§18377. Dental therapist

1.  Scope of practice.  A dental therapist may perform the following procedures in limited practice settings, if authorized by a written practice agreement with a 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 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;

(3) Provide referrals;

(4) Administer local anesthesia and nitrous oxide analgesia;

(5) Perform preventive services;

(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;

(7) Provide, dispense and administer anti-inflammatories, nonprescription analgesics, antimicrobials, antibiotics and anticaries materials;

(8) Administer radiographs; and

(9) Perform other related services and functions authorized by the supervising dentist and for which the dental therapist is trained.   [PL 2019, c. 388, §10 (AMD).]

B. To the extent permitted in a written practice agreement, a dental therapist may provide the care and services listed in section 18374, subsections 1 and 2 under the general supervision of the supervising dentist.   [PL 2019, c. 388, §10 (AMD).]

[PL 2019, c. 388, §10 (AMD).]

2.  Supervision responsibilities.  A dental therapist may be delegated a dentist's responsibility to supervise up to 2 dental hygienists and 3 unlicensed persons in any one practice setting through a written practice agreement pursuant to subsection 3.

[PL 2019, c. 388, §10 (AMD).]

3.  Practice requirements.  A dental therapist must comply with the following practice limitations.

A. [PL 2019, c. 388, §10 (RP).]

B. A dental therapist may practice only under the direct 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.   [PL 2019, c. 388, §10 (AMD).]

C. A written practice agreement between a supervising dentist and a dental therapist must include the following elements:

(1) The services and procedures and the practice settings for those services and procedures that the dental therapist may provide, together with any limitations on those services and procedures;

(2) Any age-specific and procedure-specific practice protocols, including case selection criteria, assessment guidelines and imaging frequency;

(3) Procedures to be used with patients treated by the dental therapist for obtaining informed consent and for creating and maintaining dental records;

(4) A plan for review of patient records by the supervising dentist and the dental therapist;

(5) A plan for managing medical emergencies in each practice setting in which the dental therapist provides care;

(6) A quality assurance plan for monitoring care, including patient care review, referral follow-up and a quality assurance chart review;

(7) Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed;

(8) Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation prior to initiating care; and

(9) Specific written protocols, including a plan for providing clinical resources and referrals, governing situations in which the patient requires treatment that exceeds the scope of practice or capabilities of the dental therapist.   [PL 2019, c. 388, §10 (AMD).]

D. Revisions to a written practice agreement must be documented in a new written practice agreement signed by the supervising dentist and the dental therapist.   [PL 2019, c. 388, §10 (AMD).]

E. A dental therapist shall file a copy of a written practice agreement with the board, keep a copy for the dental therapist's own records and make a copy available to patients of the dental therapist upon request.   [PL 2019, c. 388, §10 (AMD).]

F. A dental therapist shall refer patients in accordance with a written practice agreement to another qualified dental or health care professional to receive needed services that exceed the scope of practice of the dental therapist.   [PL 2019, c. 388, §10 (AMD).]

G. A dental therapist who provides services or procedures beyond those authorized in a written agreement engages in unprofessional conduct and is subject to discipline pursuant to section 18325.   [PL 2019, c. 388, §10 (AMD).]

[PL 2019, c. 388, §10 (AMD).]

4.  Dental coverage and reimbursement.  Notwithstanding Title 24-A, section 2752, any service performed by a dentist, dental assistant or dental hygienist licensed in this State that is reimbursed by private insurance, a dental service corporation, the MaineCare program under Title 22 or the Cub Care program under Title 22, section 3174-T must also be covered and reimbursed when performed by a dental therapist authorized to practice under this chapter.

[PL 2019, c. 388, §10 (AMD).]

SECTION HISTORY

PL 2015, c. 429, §21 (NEW). PL 2019, c. 388, §10 (AMD).