<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.44.27.04" title_num="10" subtitle_num="44" chapter_num="27" heading="Guidelines for Operating under General Supervision in a Private Dental Office.">
  <paragraph num="A.">
    <text>In addition to the requirements contained in Health Occupations Article, §4-308(l), Annotated Code of Maryland, if a dental hygienist works under general supervision in a private dental office where a dentist is not on the premises while authorized dental hygiene services are provided, the requirements in §§B—F of this regulation shall be met.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Both the private dental office and the dental hygienist shall maintain written documentation of at least 1,500 hours of dental hygiene clinical practice in direct patient care before commencing practice.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Before an appointment, the patient or the custodial parent or legal guardian of a minor or incompetent adult shall:</text>
    <paragraph num="(1)">
      <text>Be informed that a dental hygienist will be providing services previously prescribed by a dentist who will not be on the premises during the appointment; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Consent in writing to receiving the dental hygiene services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>A copy of the signed consent shall be maintained in the patient's record.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The number of unsupervised clinical hours worked by a dental hygienist in any given 3-month period shall be less than 60 percent of the dental hygienist’s total hours worked during that 3-month period. To insure compliance with this provision, the supervising dentist and the dental hygienist shall maintain a written record of the dental hygienist’s total monthly hours worked and the total number of monthly hours worked by the dental hygienist when a dentist was not on the premises.</text>
  </paragraph>
  <paragraph num="F.">
    <text>A supervising dentist may not have more than two dental hygienists working under the dentist's general supervision at any given time, regardless of the number of offices in which the supervising dentist practices dentistry.</text>
  </paragraph>
</regulation>