Regulation .10 Long-Term Care Facilities.
Regulation .10 Long-Term Care Facilities.LinkCopy Citation
A.
A dental hygienist may practice dental hygiene under the general supervision of a dentist in a long-term care facility in accordance with this regulation.
B.
Initial Appointment. A dental hygienist practicing under the general supervision of a licensed dentist in a long-term care facility and performing an authorized dental hygiene service for a patient’s initial appointment shall:
(1)
Have a written agreement between the supervising dentist and the dental hygienist that clearly sets forth the terms and conditions under which the dental hygienist may practice, including a statement that the dental hygienist may provide dental hygiene services without the dentist on the premises; and
(2)
Ensure that the supervising dentist is available for consultation with the dental hygienist:
(a)
In person;
(b)
By telephone; or
(c)
Electronically.
C.
A dental hygienist working under general supervision in a long-term care facility shall:
(1)
Consult with the supervising dentist or a treating physician before proceeding with initial treatment if there has been a change in a recall patient’s medical history;
(2)
Assess the appropriate recall interval based on the individual needs of the patient or as otherwise recommended by the supervising dentist;
(3)
Limit dental hygiene tasks and procedures to:
(a)
Toothbrush prophylaxis;
(b)
Application of fluoride;
(c)
Dental hygiene instruction; and
(d)
Other duties as may be delegated, verbally or in writing, by the supervising dentist.
D.
A dental hygienist shall:
(1)
Assess the patient’s apparent need for further evaluation by a dentist in order to diagnose the presence of dental disease; and
(2)
Submit the findings of the initial assessment to the supervising dentist for a determination of future treatment.
E.
A dental hygienist may perform subsequent authorized dental hygiene services without the supervising dentist on the premises only if:
(1)
The supervising dentist examines the patient and authorizes in the patient’s record a prescription of specific treatment to be provided by the dental hygienist; and
(2)
An authorized treatment is provided by the dental hygienist as soon as possible, but no later than 7 months from the date the patient was examined by the supervising dentist.
F.
Upon expiration of a prescribed treatment, the supervising dentist is responsible for determining future protocols for the treatment of the patient.
G.
Qualifications of a Dental Hygienist. Before a dental hygienist is authorized to practice dental hygiene under general supervision in a long-term care facility, the dental hygienist shall:
(1)
Hold an active license to practice dental hygiene in the State;
(2)
Hold a current certificate evidencing Health Care Provider Level C Proficiency, or its equivalent, in cardiopulmonary resuscitation;
(3)
Have at least 2 years of active clinical practice in direct patient care; and
(4)
Ensure that the long-term care facility where the dental hygienist will practice under general supervision has:
(a)
A written medical emergency plan in place;
(b)
Adequate equipment, including portable equipment and appropriate armamentarium, available for the appropriate delivery of dental hygiene services; and
(c)
Adequate safeguards to protect the patient’s health and safety.
H.
Qualifications of a Dentist. Before a dental hygienist is authorized to practice dental hygiene under general supervision in a long-term care facility, the supervising dentist shall:
(1)
Hold an active general license to practice dentistry in the State;
(2)
Hold a current certificate evidencing Health Care Provider Level C Proficiency, or its equivalent, in cardiopulmonary resuscitation; and
(3)
Have at least 2 years of active clinical practice in direct patient care.
I.
This regulation may not be construed to:
(1)
Authorize a dental hygienist to practice dental hygiene independent of a supervising dentist;
(2)
Prohibit a dentist from being available for personal consultation or on the premises where a dental hygienist is practicing; or
(3)
Prohibit a dental hygienist, without the supervision of a dentist, from performing a preliminary dental examination with a subsequent referral to a dentist.
J.
Long-term care facilities are not required to obtain a waiver from the Board pursuant to Health Occupations Article, §4-308(e), Annotated Code of Maryland.
K.
Before a long-term care facility may allow a dental hygienist to practice dental hygiene, the facility shall report to the Board:
(1)
That the facility is operating under general supervision;
(2)
The identity of each dental hygienist providing dental hygiene services in the facility; and
(3)
The identity of each supervising dentist.