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<chapter num="36" heading="Private Dental Offices—Infection Control" title_num="10" subtitle_num="44">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“CDC Guidelines” means the Centers for Disease Control and Prevention Guidelines for Infection Control in Dental Health-Care Settings—2003.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Practice dentistry” has the meaning stated in Health Occupations Article, §4-101, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Private dental office” has the meaning stated in Health Occupations Article, §4-308, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Standard and transmission based precautions” means the minimum infection control prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Supervising dentist” means a dentist licensed in the State, including a solo practitioner, who is responsible for all infection control activities within a private dental office as set forth in this chapter.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Incorporation by Reference.">
    <text>Guidelines for Infection Control in Dental Health-Care Settings—2003 (Morbidity and Mortality Weekly Report (MMWR): Recommendations and Reports, 2003; v. 52; no. 17, Centers for Disease Control and Prevention (CDC, Atlanta, GA)) is incorporated by reference.</text>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Supervising Dentist—Board Registration.">
    <paragraph num="A.">
      <text>Each owner of a private dental office shall designate a licensed dentist to be the supervising dentist for the private dental office.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A supervising dentist designated under §A of this regulation shall:</text>
      <paragraph num="(1)">
        <text>Complete the registration required by the Board on a form provided by the Board; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Be responsible for all infection control activities within the private dental office.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>If a supervising dentist for a private dental office relinquishes the supervising dentist’s responsibilities under §B(2) of this regulation, for any reason, the owner of the private dental office shall immediately designate an interim supervising dentist who shall be responsible for all infection control within the private dental office until a new supervising dentist for the private dental office registers with the Board.</text>
    </paragraph>
    <paragraph num="D.">
      <text>An interim supervising dentist may remain an interim supervising dentist for no more than 45 calendar days prior to the registration of a subsequent supervising dentist.</text>
    </paragraph>
    <paragraph num="E.">
      <text>The responsibilities of a supervising dentist set forth in this regulation is not considered the practice of dentistry.</text>
    </paragraph>
    <paragraph num="F.">
      <text>This regulation may not be construed to prevent an unlicensed individual from assisting with regulatory compliance consistent with Health Occupations Article, §4-103(e)(12), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="G.">
      <text>The Board may charge a fee not to exceed the fee set forth in COMAR 10.44.20 for the registration and any subsequent registrations of supervising dentists.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Display of Registration.">
    <text>The owner of a private dental office shall display the name of the supervising dentist and the name of the interim supervising dentist, if applicable, conspicuously in the office on the form provided by the Board.</text>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Supervising Dentist—Infection Control Activities.">
    <paragraph num="A.">
      <text>The supervising dentist in a private dental office shall be responsible for the following infection control activities:</text>
      <paragraph num="(1)">
        <text>Adherence to the CDC Guidelines in their individual capacity as described in Regulation .06 of this chapter;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The provision and accessibility of sufficient and appropriate:</text>
        <paragraph num="(a)">
          <text>Personal protective equipment including but not limited to:</text>
          <paragraph num="(i)">
            <text>Gloves;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Masks;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Eyewear; and</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Gowns;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>Hand soaps and hand scrubs;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Puncture-resistant sharps containers located in close proximity to where they are to be used;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Products for cleaning and disinfecting environmental surfaces that are approved by the Environmental Protection Agency or its successor;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Periodic water quality testing to ensure that water meets Environmental Protection Agency regulatory standards for drinking water;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Sterilization monitoring of reusable dental equipment and instruments in accordance with the manufacturer’s instructions for use, including:</text>
          <paragraph num="(i)">
            <text>Biological spore testing;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Chemical monitoring; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Mechanical monitoring;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(g)">
          <text>Maintenance of a biohazard waste removal contract for the office; and</text>
        </paragraph>
        <paragraph num="(h)">
          <text>Signage for patient waiting areas for those exhibiting symptoms of respiratory infection.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>In addition to the activities set forth in §A of this regulation, a supervising dentist shall be responsible for the training of clinical staff upon hire and before engaging in clinical duties, and at minimum, annually.</text>
    </paragraph>
    <paragraph num="C.">
      <text>The training of clinical staff shall include training regarding:</text>
      <paragraph num="(1)">
        <text>Standard and transmission based precautions;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Hand hygiene;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Personal protective equipment;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Respiratory hygiene/cough etiquette;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Sharps safety;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Safe injection practices;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Sterilizing and disinfecting clinical contact and housekeeping surfaces;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Spore testing;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Water quality testing; and</text>
      </paragraph>
      <paragraph num="(10)">
        <text>The Occupational Safety and Health Administration Bloodborne Pathogens Standard as set forth in 29 C.F.R. §1910.1030.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A supervising dentist shall ensure that evidence-based written policies and procedures, based upon current CDC Guidelines, regulatory requirements, and other relevant guidance documents, are developed, maintained, and readily available for review by the office’s clinical staff.</text>
    </paragraph>
    <paragraph num="E.">
      <text>The policies and procedures referred to in §D of this regulation shall be updated either annually or more often if appropriate, to reflect new evidence, guidelines, or regulatory requirements.</text>
    </paragraph>
    <paragraph num="F.">
      <text>A supervising dentist shall maintain adequate written records of the activities set forth in §§A—E of this regulation in each office for which the records apply.</text>
    </paragraph>
    <paragraph num="G.">
      <text>A supervising dentist who practices clinical dentistry shall, for their own practice of dentistry, be responsible for all infection control activities in the dental office including those activities that are not considered structural infection control or those that do not impact the entirety of the private dental office.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Individual Dentist Responsibilities.">
    <text>Notwithstanding the responsibilities of a supervising dentist set forth in Regulation .05 of this chapter, an individual dentist who is not a supervising dentist shall be responsible for infection control activities in the control of the individual dentist including:</text>
    <paragraph num="A.">
      <text>Use of adequate personal protective equipment; and</text>
    </paragraph>
    <paragraph num="B.">
      <text>Sterilization of instruments.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Violations.">
    <text>Violations of this chapter constitutes unprofessional conduct and may result in disciplinary action against a dentist as set forth in Health Occupations Article, §4-315, Annotated Code of Maryland.</text>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §§4-104 and 4-205(c)(1)(v), Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: January 19, 2026 (53:1 Md. R. 23))</annotation>
  </annotations>
</chapter>