§ 20-126y — Practice of dental therapy by dental hygienists. Scope of practice. Requirements. Collaborative agreement. Continuing education.

(a) As used in this section: (1) “Practice of dental therapy” means the performance of educational, preventive and therapeutic services through any one or more of the following practices and procedures: (A) Identification of oral and systemic conditions requiring evaluation or treatment by dentists, physicians or other health care providers, and management of referrals to dentists, physicians and other health care providers; (B) diagnosis and treatment of oral diseases and conditions that are within the dental therapist scope of practice; (C) comprehensive charting of the oral cavity; (D) oral health instruction and disease prevention education, including nutritional counseling and dietary analysis; (E) dispensing and administering of nonnarcotic analgesics and anti-inflammatory and antibiotic medications as prescribed by a licensed health care provider, except schedule II, III or IV controlled substances; (F) applying topical preventive or prophylactic agents, including fluoride varnish, antimicrobial agents and pit and fissure sealants; (G) pulp vitality testing; (H) applying desensitizing medication or resin in the oral cavity; (I) interim therapeutic restorations; (J) fabricating athletic mouth guards; (K) changing periodontal dressings; (L) administering local anesthetics in the oral cavity under the general supervision of a dentist; (M) simple extraction of erupted primary teeth; (N) nonsurgical extraction of periodontally diseased permanent teeth with tooth mobility of three or greater, except a tooth that is unerupted, impacted, fractured or needs to be sectioned for removal; (O) emergency palliative treatment of dental pain; (P) preparation and placement of direct restoration in primary and permanent teeth that does not require the fabrication of crowns, bridges, veneers or dentures; (Q) fabrication and placement of single-tooth temporary crowns; (R) preparation and placement of preformed crowns on primary teeth; (S) indirect and direct pulp capping on permanent teeth; (T) indirect pulp capping on primary teeth; (U) dental suture removal; (V) minor adjustments and repairs on removable prostheses; (W) placement and removal of space maintainers; and (X) recementing permanent crowns; (2) “Collaborative agreement” means a written agreement between a dental therapist and a dentist licensed pursuant to chapter 379, that defines the working relationship between the dental therapist and the dentist and the parameters of the practice of dental therapy; (3) “Dental therapist” means a licensed dental hygienist authorized to engage in the practice of dental therapy under a collaborative agreement; and (4) “Public health facility” has the same meaning as provided in section 20-126 l . (b) No person shall engage in the practice of dental therapy unless such person (1) is a dental hygienist licensed pursuant to this chapter; (2) has obtained a dental therapist certification that is (A) in writing, on a form issued by an institution of higher education accredited by the Commission on Dental Accreditation after successful completion of a dental therapy program that includes, in accordance with the Commission on Dental Accreditation's standards for dental therapy education programs, full-time instruction or its equivalent at the postsecondary college level and incorporates all dental therapy practice competencies, (B) signed by the dental therapist and the director of the dental therapy education program, and (C) made available to the Department of Public Health upon request; (3) has successfully completed a comprehensive examination prescribed by the Commission on Dental Competency Assessments, or its equivalent, and administered independently of any institution of higher education that offers a program in dental therapy; (4) prior to entering the first collaborative agreement, (A) has received a certificate of completion, signed by a dentist licensed pursuant to chapter 379, that verifies completion of one thousand hours of clinical training under the direct supervision of such dentist, and (B) has successfully completed six hours of continuing education related to dental therapy; and (5) has entered into a collaborative agreement with a dentist. (c) A dental therapist shall practice in a public health facility under the general supervision of a dentist licensed pursuant to chapter 379 in accordance with a collaborative agreement. (d) No provision of this section shall be construed to prohibit a dental hygienist enrolled in a dental therapy program, as described in subdivision (2) of subsection (b) of this section, from performing dental therapy work as a required component of his or her course of study in such program, provided such dental hygienist (1) performs such work under the direct supervision of a dentist licensed pursuant to chapter 379, (2) shall not hold himself or herself out as a certified dental therapist, and (3) shall not receive compensation for such work. (e) (1) A collaborative agreement entered into pursuant to subsection (b) of this section shall include: (A) Identification of public health facilities where services may be provided and the populations to be served; (B) any limitations on the services that may be provided by the dental therapist; (C) age and procedure-specific practice protocols, including case selection criteria, assessment guidelines and imaging frequency; (D) a procedure for creating and maintaining dental records for the patients that are treated by the dental therapist; (E) a plan to manage medical emergencies in each public health facility where the dental therapist provides care; (F) a quality assurance plan for monitoring care provided by the dental therapist, including patient care review, referral follow-up and a quality assurance chart review; (G) protocols for dispensing and administering medications, including the specific conditions and circumstances under which these medications may be dispensed and administered; (H) criteria relating to the provision of care to patients with specific medical conditions or complex medication histories, including requirements for consultation prior to the initiation of care; (I) criteria for the supervision of dental assistants, expanded function dental assistants, as defined in section 20-112a , and dental hygienists in accordance with subsection (g) of this section; and (J) a plan for the provision of referrals in situations that are beyond the capabilities or the scope of practice of the dental therapist. (2) A collaborative agreement shall be (A) signed and maintained by the supervising dentist and the dental therapist and kept on file at the locations where such dental therapist is employed; (B) reviewed by the dentist and dental therapist on an annual basis and revised as needed; and (C) available for inspection upon the request of the Department of Public Health. (f) A dentist who enters into a collaborative agreement with a dental therapist (1) shall be professionally responsible and legally liable for all services authorized and performed by the dental therapist pursuant to a collaborative agreement, and (2) may not enter into a collaborative agreement with more than two dental therapists at any one time. Nothing in this section shall be construed to require a dentist to enter into a collaborative agreement with a dental therapist. (g) A dental therapist may directly supervise not more than two dental assistants or expanded function dental assistants, as defined in section 20-112a , or dental hygienists licensed pursuant to this chapter to the extent permitted in the collaborative agreement. (h) (1) Each dental therapist shall complete, in addition to the continuing education requirements of subsection (g) of section 20-126 l , six hours of continuing education in dental therapy within the twelve-month period after such dental therapist enters into a collaborative agreement with a dentist and within each subsequent twenty-four-month period thereafter. (2) Each dental therapist applying for a renewal of a dental hygiene license pursuant to this chapter and in accordance with section 19a-88 shall sign a statement attesting that he or she has satisfied the continuing education requirements described in subdivision (1) of this subsection on a form prescribed by the Department of Public Health. Each dental therapist shall retain records of attendance or certificates of completion that demonstrate compliance with the continuing education requirements described in subdivision (1) of this subsection for not less than three years following the date on which the continuing education was completed or the license was renewed. Each dental therapist shall submit such records to the department for inspection not later than forty-five days after a request by the department for such records. A dental therapist who fails to comply with the provisions of this section may be subject to disciplinary action pursuant to section 20-126o .

Legislative History

(P.A. 19-56, S. 14.) History: P.A. 19-56 effective January 1, 2020.