This chapter governs the practice of dental hygiene in a private dental office. The practice of dental hygiene in a facility is governed by COMAR 10.44.21. In this chapter, the following term has the meaning indicated. Term Defined. “General supervision” means the supervision of a dental hygienist by a dentist in a private dental office where the dentist may or may not be present when the dental hygienist performs the dental hygiene procedures. While it is effective, a general license to practice dental hygiene issued under Health Occupations Article, Title 4, Annotated Code of Maryland, authorizes the licensee to practice dental hygiene under the general supervision of a licensed dentist in a private dental office pursuant to the provisions of Health Occupations Article, §4-308(i), Annotated Code of Maryland. 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. 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. Before an appointment, the patient or the custodial parent or legal guardian of a minor or incompetent adult shall: 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 Consent in writing to receiving the dental hygiene services. A copy of the signed consent shall be maintained in the patient's record. 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. 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. A violation of this chapter by a dentist or dental hygienist is unprofessional conduct. Health Occupations Article, §4-308, Annotated Code of Maryland; Ch. 221, Acts of 2003 Effective date: December 11, 2003 (30:24 Md. R. 1743) Regulation .04E amended effective March 3, 2014 (41:4 Md. R. 301)