(1) (a) A dental therapist may perform the following tasks and procedures under the
direct supervision of a dentist with an active license in good standing:
(I) Prepare and place direct restorations in primary and permanent teeth;
(II) Perform brush biopsies;
(III) Extract periodontally diseased permanent teeth with mobility of +3 to
+4, except for teeth that are unerupted, impacted, fractured, or require sectioning;
(IV) Extract primary teeth that are erupted or not impacted with radiological
evidence of roots;
(V) Oral examination and evaluation for conditions and services that are
within the dental therapist's scope of practice and education;
(VI) Place temporary crowns;
(VII) Prepare and place preformed crowns; and
(VIII) Repair prosthetic devices.
(b) A dental therapist licensed pursuant to this article 220 who has
completed one thousand hours or more under direct supervision, or who has
completed the direct supervision hours required under the waiver described in
subsection (1)(e) of this section, may practice the tasks and procedures identified in
subsection (1)(a) of this section under the indirect supervision of a licensed dentist
pursuant to a written articulated plan with the dentist that meets the requirements
of subsection (2) of this section.
(c) A dental therapist licensed pursuant to this article 220 may perform the
following tasks under the indirect supervision of a licensed dentist, regardless of
the number of hours the dental therapist has practiced:
(I) Reimplanting teeth;
(II) Stabilizing reimplanted teeth;
(III) Extracting primary teeth that are erupted or not impacted without
radiological evidence of roots;
(IV) Removing sutures;
(V) Preparing dental study casts;
(VI) Administering local anesthesia in accordance with section 12-220-411;
(VII) Dispensing and administering the following drugs within the parameters
of a written articulated plan and with the authorization of the supervising dentist:
Nonnarcotic analgesics, anti-inflammatories, and antibiotics;
(VIII) Any task or procedure authorized to be performed by a licensed dental
hygienist as specified in rules adopted pursuant to sections 12-220-106 (1)(a)(I), 12-220-501, 12-220-503 (1), 12-220-504 (1), and 12-220-505; and
(IX) Directing dental assistants to assist in activities that are within the
scope of practice for a dental therapist under direct and indirect supervision of the
dental therapist only; except that dental assistants shall not perform activities
disallowed under section 12-220-501 (3)(a).
(d) A dental therapist shall complete at least a majority of the direct
supervision hours required under subsection (1)(b) or (1)(e) of this section performing
the tasks and procedures identified in subsection (1)(a) of this section.
(e) For the purposes of satisfying the practice hours requirement specified in
subsection (1)(a) of this section, the board, by rule, may waive up to six hundred
hours of the required practice hours. In promulgating these rules, the board shall, at
a minimum, consider the number of years the dental therapist has practiced as:
(I) A licensed dental hygienist in Colorado;
(II) A licensed dental hygienist in another state; or
(III) A licensed dental therapist in another state.
(2) (a) An articulated plan between a dental therapist and a dentist must
include:
(I) Methods of dentist supervision, consultation, and approval;
(II) Protocols for informed consent, record keeping, quality assurance, and
dispensing or administering medications;
(III) Policies for handling referrals when a patient needs services the dental
therapist is not authorized or qualified to provide;
(IV) Protocols for assessment of dental disease and the formulation of an
individualized treatment plan authorized by the supervising dentist;
(V) Policies for handling medical emergencies; and
(VI) Consistent with dental assistants' scope of practice, policies for
supervising dental assistants and working with dental hygienists and other dental
practitioners and staff.
(b) (I) A dentist who enters into a written articulated plan with a dental
therapist shall ensure that the dentist, or another dentist, is available to the dental
therapist for timely communication during the dental therapist's provision of care to
a patient.
(II) A dental therapist and a dentist who enter into a written articulated plan
shall each maintain a physical or digital copy of the plan.
(III) A dental therapist may enter into written articulated plans with more
than one dentist if each articulated plan includes the same supervision
requirements and scope of practice.
(c) A written articulated plan must be signed by the dentist and the dental
therapist.
(d) For purposes of this section, a written articulated plan satisfies the
requirement of prior knowledge and consent for indirect supervision.
(3) (a) Except as provided in subsection (3)(b), (3)(c), or (3)(d) of this section,
a dentist may not simultaneously supervise more than three full-time or full-time-equivalent dental therapists.
(b) A dentist may supervise an additional two full-time or full-time-equivalent dental therapists who practice in a federally qualified health center
pursuant to 42 U.S.C. sec. 1395x (aa)(4) or a rural health clinic pursuant to 42 U.S.C.
sec. 1395x (aa)(4).
(c) The board shall promulgate rules creating a process for a dentist to seek
a waiver from the supervision limit specified in subsection (3)(a) of this section. At a
minimum, the rules must specify the application process and waiver requirements.
(d) A dentist shall not supervise in aggregate more than five full-time
equivalent dental hygienists or dental therapists pursuant to this section and
section 12-220-505 (6)(a), and limits on supervision of dental therapists must
remain consistent with this subsection (3).