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2958Ratification Number: 388Act Number: 363Introducing Body: HouseSubject: Relating to dentists, dental hygienists, and dental technicians
(A363, R388, H2958)
AN ACT TO AMEND SECTIONS 40-15-70, 40-15-110, 40-15-120, 40-15-130, 40-15-140, AS AMENDED, 40-15-170, 40-15-190, 40-15-200, AS AMENDED, 40-15-210, 40-15-250, 40-15-300, AND 40-15-320, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO DENTISTS, DENTAL HYGIENISTS, AND DENTAL TECHNICIANS, SO AS TO TO CHANGE THE REFERENCE TO COUNCIL ON DENTAL EDUCATION OF THE AMERICAN DENTAL ASSOCIATION TO THE COMMISSION ON DENTAL ACCREDITATION; TO PERMIT DENTAL ASSISTANTS AND HYGIENISTS TO TAKE IMPRESSIONS UNDER SUPERVISION OF A DENTIST; TO PROVIDE THAT A PERSON MAY PERFORM ORTHODONTIC TECHNOLOGICAL WORK IF UNDER CONTROL OF AN ORTHODONTIC TECHNICIAN, AND TO MAKE IT UNLAWFUL FOR A PERSON TO PERFORM ORTHODONTIC TECHNOLOGY WITHOUT BEING REGISTERED AS A DENTAL OR ORTHODONTIC TECHNICIAN, TO PROVIDE FOR THE EXAMINATION, REGISTRATION, AND REREGISTRATION OF ORTHODONTIC TECHNICIANS; TO PERMIT DENTISTS AND DENTAL SPECIALISTS TO ADVERTISE, REQUIRE DENTISTS PRACTICING UNDER A TRADE NAME OR AS AN EMPLOYEE OF A DENTIST OR OF A PROFESSIONAL ASSOCIATION TO DISPLAY HIS NAME AND PLACE OF PRACTICE AT THE ENTRANCE WHERE PRACTICE IS CONDUCTED; AND TO PROVIDE THAT AN APPLICANT'S FEE BE FIXED BY REGULATION; TO PROVIDE THAT THE LICENSE OF A DENTIST OR DENTAL HYGIENIST WHO DOES NOT RESIDE OR PRACTICE IN THIS STATE FOR SIX SUCCESSIVE YEARS IS INACTIVE INSTEAD OF REVOKED; TO PROVIDE GROUNDS FOR REVOCATION, SUSPENSION, PROBATION, REPRIMAND, OR OTHER RESTRICTION OF THE LICENSE OF A DENTIST, DENTAL HYGIENIST, OR TECHNICIAN; TO PROVIDE FOR A PUBLIC OR PRIVATE REPRIMAND FOR VIOLATION OF THIS ACT AND PLACE THE PARTY ON PROBATION OR IMPOSE A FINE OF UP TO ONE THOUSAND DOLLARS; TO PROVIDE A PENALTY; AND TO PROVIDE THAT THE FEE FOR THE EXAMINATION FOR LICENSING SPECIALISTS IS FIXED BY REGULATION AND EXEMPT DIPLOMATES OF A NATIONAL CERTIFYING BOARD; AND TO AMEND THE 1976 CODE BY ADDING SECTIONS 40-15-85, 40-15-95, AND 40-15-215 SO AS TO DEFINE THE TERM DIRECT SUPERVISION IN A DENTIST'S OFFICE AND THE TERM ORTHODONTIC TECHNOLOGICAL WORK; AND TO PROVIDE THAT FINAL ORDERS OF THE BOARD THAT THE DENTIST, DENTAL HYGIENIST, OR TECHNICIAN IS GUILTY ARE MADE PUBLIC UNLESS THE ACCUSATION IS DISMISSED.
Be it enacted by the General Assembly of the State of South Carolina:
Person practicing dentistry
SECTION 1. Section 40-15-70 of the 1976 Code is amended to read:
"Section 40-15-70. A person is practicing dentistry who:
(1) Uses the word 'dentist', 'dental surgeon', or the letters 'D.D.S.', 'D.M.D.', or other letters or titles in connection with his name which in any way represents him as engaging in the practice of dentistry or in the administration of any dental health program; or
(2) For a fee or other consideration:
(a) shall profess or indicate in any manner that he can or will attempt to perform dental procedures in the oral cavity and associated adjacent structures; or
(b) shall diagnose or treat or profess to diagnose or treat any diseases or lesions or conditions of the oral cavity and associated adjacent structures; or
(c) shall extract teeth, correct malpositions of the teeth or jaws, or take impressions, or construct, supply, repair, reline, or duplicate artificial teeth as substitutes for natural teeth, or adjust such substitutes, or do any practice included in the curricula of dental colleges accredited by the Commission on Dental Accreditation, or administer or prescribe drugs or therapy utilized in the treatment of dental or oral diseases, or shall use X ray for dental treatment or dental diagnostic purposes, or shall administer anaesthetics, local or general, for dental procedures; or
(d) shall teach or profess to teach any phase of dental practice or related procedures."
SECTION 2. The 1976 Code is amended by adding:
"Section 40-15-85. The term 'direct supervision' means that the dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure and before the dismissal of the patient, evaluates the performance of the dental auxiliary. Such a requirement does not mandate that the dentist be present at all times but he must be on the premises actually involved in supervision and control."
SECTION 3. The 1976 Code is amended by adding:
"Section 40-15-95. The term 'orthodontic technological work' as used in this chapter is hereby defined as the extra-oral procedures of constructing, making, altering, repairing or duplicating of orthodontic appliances. The persons performing orthodontic technological work, other than dentists, shall be referred to as orthodontic technicians. For the purposes of this chapter references to dental technicians or dental technological work include orthodontic technicians and orthodontic technological work unless specific reference is made to orthodontic technicians or orthodontic technological work."
Chapter may not be construed
SECTION 4. Section 40-15-110 of the 1976 Code is amended to read:
"Section 40-15-110. Nothing in this chapter may be construed to prevent the practice of medicine by a licensed physician or the administration of anaesthesia by those persons otherwise qualified by law to do so; or to prevent the performance of official duties by commissioned dental or medical officers of the United States Army, Navy, Air Force, Veterans' Administration, or United States Public Health Service; or to prevent any person from teaching or demonstrating dentistry or related procedures at a dental society meeting or at a dental convention or at an accredited dental college; or to prevent a licensed dentist of another state or country from performing duties in connection with a specific case for which he is called into the State by a dentist licensed in this State; or to prevent dental students from performing dental procedures under the supervision of instructors in any dental school in this State accredited by the Commission; or to require a license for interns or residents enrolled in an intern or residency training program approved by the Commission; or prevent licensed dental hygienists or registered dental technicians from teaching in programs accredited by the Commission.
A dentist licensed in another state teaching in a dental college in South Carolina accredited by the Commission is exempt from the licensure requirement unless he engages in the intramural or private practice of dentistry.
Nothing in this chapter prevents a person from making roentgenograms or X-ray exposures under the supervision of a licensed dentist or prevents persons licensed to practice dental hygiene from performing an intra-oral dental hygiene procedure if it is performed under the direction and control of a licensed dentist present on the premises.
Nothing in this chapter prevents a person from performing dental or orthodontic technological work if:
(a) the intra-oral procedures relative to such work are performed by a licensed dentist; and
(b) the work is performed by or under the direction and control of a licensed dentist and on his premises, or by or under the direction and control of a registered dental or orthodontic technician present on the premises, provided, however, that orthodontic work performed under the direction and control of a registered orthodontic technician is limited to orthodontic technological work; and
(c) the work is performed pursuant to a properly executed work authorization, as described elsewhere in this chapter, if the work is to be done by or under the direction and control of a registered dental or orthodontic technician.
Nothing in this chapter prevents a certified or qualified dental assistant or licensed dental hygienist from taking impressions for dental study casts under the direct supervision of a licensed dentist present on the premises.
Unlicensed personnel in a dental office may perform those tasks as authorized by the board and for which minimal training standards and qualifications are established by regulation. All tasks permitted to be performed by other than licensed personnel must be under the direct supervision of a dentist present on the premises and licensed in South Carolina."
SECTION 5. Section 40-15-120 of the 1976 Code is amended to read:
"Section 40-15-120. Any person who:
(a) practices, attempts, or offers to practice dentistry or dental hygiene in the State without having been licensed by the Board; or
(b) practices, attempts, or offers to practice dentistry or dental hygiene, or performs dental technological work in the State during any period of suspension or revocation of his license or registration certificate; or
(c) performs dental technological work without being registered by the Board or if unregistered, without performing such work under the direction and control of a registered dental technician present on the premises, or under the direction and control of a licensed dentist and on his premises; or
(d) performs orthodontic technological work without being a registered dental or orthodontic technician or if unregistered, without performing such work under the direction or control of a registered dental or orthodontic technician and on his premises, or under the direction and control of a licensed dentist and on his premises;
shall be deemed guilty of a misdemeanor and, upon conviction, shall be fined not more than one thousand dollars, or imprisoned not more than six months, or both, in the discretion of the court. Each day upon which such acts are performed shall constitute a separate offense."
Dentists may advertise
SECTION 6. Section 40-15-130 of the 1976 Code is amended to read:
"Section 40-15-130. Dentists may advertise their services so long as these public communications are not false, deceptive, or misleading and do not attempt to create any impression, unsupported by fact, of superior skills or qualifications of those who practice thereunder. Licensed dental specialists may announce their specialization and may advertise their services so long as the public communications are not false, deceptive, or misleading.
Every dentist practicing dentistry under a trade name and every dentist practicing as an employee of another licensed dentist or a partnership or of a professional association shall cause his name and licensed area of practice to be conspicuously displayed and kept so displayed in a conspicuous place at the entrance of the place where the practice is conducted.
Dentists may practice or continue to practice under trade names so long as the names are not false, deceptive, or misleading and do not attempt to create any impression of superior skills or qualifications of those who practice thereunder."
Examination by the board
SECTION 7. Section 40-15-140 of the 1976 Code, as last amended by Act 117 of 1981, is further amended to read:
"Section 40-15-140. It is the duty of the Board to examine (or cause to be examined) all qualified applicants for a license to practice dentistry or dental hygiene or who desire to be registered as dental technicians in this State. No examination is required to be registered as an orthodontic technician. Prior to admittance to the examination or the registration of an orthodontic technician, each applicant shall produce evidence satisfactory to the Board that he possesses good moral character. If the Board refuses an applicant admission to the examination or registration as an orthodontic technician because of unsuitable moral character the Board shall notify the applicant in writing and set forth in detail the reason supporting the Board's decision. An applicant who holds a license or certificate from any jurisdiction shall certify that he has not violated any of the provisions of the Dental Practice Act governing his prior license or practice or operation. In addition, each applicant shall present the following:
(a) in the case of applicants to practice dentistry or dental hygiene, satisfactory evidence of graduation from a dental college or school of dental hygiene, respectively, accredited by the Commission.
(b) in the case of applicants who desire to be registered as dental technicians, a high school diploma, or its equivalent, and satisfactory evidence of successful completion of a full two-year course of study in a school for dental technological work acceptable to the board, or in lieu of the dental school program, the applicant must have performed dental technological work under the direct supervision of a licensed dentist or registered dental technician for a period of at least three years.
The application must be received by the Board not less than forty-five days before the examination date. An application for registration as an orthodontic technician may be submitted at any time. Each applicant shall pay to the Board a fee as prescribed by it by rules and regulations. Each applicant must satisfactorily pass the examination prepared by the Board on subjects and operations pertaining to dentistry that are regularly taught in such accredited schools. The examination must be given either orally or in writing, or by requiring a practical demonstration of the applicant's skill, or by any combination of such methods as the Board may in its discretion require. The Board shall grade each examination and inform the applicant of the result within a reasonable time after the date thereof. The Board shall issue a numbered license to each person who passes the dental or dental hygiene examination and a numbered certificate to each person who passes the dental technician examination and to each applicant to be registered as an orthodontic technician. All examination papers must be retained by the Board for two years and upon request be available for inspection by a person examined.
Dentists and dental hygienists, and dental technicians who are validly licensed or registered in this State as of April 13, 1968, are exempt from reexamination except in instances where application for relicensing or reregistration is made following a period of suspension or revocation of a license or registration certificate, in which instances reexamination is discretionary with the Board."
Secretary to send reregistration application
SECTION 8. Section 40-15-170 of the 1976 Code is amended to read:
"Section 40-15-170. The secretary of the Board shall on or about the fifteenth day of October, of each year, send a reregistration application to the last address furnished the Board of each person licensed or registered by the Board. The failure to receive the application does not excuse a failure to reregister, as required by this chapter. An annual registration fee, to be set by the Board, shall cover fully all costs and is payable by each licensed dentist and dental hygienist and each registered dental technician not later than the thirty-first of December. If reregistration is not completed by the thirty-first of December, the fee must be doubled. If the licensee or dental technician fails to reregister by the thirtieth of June of the following year, the secretary of the Board shall notify the licensee or dental technician by registered mail at his last known address that failure to reregister by the first of October will result in the license or registration expiring as of the first of October. Any expired license may be reinstated or any dental technician may be reregistered by taking the licensure or dental technician examination or appearing in person before the Board with a satisfactory explanation for the failure to reregister. An orthodontic technician may be reregistered by submitting a completed application or appearing in person before the Board with a satisfactory explanation for the failure to reregister. It is the responsibility of each licensee or dental technician to keep the office of the secretary notified of his current mailing address.
If an individual's license to practice dentistry or dental hygiene is revoked by another state for cause this shall, in the discretion of the Board, constitute grounds for revocation of his South Carolina license. The license of a dentist or dental hygienist who does not either reside or practice in South Carolina for a period of six successive years is considered inactive. The time spent in active service by any person in the armed forces or public health service of the United States or with the Veterans' Administration is not construed as absence from or failure to practice in the State. Relicensing after an absence of over six years may be made at the discretion of the Board upon proof of high professional fitness and moral character."
SECTION 9. Section 40-15-190 of the 1976 Code is amended to read:
"Section 40-15-190. Misconduct which constitutes grounds for revocation, suspension, probation, reprimand, or other restriction of a license or certificate or a limitation or other discipline of a dentist, dental hygienist, or dental technician is when the holder of a license or certificate:
(1) has made any false, fraudulent, or forged statement or document, or committed any fraudulent, deceitful, or dishonest act in connection with any of the licensure or registration requirements;
(2) has been convicted of a felony or any other crime involving moral turpitude or controlled substances;
Forfeiture of bond or a plea of nolo contendere is equivalent of a conviction.
(3) is unable to practice dentistry, dental hygiene, or perform dental technological work with reasonable skill and safety to patients by reason of physical illness or disability, mental illness, or the illness of alcoholism or substance abuse;
(4) has employed or permitted any unlicensed or unregistered person to practice dentistry or dental hygiene or to perform dental technological work except as permitted under this chapter;
(5) has published, circulated, or made public in any manner, either directly or indirectly, any false, fraudulent, deceptive, or misleading statements as to the skill or methods or practice of any dentist, dental hygienist, or dental technologists;
(6) has instructed, advised, or required a patient to deal directly with an organization or individual performing dental technological work;
(7) has failed to provide and maintain reasonable sanitary facilities or conditions;
(8) has failed to provide adequate radiation safeguards;
(9) has violated the principles of ethics in the practice of dentistry as promulgated in the regulations of the State Board of Dentistry;
(10) has practiced fraud or deceit in the practice of dentistry or dental hygiene or the performance of any dental technological work;
(11) has represented the care being rendered to a patient or the performance of dental technological work, or the fees being charged for providing the care or work, in a false or misleading manner;
(12) has used any false, fraudulent, deceptive, or misleading statements in any document including, but not limited to, claims for reimbursement from third parties, connected with the practice of dentistry, dental hygiene, or dental technological work;
(13) has obtained any fee which is charged or any reimbursement from third parties, or has assisted in obtaining the fees or reimbursement through dishonesty or under false or fraudulent circumstances;
(14) has been grossly incompetent in the practice of dentistry, dental hygiene, or the performance of dental technological work;
(15) has violated any other provisions of this chapter regulating the practice of dentistry, dental hygiene, or dental technological work or the regulations promulgated by the Board;
(16) has committed any act which would constitute battery upon a patient;
(17) has solicited or accepted dental technological work directly from the general public;
(18) has engaged in fraud, deceit, or misrepresentation in dealings with licensed dentists."
Board may revoke or suspend license
SECTION 10. Section 40-15-200 of the 1976 Code, as last amended by Act 432 of 1982, is further amended to read:
"Section 40-15-200. If the Board is satisfied that the dentist, dental hygienist, or dental technician is guilty of any offense charged in the formal accusation provided for in this chapter, it may revoke or suspend the license or the registration certificate, reprimand the dentist, dental hygienist, or dental technician either publicly or privately, or take any other reasonable action short of revocation or suspension, such as probation or the imposition of a fine of up to one thousand dollars to be paid into the general fund except for expenses incurred by the Board in the procuring, or requiring the person to undertake additional professional training subject to the direction and approval of the board, psychiatric evaluations, controlled substance restrictions, institutional practice under supervision, and any other actions considered appropriate by the board.
Any decision by the Board to revoke, suspend, or otherwise restrict or limit a license or registration certificate or otherwise discipline a licensee or holder of a registration certificate must be by majority vote of the members of the Board eligible to participate and is subject to review by the circuit court upon petition filed by the licensee or holder of a registration certificate with the court and a copy thereof served upon the director of the Board within thirty days from the date of delivery of the Board's decision to the licensee or holder of the registration certificate. The review is governed by Act 176 of 1977."
SECTION 11. Section 40-15-210 of the 1976 Code is amended to read:
"Section 40-15-210. Any person who practices dentistry or dental hygiene or performs dental technological work, in violation of the provisions of this chapter, is guilty of a misdemeanor and upon conviction must be fined not more than one thousand dollars or imprisoned for not more than two years, or both. Each violation constitutes a separate offense. The provisions of this section apply to any person aiding or abetting in any violation of this chapter."
Final order is public knowledge
SECTION 12. The 1976 Code is amended by adding:
"Section 40-15-215. Any final order of the Board finding that a dentist, dental hygienist, or dental technician is guilty of any offense charged in a formal accusation is public knowledge except for a final order dismissing the accusation or determining that a private reprimand is in order or unless stayed by the court or the Board. Any final order which is made public may be mailed to local and state dental associations and all hospitals in which the respondent has staff privileges, to states where the dentist, dental hygienist, or dental technician has a license or certificate as known to the Board, or to any other agency the Board considers appropriate. If a license or certificate is voluntarily limited or surrendered by the holder, a public record of the existence and duration of the limitation or surrender must be maintained by the Board, and no further distribution of the information may be made. All information, investigations, and proceedings concerning the circumstances underlying an action by the holder of the license or certificate is privileged and confidential."
SECTION 13. Section 40-15-250 of the 1976 Code is amended to read:
"Section 40-15-250. Examinations for licensing as specialists are held annually or as the Board may determine. The examinations must be theoretical and practical. The theoretical examinations shall include subjects represented in that recognized special area of dentistry in which the applicant desires to specialize. The examination must be given either orally or in writing, or by requiring a practical demonstration of the applicant's skill, or by any combination of the methods as the Board may require. The fee for the examinations and special license is prescribed in the regulations of the Board. Any applicant who fails to pass the examination may apply for a subsequent examination, in which case he shall pay to the secretary a fee prescribed in the regulations of the Board for each subsequent examination. A diplomate of a national certifying board recognized by the American Dental Association may be granted a specialty license without examination by the Board after satisfactory completion of the application and submission of fees applicable to other applicants. A dentist now holding a valid South Carolina specialty license is not required to be reexamined for that specialty license after April 13, 1968."
Return work authorization required
SECTION 14. Section 40-15-300 of the 1976 Code is amended to read:
"Section 40-15-300. No person other than a licensed dentist, a student in an accredited dental school, or the recipient patient shall have in his possession any prosthetic or orthodontic model, impression, or appliance on which dental technological work has been, is being, or will be performed without having in his possession a properly executed written work authorization therefor. The Board has authority to inspect the premises of any person licensed or registered by the Board to insure compliance with this section. Nothing in this section precludes a certified or qualified dental assistant or licensed dental hygienist from taking impressions for dental study casts under the direct supervision of a licensed dentist present on the premises."
Prima facie evidence
SECTION 15. Section 40-15-320 of the 1976 Code is amended to read:
"Section 40-15-320. Any dental prosthetic or orthodontic model, impression, or appliance in the possession of any person other than a dentist, a student at an accredited dental school, or recipient patient without a written work authorization and corresponding number or identification on the model, impression, or appliance must be impounded by the Board and is prima facie evidence of violation of this chapter.
Nothing in this section precludes a certified or qualified dental assistant or licensed dental hygienist from taking impressions for dental study casts under the direct supervision of a licensed dentist present on the premises."
SECTION 16. This act shall take effect upon approval by the Governor.