(a) If the collaborative agreement is approved by the board under (d) of this section, a licensed dental hygienist with a minimum of 4,000 documented hours of clinical experience within the five years preceding application for the board’s approval may enter into a collaborative agreement with a licensed dentist in which the licensed dentist authorizes the licensed dental hygienist to perform one or more of the following:

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(1) oral health promotion and disease prevention education;
(2) removal of calcareous deposits, accretions, and stains from the surfaces of teeth;
(3) application of topical preventive or prophylactic agents, including fluoride varnishes and pit and fissure sealants;
(4) polishing and smoothing restorations;
(5) removal of marginal overhangs;
(6) preliminary charting and triage to formulate a dental hygiene assessment and dental hygiene treatment plan;
(7) the exposure and development of radiographs;
(8) use of local periodontal therapeutic agents; and
(9) performance of nonsurgical periodontal therapy, with or without the administration of local anesthesia, subsequent to a licensed dentist’s authorization or diagnosis as specified in the licensed hygienist’s collaborative agreement.
(b) The services described in (a) of this section may be performed under a collaborative agreement approved by the board

(1) without the presence of the licensed dentist;
(2) in a setting other than the usual place of practice of the licensed dentist; and
(3) without the dentist’s diagnosis and treatment plan unless otherwise specified in the collaborative agreement or in (a) of this section.
(c) The board shall adopt regulations regarding approval of collaborative agreements between licensed dental hygienists and licensed dentists.
(d) The board may approve a collaborative agreement between a licensed dentist and a licensed dental hygienist. However, the board may not approve more than five collaborative agreements with a licensed dentist, not including any collaborative agreements that have been terminated. A licensed dental hygienist shall notify the board of the termination of a collaborative agreement with a licensed dentist.