These regulations govern the continuing education requirements for dentists and dental hygienists seeking renewal of their licenses. In this chapter, the following terms have the meanings indicated. Terms Defined. Advanced Clinical Training Program. “Advanced clinical training program” means: A program of postgraduate training developed, offered, and sponsored by the University of Maryland Dental School as part of its curriculum for dental students or dental school graduates; A program of postgraduate training offered by the University of Maryland Dental School as continuing education for licensed dentists; or A program of postgraduate training offered by an approved continuing education sponsor or its equivalent as provided in Regulation .08 of this chapter. “Advanced clinical training program” includes clinical treatment provided to a patient by a student of dentistry while under the supervision of the training faculty. “Board” means the State Board of Dental Examiners. “Continuing education” means any eligible course or program approved by the Board. “Cultural competency” means courses or programs that teach a defined set of values, principles, demonstrated behaviors, attitudes, policies, and structures that will increase a licensee’s ability to work effectively in a cross-cultural manner. “Direct supervision” means that the supervising dentist personally: Diagnoses the condition to be treated; Authorizes the procedure; and Examines the patient before dismissal. “Licensee” means a licensed dentist or a licensed dental hygienist. “Significant change” means a change in a Board-approved continuing education program that in the sole discretion of the Board produces a measurable change in the course material or course objectives. “Student of dentistry” means: A student enrolled in a doctoral program in an accredited dental school with a curriculum leading to either a Doctor of Dental Surgery or Doctor of Dental Medicine degree; A graduate of a dental doctoral program enrolled in an advanced dental education program offered as a course of one semester or longer by the University of Maryland Dental School; A dentist licensed in Maryland who enrolls in an advanced clinical training program offered as a continuing education program for licensed dentists; A dentist licensed in another state, who does not hold a Maryland dental license and who: Enrolls in an advanced clinical training program offered as a continuing education program for licensed dentists; and Receives written approval from the Board to participate in the advanced clinical training program; A dentist licensed in Maryland who enrolls in an advanced clinical training program offered as continuing education by an approved sponsor or its equivalent as provided in Regulation .08 of this chapter; or A dentist licensed in another state, who does not hold a Maryland dental license and who: Enrolls in an advanced clinical training program offered as continuing education by an approved sponsor or its equivalent as provided in Regulation .08 of this chapter; and Receives written approval from the Board to participate in the advanced clinical training program. “Webinar” means a live seminar or other presentation for continuing education credit that takes place on the Internet, allowing participants in different locations to see and hear the presenter and ask questions and receive responses in real time. The licensee shall: Maintain for 5 years accurate records of continuing education courses or programs in which the licensee has participated under these regulations; and Make continuing education records available to the Board or the Board's representative or representatives on request. On a renewal form provided by the Board, a licensee shall verify compliance with this regulation. All continuing education credits shall be pre-approved by the Board. A licensee seeking renewal shall complete at least 30 full hours of Board-approved continuing education. Of the 30 hours of Board-approved continuing education, a minimum of 13 hours shall be completed with attendance at: In-person Board-approved courses or programs; or Webinars. To be considered for Board approval, a webinar shall: Be designed to enhance the licensee’s clinical knowledge and ability to treat dental patients; Be presented in real time; Allow all participants an opportunity to interact with the instructor; and Allow the participants an ample opportunity to ask questions and receive responses in real time. A pre-recorded webinar viewed by a licensee that otherwise meets the requirements of this chapter may be considered by the Board for continuing education credit toward the 17 hours that do not require in-person attendance. A maximum of 17 hours of Board-approved continuing education may be earned for self-study activities, including: Preparing and presenting table clinics; Preparing lectures; and Preparing articles for publication in dental journals. Continuing education courses and programs shall meet the criteria established in Regulation .06 of this chapter. A licensee shall maintain written documentation of successful completion of continuing education programs for 5 years. A licensee may not receive continuing education credit for a course or program that was: Not Board-approved; or Completed before the course or program gained Board approval. Unless otherwise provided in this chapter, the Board may not accept a submission for continuing education credit of less A licensee shall maintain cardiopulmonary resuscitation certification from one of the following programs: The American Heart Association's Basic Life Support for Healthcare Providers; The American Red Cross's Cardiopulmonary Resuscitation for Professional Rescuers; or An equivalent program approved by the Board. A licensee seeking renewal shall complete a Board- approved course of 2 hours in infection control. A licensee seeking renewal in 2025 and thereafter shall complete a Board-approved course of 3 hours in infection control every renewal cycle. A licensee seeking renewal shall complete a Board-approved course of 2 hours in abuse and neglect. The 2-hour, Board-approved course in abuse and neglect required by §N of this regulation shall: Be completed by each licensee every other renewal cycle; Relate to Maryland law on the subject of abuse and neglect; and Count toward the 30 full hours of required continuing education. A dentist seeking renewal shall complete a 2-hour Board- approved course on proper prescribing and disposal of prescription drugs, which shall count toward the 30 full hours of required continuing education. A dentist seeking renewal shall complete a 2-hour Board- approved course on proper prescribing and disposal of prescription drugs, which shall count toward the 30 full hours of required continuing education. Optional Pro Bono Program. A licensee seeking renewal may receive up to 8 continuing education hours for providing volunteer pro bono dental or dental hygiene services in accordance with Regulation .07 of this chapter. Cultural Competency, Military Culture, and Implicit Bias Training. A licensee may receive up to a combined total of 4 continuing education hours for Board-approved courses on: Cultural competency; Military culture; or Implicit bias training. A licensee may receive up to 2 continuing education hours for Board-approved courses on abuse and neglect. A study club course shall first receive Board approval before attendees may receive continuing education credit for attendance at the study club meeting. Dentists and dental hygienists may receive one continuing education credit for attending a regularly scheduled open session Board meeting in its entirety. The Board shall issue a certificate of completion to dentists and dental hygienists who attend a regularly scheduled open session Board meeting in its entirety. A dentist or a dental hygienist may earn up to two continuing education credits per renewal period for attendance at regularly scheduled open session Board meetings. A licensee who has received a license within 6 months of graduation from an approved dental or dental hygiene school is not required to fulfill the continuing education requirements of the Board for the first renewal following initial licensure. A licensee who is on inactive status shall provide evidence of compliance with the continuing education requirements of the Board for the 2-year period preceding application for reactivation of the licensee's license. A licensee who fails to obtain the required continuing education due to disability or retirement shall comply with this regulation within 6 months of the licensee's return to practice. The infection control course identified in §M of this regulation shall be a single 3-hour course which teaches the practices contained in the document Centers for Disease Control and Prevention, Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, Atlanta, GA: Centers for Disease Control and Prevention, US Dept. of Health and Human Services; October 2016, or its successor document. A. The period for completing continuing education requirements extends for a 2-year period from July 1 through June 30 of the second year following the effective date of the license. The 2-year period in which the continuing education shall be completed ends on June 30 of the year in which the license is due for renewal. For the renewal period beginning on June 1, 2025, only, the period for completing continuing education requirements extends for the period January 1, 2023, through June 30, 2025. Eligibility Guidelines. General. With the exceptions listed in §A(2) of this regulation, only those courses or programs that satisfy the following eligibility guidelines qualify for continuing education credit for license renewal: The course or program is designed to enhance the licensee's clinical knowledge and ability to treat dental patients; and The course or program is offered by a Board-approved sponsor. Abuse and Neglect Courses, Cultural Competency Courses, Military Culture Courses, Implicit Bias Training Courses, and Pro Bono Programs. To qualify for continuing education credit for license renewal: The mandatory course in abuse and neglect identified in Regulation .04N and O of this chapter: Does not need to be designed to enhance the licensee’s clinical knowledge and ability to treat dental patients; and Shall be offered by a Board-approved sponsor; Cultural competency courses: Do not need to enhance the licensee’s clinical knowledge; and Shall be offered by a Board-approved sponsor; Military culture courses: Do not need to enhance the licensee’s clinical knowledge; and Shall be offered by a Board-approved sponsor; Implicit bias training courses: Do not need to be designed to enhance the licensee’s clinical knowledge and ability to treat dental patients; and Shall be approved by the Maryland Office of Minority Health and Health Disparities. Pro bono programs: Do not need to enhance the licensee’s clinical knowledge and ability to treat dental patients; and Shall be offered by a Board-approved sponsor. Excluded Courses and Programs. Courses and programs that are not approved for continuing education credit for license renewal include, but are not limited to, the subjects of: Money management; Personal finance; Personal business matters; With the exception of those courses or programs on cultural competency, military culture, and implicit bias training courses, cultural subjects; Personal health and recreation; Politics; Memory training; and Speed reading. Beginning on the effective date of this regulation dentists or dental hygienists may receive continuing education credit for providing volunteer pro bono dental and dental hygiene services within the State as provided in this regulation. A dentist or dental hygienist may provide volunteer pro bono care at a Board-approved program that: Is a non-profit entity or event; and Provides substantial pro bono dental services to the indigent or dentally underserved populations. With the exception of food, lodging, and parking fees, a dentist or dental hygienist may not receive direct or indirect remuneration of any kind, including but not limited to remuneration for materials purchased or used. With the exception of those pro bono services provided at a dentist’s or dental hygienist’s office as outlined in §E of this regulation, the program shall require a dentist or dental hygienist to sign in and sign out daily upon commencement and termination of the provision of services. A dentist or dental hygienist may provide pro bono services for continuing education credit at the dentist’s or dental hygienist’s office: If the patient is referred to the dentist or dental hygienist by a Board-approved nonprofit entity that provides substantial pro bono dental services to the indigent or dentally underserved populations; and If the Board provides prior approval of the provision of the dental or dental hygiene services. Continuing education credit shall be calculated based on the time a dentist or dental hygienist has actually dedicated to the performance of dental or dental hygiene services. Continuing education credit shall be calculated at the ratio of 1 continuing education credit for each 60 minutes of patient services. Credit may not be provided for missed appointments. Board-approved nonprofit entities that provide substantial dental services for continuing education credit shall: Retain patient records; Retain documentation of all pro bono assignments and the hours of service provided; and Provide the records and a copy of the assignments and the hours of service provided to the Board upon request. The Board may revoke the approval status of any nonprofit entity that fails to cooperate with the Board. A dental hygienist who provides pro bono dental services shall work under the direct supervision of a dentist. A dentist or dental hygienist that is employed by a nonprofit entity that provides substantial pro bono dental services to the indigent or dentally underserved populations may not obtain credit for pro bono services at the entity at which the dentist or dental hygienist is employed, but may receive credit for qualified pro bono services at other nonprofit entities. A dentist who is a Board-recognized specialist and who has announced a specialization shall limit the pro bono services exclusively to the announced special areas. In accordance with COMAR 10.44.12, a dentist may administer general anesthesia or sedation only with the appropriate Board permit issued for the specific practice location at which the dentist wishes to administer general anesthesia or sedation. A dental hygienist may administer local anesthesia by infiltration only with the appropriate Board recognition. A dentist and dental hygienist who provide pro bono dental services shall: Maintain proof of such services for at least 5 years on a Board-approved form; and Provide documentation of the services to the Board on request. A dentist or dental hygienist who fails to maintain accurate and complete records of services rendered may not receive continuing education credit for those services. A dentist shall use a Board-approved form for patients with clear instructions for any follow-up care. A dentist or a dental hygienist under a formal or informal Board order or agreement that provides for the provision of pro bono services may not receive continuing education credit for the provision of the pro bono services. Failure to comply with the provisions of this regulation constitutes unprofessional conduct. The Board approves for credit any course or program that: Satisfies all eligibility criteria in Regulations .06 and .07 of this chapter; and Is sponsored by any one of the following entities: An accredited dental school; An accredited dental hygiene school; The American Dental Association; The National Dental Association; The American Dental Hygienists' Association; The National Dental Hygiene Association; The American Medical Association; The American Hospital Association; The American Heart Association; The American Red Cross; The American Society of Dentistry for Children; Any American Dental Association recognized specialty society; The Academy of General Dentistry; The Veterans Administration; The United States uniformed services; The U.S. Department of Health and Human Services; The Maryland Department of Health; Any American Medical Association recognized specialty society; The Mid-Atlantic PANDA Coalition; and Any constituent or component organization of the groups in §A(2)(a)—(s) of this regulation. The Board approves for credit any course or program that is designed to enhance the licensee’s clinical knowledge and ability to treat dental patients and is approved by any one of the following credentialing agencies: The American Dental Association Commission for Continuing Education Recognition Program (CERP); The Academy of General Dentistry Program Approval for Continuing Education (PACE); The American Association of Dental Boards Accredited Continuing Education Program (ACE); and The American Academy of Dental Hygiene (AADH). The Board may approve individual programs of sponsors who are not automatically approved sponsors of continuing education credits under Regulation .08 of this chapter. Applicants meeting the requirements of this chapter, who are not automatically approved to sponsor continuing education programs may apply to the Board at least 90 days before the scheduled program for authorization to sponsor a program. The Board shall provide the applicant with an application form. An applicant shall provide the following information on the application which shall be submitted to the Board along with a processing fee as set forth in COMAR 10.44.20: Full name, business address, and contact information of the sponsor; Full name of the program for which approval is sought; A program description; Program objectives; A detailed syllabus of the course; Continuing education hours requested; An overview of any examinations that shall be passed as a condition of program completion; and A sample of the certificate of completion that will be provided to program participants. In addition to the requirements of §D of this regulation, the applicant shall provide the following to the Board regarding the program presenter or speaker: Full name, business address, and contact information; Current curriculum vitae; Educational background and all professional degrees earned; A list of all professional licenses or certifications held; A brief description of any other professional programs taught; and A copy of any public disciplinary orders issued by any health occupational board, including the Maryland Dental Board. The Board shall give notice to the applicant that the applicant has been approved or disapproved, including a statement whether the number of approved continuing education hours is different from the number requested. If a program is disapproved, the Board shall advise the applicant of the reasons for disapproval. An approval of a particular program is an approval of the program and the presenter or speaker of that program. A sponsor shall resubmit an application and pay a processing fee for approval of the program if: The presenter or speaker changes; or There is a significant change in the course material or course objectives. Fees for approval of a continuing education program are nonrefundable. A licensee or certificate holder under a Board order may not present a continuing education course or program during the pendency of their Board order. A sponsor of a Board-approved continuing education program shall: Maintain records of all attendees for at least 5 years; Provide copies of program attendance to the Board upon request; Provide attendees with an opportunity to complete a program evaluation at the conclusion of the program, which shall be provided to the Board upon request; and Allow the Board to audit the program upon payment of any applicable program fees. The Board may rescind approval of a continuing education course or program if it determines that: The course or program: Does not meet the requirements of Regulations .06 and .07 of this chapter; or In the Board’s sole discretion, does not meet its stated objectives; or The sponsor has committed fraud or made other misrepresentations to the Board. Legible certificates of program completion shall be provided to those who complete the program and shall contain at least: The full name of the sponsor; The full name of the program; The dates of program presentation; The location of the program, including whether the program was presented electronically; The number of continuing education hours awarded, which may not exceed those approved by the Board; The printed name and signature of the presenter or speaker; A statement that the program is approved by the Board; The Board’s program approval number; and A statement that the sponsor maintains responsibility for the program. A dentist licensed in another state who does not hold a Maryland dental license and who wishes to participate in an advanced clinical training program of postgraduate training offered as continuing education for licensed dentists shall receive written approval from the Board before participation in the advanced clinical training program as provided in Regulation .10B of this chapter. At least 45 days before the commencement of an advanced clinical training program of postgraduate training offered as continuing education for licensed dentists, a dentist who is licensed in another state and who is not licensed in Maryland shall apply to the Board for written approval to participate in the advanced clinical training program as provided in Regulation .10A of this chapter. To qualify to participate in an advanced clinical training program, a dentist who is licensed in another state and who does not hold a Maryland dental license shall hold a degree of Doctor of Dental Surgery or Doctor of Dental Medicine, or the equivalent, from a college or university that is authorized by any state or province of Canada to grant the degree. To apply for written approval to participate in an advanced clinical training program offered as continuing education for licensed dentists, a dentist licensed in another state who does not hold a Maryland dental license shall: Apply to the Board on a form approved by the Board; Pay a nonrefundable fee to the Board as set forth in COMAR 10.44.20; Submit to the Board a copy of the applicant's National Practitioner Data Bank file; Submit documentation of change of name if the name on any of the documents submitted to the Board differs from the applicant's name; and Submit any other pertinent documents or information requested by the Board. After review of the documentation and other pertinent information provided to the Board, the Board shall provide the applicant with a written notice stating that the application to participate in the advanced clinical training program has been approved or denied. The Board's approval or denial of an application to participate in an advanced clinical training program shall apply only to the advanced clinical training program for which the applicant has made application. A dentist whose application to participate in an advanced clinical training program for continuing education has been approved shall be covered by a policy of malpractice insurance during the period in which the dentist participates in the advanced clinical training program. An individual who is a student of dentistry under Regulation .02B(6)(d) and (f) of this chapter may only practice dentistry in Maryland in accordance with the advanced clinical training program. Successful completion of a Board-approved examination within the preceding 2-year period may be substituted for continuing education credits. The Board recognizes successful completion of the following written examinations as equivalent to 30 full hours of continuing education: For dental hygienists only, the North East Regional Board's (NERB) Dental Hygiene Comprehensive Examination; NERB's Simulated Clinical Examinations; Academy of General Dentistry's Fellowship Examination; Examinations leading to recognized specialty boards' Diplomate status; National Board's Part II examination; Central Regional Dental Testing Agency's written examinations; South East Regional Testing Agency's written examinations; or Western Regional Examining Board's written examination. A dentist or dental hygienist who has completed the continuing education requirements shall attest to the completion on a form supplied by the Board as part of the application for license renewal, reinstatement, or reactivation. The Board may request verification of compliance with this chapter through inspection of continuing education records maintained by licensees in accordance with Regulation .03A of this chapter. Except as provided in this regulation, the Board shall audit a percentage of dentists and dental hygienists, selected by the Board for each renewal cycle. A licensee who receives notice of a continuing education audit shall verify compliance with this chapter by the date specified in the notice and submit to the Board a report of the continuing education hours required for renewal on a form approved by the Board along with the appropriate documentation. Documentation. A dentist or dental hygienist shall provide to the Board: A certificate of completion for approved courses or programs; Current CPR certification as specified under Regulation .04 of this chapter; If applicable, proof of Board-approved pro bono dental or dental hygiene services provided; and If a certificate of completion is not available, satisfactory proof of time spent preparing and presenting table clinics, lectures, articles for publications in dental or medical journals, or attending study clubs, or other meetings involved with performing clinical dentistry. A dentist or a dental hygienist may request an extension of time to comply with the requirements of this chapter. A request for an extension of time under §F of this regulation shall: Be made in writing; Detail and document the reasons the licensee was not able to complete the continuing education requirements within the allotted time; and Provide a period of time requested by the licensee to complete the required continuing education. The grant of an extension and the period of the extension is within the sole discretion of the Board. A dentist or dental hygienist who requests and is granted an extension of time by the Board shall be audited at the next renewal cycle. A dentist or dental hygienist granted an extension of time shall attest to completion of continuing education requirements by the end of the extension period. Failure to submit the required attestation or failure to meet continuing education requirements by the end of the extension period may subject the licensee to disciplinary action. The Board’s staff shall conduct a preliminary review and evaluation of the documentation submitted to the Board and report their findings to the Board. After the Board’s review of the submitted documentation, the Board may find one or both of the following: That the dentist or dental hygienist has not met the Board’s continuing education requirements; or That the dentist or dental hygienist has submitted courses or programs that have not been Board-approved. The Board may require a dentist or a dental hygienist who has not met the Board’s continuing education requirements or who has submitted courses or programs that have not been Board-approved to take additional continuing education courses or programs in order to meet the Board’s continuing education requirements. Penalties for Violation. A false, misleading, or deceptive statement on a renewal, reinstatement, or reactivation form may constitute unprofessional conduct and may result in disciplinary action against the licensee as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland. Failure to complete continuing education requirements within the time period specified under Regulation .05 of this chapter or any applicable extension constitutes unprofessional conduct and may result in disciplinary action against the licensee as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland. The Board may waive any or all of the requirements of this chapter for a licensee who is unable to complete the requirements due to the licensee's active military service. Health Occupations Article, §4-205, Annotated Code of Maryland Effective date: Regulations .01—.09 adopted as an emergency provision effective November 25, 1992 (19:25 Md. R. 2199); adopted permanently effective May 26, 1993 (20:6 Md. R. 581) Regulation .04 amended effective July 12, 1998 (25:14 Md. R. 1132) Regulation .09B amended effective June 25, 2001 (28:12 Md. R. 1110) Chapter revised effective January 5, 2004 (30:26 Md. R. 1915) Regulation .10 recodified to be Regulation .11 and new Regulation .10 adopted effective June 21, 2004 (31:12 Md. R. 913) Chapter revised effective July 17, 2006 (33:14 Md. R. 1164) Regulation .04 amended effective January 26, 2009 (36:2 Md. R. 101) Regulation .06A amended effective January 26, 2009 (36:2 Md. R. 101) Regulation .07 amended effective January 26, 2009 (36:2 Md. R. 101) Chapter revised effective April 18, 2011 (38:8 Md. R. 506) Regulation .02B amended effective March 18, 2013 (40:5 Md. R. 411); March 3, 2025 (52:4 Md. R. 218) Regulation .04 amended effective October 13, 2014 (41:20 Md. R. 1112); March 3, 2025 (52:4 Md. R. 218) Regulation .04D-1 adopted effective March 18, 2013 (40:5 Md. R. 411) Regulation .05 amended effective March 3, 2025 (52:4 Md. R. 218 Regulation .06 amended effective March 3, 2025 (52:4 Md. R. 218) Regulation .06A amended effective October 13, 2014 (41:20 Md. R. 1112) Regulation .08 amended March 3, 2025 (52:4 Md. R. 218) Regulation .08C amended effective October 13, 2014 (41:20 Md. R. 1112) Regulation .09 adopted effective March 3, 2025 (52:4 Md. R. 218) Regulations .09—.11 recodified to Regulations .11—.13 and Regulation .13 to be Regulation .15 effective March 3, 2025 (52:4 Md. R. 218) Regulation .10 adopted effective March 3, 2025 (52:4 Md. R. 218) Regulation .12 repealed effective March 3, 2025 (52:4 Md. R. 218) Regulation .14 repealed and new Regulation .14 adopted effective March 3, 2025 (52:4 Md. R. 218)