(1) A dental therapist may practice only under the supervision of a dentist and through a written practice agreement signed by the dental therapist and the dentist. A dental therapist may provide only the services that are within his or her scope of practice, are authorized by a supervising dentist, and are provided according to written protocols or orders established by the supervising dentist.

    (2) A dental therapist may perform an oral evaluation and assessment of dental disease and develop an individualized treatment plan if the supervising dentist has given the dental therapist written authorization to provide the services and reviews the patient records as provided in the written practice agreement. The written practice agreement may require the supervising dentist to personally examine patients either face-to-face or by the use of electronic means.

    (3) A written practice agreement between a supervising dentist and a dental therapist must include all of the following elements:

    (a) The services and procedures and the practice settings for those services and procedures that the dental therapist may provide, together with any limitations on those services and procedures.

    (b) Any age-specific and procedure-specific practice protocols, including case selection criteria, assessment guidelines, and imaging frequency.

    (c) Procedures to be used with patients treated by the dental therapist for obtaining informed consent and for creating and maintaining dental records.

    (d) A plan for review of patient records by the supervising dentist and the dental therapist.

    (e) A plan for managing medical emergencies in each practice setting in which the dental therapist provides care.

    (f) A quality assurance plan for monitoring care, including patient care review, referral follow-up, and a quality assurance chart review.

    (g) Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed.

    (h) Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation before initiating care.

    (i) Specific written protocols, including a plan for providing clinical resources and referrals, governing situations in which the patient requires treatment that exceeds the dental therapist’s capabilities or the scope of practice as a dental therapist.

    (4) A dental therapist who provides services or procedures beyond those authorized in the written practice agreement engages in unprofessional conduct for the purposes of section 16221.

    (5) A supervising dentist shall not supervise more than 4 dental therapists.

    (6) A supervising dentist shall actively participate in drafting a written practice agreement with a dental therapist. Any revision to the written practice agreement must be documented in a new written practice agreement signed by the supervising dentist and the dental therapist.

    (7) A written practice agreement is valid for 3 years. A supervising dentist and dental therapist shall each review the practice agreement before renewing the practice agreement.

    (8) A supervising dentist and a dental therapist who sign a written practice agreement shall keep a copy for the dentist’s or dental therapist’s own records and make a copy available to patients of the dental therapist, or to the department, on request.

    (9) As used in this section and section 16656 and 16657, “written practice agreement” means a document that is signed by a dentist and a dental therapist and that, in conformity with the legal scope of practice as a dental therapist, outlines the functions that the dental therapist is authorized to perform.