An Act Regarding Dental Hygienists and Dental Therapists
Maine Legislature, Session 131, LD 1581
Committee: Health Coverage, Insurance and Financial Services
Sponsors: MASTRACCIO, GROHOSKI
Amends: 32 MRSA §18374, 32 MRSA §18375, 32 MRSA §18376, 32 MRSA §18377

Legislative Document
No. 1581
H.P. 1026
House of Representatives, April 11, 2023
An Act Regarding Dental Hygienists and Dental Therapists
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative MASTRACCIO of Sanford.
Cosponsored by Senator GROHOSKI of Hancock.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  32 MRSA §18374, sub-§1, as amended by PL 2021, c. 223, §12, is further 
amended to read:
1.  Scope of practice; direct supervision.  A dental hygienist and faculty dental 
hygienist may perform the following under the direct supervision of a dentist:
A.  Administer local anesthesia or nitrous oxide analgesia, as long as the dental 
hygienist or faculty dental hygienist has authority to administer the relevant medication 
pursuant to section 18345, subsection 2, paragraph D or E.
Sec. 2.  32 MRSA §18374, sub-§2, as amended by PL 2021, c. 223, §12, is further 
amended to read:
2.  Scope of practice; general supervision.  A dental hygienist and faculty dental 
hygienist may perform under the general supervision of a dentist all of the activities that 
may be delegated to an unlicensed person pursuant to section 18371, subsection 3.  A dental 
hygienist and faculty dental hygienist may also perform the following procedures under the 
general supervision of a dentist:
A.  Prescribe, dispense or administer anticavity toothpastes or topical gels with 1.1% 
or less sodium fluoride and oral rinses with 0.05%, 0.2%, 0.44% or 0.5% sodium 
fluoride, as well as chlorhexidine gluconate oral rinse;
A-1.  Prescribe, dispense or administer fluoride, silver diamine fluoride, antimicrobial 
solutions for mouth rinsing, other nonsystemic antimicrobial agents, desensitizing 
agents and resorbable antimicrobial agents; 
C.  Apply desensitizing agents to teeth;
D.  Apply fluoride to control caries;
F.  Apply sealants;
J.  Expose and process radiographs;
S.  Perform all procedures necessary for a complete prophylaxis, including but not 
limited to scaling and root planing and periodontal maintenance;
U.  Perform complete periodontal and dental restorative charting;
X.  Perform oral inspections, recording all conditions that should be called to the 
attention of the dentist;
GG.  Place localized delivery of chemotherapeutic agents when treatment is planned 
by the dentist;
JJ.  Place temporary restorations as an emergency procedure, as long as the patient is 
informed of the temporary nature of the restoration in compliance with the protocol 
adopted by the board; and
TT.  Smooth and polish amalgam restorations.;
ZZ.  Administer local anesthesia, as long as the dental hygienist or faculty dental 
hygienist has authority to administer the medication pursuant to section 18345, 
subsection 2, paragraph D;
AAA.  Perform dental hygiene assessment, dental hygiene diagnosis and dental 
hygiene treatment planning for dental hygiene services; and
BBB.  Obtain impressions for and deliver athletic mouth guards and custom fluoride 
trays.
Sec. 3.  32 MRSA §18375, sub-§1, as amended by PL 2017, c. 388, §§20 and 21, 
is further amended to read:
1.  Scope of practice.  An independent practice dental hygienist 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 but not 
limited to scaling and root planing and periodontal maintenance;
F.  Apply fluoride to control caries;
G.  Apply desensitizing agents to teeth;
H.  Apply topical anesthetics;
I.  Apply sealants;
J.  Smooth and polish amalgam restorations, limited to slow-speed application only;
L.  Obtain impressions for and deliver 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;
O.  Apply topical antimicrobials, including fluoride but excluding antibiotics, 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;
P.  Expose and process radiographs, including but not limited to vertical and horizontal 
bitewing films, periapical films, panoramic images and full-mouth series, under 
protocols developed by the board as long as the independent practice dental hygienist 
has a written agreement with a licensed dentist that provides that the dentist is available 
to interpret all dental radiographs within 21 days from the date the radiograph is taken 
and that the dentist will sign a radiographic review and findings form and provide the 
radiographs to a dentist as needed; and
Q.  Prescribe, dispense or administer anticavity toothpastes or topical gels with 1.1% 
or less sodium fluoride and oral rinses with 0.05%, 0.2%, 0.44% or 0.5% sodium 
fluoride, as well as chlorhexidine gluconate oral rinse. For the purposes of this 
paragraph, "topical" includes superficial and intraoral application. fluoride, silver 
diamine fluoride, antimicrobial solutions for mouth rinsing, other nonsystemic 
antimicrobial agents, desensitizing agents and resorbable antimicrobial agents;
R.  Administer local anesthesia, as long as the independent practice dental hygienist 
has authority to administer the medication pursuant to section 18345, subsection 2, 
paragraph D; and
S.  Perform dental hygiene assessment, dental hygiene diagnosis and dental hygiene 
treatment planning for dental hygiene services.
Sec. 4.  32 MRSA §18376, sub-§1, as amended by PL 2017, c. 388, §§22 and 23, 
is further amended to read:
1.  Scope of practice.  A public health dental hygienist may perform the following 
procedures in a public health setting under a supervision agreement with a dentist that 
outlines the roles and responsibilities of the collaboration:
A.  Prescribe, dispense or administer anticavity toothpastes or topical gels with 1.1% 
or less sodium fluoride and oral rinses with 0.05%, 0.2%, 0.44% or 0.5% sodium 
fluoride, as well as chlorhexidine gluconate oral rinse fluoride, silver diamine fluoride, 
antimicrobial solutions for mouth rinsing, other nonsystemic antimicrobial agents, 
desensitizing agents and resorbable antimicrobial agents;
B.  Apply cavity varnish;
C.  Apply desensitizing agents to teeth;
D.  Apply fluoride to control caries;
E.  Apply liquids, pastes or gel topical anesthetics;
F.  Apply sealants;
G.  Apply topical antimicrobials, including fluoride but excluding antibiotics, for the 
purposes of bacterial reduction, caries control and desensitization in the oral cavity.  
The public health dental hygienist shall follow current manufacturer’s instructions in 
the use of these medicaments. For the purposes of this paragraph, "topical" includes 
superficial and intramuscular application;
I.  Expose and process radiographs upon written standing prescription orders from a 
dentist who is available to interpret all dental radiographs within 21 days and who will 
complete and sign a radiographic review and findings form;
J.  For instruction purposes, demonstrate to a patient how the patient should place and 
remove removable prostheses, appliances or retainers;
K.  For the purposes of eliminating pain or discomfort, remove loose, broken or 
irritating orthodontic appliances;
L.  Give oral health instruction;
M.  Interview patients and record complete medical and dental histories;
N.  Irrigate and aspirate the oral cavity;
O.  Isolate operative fields;
P.  Perform all procedures necessary for a complete prophylaxis, including but not 
limited to scaling and root planing and periodontal maintenance;
Q.  Perform complete periodontal and dental restorative charting;
R.  Perform dietary analyses for dental disease control;
S.  Perform temporary filling procedures without a dentist present under protocols 
adopted by board rule;
T.  Perform oral inspections, recording all conditions that should be called to the 
attention of the dentist;
U.  Perform pulp vitality tests pursuant to the direction of a dentist;
V.  Place and remove gingival retraction cord without vasoconstrictor;
W.  Place and remove matrix bands for purposes of fabricating or placing temporary 
restorations;
X.  Place and remove rubber dams;
Y.  Place and remove wedges for purposes of fabricating or placing temporary 
restorations;
Z.  Place temporary restorations in compliance with the protocol adopted by board rule;
AA.  Remove excess cement from the supragingival surfaces of teeth;
BB.  Retract lips, cheek, tongue and other tissue parts;
CC.  Smooth and polish restorations, limited to slow-speed application only;
DD.  Take and record the vital signs of blood pressure, pulse and temperature;
EE.  Take dental plaque smears for microscopic inspection and patient education;
FF.  Obtain impressions for and deliver athletic mouth guards and custom fluoride 
trays; and
GG.  Take intraoral photographs.
HH.  Perform dental hygiene assessment, dental hygiene diagnosis and dental hygiene 
treatment planning for dental hygiene services; and
II.  Administer local anesthesia, as long as the public health dental hygienist has 
authority to administer the medication pursuant to section 18345, subsection 2, 
paragraph D.
Sec. 5.  32 MRSA §18377, sub-§1, as amended by PL 2021, c. 223, §13, is further 
amended to read:
1.  Scope of practice.  A dental therapist may perform the following procedures in 
limited practice settings, if authorized by a written practice agreement with under the 
general supervision of a supervising dentist licensed in this State pursuant to subsection 3.
A.  To the extent permitted in a written practice agreement, a dental therapist may 
provide the care and services listed in this paragraph only under the direct general 
supervision of the supervising dentist:
(1)  Perform oral health assessments, pulpal disease assessments for primary and 
young teeth, simple cavity preparations and restorations and simple extractions;
(2)  Prepare and place stainless steel crowns and aesthetic anterior crowns for 
primary incisors and prepare, place and remove space maintainers;
(4)  Administer local anesthesia and nitrous oxide analgesia;
(6)  Conduct urgent management of dental trauma, perform suturing, extract 
primary teeth and perform nonsurgical extractions of periodontally diseased 
permanent teeth if authorized in advance by the supervising dentist; and
(7)  Provide, dispense and administer anti-inflammatories, nonprescription 
analgesics, antimicrobials, antibiotics and anticaries materials.
B.  To the extent permitted in a written practice agreement, a dental therapist may 
provide the care and services identified in section 18371, subsection 3 and section 
18374 under the general supervision of the supervising dentist.
Sec. 6.  32 MRSA §18377, sub-§3, ¶B, as amended by PL 2019, c. 388, §10, is 
further amended to read:
B.  A dental therapist may practice only under the direct general supervision of a dentist 
through a written practice agreement signed by both parties.  A written practice 
agreement is a signed document that outlines the functions that the dental therapist is 
authorized to perform, which may not exceed the scopes of practice specified in 
subsections 1 and 2.  A dental therapist may practice only under the standing order of 
the supervising dentist, may provide only care that follows written protocols and may 
provide only services that the dental therapist is authorized to provide by the written 
practice agreement.
SUMMARY
This bill changes the supervision required for dental hygienists, independent practice 
dental hygienists and public health dental hygienists to administer local anesthesia from 
direct to general supervision. The bill also changes the supervision for dental therapists 
from direct to general supervision. The bill also makes other changes to the scope of 
practice for dental hygienists, independent practice dental hygienists and public health 
dental hygienists.