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General Supervision

General Supervision Bill Signed into Law
Public Act 093-0821

On July 28, 2004, the General Supervision Bill was signed into law by Governor Rod Blagojevich. The new law - Public Act 93-821 - was negotiated and agreed upon - with the help of the Illinois Federation of Teachers, Senator DeLeo and Representative Saviano by both the IDHA and the ISDS. The provisions of the bill are a major step forward when it comes to increasing access to oral health care in Illinois.

Public Act 093-0821

HB4157 Enrolled LRB093 14619 AMC 42676 b



AN ACT concerning professional regulation.

Be it enacted by the People of the State of Illinois,
represented in the General Assembly:

Section 5. The Illinois Dental Practice Act is amended by
changing Sections 4, 6, and 18 as follows:

(225 ILCS 25/4) (from Ch. 111, par. 2304)
(Section scheduled to be repealed on January 1, 2006)
Sec. 4. Definitions. As used in this Act:
(a) "Department" means the Illinois Department of
Professional Regulation.
(b) "Director" means the Director of Professional
Regulation.
(c) "Board" means the Board of Dentistry established by
Section 6 of this Act.
(d) "Dentist" means a person who has received a general
license pursuant to paragraph (a) of Section 11 of this Act and
who may perform any intraoral and extraoral procedure required
in the practice of dentistry and to whom is reserved the
responsibilities specified in Section 17.
(e) "Dental hygienist" means a person who holds a license
under this Act to perform dental services as authorized by
Section 18.
(f) "Dental assistant" means an appropriately trained
person who, under the supervision of a dentist, provides dental
services as authorized by Section 17.
(g) "Dental laboratory" means a person, firm or corporation
which:
(i) engages in making, providing, repairing or
altering dental prosthetic appliances and other artificial
materials and devices which are returned to a dentist for
insertion into the human oral cavity or which come in
contact with its adjacent structures and tissues; and

(ii) utilizes or employs a dental technician to provide
such services; and
(iii) performs such functions only for a dentist or
dentists.
(h) "Supervision" means supervision of a dental hygienist
or a dental assistant requiring that a dentist authorize the
procedure, remain in the dental facility while the procedure is
performed, and approve the work performed by the dental
hygienist or dental assistant before dismissal of the patient,
but does not mean that the dentist must be present at all times
in the treatment room.
(i) "General supervision" means supervision of a dental
hygienist requiring that the patient be a patient of record,
that the dentist examine the patient in accordance with Section
18 prior to treatment by the dental hygienist, and that the a
dentist authorize the procedures which are being carried out by
a notation in the patient's record, but not requiring that a
dentist be present when the authorized procedures are being
performed. The authorized procedures may also be performed at a
place other than the dentist's usual place of practice. The
issuance of a prescription to a dental laboratory by a dentist
does not constitute general supervision.
(j) "Public member" means a person who is not a health
professional. For purposes of board membership, any person with
a significant financial interest in a health service or
profession is not a public member.
(k) "Dentistry" means the healing art which is concerned
with the examination, diagnosis, treatment planning and care of
conditions within the human oral cavity and its adjacent
tissues and structures, as further specified in Section 17.
(l) "Branches of dentistry" means the various specialties
of dentistry which, for purposes of this Act, shall be limited
to the following: endodontics, oral and maxillofacial surgery,
orthodontics and dentofacial orthopedics, pediatric dentistry,
periodontics, prosthodontics, and oral and maxillofacial
radiology.

(m) "Specialist" means a dentist who has received a
specialty license pursuant to Section 11(b).
(n) "Dental technician" means a person who owns, operates
or is employed by a dental laboratory and engages in making,
providing, repairing or altering dental prosthetic appliances
and other artificial materials and devices which are returned
to a dentist for insertion into the human oral cavity or which
come in contact with its adjacent structures and tissues.
(o) "Impaired dentist" or "impaired dental hygienist"
means a dentist or dental hygienist who is unable to practice
with reasonable skill and safety because of a physical or
mental disability as evidenced by a written determination or
written consent based on clinical evidence, including
deterioration through the aging process, loss of motor skills,
abuse of drugs or alcohol, or a psychiatric disorder, of
sufficient degree to diminish the person's ability to deliver
competent patient care.
(p) "Nurse" means a registered professional nurse, a
certified registered nurse anesthetist licensed as an advanced
practice nurse, or a licensed practical nurse licensed under
the Nursing and Advanced Practice Nursing Act.
(q) "Patient of record" means a patient for whom the
patient's most recent dentist has obtained a relevant medical
and dental history and on whom the dentist has performed an
examination and evaluated the condition to be treated.
(Source: P.A. 91-138, eff. 1-1-00; 91-689, eff. 1-1-01; 92-280,
eff. 1-1-02; 92-651, eff. 7-11-02.)

(225 ILCS 25/6) (from Ch. 111, par. 2306)
(Section scheduled to be repealed on January 1, 2006)
Sec. 6. Board of Dentistry - Report By Majority Required.
There is created a Board of Dentistry, to be composed of
persons designated from time to time by the Director, as
follows:
Eleven persons, 8 of whom have been dentists for a period
of 5 years or more; 2 of whom have been dental hygienists for a

period of 5 years or more, and one public member. None of the
members shall be an officer, dean, assistant dean, or associate
dean of a dental college or dental department of an institute
of learning, nor shall any member be the program director of
any dental hygiene program. A board member who holds a faculty
position in a dental school or dental hygiene program shall not
participate in the examination of applicants for licenses from
that school or program. None of the members shall be employed
by or be an officer of any dental college, or dental or dental
hygiene department of any institution of learning. The dental
hygienists shall not participate in the examination of
applicants for licenses to practice dentistry. The public
member shall not participate in the examination of applicants
for licenses to practice dentistry or dental hygiene. The board
shall annually elect a chairman who shall be a dentist.
Terms for all members shall be for 4 years. Partial terms
over 2 years in length shall be considered as full terms. A
member may be reappointed for a successive term, but no member
shall serve more than 2 full terms in his or her lifetime.
The membership of the Board shall include only residents
from various geographic areas of this State and shall include
at least some graduates from various institutions of dental
education in this State.
In making appointments to the Board the Director shall give
due consideration to recommendations by organizations of the
dental profession in Illinois, including the Illinois State
Dental Society and Illinois Dental Hygienists Association, and
shall promptly give due notice to such organizations of any
vacancy in the membership of the Board. The Director may
terminate the appointment of any member for cause which in the
opinion of the Director reasonably justifies such termination.
A vacancy in the membership of the Board shall not impair
the right of a quorum to exercise all the rights and perform
all the duties of the Board. Any action to be taken by the
Board under this Act may be authorized by resolution at any
regular or special meeting, and each such resolution shall take

effect immediately. The Board shall meet at least quarterly.
The Board may adopt all rules and regulations necessary and
incident to its powers and duties under this Act.
The members of the Board shall each receive as compensation
a reasonable sum as determined by the Director for each day
actually engaged in the duties of the office, and all
legitimate and necessary expense incurred in attending the
meetings of the Board.
Members of the Board shall be immune from suit in any
action based upon any disciplinary proceedings or other
activities performed in good faith as members of the Board.
(Source: P.A. 91-594, eff. 1-1-00.)

(225 ILCS 25/18) (from Ch. 111, par. 2318)
(Section scheduled to be repealed on January 1, 2006)
Sec. 18. Acts constituting the practice of dental hygiene; .
limitations.
(a) A person practices dental hygiene within the meaning of
this Act when he or she performs the following acts under the
supervision of a dentist: A dental hygienist may be employed or
engaged only:
(a) Under the supervision of a dentist:
(1) In the office of a dentist;
(2) By a federal, State, county or municipal agency
or institution;
(3) By a public or private school; or
(4) By a public clinic operating under the
direction of a hospital or federal, State, county,
municipal or other public agency or institution.
When employed or engaged pursuant to this paragraph (a) a
dental hygienist may perform the following procedures and acts:
(i) the operative procedure of dental hygiene,
consisting of oral prophylactic procedures;
(ii) the exposure and processing of X-Ray films of
the teeth and surrounding structures;
(iii) the application to the surfaces of the teeth

or gums of chemical compounds designed to be
desensitizing agents or effective agents in the
prevention of dental caries or periodontal disease;
(iv) all services which may be performed by a
dental assistant as specified by rule pursuant to
Section 17;
(v) administration and monitoring of nitrous oxide
upon successful completion of a training program
approved by the Department;
(vi) administration of local anesthetics upon
successful completion of a training program approved
by the Department; and
(vii) such other procedures and acts as shall be
prescribed by rule or regulation of the Department.
(b) A dental hygienist may be employed or engaged only:
(1) by a dentist;
(2) by a federal, State, county, or municipal agency or
institution;
(3) by a public or private school; or
(4) by a public clinic operating under the direction of
a hospital or federal, State, county, municipal, or other
public agency or institution.
(c) When employed or engaged in the office of a dentist, a
dental hygienist may perform, under general supervision, those
procedures found in items (i) through (iv) of subsection (a) of
this Section, provided the patient has been examined by the
dentist within one year of the provision of dental hygiene
services, the dentist has approved the dental hygiene services
by a notation in the patient's record and the patient has been
notified that the dentist may be out of the office during the
provision of dental hygiene services.
(d) If a patient of record is unable to travel to a dental
office because of illness, infirmity, or imprisonment, a dental
hygienist may perform, under the general supervision of a
dentist, those procedures found in items (i) through (iv) of
subsection (a) of this Section, provided the patient is located

in a long-term care facility licensed by the State of Illinois,
a mental health or developmental disability facility, or a
State or federal prison. (b) Under the general supervision of a
dentist in a long-term care facility licensed by the State of
Illinois, or a mental health or developmental disability
facility operated by the Department of Human Services, if the
patient is unable to travel to a dental office because of
illness or infirmity. The dentist shall personally examine and
diagnose the patient and determine which services are necessary
to be performed, which shall be contained in an a written order
to the hygienist and a notation in the patient's record. Such
order must be implemented within 120 days of its issuance, and
an updated medical history and observation of oral conditions
oral inspection must be performed by the hygienist immediately
prior to beginning the procedures to ensure that the patient's
health has not changed in any manner to warrant a reexamination
by the dentist.
(e) School-based oral health care, consisting of and
limited to oral prophylactic procedures, sealants, and
fluoride treatments, may be provided by a dental hygienist
under the general supervision of a dentist. A dental hygienist
may not provide other dental hygiene treatment in a
school-based setting, including but not limited to
administration or monitoring of nitrous oxide or
administration of local anesthetics. The school-based
procedures may be performed provided the patient is located at
a public or private school and the program is being conducted
by a State, county or local public health department initiative
or in conjunction with a dental school or dental hygiene
program. The dentist shall personally examine and diagnose the
patient and determine which services are necessary to be
performed, which shall be contained in an order to the
hygienist and a notation in the patient's record. Any such
order for sealants must be implemented within 120 days after
its issuance. Any such order for oral prophylactic procedures
or fluoride treatments must be implemented within 180 days

after its issuance. An updated medical history and observation
of oral conditions must be performed by the hygienist
immediately prior to beginning the procedures to ensure that
the patient's health has not changed in any manner to warrant a
reexamination by the dentist.
(f) (c) Without the supervision of a dentist, a dental
hygienist may perform dental health education functions and may
record case histories and oral conditions observed.
(g) The number of dental hygienists practicing in a dental
office shall not exceed, at any one time, 4 times the number of
dentists practicing in the office at the time.
(Source: P.A. 93-113, eff. 1-1-04.)

Section 99. Effective date. This Act takes effect upon
becoming law.