The New York State Education Department (“SED”) Office of the Professions (“OP”) is alerting everyone to a vishing scam that has been brought to our attention. Phishing—or “vishing”—scams impersonate SED employees or websites attempting to collect licensure and personal information from the licensee. If you receive an inquiry which you believe to be suspicious do not provide any information. To verify if the inquiry was from OP, contact us directly. You may report any suspicious communication received to the Federal Trade Commission.
  • NYSED Homepage
  • Disclaimer
  • Contact Us
  • NYSED Employment
  • Board Members Only

Professional Practice for Dental Hygienists

Disclaimer: Practice guidelines provide licensees with general guidance to promote good practice. Law, rules and regulations, not guidelines, specify the requirements for practice and what may constitute professional misconduct.

New York State Teledentistry Guidelines

As recommended by the New York State Board for Dentistry 2023

Advisory Notice: The following advisory constitutes a general discussion of the issues that may arise when a licensee provides professional services. The discussion is intended to alert practitioners to questions and concerns that they may want to consider with their legal counsel, if necessary, and are not to be construed as a directive or other requirement to take any particular action. The Advisory cannot be used as the basis for a charge of professional misconduct. The statements are generally based upon statutory and regulatory provisions relating to the practice of dentistry, but are not legal interpretations of any of these provisions. The citations to the provisions of law, regulation and Regents Rules are included to add clarity to the discussion.

What is Telepractice?

Telepractice is defined as the provision of professional service over geographical distances by means of modern telecommunications technology. This generic term includes, for example, telehealth, teletherapy, teledentistry, telemedicine, telenursing, etc. Telepractice is used by many professionals in a growing number of areas including, but not limited to, health care (telehealth). These professional services may include communications between a practitioner and a patient or a practitioner and designated caregiver, as well as practitioner-to-practitioner consultation and conferencing. Examples of technologies that may be used to provide these services are telephones, including cellular devices, e-mail, instant message, video chat, and the computer applications or portals used to facilitate these modes of communication. Telepractice may also include the keeping of electronic medical records or EMRs.

In accordance with New York State statute, full licensure and current registration are required of any professional who practices in New York State, unless specifically suspended or waived pursuant to an Executive Order issued by the New York State Governor during a disaster emergency. All New York State licensed professionals are responsible for adhering to the same laws, rules and regulations and for upholding the same standards and competencies when engaging in telepractice as they are when practicing without the use of technology over a distance.

Teledentistry refers to the use of telehealth systems and methodologies in dentistry. The delivery of services via teledentistry must comply with all laws, rules, and regulations in New York State. Including, but not limited to NYS Education Law, Title VIII, Art. 133; 8 NYCRR Part 61 and Part 29 of the Rules of the Board of Regents. The same standards that apply to all forms of dental practice apply to teledentistry, including all ethical considerations. The benefits of teledentistry for patients of New York State and for all patients, are increased access to care and reduced or contained treatment costs. The benefits to the dental profession are reduced disparities in treatment between urban and rural areas, and access to second opinions, preauthorization, and other insurance requirements to help improve outcomes.

Teledentistry Issues

Teledentistry should be considered a modality and applied only as appropriate to address the patient's needs. In order to engage in teledentistry in an effective, safe and legal manner, licensed dentist and licensed dental hygienist providers should consider the following:

  1. Licensure Requirements:
    1. A dentist or dental hygienist using teledentistry to practice dentistry on patients in NYS must be licensed and currently registered to practice dentistry or dental hygiene in New York State and must provide proof of identity, jurisdiction and licensure status to the patient.
    2. Education Law §6610 provides for the following exemptions related to licensing requirements:
      • A dentist or a dental hygienist licensed in some other state or country from making a teaching clinical demonstration before a regularly organized dental or medical society or group, or from meeting licensed dentists in this state for consultation, provided such activities are limited to such demonstration or consultation.
      • A dentist licensed in another state or country who is employed on a full-time basis by a registered dental school as a faculty member with the rank of assistant professor or higher from conducting research and clinical demonstrations as a part of such employment, under the supervision of a licensed dentist and on the premises of the school. No fee may be charged for the practice of dentistry authorized by this subdivision.
      • A dentist licensed in another state or country who is visiting an approved dental school or any other entity operating a residency program that has been accredited by a national accrediting body approved by the department to receive dental instruction for a period not to exceed ninety days from engaging in clinical practice, provided such practice is limited to such instruction and is under the direct supervision of a NYS licensed dentist.
    3. All dentists, providing consulting services, whether licensed in NYS or in another jurisdiction, must have a valid dental license to practice within the state they are consulting from, abide by competency requirements and have sufficient knowledge of dentistry laws, rules, and regulations of the state where a patient resides.
  2. Teledentistry Provider Responsibilities
    When practicing teledentistry:
    • The teledentistry health care provider may provide any treatment deemed appropriate for the patient within their scope of practice, including prescriptions, if the evaluation performed is adequate to justify the action taken. The health care provider is responsible for knowing the limitations of the care he or she can provide, no matter how the care is delivered. Just as in a traditional setting, teledentistry dentists should recognize situations that are beyond their expertise, their ability, or the limits of the available technology to adequately evaluate or manage the existing circumstances, and to refer such patients for appropriate care. The evaluation performed must be adequate to justify the action.
    • The relationship for teledentistry should mirror those parameters that would be expected for similar in-office dental encounters. The relationship between a teledentistry health care provider and patient are based on a mutual understanding of their shared responsibility for the patient's oral health care and is established when the dentist agrees to undertake diagnosis and/or treatment of the patient and the patient agrees that the dentist will diagnose and/or treat, whether or not there has been or is an in- person encounter between the parties.
    • The dental provider should establish a practitioner-patient relationship with the patient. The absence of in-person contact does not eliminate this requirement.
    • The dental provider should make appropriate effort to confirm the patient's identity and location.
    • The dental provider should confirm and document that the patient is physically located in a jurisdiction in which the dentist is licensed.
    • The dental provider should make appropriate efforts to confirm that the minor's parent or legal guardian is present when required.
    • The dental provider may delegate allowable tasks to New York State licensed dental hygienists through teledentistry such as taking and transferring images and performing procedures that fall under general supervision.
    • The dental provider should not directly or indirectly engage in false, misleading, or deceptive advertising of teledentistry services.
    • There will be no allowance for fee-splitting through the use of teledentistry services.
    • The delegation of tasks through teledentistry must be under the general supervision of a NYS licensed and registered dentist. Specifically, pursuant to NYS Education Law §6606, the practice of dental hygiene may be conducted in the office of any licensed dentist or in any appropriately equipped school or public institution but must be done either under the supervision of a licensed dentist or, in the case of a registered dental hygienist working for a hospital as defined in article twenty-eight of the public health law. Pursuant to a collaborative arrangement with a licensed and registered dentist who has a formal relationship with the same hospital in accordance with regulations promulgated by the department in consultation with the department of health. Such collaborative arrangement shall not obviate or supersede any law or regulation which requires identified services to be performed under the personal supervision of a dentist. When dental hygiene services are provided pursuant to a collaborative agreements, such dental hygienist shall instruct individuals to visit a licensed dentist for comprehensive examination or treatment.
    • Teledentistry does not meet the definition of personal supervision when the dentist is not physically present.
    • All providers are responsible for knowing the limitations of the care he or she can provide, no matter how the care is delivered.
    • Dental hygienist providers are allowed to originate a teledentistry session in collaboration with a Dentist.
  3. The Role of the Dental Hygienist in Teledentistry
    The dental hygienist can be instrumental in identifying areas of concern to help determine the need for asynchronous or synchronous care, or determine the potential need to disqualify teledentistry and to recommend a face to face interaction with a dentist.
    1. Asynchronous: which includes information being gathered and used to evaluate the patient's condition and transmitted through a secure electronic communication system and stored for review by a dentist or specialist prior to future consultation and treatment planning.
      The dental hygienist in a clinical setting may facilitate the access to care by:
      1. Triaging the patient. This is particularly important in clinical settings including but not limited to nursing homes, hospitals, or school-based programs.
      2. Completing patient assessment, including but not limited to, medical and dental history.
      3. Exposing the appropriate radiographs.
      4. Documenting the patient encounter, including chief complaint by collecting data about the dental problem.
      5. Uploading patient data (i.e., photos, radio graphs, clinical notes, video).
      6. Sending the clinical information to the dentist for evaluation.
      7. Communicating to the patient the dentist's observations, diagnosis, and results.
    2. Synchronous - which includes real time consultation through live video using advanced telecommunication technology.
      The dental hygienist in a clinical setting may facilitate the access to care by:
      1. Virtually connecting the patient with the dentist.
      2. Triaging the patient.
      3. Completing patient assessment: including medical and dental history.
      4. Exposing appropriate radiographs.
      5. Taking the video of the patient's oral cavity and face.
      6. Facilitating the communication between the patient and the dentist.
  4. Confidentiality
    The licensee shall ensure that the electronic and/or digital communication is secure to maintain confidentiality of the patient's medical information as required by the Health Insurance Portability and Accountability Act (and other applicable federal and state laws). Confidentiality shall be maintained throughout the appropriate processes, practices and technology, including disposal of electronic and/or digital equipment and data in order to ensure confidentiality, encryption, password restricted access and other technologies should be used whenever possible.
  5. Patient Records
    • Dental providers providing teledentistry services must document the encounter appropriately and completely so that the record clearly, concisely, and accurately reflects what occurred during the encounter. Read more Recordkeeping guidance for Dental Providers.
    • Such records should be permanent and easily available to the patient, legal guardian or their designees and other practitioners in accordance with patient consent, direction, and applicable standards.
    • Dental providers should maintain the security and confidentiality of the patient record in compliance with applicable laws and regulations related to the maintenance and transmission of such records and have a mechanism to make such records readily available to other providers as data sharing is vital to patients who need the advice of a specialist, but who may not have one nearby.
    • Patient Dental records are subject to the same confidentiality and privilege as any other medical record, consistent with all established laws, regulations and guidelines governing Patient healthcare records and should include, but not be limited to: demographics, medical and dental history, OTC prescribed medicines diagnostic notes, radiographs, consent forms, all communications relative to the patient, and all other pertinent information that is applicable to regular in office patients.
  6. Consent
    1. The dentist should obtain and document appropriate informed consent for teledentistry encounters. Because of the unique characteristics of teledentistry, it is best practice for the informed consent to include but not be limited to:
      1. The manner in which the dentist and patient will use particular enabling technologies, the boundaries that will be established and observed, and procedures for responding to electronic communications from patients.
      2. Limitations on the availability and/or appropriateness of specific teledentistry services that may be hindered as a res ult of the services being offered through teledentistry.
    2. All treatments should be preceded by pre treatment radiographs, patient evaluation data, a thorough informed consent discussion, and an acknowledged and signed informed consent document by the patient and provider.
      1. There should be a clear understanding by the patient or legal guardian that it is the role of the dentist to determine whether the condition being diagnosed or treated is appropriate for a teledentistry encounter.
      2. Requirements for explicit patient or legal guardian consent should be in place to forward patient identifiable information to a third party.
      3. Informed consent should include the contact information for the New York State Office of Professional Discipline and a description of, or link to, the patient complaint process.
      4. Informed consent should cover the same information as in the traditional in office informed consent form.
      5. The patient should be informed of the way their information is to be shared; and made aware of the risks of having electronically transmitted information intercepted despite the efforts to maintain security of the information.
  7. Standard of Care
    Dentists and Dental Hygienists using teledentistry will be held to the same standard of care as practitioners engaging in more traditional in person care delivery, including the requirement to meet all technical, clinical, confidentiality and ethical standards required by law. Failure to conform to the standard of care, whether rendered in person or via teledentistry, may subject the practitioner(s) to potential discipline.
  8. Patient Evaluation
    An appropriate history and evaluation of the patient should precede the rendering of any care, including provision of prescriptions. Not all patient situations will be appropriate for teledentistry. Evaluating the adequacy and significance of any examination remains the responsibility of the teledentistry health care provider Since, by definition, teledentistry does not involve in person contact between dentist and patient, if circumstances require in person contact, a credentialed dentist may provide in person observations.
  9. Prescriptions
    Prescribing medications, whether in person or via teledentistry, is at the professional discretion of the dentist. The dentist, in accordance with current standards of practice, should evaluate the indications, appropriateness, and safety considerations.
    • All New York State laws relative to prescribing medications and/or appliances should be documented and kept in the patient's file.
    • The indication, appropriateness, and safety considerations for each prescription, either for medication, laboratory services or dental lab services, provided via teledentistry services must be evaluated by the licensee in accordance with applicable law and current standards of care and consequently carries the same professional accountability as all prescriptions delivered during an in person encounter.
    • A dentist who prescribes as part of the provision of teledentistry services shall comply with all New York State requirements.

New York State Education Law Continues to Require Protective Shielding for Dental Radiography

Reviews of recent studies and reports have led researchers to conclude that radiation doses from dentomaxillofacial imaging pose negligible risk. These studies and reports have led some organizations to recommend the discontinuation of patient shielding during dental X-rays. Dentists may be reading these studies and reports with interest, as well as with concern regarding how the discontinuation of patient shielding might impact their practices.

However, please note that Education Law §6611(7) still mandates the continued use of protective shielding for dental radiographs: https://www.op.nysed.gov/title8/education-law/article-133

*Although this law does not specifically state that dental assistants must comply with this requirement, dental assistants operate under the direct personal supervision of a licensed dentist. Therefore, the Department, in consultation with the New York State Board for Dentistry and upon its recommendation, advises that all individuals taking dental x-rays follow these precautions.

Sleep Apnea Practice Alert

Pursuant to Education Law §6601, the practice of dentistry includes, among other things, the prescribing and fabrication of dental prostheses and appliances. Thus, a dentist may fabricate an intra-oral sleep disorder appliance only following a definitive diagnosis by a licensed physician and a patient specific order.  However, administering sleep apnea tests in the dental office or giving at home tests are not within the scope of practice of a dentist and/or dental hygienist.

Furthermore, under Education Law §§6604-A(4) and 6609-A(4), acceptable formal continuing education for dentists and dental hygienists shall mean formal programs of learning which contributes to professional practice and which meet the standards prescribed by the Commissioner’s regulations. Sleep medicine is not a recognized dental specialty in New York State. Therefore, in order to use course work in sleep medicine to meet mandatory continuing education requirements for dentists and dental hygienists, the course must address content relative to fabrication of intra-oral sleep disorder appliances and care/maintenance of the oral appliances.

Practice Alert for the Administration of Botox and Dermal Filler

NYS Education Law does not specify modalities of practice and does not limit the practice of dentistry to any specific methods of treatment. As a result, Education Law Does not prohibit a NY State licensed dentist from using botulinum toxin type A or dermal fillers in the oral and maxillofacial area consistent with Section 6601, as long as it is related to restoring and maintaining dental health.

For example: A dentist who is completing orthognathic surgery to correct a jaw discrepancy, and wishes to do an allograft of the chin, or to administer filling materials such as Botox or Restylane would be considered to be within the scope, if trained. However, to administer these regimens as stand-alone procedures for esthetics or facial recontouring without parallel dental reconstructive work on either the teeth themselves or jaws is not within scope.

Practice Alert Regarding Dental Hygienists Performing Oral Myofunctional Therapy

The dental hygienists' scope of practice is defined in Education Law, §6606 Definition of practice of dental hygiene and the Commissioner's Regulations §61.19 Practice of Dental Hygiene. Dental hygienists must practice within their defined scope of practice, or they may be subject to a charge of unprofessional conduct pursuant to Board of Regents Rule §29.1 (b)(9). This Regents Rule specifically provides that it shall be unprofessional conduct to practice or offer to practice beyond the scope permitted by law.

Oral Myofunctional Therapy (OMT) is not within the dental hygiene scope of practice in New York State. Therefore, dental hygienists licensed in New York are prohibited from performing OMT while holding themselves out as dental hygienists. OMT is loosely defined as an exercise training program for the muscles around the face, mouth, and tongue. Many OMT courses and certifying bodies exist. However, dental hygienists may only receive continuing education credit for courses when the subject matter of the course is within their defined scope of practice.

Citations of Pertinent Laws, Rules, or Regulations:

Administration of General Anesthetic Agents

Education Law 6605-a provides that a licensed dentist shall not employ conscious sedation, deep sedation or general anesthesia in the practice of dentistry, at any location other than a general hospital, without a dental anesthesia certificate issued by the department. Part 61.10 of the Commissioner’s regulations provides for the issuance of different types of dental anesthesia certificates and sets forth the educational and training requirements required to obtain such certificates.

Section 61.10 (b) (2) (i) of the Commissioner’s regulations provides that certificates in dental general anesthesia authorizes a licensed dentist to employ conscious (moderate) sedation (enteral or parenteral route with or without inhalation agents), deep sedation, and general anesthesia. Due to the potential complications and patient safety concerns that may arise during the administration of deep sedation using general anesthetic agents, dentists must meet the required training, experience and certification requirements to obtain a dental general anesthesia certificate in accordance with the regulations. As a general rule, dentists must hold a current dental general anesthesia (deep sedation) certificate in order to employ deep sedation and general anesthesia through the administration of general anesthetic and deep sedation agents including but not limited to, Ketamine and Propofol, by any route of administration outside a hospital or dental school-based practice. Dentists holding dental certificates in other titles, such as dental parenteral conscious (moderate) sedation and dental enteral conscious (moderate) sedation, whether issued for patients 13 years or older or 12 years or younger, should not be utilizing or administering general anesthetic and deep sedation agents, outside a hospital or dental school-based practice, regardless of the level of sedation achieved when utilizing these agents.

A certificate in dental general anesthesia (deep sedation) may be granted based upon, among other things, the following criteria:

  1. completion of a 2-year post-doctoral education program in dental anesthesia (completion of a Commission on Dental Accreditation accredited residency in dental anesthesiology); or
  2. completion of 3- years of post-doctoral education in dental anesthesia, acceptable to the Department and accredited by an acceptable accrediting body (completion of a Commission on Dental Accreditation accredited residency in dental anesthesiology); or
  3. completion of a graduate level program in oral & maxillofacial surgery acceptable to the Department and accredited by an acceptable accrediting body (completion of a Commission on Dental Accreditation accredited residency in oral & maxillofacial surgery).

For more information on general anesthesia/deep sedation certificates please review New York Education Law §6605-a, Part 86.10 of the Commissioner’s Regulations and the New York State Office of Professions Dental Professions website.

November 18, 2019.

Patient Confidentiality

Privacy is a patient right. Dentists have an ethical and legal responsibility to safeguard patient information. Patient information includes such information as personal data, medical history, diagnosis, treatment, and financial situation.

Patient information should be shared only on a need-to-know basis with those who participate in the care of the patient. Unless disclosure is required or permitted by law, patient information should not be shared with anyone without the patient's written permission. Court orders, subpoenas and investigations by the Office of Professional Discipline are examples of disclosures that may be required even in the absence of the patient's consent.

Patient information, written or electronic, must be kept secure from loss, theft, or unauthorized access, use or disclosure. Confidential information should be kept out of plain view, and stored in a secure environment. Care should be taken not to talk about patients in public places, even if you are not using the patient's name.

Under section 29.1(b)(8) of the Regents Rules, it is unprofessional conduct to reveal personally identifiable facts, data or information obtained in a professional capacity without the prior consent of the patient or client, except as authorized or required by law. If you violate this confidentiality rule, you may be subject to charges of unprofessional conduct.

Your decision to disclose patient information must be consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), if it applies. More information regarding HIPAA may be found on the United States Department of Health and Human Services website.

Recordkeeping

Health professionals are required to maintain records for each patient that accurately reflect the evaluation and treatment of the patient according to section 29.2(a)(3) of the Rules of the Board of Regents. All patient records must be retained for at least six years, with the exception of records for minor patients, which must be maintained for at least six years and for one year after the minor patient reaches the age of 21.

Accurate and complete patient records serve many purposes. For example, patient records can protect both the consumer and the practitioner, guide professional treatment, and facilitate professional consultations. Patient records are important documents in matters pertaining to professional liability and professional discipline.

Practitioners and their patients should be aware that under some conditions other parties might have reason to have access to patient records. For example, in some cases, patient records may be needed by other professionals to provide requisite patient care. Your records, therefore, should be an accurate and legible account of the evaluation and treatment of the patient.

Under Section 18 of the Public Health Law, patients have the right of access to their records under most circumstances. If you deny access to records to a patient, you have an obligation to inform the patient of his/her right to appeal to the Office of Record Access of the Department of Health. Contact information is available on the New York State Department of Health website.

If you dispose of records when there is no longer any obligation or need to maintain them, they should be properly destroyed to safeguard patient confidentiality.

Dentists who retire or sell their practices must make provisions for records to be maintained and accessed, if requested. The obligation to maintain records is not changed by the retirement or sale of a practice by a dentist.

Your records may be your principal defense to charges of professional misconduct. There is no statute of limitations for charges of professional misconduct.

Dentists should also make provisions for the maintenance and destruction, as appropriate, of their patients' records in the event of the dentist's death. Patient records may be important documents in the event of a malpractice suit against the dentist's estate after his or her death.

Supervision

The dentist should adequately monitor the performance of all personnel, licensed or unlicensed, that he or she supervises. The dentist is ultimately responsible for quality patient care and may be held accountable for all services provided by administrative and clinical individuals that the dentist supervises.

Patient Abandonment

Section 29.2(a)(1) of the Rules of the Board of Regents defines as a basis for unprofessional conduct, "abandoning or neglecting a patient or client under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care, or abandoning a professional employment by a group practice, hospital, clinic or other health care facility, without reasonable notice and under circumstances which seriously impair the delivery of professional care to patients or clients."

If a dentist becomes unexpectedly ill or disabled rendering him or her unable to continue to provide services, the discontinuation of services would generally not be considered abandonment. However, appropriate planning for such events early in the professional relationship can ensure that patients receive the essential services they need when such emergencies occur.

Dentists who surrender or lose a license as a result of a professional disciplinary action should also ensure that patients are referred to other dentists who can provide essential professional services.

Consultation with Other Professionals

Good practice often involves the need to consult with other professionals to provide quality patient care. When legally required or when consultation is otherwise appropriate, you should obtain the patient's consent before consulting with other professionals.

It is also good practice, and in certain circumstances it may be necessary, for the patient to give informed consent permitting you to reveal any personally identifiable information to a consultant.

Fee Disputes

The Office of the Professions does not negotiate or resolve fee disputes. However, fee disputes can often lead to complaints of professional misconduct including claims unrelated to the actual fee dispute, such as claims of negligence or incompetence. Even when these complaints are determined to be unfounded, the dentist will have had the inconvenience and expense sometimes associated with an investigation.

To avoid these complaints, dentists should:

  • Clarify the billing conditions, including insurance coverage if applicable, with the patient at the outset of the evaluation and treatment, and specify the financial arrangements in terms that the patient can understand.
  • Explain to the patient all costs involved with their treatment, including co-payments and expenses that are not covered by insurance. It would be useful to have a written policy in place which is signed by patients to indicate their understanding of the costs involved for their evaluation and treatment, and for the dentist and the patient to develop an individualized payment agreement in advance of treatment when the patient must pay for non-covered expenses.

Insurance Billing and Pitfalls

Insurance billing, though sometimes seemingly uncomplicated and straightforward, may easily lead to disputes and/or allegations of misconduct. To avoid this, billing statements, insurance claims, and treatment reports should be simple, clear, direct, and accurate representations of the services provided, the fees charged for each service, and the nature of the patient's evaluation and treatment.

  • Discussing payment and insurance issues (including pre-certification) at the first meeting with the patient, or soon afterward, could help to ensure that the patient fully understands all financial arrangements and could also help to avoid any possible misunderstandings and subsequent disputes regarding issues such as co-payments or contract differences.
  • It is good practice to have the patient's written authorization to release information necessary to process an insurance claim or to complete a treatment report for pre-certification; there may be circumstances in which authorization is required.
  • Dentists should be aware of precisely what they are stating when signing any insurance form or report. What information you are asked to provide and what you are asked to attest to often varies depending upon the insurance form or report. For example, a signature as provider on the insurance form may, in some instances, constitute a certification that the signatory directly provided the services him or herself.
  • Attention to details and making certain that you have provided all of the required information when completing insurance forms and reports can help to avoid delays in payment and subsequent misunderstandings and disputes between you and the patient.
  • When a patient cancels or does not appear for an appointment, it is usually considered fraudulent to bill an insurance company for that appointment unless the insurer has provided for cancellations within the contract.

Professional Conduct in Patient Relations

As a dentist, you have a responsibility to maintain appropriate boundaries in your professional relationships. You should treat all patients with respect and with a professional demeanor.

A dentist should establish a working relationship with patients and when appropriate, with their legal guardians, involving them as active participants in treatment decisions.

Section 29.2(a)(2) of the Rules of the Board of Regents defines unprofessional conduct to include "willfully harassing, abusing or intimidating a patient either physically or verbally."

Sometimes problems may arise due to miscommunication and misperceptions between dentists and patients/guardians. You should try to recognize the indicators of such problems and try to prevent or quickly defuse these situations.

The dentist should keep careful records of what transpires in discussions with each patient and, if appropriate, his or her legal representative.

Office Hygiene - Infection Control

The Education Law requires that every four years every dentist and dental hygienist practicing in New York State complete approved coursework or training appropriate to his/her practice in infection control and barrier precautions. Regular training is necessary to prevent the transmission of disease in the course of professional practice. You must document compliance with this requirement at the time of your first registration and at each subsequent reregistration.

Dental Auxiliaries Permitted to Perform Bleaching Services

A dental hygienist may perform bleaching services under the personal supervision of a dentist However, for the reasons set forth below, a registered dental assistant may not.

Education Law §6608 defines the scope of practice for registered dental assisting and it states, in part, that registered dental assisting services "shall not include diagnosing and/or performing surgical procedures, irreversible procedures or procedures that would alter the hard or soft tissue of the oral and maxillofacial area or any other procedures determined by the department." These exclusions also appear in §§61.13(c)(3) and 61.13(c)(4) of the Commissioner's regulations.

Based on the foregoing, the Department has determined, in consultation with the State Board for Dentistry, that the bleaching process is an irreversible procedure that alters the enamel surface of teeth and, therefore, would not be permissible for registered dental assistants to perform. However, since Education Law §6606, which defines the scope of practice for dental hygiene, contains no such statement about irreversible procedures or altering the hard or soft tissue of the oral and maxillofacial area, dental hygienists may perform bleaching services under the personal supervision of a licensed dentist.

Citations of Pertinent Law, Rules or Regulations:

Questions or Additional Information

The laws, rules, and regulations pertaining to the practice of dentistry in New York State can be found at Laws, Rules & Regulations for Dentists. If more detailed information is required, you may contact the New York State Board for Dentistry by calling 518-474-3817 ext. 550 or e-mailing dentbd@nysed.gov.