/A / N/A
(38) / Placecottonpelletsandtemporaryrestorative
materialsintoendodonticopenings / G / WCA / G / D / D / D
(39) / Remove excesscementandbondingagents / G / WCA / G / D / D / I
from bridges and applianceswith hand
instruments
(40) / Cementandremovetemporarycrownsandbridges / G / WCA / G / G / G / I
(41) / Insertand/orperformminoradjustmentofnight
mouthguards,athleticmouthguards,andcustomfluoridetrays / G / WCA / G / G / G / I
(42) / Selectandadaptstainlesssteelcrownsorotherpre
formedcrownforinsertionbydentist / I / I / I / I / I / I
(43) / Performsub-gingivalandsupra-gingivalscaling / G / WCA / N/A / N/A / N/A / N/A
DELEGATEDDUTY / RDH / PHDH / EFDA / CA / FTDA / OJT
(44) / Polishteeth,afterdentistordentalhygienisthas
determinedthatteetharefreeofcalculus,withslowspeedhandpiece / G / WCA / G / G / G / N/A
(45) / Administerlocalanesthesiapursuantto234CMR
6.00 / D / D / N/A / N/A / N/A / N/A
(46) / Performgrossdebridementand/orscalingandroot
planing / G / WCA / N/A / N/A / N/A / N/A
(47) / Perform scaling and root planing / G / N/A / N/A / N/A / N/A / N/A
(478) / Prepareandperformoralcytologicalsmearsorstudies / D / N/A / N/A / N/A / N/A / N/A
(489) / Usediagnosticandperiodonticnon-cuttinglasers / D / N/A / N/A / N/A / N/A / N/A
(4950) / Preliminarilyfitcrownstocheckcontacts,adjustocclusiononcrownsinsidethemouth / G / WCA / D / D / N/A / N/A
(510) / Placetemporarysoftlinersinaremovalprosthesis / G / WCA / D / D / I / N/A
(521) / Obtainendodonticcultures / D / N/A / D / D / I / N/A
(532) / Applybleachingagentsandactivatewithnon-lasernon-curingdevice / G / WCA / D / D / D / I
(543) / Fabricateprovisionalrestorationsintraorally / G / WCA / G / D / D / I
(554) / Placeandcondenseamalgamrestorations / D / N/A / D / N/A / N/A / N/A
(565) / Carve,contour,adjustamalgamrestorations / D / N/A / D / N/A / N/A / N/A
(576) / Placeandfinishcompositerestorations / D / N/A / D / N/A / N/A / N/A
(587) / Adjustdenturesonthetissuesidetoeliminatetissueirritation / G / WCA / G / N/A / N/A / N/A
(598) / Placetemporarysedativerestorations/fillings / G / WCA / G / I / N/A / N/A
(6059) / PlaceStainlessSteelCrowns / D / D / D / I / I / N/A
(610) / Takeimpressionsfororthodonticretainers / G / WCA / G / G / G / D
(621) / Preliminaryintra-oralfitofbands / G / WCA / G / G / G / D
(632) / Preliminaryoralfitofarchwire / G / WCA / G / G / G / D
(643) / Selectsizeofheadgear / G / WCA / G / G / G / D
(654) / Placeandremoveorthodonticseparators / G / WCA / G / G / G / D
(665) / Placeandremoveorthodonticarchwires / G / WCA / G / G / G / D
(676) / Etchappropriateenamelsurfacesbeforebondingof
orthodonticappliancesbyadentist / G / WCA / G / G / G / D
(687) / Placeelasticsandligaturewires / G / WCA / G / G / G / D
(698) / Removefixedorthodonticappliances / G / WCA / G / G / G / D
(7069) / Removeexcesscementandbondingagentsfrom
orthodonticapplianceswithhandinstruments / G / WCA / G / G / G / D
(710) / Performminoremergencypalliativeorthodontic
adjustmentstoeliminatepainanddiscomfort / G / WCA / G / G / G / I
(721) / PerformanyotherprocedureapprovedbytheBoard
5.12: Non-delegableDental Duties
Onlya licenseddentistsshallmay:
(1)Performfinaldiagnosesandtreatmentplanning;
(2)Performsurgical or cuttingprocedures on hard orsoft tissue;
(3)Prescribeorparenterallyadministerdrugsormedicaments;
(4)Prescribedentallabworkordersforanyapplianceorprostheticdeviceorrestorationtobeinserted into a patient's mouth;
(5)Operatehigh speedrotaryinstruments in the mouth;
(6)Performpulp-cappingprocedures;
(7)Takefinalimpressionsforfixedandremovableprostheticrestorationofteethororalstructures;
(8)Performfinalpositioningandattachmentoforthodontic bondsandbands;
(9)Performfinalcementation of crowns andbridges; and
(10)Irrigate rootcanals.
5.13: Patient Records:Content,Confidentiality,Retention,andAvailability
(1)ContentofPatientRecord.Patientrecordsinclude,butarenotlimitedto,dentalcharts,photographs,patienthistories,examinationandtestresults,diagnoses,treatmentplans,progressnotes,anesthesiacharts,orthodonticmodels,prescriptions,radiographs,patientconsents,andbillingrecords.
(2)ConfidentialityofPatientRecords.Allpatientrecordsincluding,butnotlimitedto,dentalcharts,photographs,patienthistories,examinationandtestresults,diagnoses,treatmentplans,progressnotes,anesthesiacharts,orthodonticmodels,prescriptions,radiographs,patientconsents,andbillingrecordsofanypatienttreatedshallbemaintainedinamannerthattoensuresconfidentialityandaccessforpatientsandauthorizedpractitionerswhomaywishtoobtainacopyofpatientrecords.
(3)RecordRetentionRequirement.Thelicenseeshallmaintainapatient'soriginaldentalrecordandoriginalradiographs(x-rays)foraminimumofsevenyearsfromthelast dateofthelastpatienttreatment.Inaddition,tThepatientrecordofaminorshallberetainedforaminimumofseven years from the last date ofthelastpatienttreatment orthreeyears after fromwhenthe patient hasreached theage of majority,whichever is later.
(4)AvailabilityofDentalRecords.
(a)RequestforCopyofDentalRecord.Thelicenseeshallprovideuponrequestbyapatientoranotherspecificallyauthorizedperson,acompletecopyofthepatient'sdentalrecord in accordancewithM.G.L. c. 112, § 12CC. A copyof the patientrecord, includingdiagnostic-quality radiographs,shallbeprovidedwithinareasonableamountoftimenottoexceed30calendardaysfromthedateoftherequest.Thelicenseemaychargeareasonablefeefortheexpenseofprovidingapatient'sdentalrecord,nottoexceedthecostofeitherlaborand/ormaterialsincurredinthecopyingofthepatientrecord,radiographsandmodels.Thelicenseeshallnotrequirepaymentfordentalservicesrenderedperformedasaconditionofprovidingacopyofthedentalrecord.Adentistmayoffertoprovidethepatientwithasummaryofthepatient'srecord,butthe summaryshall not be in lieu of the complete patient record if requested.
(b)TreatmentinaSchoolSetting.Wherethe patient or legal representative consentshasbeengrantedbythepatientorlegalrepresentative,acopyofthepatient'sInformationSheetorotherwrittensummaryofthescreening,examination,ortreatmentshallbeprovidedtotheofficialdesignatedbytheschool.
(c)TreatmentinaNursingHomeorResidentialTreatmentFacility.Acopyofthepatient'sIinformationSsheetorotherwrittensummaryofthescreening,examination,ortreatmentshallbeprovidedtotheofficialdesignatedbythefacilityorinstitutionandshallbemadepartofthe patient’srecordmaintained bythe nursinghomeor residentialfacility.
(d)Ifthelicenseediesandthepracticeisclosed,theestatemayshallnotifypatientstreatedwithinthetwoyearspriortothedate ofpassing. Saidnoticeshallinformpatientsofhowtheymaytoobtainacopyoftheirapatientrecord,includingdiagnostic-quality radiographs.Noticemayshallbemade byawrittenor electronic notice lettersenttoeachpatient,by electronicnotice,publicnoticeintheappropriatenewspaper,and/orbyothermeanswhichiswidelydisseminated.Acopyofsaidany such noticemustbesubmitted to the Board upon issuanceand/orpublication.
(e)Electronicpatientrecordsshallcomplywiththerequirementsof234CMR5.13and5.14andshallbe unalterableandproducible inpaperformuponrequest.
5.14: Content of Patient Records
(1)Thepatientrecordshallbeacompleterecordofallpatientcontact,including,butnotlimitedto,ageneraldescriptionofthepatient'smedicalanddentalhistoryandstatusattimeofexamination,diagnoses,patienteducation,treatmentplan,referralforspecialtytreatment,medicationsadministeredandprescribed,pre-andpost-treatmentinstructionsandinformationconveyedtothepatientpursuanttoM.G.L.c.112,§§43through53and234CMR2.00: Purpose, Authority, Definitions.
(2)Patientrecordsshallbelegibleandclearinmeaningtoasubsequentexaminingortreatingdentist,thepatient,dentalauxiliariesorotherauthorizedpersons.
(3)At aminimum, a patient'srecord must include:
(a)Patient Information.
1.Name,addressanddateofbirthofthepatient;
2.Ifthepatientisnotoftheageofmajority,thenameoftheparentorlegalrepresentative, or documentation of emancipation;
3.Iftheparentsoftheminorchildareseparatedordivorced,thenameofthecustodialparent;
4.Ifthepatienthasalegalrepresentativepursuantto234CMR2.00:Purpose,Authority, Definitions, the name andaddress of the legalrepresentative.;
5.Whether the patient is an emancipated minor; and
6.Patient'stelephonenumbers(s)andelectronicmailaddresses,exceptifthepatientdeclines to providethis information.
(b)MedicalandDentalHistoryForm.Thepatient'smedicalhistoryanddentalhistoryshall
include, but not be limited to:
1.Areviewofpastandpresentillnesses, diseasesanddisabilities;
2.Systemic disease(s) thatmayaffect the oralcavity;
3.Currentprescriptionandnon-prescriptionmedicationsaswellasanyknowndrugallergies;
4.Documentationofconsultationwiththepatient'smedicalphysician(s)asappropriate;and
5.Dateofthepatient'slastdentalexamination,frequencyofdentalvisits,currenthomecare regime anddocumentation ofthe patient'sprimarydentalcomplaint, ifany.
6.Uponreviewofthepatient'smedicalanddentalhistory,anylicenseeordentalauxiliaryinthepracticetreatingthepatientshallsignanddate, electronically or otherwise,themedicalanddentalhistory;
7.Ateachpatientvisit,thelicenseeshallinquireanddocumentandinitialinthepatientrecord,whetherthereareanychangesinthepatient'smedicalhistory,includingbutnotlimitedto,changesinprescriptionmedications.
(c)RecordofDentalExamination.Eachpatientrecordshallincludedocumentationoftheresultsofa comprehensiveclinicalexaminationofthefollowingareas:
1.Head and neck;
2.Radiographicimagesasnecessaryandappropriatetofacilitateacomprehensivediagnosisofthepatient.Radiographsshallbeclearlyidentifiedwith thepatientname,dateofexaminationandthenameofthedentist;
3.Intra-oralandextra-oralsofttissueexamination,includingchartingofexistingrestorations and current status of patient's hard and soft tissue;
4.Comprehensiveperiodontalscreening;
5.Oralcancerscreening;
6.Examination of the teeth;
7.Theresultsofall anyotherexaminationsperformedbythelicenseeand/ordental auxiliaryasnecessaryandappropriatetofacilitatecomprehensivediagnosesofthepatient's dental status; and
8.Findingswhicharewithinoroutsideofnormallimits.
(d)Diagnoses.Thepatientrecordshallincludewrittendiagnosesofthepatient'scurrentdentalstatusbasedontheevaluationofthepatient'smedicalanddentalhistory,dentalclinicalexaminationandradiographicfindings.
(e)TreatmentPlan.Thepatientrecordshallincludeawrittentreatmentplandescribingindetailtheproposedtreatment.Theproposedtreatmentplanandinformationregardingestimatedfeesmustbe reviewedwithand agreed to by thepatientpriortobeforethecommencementof implementing thetreatment plan.Thetreatmentplanshallalsoincludereferralstospecialistsasnecessary.Ifthereisnotreatment plan this mustbe explained and documented in the patient record.
(f)GeneralandSpecificInformedConsent.Generaland/orspecificinformedconsentmustbeobtainedinwriting,signedanddatedfrombythepatientorlegalrepresentativepriortotreatmentandshallnotbeobtainedfraudulentlyfromapatientunderduressorwhoisnotmentallycompetent, the age of majorityor an emancipated minor.
1.GeneralInformedConsent.Eachlicenseeshallobtainfromthepatientorlegalrepresentativegeneralinformedconsentallowingthelicenseetoexamine,diagnoseandtreatthepatient.Procedurescoveredbyageneralinformedconsentincludebasicrestorativeorpreventiveproceduresandpermissiontobillpatient'sinsurer,ifany.Thegeneralinformedconsentmayremainineffectuntiltreatmentisterminatedeitherbythelicenseeand/or the patient and the patient is no longerregarded as a patient of record.
2.SpecificInformedConsent.Eachlicenseeshallobtainfromthepatientorthepatient'slegalrepresentativeaspecificinformedconsentallowingthelicenseetoperformspecializedtreatmentincluding,butnotlimitedto:administrationofanesthesiaotherthanlocalanesthesia,periodontal,endodontic,orthodontic,prostheticandoralandmaxillofacialprocedures,andspecializedtreatmentforpediatricpatients,includingbehaviormanagementtechniques.
3.AdditionalRequirementsforMobileDentalFacilities,PortableDentalOperations,andforLicenseesProvidingDentalServicesinaPublicHealthSetting.AnMDF,PDOasdefinedin234CMR7.03:PermitM:ApplicationforMobileDentalFacilityPermitand/orPortableDentalOperationorlicenseeprovidingdentalservicesinapublichealthsettingshallobtainasignedwrittenconsentfromthepatientorlegalrepresentativewhichconforms to 234 CMR 5.154(3)(f)andalsoincludesthefollowing:
a.An explanation of the scope of services that maybe renderedprovided;
b.Noticethatthepatientmaycontinuetoobtaindentalcarethroughanyotherprovider;
c.Notice thatthe treatmentofthepatientmayaffectthe future rightsandbenefitsduethepatientunderprivateinsurance,Medicaid,orthechildren'shealthinsuranceprogram;
d.Ifapplicable,arequestforpermissiontoallowthepatient'sdentalinsurancecarriertobe billedfortreatmentprovidedtothepatient;
e.Ifapplicableforservicesrenderedinapublichealthsetting,arequestforpermissiontoprovidetheofficialdesignatedbytheschool,nursinghome,residentialfacility, or institution with a written summaryof the examination; and
f.InformationonhowthepatientorlegalrepresentativecancontacttheMDForPDOpermit-holder,orpublic healthdentalservicesprogram.
(g)ProgressNotes.Thepatientrecordshallincludewrittendocumentationofthetreatmentprovided bythe dentist and/ordental auxiliarythat is signed and dated electronically or otherwise by the treating licensee and includesing but is not limited to:
1.AdministrationofMmedicinesandmedicamentsadministered, includingthetype,amount,androuteof administration;
2.AstatementofsServicesand procedures performed providedincludingpatientreaction,ifany,duringthetreatmentvisit,proceduresperformedanddiagnoses;
3.AdescriptionofthepPre-andpost-treatmentinstructionsincluding,ifapplicable,plans forsubsequenttreatment; and
4.DocumentationofaEachnyreferralforspecialtytreatment,includingthenameofthespecialist the patient is referred to.; and
Adatedwrittenorelectronicsignaturebythedentistordentalauxiliarywhotreatedthepatient.
(h)ProstheticandOrthodonticPrescriptions.Allprostheticandorthodonticprescriptions,whetherfilledbythelicenseeorotherlaboratory,shallbewritteninaccordancewith M.G.L. c. 112, § 50, must be in duplicate (copyto be retained bydentist) and include:
1.Name andaddress ofthe dentallaboratory;
2.Name,initialsoridentifyingnumberforthepatient;
3.Date;
4.Descriptionofthetreatmentandprocedures,includingplacementofthepatient'sname and/oridentifyingpatient number;
5.Specification of the type and qualityof materials to be used; and
6.Signature andlicense numberofthedentist.
(i)PatientFinancialRecord.Thepatient'sfinancialrecordshallinclude,butnotbelimitedto,thenameofthepatient'sdentalinsurer,documentationoffeesfortreatmentandpaymentschedule,andclaimssubmittedtothirdparties.
5.15: EmergencyProtocol
Alldentalpracticesshall:
(1)Havea writtenprotocolformanagingmedicalordentalemergencies;
(2)Maintainacurrentemergencydrugkitmedication and equipment (see 234 CMR 6.15(2) and (3): Administration of Local Anesthesia Only);
(3)Havecommunicationequipmentthatensuresrapidaccesstoemergencyrespondersandothers as necessary; and
(4)Ensurethatallstaffaretrainedwhenhired,andatleastannuallythereafter,toimplementtheemergencyprotocols.
5.16: Reporting ofPatient Deaths in DentalFacilities
(1)Purpose.AllEachdentalpatientdeathsthatoccursinadentalfacilityoris thatarepronounced inanotherfacility,e.g.hospitaltowhichthedentalpatienthasbeen transportedfromadentalfacility,mustshallbereportedtotheBoard.Thedentistwhowastreatingand/orresponsibleforsaidpatientmustshallsubmitawrittenreportdescribingtheeventtotheBoardbycertifiedmail,electronicmail,orfacsimilewithinsevendays.
(2)FailuretoComply.Thelicense or ,permit, orregistrationofthedentistresponsibleforsaidpatientmaybesubject to Board disciplinary actionrevoked,suspended,orplacedonprobationforfailuretocomplywiththisreportingrequirement.
5.17: Inspection of Facilities and Requirements for CorrectiveAction
(1)Inspectionof DentalFacilities.TheBoardoritsdesignee(s)mayvisitadentalpracticeatanytimewithoutpriornoticeandto conductaninspectiontodeterminecompliancewithstatelaw M.G.L.c.112,§§43through53and§61, and234CMRandanyrule,advisoryorwrittenpolicyadoptedbytheBoardrelatedto thepractice ofdentistry,dentalhygiene,ordentalassisting.
(2)DeficiencyStatement. FollowingaBoardinspectionduringwhichanyviolationof
M.G.L.c.112,§§43through53and234CMR2.00:Purpose,Authority,Definitionsisfound,theBoardoritsdesignee(s)mayprepareadeficiencystatementcitinganyandallviolationsobserved, a copyof which shall be sent to the licenseefor response.
(3)PlansofCorrection.ThelicenseeshallsubmittotheBoardawrittenplanofcorrectionforviolationscitedinadeficiency statementwithinthetimespecifiedbytheBoard.Theplanofcorrectionshallsetforth,withrespecttoeachdeficiency,thespecificcorrectivestep(s)tobetaken,atimetableforsuchsteps,andthedatebywhichcompliancewillbeachieved.ThetimetableandtheCcompliance datesshallbeconsistentwithprotecting the public’s health, safety and welfareachievementofcomplianceinthemostexpeditiousmannerpossible.AplanofcorrectionwhichdoesnotmeettherequirementsofthissectionshallmaybeconsideredunacceptablebytheBoardandmaybereturnedtothelicenseefor furthercorrection.
5.18: Advertising
(1)IllegalAdvertisingPractices.Adentistor public health dental hygienist mayadvertisetruthfulandaccurateinformationpertainingtodentalservices.Unfair,misleading,deceptiveandfraudulentadvertisingisprohibited.
(2)AdvertisingDentalServicesandDentalFees.
(a)Adentalserviceisonethatadentistand/ordentalauxiliaryperformsforaspecificfee.
(b)Dentalservicesadvertisedasfreeornochargemustdescribethespecificservicesofferedand the comparativemonetaryvalue.
(c)The period oftime duringwhichtheadvertisedfeeswill bein effectmust beincludedintheadvertisement.Advertisedfeesforalldentalservicesmustbeineffectforareasonableperiodoftime fromtheinitialdateoftheadvertisement.
(3)ContentofAdvertisements.
(a)Anyadvertisementfordentalservices,regardlessofmedium,mustincludethefollowing:
1.Thenameofatleastone ownerofthepracticewhoiscurrentlylicensedtopracticedentistryor dental hygiene in the Commonwealth; and
2.If the dentalor public health dental hygiene practiceisorganizedasa professionalcorporationpursuant to M.G.L.c.156A,thenameofatleastoneoftheownerswhoislicensedtopracticedentistryor dental hygiene in the Commonwealth.
(b)Theinformationdisclosedbytheadvertisingdentistor dental hygienist inapublicationorabroadcastshallcomplywithM.G.L.c.112,§52A,andotherprovisionsof234CMR2.00:Purpose,Authority, Definitions.
5.19: Principles of Ethics and Code ofProfessional Conduct
Alldentists licensedbythe Board andallpracticesprovidingdentalservicesshallcomplywiththePrinciplesofEthicsandCodeofProfessionalConduct,January2004oftheAmericanDentalAssociation,andallregistereddentalhygienistsshallcomplywiththeCodeofEthics,2006oftheAmericanDentalHygienistsAssociation,Inc.AllregistereddentalassistantsshallcomplywithThePolicyonPrinciplesofEthicsandCodeofProfessionalConduct2011,published bythe AmericanDental Assistants Association.
5.20: Prohibited Practices
Licenseesareprohibitedfromengaginginthefollowingpractices:
(1)Associatingorcooperatingwithanyperson,firmorcorporationinanymannerinaneffortto avoid or circumvent the intent or provisions of M.G.L. c. 112, §§ 43 through 53 and § 61;
(2)Payingoracceptingfeesinanyformormannerascompensationforreferringpatientstoanypersonforprofessionalservices,writtenworkorders,orotherservicesorarticlessuppliedtothepatient;
(3)Enteringintoanagreementorotherarrangementwitha personwhodoesnotholdavaliddental licensetopracticedentistryintheCommonwealththatwhichallowssaidpersonfinaldecision-makingauthorityoveranyofthefollowing:
(a)Selectionofacourse oftreatmentforapatient;
(b)Proceduresformaterialstobe usedaspartofsuchtreatment;
(c)Mannerin which treatment is carried out bythe licensee;
(d)Professionalpracticedecision-making;
(e)Patientrecords;
(f)Policiesanddecisionsrelatingto pricing,credit,refunds,warrantiesandadvertising;
(g)Decisionsrelated to delegation of dental duties; and
(h)Controlandmaintenance ofdentalequipment,materialsandsupplies.
(4)Operatingorowningacommercialdentallaboratoryandcontinuingintheactivepracticeofdentistryexceptwhereadentistownsoroperatesaprivate,non-commercialdentallaboratoryforhisorherownuseandbenefit.Wherethelicenseeownsoroperatesaprivate,non-commercialdentallaboratory andemploysadentaltechnician,thelicenseeshallprovidethedentaltechnicianawrittenworkorderwhichcontainsthedate,informationidentifyingthepatient(e.g.name,initials,orsocialsecuritynumber),thedescriptionoftheworktobedone,and aspecificationofthetypeandqualityofmaterialstobeused. Theworkordershallbeinduplicate, signed bythe dentist and a copybe retained in the patient record.
REGULATORYAUTHORITY
234 CMR 5.00:M.G.L. c. 112, §§ 12CC, 43 through53,61;c.94C andc.111, §§ 51, 51½
and 52.
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