An Act Regarding the Sunrise Review of Oral Health Care Issues
Maine Legislature, Session 123, LD 2277
Committee: Business, Research and Economic Development
Amends: 32 MRSA §1078, 32 MRSA §1079, 32 MRSA §1062-A, 32 MRSA §1081, 32 MRSA §1094-D, 32 MRSA §1100-A, 32 MRSA §1100-C, 13 MRSA §732

Legislative Document 
No. 2277 
H.P.1643 
House of Representatives, March 26, 2008 
An Act Regarding the Sunrise Review of Oral Health Care Issues 
Reported by Representative SMITH of Monmouth for the Joint Standing Committee on 
Business, Research and Economic Development pursuant to Resolve 2007, chapter 85, section 
2. 
Reference to the Committee on Business, Research and Economic Development suggested 
and ordered printed under Joint Rule 218. 
Pfllllt.:J ()!l recycleJ paper 
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MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-I. 32 MRSA §1078, as enacted by PL 2003, c. 669, §3, is amended to 
read: 
§1078. Subcommittee on Denturists 
The Subcommittee on Dent\uist Discipline Denturists, referred to in this section as 
"the subcommittee," is established as follows. 
1. Membership. The subcommittee consists of 5 members as follows: 
A. The denturist who is a member of the board; 
lOB. Two denturists, appointed by the Governor, who are qualified pursuant to 
II 
subchapter 6, are legal residents of the State and, for appointments made after 
January I, 2006, have practiced in the State for at least 6 years immediately 
preceding appointment; and 
C. Two dentists who are members of the board, appointed by the president of the 
board. 
The subcommittee shall annually elect a chair and a secretary. 
2. Terms. Each of the 3 members of the subcommittee who also are members of the 
board shall serve on the subcommittee for the duration of that member's term on the 
board. The term of a member of the subcommittee who is not a member of the board is 5 
years. 
3. Duties. The subcommittee shall perform an initial revievi of all complaints 
initiated pursuant to section 1077 involving denturists. Upon completion of its review of 
a complaint, the secretary of the subcommittee shall report to the board the 
subcommittee's recommended disposition of the complaint in accordance 'Nith those 
dispositions authorized by seetion 1 077. 
~Jotwithstanding the provisions of seetion 1077, 
the board shall adopt the subcommittee's recommended disposition of a complaint unless 
no fe'i'ier than 2/3 of the board members who are present and voting vote to reject that 
recommended disposition. ~ 
A. Perform an initial review of all complaints initiated pursuant to section 1077 
involving denturists. Upon completion of its review of a complaint, the secretary of 
the subcommittee shall report to the board the subcommittee's recommended 
disposition of the complaint in accordance with those dispositions authorized by 
section 1077. Notwithstanding the provisions of section 1077, the board shall adopt 
the subcommittee's recommended disposition of a complaint unless no fewer than 2/3 
of the board members who are present and voting vote to reject that recommended 
disposition; 
B. Perform an initial review of all applications for licensure as a denturist pursuant to 
section 1100-0 and all submissions relating to continuing education of denturists 
Page I - 123LR3569(OI)-1 
pursuant to section 1100-E-1. Upon completion of its review of an application or 
submission, the secretary of the subcommittee shall repost to the board the 
subcommittee's recommended disposition of the application or submission, including 
issuance, renewal, denial or nonrenewal of a denturist license. Notwithstanding the 
provisions of section 1100-E, the board shall adopt the subcommittee's recommended 
disposition of an application or submission unless no fewer than 2/3 of the board 
members who are present and voting vote to reject that recommended disposition; 
and 
C. Adopt rules in accordance with the Maine Administrative Procedure Act that are 
necessary for the implementation of the provisions of this chapter dealing with 
denturists. 
Rules adopted pursuant to this section are routine technical rules as 
defined in Title 5, chapter 375, subchapter 2-A. The rules may include, but are not 
limited to, requirements for licensure, interviews for licensing and renewal, 
continuing education and inactive licensure status. 
4. Compensation. The members of the subcommittee are entitled to compensation 
according to the provisions of Title 5, chapter 379. 
Expenses of the subcommittee 
members must be certified by the secretary of the board. 
Sec. A-2. 32 MRSA §1079, sub-§5 is enacted to read: 
5. 
Rules. 
The subcommittee shall adopt rules in accordance with the Maine 
Administrative Procedure Act that are necessary for the implementation of the provisions 
of this chapter dealing with dental hygienists. Rules adopted pursuant to this subsection 
are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A. The rules 
may include, but are not limited to, requirements for licensure, interviews for licensing 
and renewal, continuing education and inactive licensure status. 
PART B 
Sec. B-1. 32 MRSA c. 16, sub-c. 3-B is enacted to read: 
SUBCHAPTER 3-B 
INDEPENDENT PRACTICE DENTAL HYGIENISTS 
§1094-1. Independent practice 
An independent practice dental hygienist licensed by the board pursuant to this 
subchapter may practice without supervision by a dentist to the extent permitted by this 
subchapter. An independent practice dental hygienist, or a person employing one or more 
independent practice dental hygienists, may be the proprietor of a place where 
independent practice dental hygiene is performed and may purchase, own or lease 
equipment necessary for the performance of independent practice dental hygiene. 
~rson practicing independent practice dental hygiene as an employee of another 
shall cause that person's name to be conspicuously displayed at the entrance of the place 
where the practice is conducted. 
§1094-J. Qualifications for licensure 
To qualify for licensure under this subchapter as an independent practice dental 
hygienist, a person must: 
1. 18 years of age. Be 18 years of age or older; 
2. Licensure as dental hygienist. Possess a valid license to practice dental hygiene 
issued by the board pursuant to subchapter 4 or qualify for licensure as an independent 
practice dental hygienist by endorsement pursuant to section 1094-L; and 
3. Education and experience. Meet the educational and experience requirements 
described in section 1094-K. 
§1094-K. Education and experience 
An applicant for licensure under this subchapter as an independent practice dental 
hygienist must: 
1. Bachelor's degree and 2,000 hours experience. Possess a bachelor's degree 
from a dental hygiene program accredited by the American Dental Association 
Commission on Dental Accreditation, or its successor organization, and document one 
year or 2,000 work hours of clinical practice in a private dental practice during the 2 
years preceding application; or 
2. Associate degree and 6,000 hours experience. Possess an associate degree from 
a dental hygiene program accredited by the American Dental Association Commission on 
Dental Accreditation, or its successor organization, and document 3 years or 6,000 work 
hours of clinical practice in a private dental practice during the 6 years preceding 
application. 
§1094-L. Licensure by endorsement 
A person eligible for licensure as a dental hygienist by endorsement pursuant to 
section 1098-D, subsection 2 or 1099 is also eligible for licensure under this subchapter 
as an independent practice dental hygienist by endorsement if the applicant meets the 
education and experience requirements set forth in section 1094-K. 
§1094-M. Application 
An applicant for licensure as an independent practice dental hygienist shall apply to 
the board on forms provided by the board. The applicant shall include as part of the 
application such information and documentation as the board may require to act on the 
application. The application must be accompanied by the application fee set under section 
1094-0. 
§1094-N. License; biennial renewal; discontinuation of dental hygienist license 
The board shall issue a license to practice as an independent practice dental hygienist 
to a person who has met the requirements for licensure set forth in this subchapter and has 
paid the application fee under section 1094-0. There is an initial license fee only for 
independent practice dental hygienists licensed by endorsement. The license must be 
exhibited publicly at the person's place of business or employment. The initial date of 
expiration of the license is the original expiration date of the person's dental hygienist 
license issued by the board pursuant to subchapter 4 or, for independent practice dental 
hygienists licensed by endorsement, January 1 st of the first odd-numbered year following 
initial licensure. On or before January 1 st of each odd-numbered year, the independent 
practice dental hygienist shall pay to the board a license renewal fee. 
Independent 
practice dental hygienists who have not paid the renewal fee on or before January 1st 
must be reinstated upon payment of a late fee before February 1 st of the vear in which 
license renewal is due. 
Failure to be properly licensed by February 1 st results in 
automatic suspension of a license to practice as an independent practice dental hygienist. 
Reinstatement of the independent practice dental hygienist license may be made, if 
approved by the board, by payment of a reinstatement fee to the board. 
A dental hygienist license issued by the board pursuant to subchapter 4 of this chapter 
automatically expires upon issuance under this subchapter of an independent practice 
dental hygienist license to the same person. 
§1094-0. Fees 
The board may establish by rule fees for purposes authorized under this subchapter in 
amounts that are reasonable and necessary for their respective purposes, except that the 
fee for anyone purpose may not exceed $275. Rules adopted pursuant to this section are 
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A. 
§1094-P. Continuing education 
As a condition of renewal under this subchapter of a license to practice, an 
independent practice dental hygienist must submit evidence of successful completion of 
hours of continuing education consisting of board-approved courses in the 2 years 
preceding the application for renewal. The board and the independent practice dental 
hygienist shall follow and are bound by the provisions of section 1084-A in the 
implementation of this section. 
Continuing education completed pursuant to section 1098-B may be recognized for 
purposes of this section in connection with the first renewal of an independent practice 
dental hygienist license. 
The board mav refuse to issue a license under this subchapter to a person who has not 
completed continuing education required by section 1098-B or may issue the license on 
terms and conditions set by the board. 
§1094-0. Scope of practice 
1. Independent practice. An independent practice dental hygienist licensed under 
this subchapter may perform only the following duties without supervision by a dentist: 
A. Interview patients and record complete medical and dental histories; 
B. Take and record the vital signs of blood pressure, pulse and temperature; 
C. Perform oral inspections, recording all conditions that should be called to the 
attention of a dentist; 
D. Perform complete periodontal and dental restorative charting; 
E. 
Perform all procedures necessary for a complete prophylaxis, including root 
planing; 
F. Apply fluoride to control caries; 
G. Apply desensitizing agents to teeth; 
H. Apply topical anesthetics; 
1. Apply sealants; 
J. Smooth and polish amalgam restorations, limited to slow speed application only; 
K. Cement pontics and facings outside the mouth; 
L. Take impressions for athletic mouth guards and custom fluoride trays; 
M. Place and remove rubber dams; 
N. 
Place temporary restorations in compliance with the protocol adopted by the 
board; and 
O. Apply topical antimicrobials, excluding antibiotics, including fluoride, for the 
purposes of bacterial reduction, caries control and desensitization in the oral cavity. 
The independent practice dental hygienist shall follow current manufacturer's 
instructions in the use of these medicaments. 
For the purposes of this subsection, "topical" includes superficial and intraoral 
application. 
2. Practice under supervision. An independent practice dental hygienist licensed 
under this subchapter may perform duties under the supervision of a dentist as set forth in 
the rules ofthe board pursuant to section 1095. 
§1094-R. Responsibilities 
An independent practice dental hygienist licensed under this subchapter has the duties 
and responsibilities set out in this section with respect to each patient seen in an 
independent capacity pursuant to section 1094-0, subsection 1. 
1. Acknowledgment. Prior to an initial patient visit, an independent practice dental 
hygienist licensed under this subchapter shall obtain from the patient or the parent or 
guardian of a minor patient written acknowledgment of the patient's or parent's or 
guardian's understanding that the independent practice dental hygienist is not a dentist 
and that the service to be rendered does not constitute restorative care or treatment. 
2. Referral plan. An independent practice dental hygienist licensed under this 
subchapter shall provide to a patient or the parent or guardian of a minor patient a written 
plan for referral to a dentist for any necessary dental care. The referral plan must identify 
all conditions that should be called to the attention of the dentist. 
§1094-S. Mental or physical examination 
For the purposes of this section, by application for and acceptance of a license to 
practice under this subchapter, an independent practice dental hygienist is considered to 
have given consent to a mental or physical examination when directed by the board. The 
board may direct an independent practice dental hygienist to submit to an examination 
whenever the board determines the independent practice dental hygienist may be 
suffering from a mental illness that may be interfering with the competent independent 
practice of dental hygiene or from the use of intoxicants or drugs to an extent that they 
are preventing the independent practice dental hygienist from practicing dental hygiene 
competently and with safety to patients. An independent practice dental hygienist 
examined pursuant to an order of the board may not prevent the testimony of the 
examining individual or prevent the acceptance into evidence of the report of an 
examining individual. Failure to comply with an order of the board to submit to a mental 
or physical examination results in the immediate suspension of the license to practice 
independent dental hygiene by order of the District Court until the independent practice 
dental hygienist submits to the examination. 
§1094-T. Use offormer employers' lists 
An independent practice dental hygienist may not use or attempt to use in any manner 
whatsoever any prophylactic lists, call lists, records, reprints or copies of those lists, 
records or reprints, or information gathered from these materials, of the names of patients 
whom the independent practice dental hygienist might have served in the office of a prior 
employer, unless these names appear on the bona fide call or prophylactic list of the 
present employer and were caused to so appear through the independent practice of 
dentistry, denturism or independent practice dental hygiene as provided for in this 
chapter. A dentist, denturist or independent practice dental hygienist who employs an 
independent practice dental hygienist may not aid or abet or encourage an independent 
practice dental hygienist employed by such person to make use of a so-called 
prophylactic call list, or to call by telephone or to use written letters transmitted through 
the mails to solicit patronage from patients formerly served in the office of a dentist, 
denturist or independent practice dental hygienist that formerly employed the independent 
practice dental hygienist. 
PART C 
Sec. C-l. 32 MRSA §1062-A, suh-§l, as corrected by RR 1995, c. 2, §79, is 
amended to read: 
1. Penalties. A person who practices or falsely claims legal authority to practice 
dentistry, dental hygiene, independent practice dental hygiene, denturism or dental 
radiography in this State without first obtaining a license as required by this chapter, or 
after the license has expired, has been suspended or revoked or has been temporarily 
suspended or revoked, commits a Class E crime. 
I 
Sec. C-2. 32 MRSA §1081, sub-§2,~, as amended by PL 1993, c. 600, Pt. A, 
§63, is further amended to read: 
E. 
The filling of prescriptions of a licensed dentist by any person, assocIatIOn, 
corporation or other entity for the construction, reproduction or repair of prosthetic 
dentures, bridges, plates or appliances to be used or worn as substitutes for natural 
teeth, provided that this person, association, corporation or other entity does not 
solicit nor advertise, directly or indirectly, by mail, card, newspaper, pamphlet, radio 
or otherwise, to the general public to construct, reproduce or repair prosthetic 
dentures, bridges, plates or other appliances to be used or worn as substitutes for 
natural teeth; aOO 
Sec. C-3. 32 MRSA §1081, sub-§2, ~G, as amended by PL 1993, c. 600, Pt. A, 
§63, is further amended to read: 
G. 
The taking of impressions by dental hygienists, independent practice dental 
hvgienists or dental assistants for study purposes only"; and 
Sec. C-4. 32 MRSA §1081, sub-§2, ~ 
is enacted to read: 
H. Practice by an independent practice dental hygienist pursuant to subchapter 3-B. 
Sec. C-S. 32 MRSA § 1081, sub-§3, as amended by PL 2007, c. 2 I 0, §2, IS 
further amended to read: 
3. Proprietor. The term proprietor, as used in this chapter, includes a person who: 
A. 
Employs dentists or dental hygienists, independent practice dental hygienists, 
denturists or other dental auxiliaries in the operation of a dental office; 
B. 
Places in possession of a dentist or a dental hygienist, independent practice 
dental hygienist or other dental auxiliary or other agent dental material or equipment 
that may be necessary for the management of a dental office on the basis of a lease or 
any other agreement for compensation for the use of that material, equipment or 
office; or 
C. 
Retains the ownership or control of dental equipment or material or a dental 
office and makes the same available in any manner for the use by dentists or dental 
hygienists"..independent practice dental hygienists or other agents, except that nothing 
in this subsection applies to bona fide sales of dental equipment or material secured 
by a chattel mortgage or retain title agreement. A person licensed to practice dentistry 
may not enter into arrangements with a person who is not licensed to practice 
dentistry, with the exception of licensed denturists and independent practice dental 
hygienists, or the legal guardian or personal representative of a deceased or 
incapacitated dentist, pursuant to the provisions of Title 13, section 732. 
Sec. C-6. 32 MRSA §1081, sub-§6 is enacted to read: 
6. Dental hygienist. "Dental hygienist" or "independent practice dental hygienist," 
as used in this chapter, means a dental auxiliary licensed pursuant to subchapter 3-B or 4 
I 
who delivers preventive and educational services for the control of oral disease and the 
promotion of oral health within the scope of practice authorized by the person's license. 
Sec. C-7. 32 MRSA §l092, sub-§l, ~J, as enacted by PL 2003, c. 452, Pt. R, § I 
and affected by Pt. X, §2, is amended to read: 
J. 
Practice as a dental hygienist or independent practice dental hygienist without 
having a license to do so; or 
Sec. C-S. 32 MRSA §l092, sub-§l,~, as enacted by PL 2003, c. 452, Pt. R, § I 
and affected by Pt. X, §2, is amended to read: 
K. 
Employ a person as a dental hygienist or independent practice dental hygienist 
who is not licensed to practice. 
II 
Sec. C-9. 32 MRSA §1094-D, as enacted by PL 2005, c. 322, § I, is amended to 
read: 
§1094-D. Definitions 
As used in this subchapter, unless the context otherwise indicates, "expanded 
function dental assistant" means an individual who holds a current valid certification 
under this subchapter to perform reversible intraoral procedures authorized by this 
subchapter under the direct supervision of a licensed dentist and under an assignment of 
duties by a dentist. As used in this subchapter, unless the context otherwise indicates, 
"reversible intraoral procedures" means placing and removing rubber dams and matrices; 
placing and contouring amalgam, composite and other restorative materials; applying 
sealants; supra gingival polishing; and other reversible procedures defined by the board 
not designated by this chapter to be performed only by licensed dentists 91', dental 
hygienists or independent practice dental hygienists. 
Sec. C-IO. 32 MRSA §1100-A, as amended by PL 2005, c. 322, §2, is further 
amended to read: 
§1100-A. Definition 
Duties of dental auxiliaries other than dental hygienists and expanded function dental 
assistants must be defined and governed by the rules of the Board of Dental Examiners, 
except that duties of independent practice dental hygienists set forth in section 1094-Q, 
subsection 1 may not be restricted or expanded by the board. Dental auxiliaries include, 
but are not limited to, dental hygienists, independent practice dental hygienists, dental 
assistants, expanded function dental assistants, dental laboratory technicians and 
denturists. 
Sec. C-l1. 32 MRS A §1100-B, sub-§3, ~C, as amended by PL 1993, c. 600, Pt. 
A, §88, is further amended to read: 
C. 
The procedures incidental to the procedures specified in paragraphs A and B, as 
defined by the 00aFa Subcommittee on Denturists. 
I 
Sec. C-12. 32 MRSA §1100-C, sub-§l, as amended by PL 1995, c. 590, §5, is 
further amended to read: 
1. 
Rules required. 
The 00affi Subcommittee on Denturists shall adopt rules 
necessary to implement this subchapter. Rules adopted may pertain, but are not limited 
to, continuing education, statement of oral conditions and other record retention 
requirements, pre licensure permits and the specification of other procedures incidental to 
the practice of denturism. 
Sec. C-13. 32 MRS A §1100-D, sub-§l, as amended by PL 1995, c. 590, §6, is 
further amended to read: 
1. Authority. The 00affi Subcommittee on Denturists is authorized to prepare and 
II 
give examinations in the area of denturism for the purpose of licensing denturists. All 
examinations prepared and given under this subchapter may be prepared and given by the 
full board, by an appointed subcommittee of tHe board Subcommittee on Denturists or by 
an entity authorized by the 00affi subcommittee. The 00affi Subcommittee on Denturists 
may also recognize a nationally or regionally administered examination given at least 
annually for applicants to practice denturism in the State. 
PART D 
Sec. D-l. 13 MRSA §732, sub-§4, as enacted by PL 200 1, c. 640, Pt. B, §2 and 
affected by §7, is amended to read: 
4. 
Dentists, denturists and independent pl'actice dental hygienists. 
For the 
purposes of this chapter, a denturist or independent practice dental hygienist licensed 
under Title 32, chapter 16 may organize with a dentist who is licensed under Title 32, 
chapter 16 and may become a shareholder of a dental practice incorporated under the 
corporation laws. At no time may a denturist one or more denturists or independent 
practice dental hygienists in sum have an equal or greater ownership interest in a dental 
practice than the dentist or dentists have in that practice. 
SUMMARY 
This bill creates the new license category of independent practice dental hygienist. 
An independent practice dental hygienist must meet the ordinary requirements for 
licensure as a dental hygienist and, in addition, must have an associate degree in dental 
I 
hygiene with 3 years' experience or a bachelor's degree in dental hygiene with one year's 
experience. 
The bill authorizes an independent practice dental hygienist to perform 
specified procedures without supervision by a dentist, but requires an independent 
practice dental hygienist to provide a patient with a referral plan to a dentist for any 
necessary dental care. Under this bill an independent practice dental hygienist could be 
the proprietor of a business or could be an employee of a dentist, denturist, another 
independent practice dental hygienist or a business owned by persons who are not dental 
professionals. The bill also provides the Subcommittee on Denturists with the authority 
to review applications for licensure and submissions relating to continuing education of 
denturists, as well as provides the subcommittee with rule-making authority. 
It also 
provides the Subcommittee on Dental Hygienist Submissions with rule-making authority. 
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