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
STATUTORY AUTHORITY: KRS 214.615(2),
313.021(1)(a) - (c), 313.040(1), (2), (7), 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 school-aged 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.
(37 Ky.R. 3027; 504; eff. 9-13-2011; 38 Ky.R. 1870; 39 Ky.R. 199; eff.
8-15-2012; TAm. 5-22-2013; 40 Ky.R. 2338; 2683; eff. 6-18-2014.)
