North Carolina General Statutes 90-233. Practice of dental hygiene
(a) A dental hygienist may practice only under the supervision of one or more licensed dentists. This subsection shall be deemed to be complied with in the case of dental hygienists employed by or under contract with a local health department, a State government dental public health program, or a federally qualified health center, and especially trained by the Oral Health Section of the Department of Health and Human Services as public health hygienists, while performing their duties for the persons officially served by the local health department, State government program, or federally qualified health center under the direction of a duly licensed dentist employed by that program or by the Oral Health Section of the Department of Health and Human Services.
(a1) A dental hygienist who has three years of experience in clinical dental hygiene or a minimum of 2,000 hours performing primarily prophylaxis or periodontal debridement under the supervision of a licensed dentist, who completes annual CPR certification, who completes six hours each year of Board-approved continuing education in medical emergencies in addition to the requirements of N.C. Gen. Stat. § 90-225.1, and who is designated by the employing dentist as being capable of performing clinical hygiene procedures without the direct supervision of the dentist, may perform one or more dental hygiene functions as described in N.C. Gen. Stat. § 90-221(a) under the direction of a dentist based on a written standing order, rather than an in-person evaluation by the dentist and without a licensed dentist being physically present if all of the following conditions are met:
(1) A licensed dentist directs in writing the hygienist to perform the dental hygiene functions.
Terms Used In North Carolina General Statutes 90-233
- Board: shall mean "The North Carolina State Board of Dental Examiners" created by Chapter 139, Public Laws of 1879, and Chapter 178, Public Laws of 1915 as continued in existence by N. See North Carolina General Statutes 90-221
- Contract: A legal written agreement that becomes binding when signed.
- Dental hygiene: as used in this Article shall mean the performance of the following functions: Complete oral prophylaxis, application of preventive agents to oral structures, exposure and processing of radiographs, administration of medicaments prescribed by a licensed dentist, preparation of diagnostic aids, and written records of oral conditions for interpretation by the dentist, together with such other and further functions as may be permitted by rules and regulations of the Board not inconsistent herewith. See North Carolina General Statutes 90-221
- Dental hygienist: as used in this Article , shall mean any person who is a graduate of a Board-accredited school of dental hygiene, who has been licensed by the Board, and who practices dental hygiene as prescribed by the Board. See North Carolina General Statutes 90-221
- Direct supervision: as used in this Article shall mean that acts are deemed to be under required supervision only when performed in a locale where the supervising licensed dentist is physically present and shall not include supervision under N. See North Carolina General Statutes 90-221
- following: when used by way of reference to any section of a statute, shall be construed to mean the section next preceding or next following that in which such reference is made; unless when some other section is expressly designated in such reference. See North Carolina General Statutes 12-3
- in writing: may be construed to include printing, engraving, lithographing, and any other mode of representing words and letters: Provided, that in all cases where a written signature is required by law, the same shall be in a proper handwriting, or in a proper mark. See North Carolina General Statutes 12-3
- License: shall mean a certificate issued to any applicant upon completion of requirements for admission to practice dental hygiene. See North Carolina General Statutes 90-221
- state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories, so called; and the words "United States" shall be construed to include the said district and territories and all dependencies. See North Carolina General Statutes 12-3
- Supervision: as used in this Article shall mean that acts are deemed to be under the supervision of a licensed dentist when performed in a locale where a licensed dentist is physically present during the performance of such acts, except those acts performed under direction and in compliance with N. See North Carolina General Statutes 90-221
- United States: shall be construed to include the said district and territories and all dependencies. See North Carolina General Statutes 12-3
(2) Repealed by Session Laws 2021-95, s. 3, effective July 23, 2021.
(3) The dental hygiene functions directed to be performed in accordance with this subsection are conducted within 270 days of the dentist’s standing order.
(4) The services are performed in nursing homes; rest homes; long-term care facilities; schools; rural and community clinics operated by Board-approved nonprofits; rural and community clinics operated by federal, State, county, or local governments; federally qualified health centers; and any other facilities identified by the Office of Rural Health and approved by the Board as serving dental access shortage areas.
(5) A licensed dentist is available to provide appropriate follow-up care as necessary.
(a2) A dental hygienist shall not establish or operate a separate care facility that exclusively renders dental hygiene services.
(a3) A dental hygienist who has been disciplined by the Board may not practice outside the direct supervision of a dentist under N.C. Gen. Stat. § 90-233(a1). A dentist who has been disciplined by the Board may not allow a hygienist to work outside of that dentist’s direct supervision under N.C. Gen. Stat. § 90-233(a1).
(a4) Each dentist who chooses to order dental hygiene services under N.C. Gen. Stat. § 90-233(a1) shall report annually to the Board the number of patients who were treated outside the direct supervision of the dentist, the location in which the services were performed by the hygienist, and a description of any adverse circumstances which occurred during or after the treatment, if any. The dentist’s report shall not identify hygienists or patients by name or any other identifier.
(a5) Clinical dental hygiene services shall be provided in compliance with both CDC and OSHA standards for infection control and patient treatment.
(a6) Dental hygienists performing procedures in accordance with subsection (a1) of this section may supervise a Dental Assistant who assists the hygienist in clinical procedures and is classified as a Dental Assistant II or permitted to perform functions of a Dental Assistant II pursuant to 21 NCAC 16H .0104(a) or (b).
(b) A dentist in private practice may not employ more than two dental hygienists at one and the same time who are employed in clinical dental hygiene positions.
(c) Dental hygiene may be practiced only by the holder of a license or provisional license currently in effect and duly issued by the Board. The following acts, practices, functions or operations, however, shall not constitute the practice of dental hygiene within the meaning of this Article:
(1) The teaching of dental hygiene in a school or college approved by the Board in a board-approved program by an individual licensed as a dental hygienist in any state in the United States.
(2) Activity which would otherwise be considered the practice of dental hygiene performed by students enrolled in a school or college approved by the Board in a board-approved dental hygiene program under the direct supervision of a dental hygienist or a dentist duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of N.C. Gen. Stat. § 90-29(c)(3), acting as an instructor.
(3) Any act or acts performed by an assistant to a dentist licensed to practice in this State when said act or acts are authorized and permitted by and performed in accordance with rules and regulations promulgated by the Board.
(4) Dental assisting and related functions as a part of their instructions by students enrolled in a course in dental assisting conducted in this State and approved by the Board, when such functions are performed under the supervision of a dentist acting as a teacher or instructor who is either duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of N.C. Gen. Stat. § 90-29(c)(3). (1945, c. 639, s. 12; 1971, c. 756, s. 13; 1973, c. 476, s. 128; 1981, c. 824, ss. 2, 3; 1989, c. 727, s. 219(6a); 1997-443, s. 11A.23; 1999-237, s. 11.65; 2007-124, s. 2; 2021-95, s. 3.)