201 KAR 8:562 - Licensure of dental hygienists
RELATES TO: KRS 214.615, 304.40 - 075, 313.030, 313.040, 313.060, 313.080, 313.130, 313.254
NECESSITY, FUNCTION, AND CONFORMITY: KRS 313.040 requires the board to promulgate administrative regulations relating to requirements and procedures for the licensure of dental hygienists. This administrative regulation establishes requirements and procedures for the licensure of dental hygienists.
Section 1. General Licensure Requirements. An
applicant desiring licensure in the Commonwealth shall at a minimum:
(1) Understand, read, speak, and write the
English language with a comprehension and performance level equal to at least
the ninth grade of education, otherwise known as Level 4, verified by testing
as necessary;
(2) Submit a
completed, signed, and notarized Application for Dental Hygiene Licensure with
an email contact address and an attached applicant photo taken within the past
six (6) months;
(3) Pay the fee
required by
201 KAR 8:520;
(4)
Not be currently subject to disciplinary action pursuant to KRS Chapter 313
that would prevent licensure;
(5)
Provide proof of completion of the requirements of
KRS 214.615(1);
(6) Complete and pass the board's
jurisprudence exam;
(7) Provide
proof of having current certification in cardiopulmonary resuscitation (CPR)
that meets or exceeds the guidelines established by the American Heart
Association, incorporated by reference in
201 KAR 8:532;
(8)
Submit to a criminal background check from the Administrative Office of the
Courts in Kentucky, from the state or states of residence for the last five (5)
years, or by fingerprint;
(9)
Provide verification within three (3) months of the date the application is
received at the office of the board of any license to practice dental hygiene
held previously or currently in any state or jurisdiction;
(10) Provide proof that the applicant is a
graduate of a Commission on Dental Accreditation (CODA) accredited dental
hygiene school or college or dental hygiene department of a
university;
(11) Provide proof that
the applicant has successfully completed the National Board Dental Hygiene
Examination, which is written and theoretical, conducted by the Joint
Commission on National Dental Examinations; and
(12) Provide a written explanation for any
positive returns on a query of the National Practitioner Data Bank.
Section 2. Requirements for
Licensure by Examination.
(1) Each individual
desiring initial licensure as a dental hygienist by examination shall complete
all of the requirements established in Section 1 of this administrative
regulation.
(2) Each individual
desiring initial licensure as a dental hygienist by examination shall
successfully complete a clinical examination within the five (5) years
preceding the filing of his or her Application for Dental Hygiene Licensure.
The board shall accept the following regional clinical examinations:
(a) The examination of the Council of
Interstate Testing Agencies (CITA);
(b) The examination of the Central Regional
Dental Testing Service (CRDTS);
(c)
The examination of the North East Regional Board of Dental Examiners
(NERB);
(d) The examination of the
Southern Regional Testing Agency (SRTA); or
(e) The examination of the Western Regional
Examining Board (WREB).
(3) An individual desiring initial licensure
as a dental hygienist by examination more than two (2) years after fulfilling
all of the requirements of his CODA accredited dental hygiene education shall:
(a) Hold a license to practice dental hygiene
in good standing in another state or territory of the United States or the
District of Columbia; or
(b) If the
applicant does not hold a license to practice dental hygiene in good standing,
complete a board-approved refresher course prior to receiving a license to
practice dental hygiene in the Commonwealth of Kentucky.
(4) An applicant who has taken a clinical
examination three (3) times and failed to achieve a passing score shall not be
allowed to sit for the examination again until the applicant has completed and
passed a remediation plan prescribed by the board based on the applicant's
deficiencies.
Section 3.
Requirements for Licensure by Credentials. Each individual desiring initial
licensure as a dental hygienist by credentials shall:
(1) Complete all of the requirements
established in Section 1 of this administrative regulation;
(2) Provide proof of having passed a state,
regional, or national clinical examination used to determine clinical
competency in a state or territory of the United States or the District of
Columbia; and
(3) Provide proof
that, for five (5) of the six (6) years immediately preceding the filing of the
application, the applicant has been engaged in the active practice of dental
hygiene while he or she was legally authorized to practice dental hygiene in a
state or territory of the United States or the District of Columbia if the
qualifications for the authorization were equal to or higher than those of the
Commonwealth of Kentucky.
Section
4. Requirements for Charitable Limited Licensure.
(1) Each individual desiring a charitable
limited license shall:
(a) Understand, read,
speak, and write the English language with a comprehension and performance
level equal to at least the ninth grade of education, otherwise known as Level
4, verified by testing as necessary;
(b) Submit a completed, signed, and notarized
Application for Charitable Dental Hygiene Licensure with an attached applicant
photo taken within the past six (6) month;
(c) Not be subject to disciplinary action
pursuant to KRS Chapter 313 that would prevent licensure;
(d) Have a license to practice dental hygiene
in good standing in another state; and
(e) Provide a written explanation for any
positive returns on a query of the National Practitioner Data Bank.
(2) An individual licensed
pursuant to this section shall:
(a) Work only
with charitable entities registered with the Cabinet for Health and Family
Services that have met requirements of
KRS 313.254 and 201 KAR 8:580;
(b) Only perform procedures allowed by
KRS 313.254, which shall be completed within the
duration of the charitable event;
(c) Be eligible for the provisions of medical
malpractice insurance procured pursuant to
KRS 304.40-075;
(d) Perform these duties without expectation
of compensation or charge to the individual and without payment or
reimbursement by any governmental agency or insurer;
(e) Have a charitable limited license that
shall be good for two (2) years and expire during the regular dental hygiene
renewal cycle; and
(f) Comply with
reciprocity requirements if applicable.
1. A
state that extends a reciprocal agreement shall comply with this
section.
2. An individual shall
notify the sponsor of a charitable clinic and the board of the intent to
conduct or participate in the clinic.
3. An individual conducting or participate in
a charitable clinic shall have a license to practice dental hygiene in the
state in which the dental hygienist practices.
Section 5. Minimum Continuing
Education Requirements.
(1) Each individual
desiring renewal of an active dental hygiene license shall complete thirty (30)
hours of continuing education that relates to or advances the practice of
dental hygiene and would be useful to the licensee in his practice.
(2) Acceptable continuing education hours
shall include course content designed to increase:
(a) Competency in treating patients who are
medically compromised or who experience medical emergencies during the course
of dental hygiene treatment;
(b)
Knowledge of pharmaceutical products and the protocol of the proper use of
medications;
(c) Awareness of
currently accepted methods of infection control;
(d) Knowledge of basic medical and scientific
subjects including, biology, physiology, pathology, biochemistry, pharmacology,
epidemiology, and public health;
(e) Knowledge of clinical and technological
subjects;
(f) Knowledge of subjects
pertinent to patient management, safety, and oral healthcare;
(g) Competency in assisting in mass casualty
or mass immunization situations;
(h) Clinical skills through the volunteer of
clinical charitable dental hygiene that meets the requirements of
KRS 313.254;
(i) Knowledge of office business operations
and best practices; or
(j)
Participation in dental or dental hygiene association or society business
meetings.
(3) A minimum
of ten (10) hours shall be taken in a live interactive presentation
format.
(4) A maximum of ten (10)
hours total may be taken that meet the requirements of subsection (2)(h) - (j)
of this section.
(5) All continuing
education hours shall be verified by the receipt of a certificate of completion
or certificate of attendance bearing:
(a) The
signature of the provider;
(b) The
name of the licensee in attendance;
(c) The title of the course or meeting
attended or completed;
(d) The date
of attendance or completion;
(e)
The number of hours earned; and
(f)
Evidence of the method of delivery if the course was taken in a live
interactive presentation format.
(6) It shall be the sole responsibility of
the individual dental hygienist to obtain documentation from the provider or
sponsoring organization verifying participation as established in subsection
(5) of this section and to retain the documentation for a minimum of five (5)
years.
(7) At license renewal, each
licensee shall attest to the fact that he or she has complied with the
requirements of this section.
(8)
Each licensee shall be subject to audit of proof of continuing education
compliance by the board.
Section
6. Requirements for Renewal of a Dental Hygiene License.
(1) Each individual desiring renewal of an
active dental hygiene license shall:
(a)
Submit a completed, signed Application for Renewal of Dental Hygiene Licensure
with an email contact address;
(b)
Pay the fee required by
201 KAR 8:520;
(c)
Maintain with no more than a thirty (30) day lapse, CPR certification that
meets or exceeds the guidelines established by the American Heart Association,
incorporated by reference in 201 KAR 8:530, unless a hardship waiver is
submitted to and subsequently approved by the board;
(d) Meet the requirements of
KRS 214.615(1); and
(e) Meet the continuing education
requirements as established in Section 5 of this administrative regulation
except in the following cases:
1. If a
hardship waiver has been submitted to and is subsequently approved by the
board;
2. If the licensee graduated
in the first year of the renewal biennium, in which case the licensee shall
complete one-half (1/2) of the hours as established in Section 5 of this
administrative regulation; and
3.
If the licensee graduated in the second year of the renewal biennium, in which
case the licensee shall not be required to complete the continuing education
requirements established in Section 5 of this administrative
regulation.
(2) If a licensee has not actively practiced
dental hygiene in the two (2) consecutive years preceding the filing of the
renewal application, he or she shall complete and pass a board-approved
refresher course prior to resuming the active practice of dental
hygiene.
Section 7.
Retirement of a License.
(1) Each individual
desiring retirement of a dental hygiene license shall submit a completed and
signed Retirement of License Form.
(2) Upon receipt of Retirement of License
Form, the board shall send written confirmation of retirement to the last known
address of the licensee.
(3) A
licensee shall not retire a license that has pending disciplinary action
against it.
(4) Each retirement
shall be effective upon the processing of the completed and signed Retirement
of License Form by the board.
Section
8. Reinstatement of a License.
(1) Each individual desiring reinstatement of
a properly retired dental hygiene license shall:
(a) Submit a completed, signed, and notarized
Application for Dental Hygiene Licensure with an email contact address and an
attached applicant photo taken within the past six (6) months;
(b) Pay the fee required by
201 KAR 8:520;
(c)
Show proof of having current certification in CPR that meets or exceeds the
guidelines established by the American Heart Association, incorporated by
reference in
201 KAR 8:532;
(d)
Provide verification within three (3) months of the date the Application for
Dental Hygiene Licensure is received at the office of the board of any license
to practice dental hygiene held previously or currently in any state or
jurisdiction;
(e) Submit to a
criminal background check from the Administrative Office of the Courts in
Kentucky, from the state or states of residence for the last five (5) years, or
by fingerprint; and
(f) Provide a
written explanation for any positive returns on a query of the National
Practitioner Data Bank.
(2) If an individual is reinstating a license
that was retired within the two (2) consecutive years immediately preceding the
filing of the reinstatement application, the individual shall provide proof of
having met the continuing education requirements as established in Section 5 of
this administrative regulation within those two (2) years.
(3) If the applicant has not actively
practiced dental hygiene in the two (2) consecutive years immediately preceding
the filing of the Application to Reinstate a Dental Hygiene License, the
applicant shall complete and pass a refresher course approved by the
board.
(4) If a license is
reinstated in the first year of a renewal biennium, the licensee shall complete
all of the continuing education requirements as established in Section 5 of
this administrative regulation prior to the renewal of his license.
(5) If a license is reinstated in the second
year of a renewal biennium, the licensee shall complete one-half (1/2) of the
hours as established in Section 5 of this administrative regulation prior to
the renewal of his license.
Section
9. Requirements for Verification of Licensure. Each individual
desiring verification of a dental hygiene license shall:
(1) Submit a signed and completed
Verification of Licensure or Registration Form; and
(2) Pay the fee required by
201 KAR 8:520.
Section 10. Requesting a Duplicate License.
Each individual desiring a duplicate dental hygiene license shall:
(1) Submit a signed and completed Duplicate
License or Registration Request Form; and
(2) Pay the fee required by
201 KAR 8:520.
Section 11. Requirements for Local Anesthesia
Registration.
(1) An individual who has
completed a course of study in dental hygiene at a board-approved CODA
accredited institution on or after July 15, 2010, which meets or exceeds the
education requirements as established in
KRS 313.060(10) shall be granted
the authority to practice local anesthesia upon the issuance by the board of a
dental hygiene license.
(2) An
individual licensed as a hygienist in Kentucky and not subject to disciplinary
action who desires to administer local anesthesia and does not qualify to do so
pursuant to Section 12(1) of this administrative regulation shall complete a
training and education course as described in
KRS 313.060(10).
(3) The training and education course shall
be offered by at least one (1) of the following institutions in Kentucky:
(a) University of Louisville School of
Dentistry;
(b) University of
Kentucky College of Dentistry;
(c)
Western Kentucky University Dental Hygiene Program; and
(d) Kentucky Community Technical College
System Dental Hygiene Programs.
(4) Training received outside of Kentucky
shall be from a CODA accredited dental or dental hygiene school and shall meet
the requirements established in
KRS 313.060(10).
(5) Once the required training is complete
the applicant shall:
(a) Complete the Dental
Hygiene Local Anesthesia Registration Application; and
(b) Pay the fee required by
201 KAR 8:520.
(6) Individuals authorized to practice
pursuant to this provision shall receive a license from the board indicating
registration to administer local anesthesia.
(7) A licensed dental hygienist shall not
administer local anesthesia if the licensee does not hold a local anesthesia
registration issued by the board.
(8) A licensed dental hygienist holding a
local anesthesia registration from the board who has not administered block
anesthesia, infiltration anesthesia, or nitrous oxide analgesia for one (1)
year shall complete a board-approved refresher course prior to resuming
practice of that specific technique.
Section 12. Requirements for General
Supervision Registration.
(1) An individual
licensed as a hygienist in Kentucky and not subject to disciplinary action who
desires to practice under general supervision shall:
(a) Complete the General Supervision
Registration Application;
(b) Meet
the requirements of
KRS 313.040(7)(a);
(c) Document through payroll records,
employment records, or other proof that is independently verifiable, the dates
and hours of employment by a dentist in the practice of dental hygiene that
demonstrate the required two (2) years and 3,000 hours of experience;
(d) Successfully complete a live three (3)
hour course approved by the board in the identification and prevention of
potential medical emergencies that shall include, at a minimum, the following
topics:
1. Medical history, including American
Society of Anesthesiologists (ASA) classifications of physical
status;
2. Recognition of common
medical emergency situations, symptoms, and possible outcomes;
3. Office emergency protocols; and
4. Prevention of emergency situations during
dental treatments.
(2) An individual authorized to practice
pursuant to these provisions shall receive a license from the board indicating
registration to practice under general supervision.
(3) A dentist who employs a dental hygienist
who has met the standards of this administrative regulation and who allows the
dental hygienist to provide dental hygiene services pursuant to
KRS 313.040(7) shall complete a
written order prescribing the dental service or procedure to be done to a
specific patient by the dental hygienist and shall retain the original order in
the patient's dental record.
(4)
The minimum requirements for the written order shall include:
(a) Medical history update;
(b) Radiographic records requested;
(c) Dental hygiene procedures
requested;
(d) Name of the
patient;
(e) Date of last oral
examination;
(f) Date of the
written order; and
(g) Signature of
the dentist.
(5) The
oral examination of the patient by the supervising dentist shall have been
completed within the seven (7) months preceding treatment by the dental
hygienist practicing under general supervision.
(6) The supervising dentist shall evaluate
and provide to the board written validation of an employed dental hygienist's
skills necessary to perform dental hygiene services established in
KRS 313.040(7) as part of the
General Supervision Registration Application.
(7) The supervising dentist shall provide a
written protocol addressing the medically compromised patients who may or may
not be treated by the dental hygienist. The dental hygienist shall only treat
patients who are in the ASA Patient Physical Status Classification of ASA I or
ASA II as established in Guidelines for Teaching Pain Control and Sedation to
Dentists and Dental Students, 2007 Edition, American Dental
Association.
(8) A licensed dental
hygienist shall not practice under general supervision if the licensee does not
hold a general supervision registration issued by the board.
Section 13. Requirements for
Starting Intravenous Access Lines.
(1) An
individual licensed as a dental hygienist in Kentucky and not subject to
disciplinary action pursuant to KRS Chapter 313 who desires to start an
intravenous (IV) access line while under the direct supervision of a dentist
who holds a sedation or anesthesia permit issued by the board shall:
(a) Submit a signed and completed Application
for Intravenous Access Line Registration;
(b) Pay the fee required by
201 KAR 8:520;
and
(c) Submit documentation
proving successful completion of a board-approved course in starting IV access
lines.
(2) An individual
authorized to practice pursuant to this provision shall receive a license from
the board indicating registration to start IV access lines.
(3) A licensed dental hygienist shall not
start an IV access line if the licensee does not hold a board-issued
registration to start IV access lines.
Section 14. Requirements for Performing Laser
Debridement.
(1) An individual licensed as a
dental hygienist in Kentucky and not subject to disciplinary action pursuant to
KRS Chapter 313 who desires to perform laser debridement while under the direct
supervision of a dentist licensed by the board shall:
(a) Submit a signed and completed Application
for Laser Debridement Registration;
(b) Pay the fee required by
201 KAR 8:520;
and
(c) Submit documentation
proving successful completion of a board-approved course in performing laser
debridement.
(2) An
individual authorized to practice pursuant to this provision shall receive a
license from the board indicating registration to perform laser
debridement.
(3) A licensed dental
hygienist shall not perform laser debridement if the licensee does not hold a
registration to do so issued by the board.
Section 15. Requirements for Public Health
Registered Dental Hygienist Registration.
(1)
An individual licensed as a hygienist in Kentucky and not subject to
disciplinary action who desires to practice as a public health registered
dental hygienist shall:
(a) Submit a completed
Public Health Registered Dental Hygienist Application;
(b) Meet the requirements established in
KRS 313.040(8);
(c) Document through payroll records,
employment records, or other proof that is independently verifiable, the dates
and hours of employment by a dentist in the practice of dental hygiene that
demonstrate the required two (2) years and 3,000 hours of experience;
and
(d) During each renewal cycle,
successfully complete a live three (3) hour course that has been approved by
the board on the identification and prevention of potential medical emergencies
that shall include, at a minimum, the following topics:
1. Medical history, including American
Society of Anesthesiologists (ASA) classifications of physical
status;
2. Recognition of common
medical emergency situations, symptoms, and possible outcomes;
3. Office emergency protocols; and
4. Prevention of emergency situations during
dental treatments.
(2) An individual authorized to practice
pursuant to subsection (1) of this section shall receive a certificate from the
board indicating registration to practice as a public health registered dental
hygienist.
(3) A public health
registered dental hygienist desiring to maintain certification as a public
health registered dental hygienist shall be required to complete at least five
(5) hours of continuing education in the area of public health or public dental
health during each renewal cycle.
(4) Pursuant to
KRS 313.040(8)(c), a public
health registered dental hygienist may practice in a government-created public
health program at the following sites:
(a)
Local health departments;
(b)
Public or private educational institutions that provide Head Start, preschool,
elementary and secondary instruction to schoolaged children under the
jurisdiction of the State Board of Education, and that have an affiliation
agreement with the health department of jurisdiction;
(c) Mobile and portable dental health
programs under contract with a governing board of health; and
(d) Public or private institutions under the
jurisdiction of a federal, state, or local agency.
(5) A public health registered dental
hygienist shall perform dental hygiene services only under the supervision of
the governing board of health, as required by
KRS 313.040(3)(b), as
established in
KRS 313.040(8), and as
identified by the Department for Public Health Practice Reference.
(a) These services shall be limited to
preventative services.
(b) The
public health registered dental hygienist shall only treat a patient who is in
the ASA Patient Physical Status Classification of ASA I or ASA II as
established in the current edition of Guidelines for Teaching Pain Control and
Sedation to Dentists and Dental Students, American Dental
Association.
(c) The informed
consent shall be required prior to preventative services and shall include:
1. The name of the public health entity,
including the name of the dentist, that assumes responsibility and
control;
2. An inquiry as to the
current dentist; and
3. A statement
that services are provided by a dental hygienist without the direct supervision
of a dentist.
(d) This
administrative regulation shall not preclude a Kentucky-licensed dentist from
directly participating in a public health program referenced in subsection
(4)(a), (b), (c), or (d) of this section.
Section 16. Issuance of Initial Licensure. If
an applicant has completed the requirements for licensure the board shall:
(1) Issue a license in sequential numerical
order; or
(2) Deny licensure due to
a violation of KRS Chapter 313 or 201 KAR Chapter 8.
Section 17. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) "Application for Dental Hygiene
Licensure", January 2011;
(b)
"Application for Charitable Dental Hygiene Licensure", July 2010;
(c) "Application for Renewal of Dental
Hygiene Licensure", May 2014;
(d)
"Retirement of License Form", July 2010;
(e) "Application to Reinstate a Dental
Hygiene License", July 2010;
(f)
"Verification of Licensure or Registration Form", July 2010;
(g) "Duplicate License or Registration
Request Form", July 2010;
(h)
"Dental Hygiene Local Anesthesia Registration Application", July 2010;
(i) "General Supervision
Registration Application", July 2010;
(j) "Guidelines for Teaching Pain Control and
Sedation to Dentists and Dental Students", 2007 Edition;
(k) "Application for Intravenous Access Line
Registration", July 2010;
(l)
"Application for Laser Debridement Registration", July 2010; and
(m) "Application for Public Health Registered
Dental Hygienist", May 2013.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Kentucky Board of
Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222,
Monday through Friday, 8 a.m. through 4:30 p.m. This material is also available
on the board's Web site at http://dentistry.ky.gov.
Notes
STATUTORY AUTHORITY: KRS 214.615(2), 313.021(1)(a) - (c), 313.040(1), (2), (7), 313.254
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