NEW JERSEY REGISTER
VOLUME 37, NUMBER 8
MONDAY, APRIL 18, 2005
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
NEW JERSEY STATE BOARD OF DENTISTRY
NEW JERSEY STATE BOARD OF DENTISTRY RULES

Proposed Readoption with Amendments: N.J.A.C. 13:30

Proposed Repeals: N.J.A.C. 13:30-1A.3, 1A.4, 2A and 8.5

Proposed New Rule: N.J.A.C. 13:30-8.6

Authorized By: New Jersey State Board of Dentistry, Sally-Jo Placa, D.M.D., President.

Authority: N.J.S.A. 45:6-1 et seq. and 45:1-15.1.
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2005-126.

Submit comments by June 17, 2005 to:

Joanne Boyer, Acting Executive Director

New Jersey State Board of Dentistry

124 Halsey Street

PO Box 45005

Newark, New Jersey 07101

The agency proposal follows:

Summary

Pursuant to Executive Order No. 66(1978) and N.J.S.A. 52:14B-5.1c, N.J.A.C. 13:30 is scheduled to expire on September 6, 2005. The New Jersey Board of Dentistry (the Board) has reviewed the existing rules and has determined that they continue to be reasonable, necessary and effective for the purposes for which they were promulgated. The Board proposes to readopt the rules with amendments as summarized and discussed below.

The existing rules proposed for readoption have enabled the Board to have in place standards and procedures which have served to maintain principles of conduct and practice in the dental profession. The Board also believes that the proposed changes further that purpose as the amendments clarify and update the language of the rules. The Board notes that it continually reviews and revises the rules in N.J.A.C. 13:30 in order to address developments which impact the dental profession, its licensees and Board regulation of the profession.

The following is a summary of the provisions of N.J.A.C. 13:30 which the Board proposes to readopt, as well as a summary of the proposed amendments, new rule and repeals to those subchapters.

Subchapter 1 outlines the rules applicable to candidates seeking licensure to practice dentistry in the State of New Jersey. N.J.A.C. 13:30-1.1 sets forth the purpose and scope of the rules contained in Chapter 30 and provides that noncompliance with the rules in Chapter 30 may be deemed professional misconduct and may subject a licensee or permit holder to disciplinary action. The Board proposes to readopt N.J.A.C. 13:30-1.2, concerning the qualification of applicants, with amendments to clarify the application process and to replace the requirement for an affidavit of good moral character with a criminal history background check that is required pursuant to N.J.S.A. 45:1-28 et seq. The proposed amendments to N.J.A.C. 13:30-1.2 also require applicants to submit a complete professional employment history as part of their initial application for licensure. Proposed new subsection (e) of N.J.A.C. 13:30-1.2 clarifies requirements applicable to applicants for dental licensure who have passed the North East Regional Board (NERB) examination five years or more prior to the date of application. In addition, proposed new subsection (e) of N.J.A.C. 13:30-1.2 sets forth application requirements for persons who are licensed to practice dentistry in another state or jurisdiction. The Board is also proposing a new subsection (f) in N.J.A.C. 13:30-1.2 which provides that licensure candidates who have passed the NERB examination five or more years prior to application, or who are seeking licensure by credentials because they are licensed to practice dentistry in another state, may be required to submit proof of continued competency to practice dentistry prior to being licensed in New Jersey. The Board proposes to amend N.J.A.C. 13:30-1.3, concerning resident permits, to clarify the types of institutions where a resident may work: public or private licensed hospitals or other public or private institution approved by the Board. The proposed amendments also limit the length of the residency program to a maximum of three years pursuant to N.J.S.A. 45:6-10 and replace the requirement for an affidavit of good moral character with a statutory requirement for a criminal history background check. The Board proposes to amend N.J.A.C. 13:30-1.4, which concerns exemptions from licensure, to make a technical change by citing to the Veterans Administration rather than the Veterans Bureau and to exempt residents holding permits issued by the Board. The Board proposes to amend N.J.A.C. 13:30-1.5, which currently concerns retired and inactive licensure, to eliminate reference to inactive and to reference the requirement that licensees seeking to resume the practice of dentistry must demonstrate proficiency through completion of continuing education credit. The Board proposes to amend the section to delete the provisions concerning inactive licensure because the Board is proposing a new rule at N.J.A.C. 13:30-8.6 which will address these requirements. N.J.A.C. 13:30-1.6 through 1.16 are reserved.

Subchapter 1A concerns the registration of dental hygienists. The Board proposes to amend N.J.A.C. 13:30-1A.1 to clarify the requirements for application that the photograph provided with the application be signed by the applicant and notarized and to replace the requirement for an affidavit of good moral character with the statutorily required criminal history background check. Additional proposed amendments replace the requirement that an applicant who has been out of practice for more than five years obtain 10 credits of continuing education in dental hygiene earned within two years prior to application with a requirement that the applicant demonstrate that he or she has maintained proficiency in dental hygiene. The Board proposes substantive and technical amendments to N.J.A.C. 13:30-1A.2, which delineates the scope of practice of all licensed dental hygienists, to clarify that a licensed dental hygienist may also perform root planing; etch teeth in preparation for bonding, sealants and desensitizing agents; place caries detecting agents; use instruments, other than lasers capable of altering, cutting, burning or damaging hard or soft tissue, for caries detection; perform hand removal of soft temporary restorations and temporarily cemented crowns and bridges; take alginate impressions; place and remove arch wires and ligature wires; demonstrate home-use bleaching systems; and apply hot and cold packs pursuant to the direction of a licensed dentist. The Board proposes to repeal N.J.A.C. 13:30-1A.3 and 1A.4 concerning inactive licensure and resumption of active practice by an inactive dental hygienist because these provisions are proposed to be replaced by a new rule at N.J.A.C. 13:30-8.6.

Subchapter 2 outlines the requirements applicable to dental assistants. N.J.A.C. 13:30-2.1 provides definitions of relevant terms. The Board proposes to amend N.J.A.C. 13:30-2.2 and 2.3, concerning the application requirements for dental assistants and limited registered dental assistants in orthodontics, respectively, to clarify the requirements for registration, to remove a section that referenced a route to licensure that no longer exists, to clarify the name of the examination and to replace the requirement for an affidavit of good moral character with a criminal history background check as required by statute. The Board proposes technical and substantive amendments to N.J.A.C. 13:30-2.4, which sets forth the scope of practice of registered dental assistants, to clarify that a registered dental assistant under the direct supervision of a licensed dentist may also etch teeth in preparation for bonding, sealants and desensitizing agents; place caries detecting agents; use instruments, other than lasers capable of altering, cutting, burning or damaging hard or soft tissue, for caries detection; perform hand removal of soft temporary restorations and temporarily cemented crowns and bridges; prepare coronal surfaces for bonding and restoration with pumice and water only, not to include a prophylaxis; take alginate impressions; place amalgam, composite or gold foil in a tooth for condensation by the dentist; place and remove arch wires and ligature wires; demonstrate home-use bleaching systems; apply hot and cold packs pursuant to the direction of a licensed dentist; and administer a topical fluoride treatment on a patient after a licensed dentist or licensed dental hygienist has performed a prophylaxis. The Board proposes technical and substantive amendments to N.J.A.C. 13:30-2.5, which sets forth the scope of practice of limited registered dental assistants in orthodontics, to clarify that a limited registered dental assistant in orthodontics under the direct supervision of a licensed dentist with a specialty permit in orthodontics may take alginate impressions; fabricate but not insert appliances; and apply hot and cold packs pursuant to the direction of a licensed dentist. The Board proposes amendments to N.J.A.C. 13:30-2.6 to clarify that the curing light that an unregistered dental assistant may hold cannot be a laser capable of altering, curing, burning or damaging hard or soft tissue and that an unregistered dental assistant under the direct supervision of a licensed dentist may apply hot and cold packs pursuant to the direction of the licensed dentist.

The Board proposes to repeal and reserve Subchapter 2A, which outlines the requirements for the registered dental assistant and limited registered dental assistant three-month internship programs, because the programs established pursuant this subchapter were to be established for a period of three years after their implementation in 1997 and, therefore, this subchapter is anachronistic.

Subchapter 3 contains the rules applicable to applicants seeking a limited teaching certificate to enable them to provide instruction at dental schools. The Board proposes to amend N.J.A.C. 13:30-3.1, which sets forth applicant qualifications, to clarify that the applicant must submit a certified transcript to verify that he or she has obtained a dental degree from an acceptable school and to delete the requirement that the applicant submit certification of successful completion of 20 hours of continuing education during the preceding year because the statutory requirement for continuing education applies to those who are licensed as dentists. The Board proposes to amend N.J.A.C. 13:30-3.2, concerning teaching certificate application procedures, to clarify the wording of the application procedures. N.J.A.C. 13:30-3.3, concerning limitations of the teaching certificate, and N.J.A.C. 13:30-3.4, concerning educational institutions, are proposed to be readopted without change.

Subchapter 4 sets forth the rules applicable to industrial or corporate dental clinics. The Board proposes to make a technical amendment to N.J.A.C. 13:30- 4.1, which defines the term industrial or corporate clinic, to make a grammatical change. The Board also proposes that N.J.A.C. 13:30-4.2, concerning applications for industrial or corporate clinic permits, be readopted without amendment. N.J.A.C. 13:30-4.3, concerning the documentation that must be submitted with an application for a dental clinic permit, is proposed to be readopted without amendment. N.J.A.C. 13:30-4.4, concerning the transferability of permits, and N.J.A.C. 13:30-4.5, which requires every dental clinic to obtain a certificate of renewal, are readopted without amendment. N.J.A.C. 13:30-4.6, concerning changes to the clinic which require Board approval, and N.J.A.C. 13:30-4.7, which concerns the qualifications of persons entitled to perform services at the dental clinic, are also readopted without amendment. N.J.A.C. 13:30-4.8 is reserved. The Board proposes to readopt N.J.A.C. 13:30-4.9, which establishes the standards of services and facilities that must be provided by clinic permit holders, and N.J.A.C. 13:30-4.10, which concerns inspections of the clinic and the responsibilities of the clinic director, without amendment.

Subchapter 5 concerns the Board's continuing education requirements. The Board proposes to amend N.J.A.C. 13:30-5.1, which sets forth the continuing education requirements for licensed dentists, to clarify the requirements for continuing education and to remove the requirements for inactive licensees because those provisions are proposed to be consolidated in N.J.A.C. 13:30- 8.6. The proposed amendments also clarify the information that the Board requires for approving continuing education courses and that the approval of these courses will be valid for two years provided the course subject matter, course instructor and course length remain unchanged from the initial application. Additional proposed amendments clarify that programs in oral and maxillofacial surgery, pathology and radiology are acceptable; that a maximum of five hours of continuing education credit may be given to a student or instructor for basic cardiopulmonary resuscitation courses and a maximum of 15 hours credit may be given to a student or instructor for advanced cardiac life support courses; and that a maximum of 20 hours credit may be given for media distance learning courses. The proposed amendments also clarify that continuing education credit for teaching and research activities will only be given for programs, courses or subject matters which a licensee has not taught or researched before in any educational or practice setting. The proposed amendments also change the formula for prorating required continuing education hours. The new rule would require 40 credits if a dentist is licensed in the first year of the biennial period and 20 credits if licensed during the second year of the biennial licensing period. A separate proposal published on August 16, 2004, in the New Jersey Register at 36 N.J.R. 3629(a), if adopted, would amend this section to implement new requirements concerning standards and continuing education requirements for dentists performing enteral sedation. The Board proposes amendments to N.J.A.C. 13:30-5.2, which set forth the continuing education requirements for dental hygienists, to clarify the requirements for licensed dental hygienists, including the deletion of language concerning the requirements for licensees with inactive or expired licenses which is proposed to be consolidated in N.J.A.C. 13:30-8.6. The proposed amendments will allow for one-half of the required continuing education hours to be obtained through media distance learning. The Board proposes amendments to N.J.A.C. 13:30-5.3, which set forth the continuing education requirements for registered dental assistants, to clarify certain requirements and to allow registered dental assistants to obtain up to one-half of the required hours through media distance learning. The Board is also proposing amendments to N.J.A.C. 13:30-5.2 and 5.3 to clarify that dental hygienists and dental assistants may only receive continuing education credit for teaching and research activities for programs, courses or subject matters which they have not taught or researched before in any educational or practice setting. The proposed amendments also clarify that dental hygienists and dental assistants must maintain records of continuing education activity for two full biennial periods from the date of completion of the activity.

Subchapter 6 concerns the Board's requirements for advertising. The Board proposes to readopt N.J.A.C. 13:30-6.1, which provides the requirements for a licensee to announce to the public of the practice in a special area of dentistry, and N.J.A.C. 13:30-6.2, which provides the standards for professional advertising by a licensed dentist.

Subchapter 7 remains reserved.

Subchapter 8 outlines provisions generally applicable to Board licensees. The Board proposes to readopt N.J.A.C. 13:30-8.1, which sets forth the fees charged by the Board; N.J.A.C. 13:30-8.2, which delineates the requirements applicable to holders of permits to administer parenteral conscious sedation; and N.J.A.C. 13:30-8.3, concerning the use of general anesthesia, without change. A separate proposal published on February 22, 2005, in the New Jersey Register at 37 N.J.R. 581(a), if adopted, would amend this section to implement a new fee schedule. N.J.A.C. 13:30-8.4 is presently reserved. However, a separate proposal published on August 16, 2004, in the New Jersey Register at 36 N.J.R. 3629(a), if adopted, would establish new rules at N.J.A.C. 13:30- 8.1A and 8.4 to implement new requirements concerning standards and continuing education requirements for dentists performing enteral sedation.

The Board proposes to repeal N.J.A.C. 13:30-8.5, Complaint review procedures, and reserve that section because the Board is in the process of undertaking a review of its actual workflow to determine how it can better and more efficiently perform a review of complaints received to facilitate appropriate resolutions. The Board currently uses the complaint form developed by the Division of Consumer Affairs for use by various professional boards and is committed to processing complaints in a timely fashion and in a manner that will ensure the public health, safety and welfare. The rule as written, however, requires the Board upon receipt of a complaint to obtain from the licensee the complete patient record, regardless of the nature of the complaint. The preferable and current practice is for the Board and its staff to make an initial assessment of the complaint to determine whether it is necessary for the licensee to forward the complete record. For example, in matters where the complaint does not involve the treatment rendered but rather the collection of a fee, a response tailored to the allegation is sought. This practice conserves the resources of the Board, its staff, and the licensed professional. Additionally, the Board's use of dental case managers may further speed the review process as the determination whether to obtain additional information from licensees who subsequently treated the patient can be made prior to full Board review. Further, the Board believes it should take advantage of technological advancements that can be afforded by web-based applications and reduce reliance on paper transmissions. As the Board identifies these approaches it will be in a better position to codify a workable process.

The Board proposes a new rule at N.J.A.C. 13:30-8.6, which is currently reserved, to clarify and consolidate the procedures for biennial license and registration renewal, license and registration suspension, the reinstatement of suspended licenses and registrations, the designation of inactive or retired status by a licensee or registrant and the return from inactive status. As proposed, N.J.A.C. 13:30-8.6 provides that a license or registration issued by the Board must be renewed biennially with the payment of a renewal fee. The new rule sets forth renewal application procedures, late fees, and the consequences of the expiration of an unrenewed license. The rule also codifies the requirement in N.J.S.A. 45:1-7.1 which states that the Board must provide at least 60 days' notice for renewal, and in the event that less than 60 days' is provided, no monetary fine or penalty may be assessed for failure to renew.

The proposed new rule provides that a person whose license or registration has been automatically suspended for five years or less for failure to renew may be reinstated by the Board by paying a reinstatement fee and all past delinquent biennial renewal fees, completing the continuing education required for each biennial period for which the license or registration was suspended, and submitting an affidavit of employment listing all jobs held during the period of suspension. Persons whose license or registration has been suspended for more than five years must also satisfy these requirements, but may also be subject to examination and other requirements determined by the Board in order to ensure continued proficiency.

Proposed new rule N.J.A.C. 13:30-8.6 also sets forth the process by which a licensee or registrant may elect to change his or her status from inactive or retired to active. A person who has been inactive or retired for five years or less may be reinstated upon the payment of a reinstatement fee, the completion of continuing education, and the submission of an affidavit of employment listing all jobs held during the period the licensee or registrant was inactive or retired. In addition to satisfying these requirements, a licensee or registrant who has been inactive or retired for more than five years who wishes to return to practice must submit a new application for licensure or registration and must demonstrate that he or she has maintained proficiency. An applicant who fails to demonstrate such proficiency may be subject to an examination or other Board-imposed requirements prior to reinstatement of the license or registration.

The Board proposes to amend N.J.A.C. 13:30-8.7, which concerns the maintenance of patient records, to clarify that the patient record shall include a diagnosis as well as the treatment risks, alternatives, and costs relative to the treatment that is recommended and/or rendered. The proposed amendments to subsection (a) of N.J.A.C. 13:30-8.7 also provide that the patient record must contain the name of the dentist of record consistent with the provisions of N.J.A.C. 13:30-8.15, which require each patient to have a dentist of record who shall be primarily responsible for the implementation of the patient's dental treatment plan and which dictate how the dentist of record can be changed in a multi-dentist practice. The proposed amendments also would relocate at N.J.A.C. 13:30-8.7(b) the provisions of N.J.A.C. 13:30- 8.15(c), which require each dentist or dental auxiliary to sign or initial each entry on the patient record pertaining to the treatment rendered and would establish a presumption that absent a signature or initials, such treatment was rendered by the dentist of record. The Board believes that it is more appropriate for this requirement to be codified under the patient records rule. The Board proposes to amend subsection (c), now codified as (d), to clarify models that must be maintained as part of the patient record. The proposed amendments provide that a licensee may charge no more than $1.00 per page or $100.00 for the entire patient record, whichever is less. If the record is less than 10 pages, the licensee may charge up to $10.00 to cover postage and other costs associated with the retrieval of the record. The proposed amendments also provide that licensees may charge a reasonable fee for the reproduction of radiographs or other materials within a patient record that cannot be routinely copied or duplicated in a commercial duplicating machine. That fee may be no more than the actual cost of the duplication of the materials or the fee charged to the license for the duplication. The licensee may also charge an administrative fee to offset the cost of office personnel time spent retrieving and reproducing the materials. The proposed amendments also clarify that a licensee may not charge for the reproduction of a patient's records when the licensee has terminated the patient from the dental practice.

The Board proposes to amend N.J.A.C. 13:30-8.9, which concerns the display of names and identifying badges, to allow a dental facility to display on exterior signs or other means of exterior display the names of licensees associated with the facility. The Board proposes to amend N.J.A.C. 13:30- 8.10, which concerns the submission of claims, bills and governmental assistance claims to third party payors for dental services, to prohibit a licensee from submitting a bill for any service or procedure the amount of which has been advertised as free or complimentary or in an amount that exceeds the advertised charge for discounted services or procedures. N.J.A.C. 13:30- 8.11, which sets forth the rules applicable to the identification of removable prosthesis, is proposed to be readopted without amendment. The Board proposes to amend N.J.A.C. 13:30-8.12, which concerns a licensee's obligation to notify the Board of a change of address, to clarify the definition of "address of record" to mean an address designated by a licensee which is part of the public record and which may be disclosed upon request and to require that the address be a licensee's home, business or mailing address, but shall not be a post office box unless the licensee also provides another address which includes a street address. The Board is also proposing to eliminate the requirement that notification of address changes be made by certified mail. The proposed amendments to N.J.A.C. 13:30-8.12 now provide that licensee may send notification of an address change to the Board by mail or by electronic means. The Board proposes to amend N.J.A.C. 13:30-8.13, which concerns permissible business structures and the prohibition on referral fees, to make technical changes regarding limited liability companies and to clarify that dentists may provide professional services in connection with a permissible dental practice as independent contractors provided the arrangement complies with all State and Federal laws.

N.J.A.C. 13:30-8.14, concerning dental x-rays and lead shields, is proposed to be readopted without amendment. The Board proposes to amend N.J.A.C. 13:30-8.15, regarding the dentist of record and fee reimbursement, to delete subsection (c) pertaining to the duty of a dentist or dental hygienist to sign or initial each entry on the patient record as the Board is proposing to relocate this subsection to N.J.A.C. 13:30-8.7(b). N.J.A.C. 13:30-8.16, which currently states that a licensee shall have the right to request an opportunity to be heard prior to any suspension, revocation or refusal to renew a license, is proposed to be readopted without amendment. The Board proposes that N.J.A.C. 13:30-8.17, concerning the delegation of physical modalities to unlicensed dental assistants, be readopted with amendments limiting the delegation of physical modalities to licensed dental hygienists, registered dental assistants, limited registered dental assistants and unregistered dental assistants to be consistent with levels of training and responsibility and limits the delegation of the administration of hot and cold packs as the sole physical modality that may be performed by an unlicensed assistant. N.J.A.C. 13:30-8.18 is reserved. The Board proposes to make a technical amendment to N.J.A.C. 13:30-8.19, concerning the allowable names for a dental practice, to remove the superfluous use of "officers" in this section since that title is not one that is contained in the definition of "associate" under N.J.A.C. 13:30-8.13(a), and, therefore, permitting a practice name to refer to an officer who is not an associate may be misleading.

The Board has determined that the comment period for this proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this proposal is excepted from the rulemaking calendar requirement.

Social Impact

The Board believes that the existing rules, which have been in effect for the past five years, have protected the health, safety and welfare of the citizens of New Jersey by identifying those individuals who are qualified and legally authorized to engage in the practice of dentistry, the practice of dental hygiene, and the practice of dental assisting. These rules establish the requisite standards of licensure and registration in the State and positively affect the regulated community by clarifying the varied aspects of the practices of dentistry, dental hygiene and dental assisting for the benefit of all licensed dentists, licensed dental hygienists, registered dental assistants, clinic permit holders and applicants for licensure and/or registration. The readoption of N.J.A.C. 13:30 is essential in order for the Board to continue to regulate the practices of dentistry, dental hygiene and dental assisting, to identify those individuals who are qualified to engage in such practices, and to ensure that every licensee, registrant, permit holder, and applicant for licensure and/or registration is aware of the procedures involved with licensure and registration.

The readoption of N.J.A.C. 13:30 continues the accepted practice standards for dentists, dental hygienists and dental assistants established by the Board, and by so doing, provides licensees, registrants, permit holders and applicants for licensure and/or registration with a clear and comprehensive set of rules to guide them in their professional practice. Applicants for licensure and/or registration will benefit by having a set of rules which govern the manner in which they may qualify for licensure and/or registration. The Board also believes that licensees and registrants will benefit from the readoption, as a result of the uniform standards that will be applied throughout the profession.

The Board believes that the proposed readoption of these rules will have a positive impact upon the general public by continuing to safeguard the public health and safety by ensuring the maintenance of professional practice standards, which will enable licensees, registrants and permitted facilities to provide the highest quality professional services in the practice of dentistry. The Board believes that the proposed amendments to Chapter 30 will have a positive impact upon the licensed community and upon the patients it serves. Specifically, the Board believes that the proposed amendments to Subchapter 1 will have a positive impact upon applicants for licensure to practice dentistry, as well as applicants for resident permits, by clarifying what information is required to be submitted to the Board.

The Board also believes that proposed amendments to Subchapter 1A, which incorporate the requirements applicable to licensed dental hygienists, will have a positive impact upon dental hygienists, to the extent that the proposed amendments clarify existing requirements for applicants and the scope of practice for licensees.

The Board likewise believes that proposed amendments to Subchapter 2, which incorporates the requirements applicable to dental assistants, will have a positive impact upon registered dental assistants, limited registered dental assistants in orthodontics and unregistered dental assistants because these amendments clarify existing requirements for applicants and the scopes of practice for registered dental assistants, registered limited dental assistants in orthodontics and unregistered dental assistants.

The Board believes that the proposed repeal of Subchapter 2A, which set forth the rules applicable to registered dental assistant and limited registered dental assistant three-month internship programs, will have a positive impact since the repeal will eliminate confusion regarding these anachronistic rules.

Furthermore, the Board believes that the proposed amendments to Subchapter 3, concerning applicants for limited teaching certificates, will have a positive impact upon licensed dentists who wish to teach dentistry in the State, by clarifying existing rules to ensure that licensees are aware of what information must be submitted to the Board to obtain a teaching certificate.

The Board, likewise, believes that the proposed amendments to Subchapter 4, concerning industrial and corporate clinics, will have a positive impact upon applicants for clinic permits, as well as permit holders, by clarifying that dentistry must be practiced, rather than just demonstrated or taught, in order for a clinic to come under this definition.

The Board believes that the proposed amendments to Subchapter 5, concerning the continuing education requirements for licensed dentists, licensed dental hygienists and registered dental assistants, will have a positive impact upon licensees and registrants to the extent that the rules provide more flexibility to the types of acceptable programs and clarify existing requirements.

The Board believes that the proposed amendments to Subchapter 8, concerning the general practice provisions, will have a positive impact upon licensees, registrants and consumers. Specifically, the proposed new rule at N.J.A.C. 13:30-8.6 will have a positive impact upon licensees and registrants by consolidating and clarifying the biennial renewal process and requirements, including reinstatement procedures for certain suspended licenses and registrations and the requirements relating to selecting inactive status and returning to active status. The proposed amendments to N.J.A.C. 13:30-8.7 will have a positive impact upon licensees, registrants and consumers by clarifying the requirements for patient records, including establishing fee limits that may be charged by licensees for copying patient records. In addition, the proposed amendments contained in N.J.A.C. 13:30-8.9, 8.10, 8.12, 8.13, 8.15, 8.17 and 8.19 will have a positive impact upon licensees and registrants by clarifying other various practice requirements. In addition, the Board believes that the positive impact from amendments to N.J.A.C. 13:30-8.17, which prohibit unregistered dental assistants from performing services for which they may not have adequate training, outweigh any possible negative impact felt by these unregistered dental assistants.

Economic Impact

The Board anticipates that the rules proposed for readoption with amendments will not impose any new or additional significant costs upon applicants for licensure, licensees, registrants, dental clinic permit holders, or consumers. The proposed readoption of the existing rules will continue the economic impact that the rules have had on such persons for the past five years.

Subchapter 1 will continue to have an economic impact upon applicants for licensure to practice dentistry, to the extent that such persons will be required to remit to the Board the fees specified in N.J.A.C. 13:30-1.2. In addition, applicants for licensure may experience an economic impact as a result of the costs associated with submitting the required applications and supporting materials, as well as the costs of the examinations required pursuant to N.J.A.C. 13:30-1.2. Applicants for licensure who have graduated from a dental school that has not been approved by the Commission on Dental Accreditation may also experience an economic impact to the extent such persons must complete at least two years of education at a dental school approved by the Commission before they are eligible for licensure. Applicants for resident permits may also experience an economic impact as a result of the fee imposed pursuant to N.J.A.C. 13:30-1.3, as well as the costs associated with submission of the required application, pursuant to N.J.A.C. 13:30-1.3(b). N.J.A.C. 13:30-1.4, concerning exemption from licensure, may also have a positive economic impact upon persons who are exempt from obtaining a license, to the extent that such persons will not be required to make application to the Board or remit the specified fees to perform certain activities. Pursuant to N.J.A.C. 13:30-1.5, any retired licensee seeking to resume the active practice of dentistry may experience the economic costs associated with having to complete the requirements specified in N.J.A.C. 13:30-8.6, prior to resumption of practice.

Subchapter 1A will continue to impose an economic impact upon applicants for licensure as dental hygienists, to the extent that such persons will be required to remit to the Board the fees specified in N.J.A.C. 13:30-1A.1. Such persons may experience an economic impact as a result of the costs associated with submitting the application and supporting materials required pursuant to N.J.A.C. 13:30-1A.1. Subsection (f) of N.J.A.C. 13:30-1A.1 may also have an economic impact upon applicants to the extent that an applicant who has graduated from an educational program more than two years prior to the date of application must complete 10 credits of continuing education prior to the issuance of a license. N.J.A.C. 13:30-1A.2, concerning the scope of practice of a licensed dental hygienist, may have an economic impact upon licensed dentists, to the extent that a licensed dentist may utilize the services of a dental hygienist to perform certain functions in a dental office or institution and, therefore, may increase the number of patients a licensee may treat throughout the day.

The proposed readoption with amendments of Subchapter 2, which sets forth the requirements applicable to dental assistants, may impose economic costs upon applicants for registration as dental assistants and limited dental assistants in orthodontics, to the extent that such individuals must remit a fee to the Board, as well as applications and supporting materials required pursuant to N.J.A.C. 13:30-2.2 and 2.3. In addition, N.J.A.C. 13:30-2.4 and 2.5, which concern the scope of practice of registered dental assistants and limited registered dental assistants in orthodontics, respectively, may have an economic impact upon licensed dentists, to the extent that dentists may utilize the services of such auxiliary personnel in the provision of services to patients. Similarly, N.J.A.C. 13:30-2.6 may have an economic impact upon licensed dentists, to the extent that dentists may also utilize the services of unregistered dental assistants to perform certain activities within a dental office.

The proposed readoption with amendments of Subchapter 3, concerning limited teaching certificates, will continue to have an economic impact upon applicants for such certificates. Applicants seeking a limited teaching certificate may experience an economic impact as a result of the costs associated with submitting the required application set forth in N.J.A.C. 13:30-3.1 and 3.2. Educational institutions may experience an economic impact as a result of the proposed readoption of N.J.A.C. 13:30-3.4, to the extent that such institutions incur administrative expenses associated with remitting required information to the Board.

Subchapter 4, concerning industrial and corporate clinics, as proposed with one amendment to the definition of clinics will continue to have an economic impact upon industrial and corporate clinic permit holders. As in the past, industrial and corporate agencies seeking a clinic permit may experience an economic impact as a result of the proposed readoption of N.J.A.C. 13:30- 4.2, which requires applicants to submit the application fee specified in N.J.A.C. 13:30-8.1. In addition, N.J.A.C. 13:30-4.2(d), which requires applicants wishing to operate more than one dental clinic to apply for separate permits for each facility, may have an economic impact upon certain applicants, to the extent that separate applications and fees must be submitted for each desired facility. Applicants for clinic permits may also experience an economic impact as a result of the proposed readoption of N.J.A.C. 13:30-4.3, which delineates the information that must be submitted with an application, to the extent that applicants incur administrative costs in remitting the required documentation to the Board. N.J.A.C. 13:30-4.5, concerning annual certificates of renewal, will continue to have an economic impact upon industrial and corporate clinic permit holders, to the extent that permit holders wishing to renew their clinic permits must remit to the Board the fee set forth in N.J.A.C. 13:30-8.1. The Board also believes that the proposed readoption of N.J.A.C. 13:30-4.6, which provides that changes to the industrial and corporate clinic must be approved by the Board, may have an economic impact upon permit holders, to the extent that such permit holders incur administrative costs in notifying the Board of such changes. In addition, industrial and corporate clinic permit holders may experience an economic impact as a result of the proposed readoption of N.J.A.C. 13:30-4.9, which sets forth requirements for services and facilities, to the extent that clinic facilities may have to be augmented to accommodate the number of persons treated at the clinic, pursuant to the rule. Industrial and corporate clinic permit holders may also experience an economic impact as a result of the proposed readoption of N.J.A.C. 13:30-4.10, to the extent that permit holders incur administrative expenses in furnishing the Board with a list of all persons employed by the clinic, as well as information regarding the clinic's methods of operation, control, direction and authority in dental matters.

The proposed readoption with amendments of Subchapter 5, which sets forth the requirements for continuing education, will continue have an economic impact upon licensees and registrants. The Board believes that N.J.A.C. 13:30-5.1, which sets forth continuing education requirements for dentists, will have an economic impact upon licensed dentists who must obtain 40 credit hours of continuing education during each biennial renewal period, as provided in N.J.A.C. 13:30-5.1, and upon licensed dentists who must complete their continuing education requirements on a pro rata basis, as provided in N.J.A.C. 13:30-5.1(a)1 and 2. The requirements of N.J.A.C. 13:30- 5.1(c) may also cause licensed dentists to incur administrative expenses associated with maintaining the continuing education records required pursuant to the rule. N.J.A.C. 13:30-5.1(f) and (g) require continuing education sponsors to apply to the Board in writing in order to receive pre-approval for a continuing education course or program. Sponsors may incur administrative costs associated with the submission of an application for pre-approval to the Board. N.J.A.C. 13:30-5.1(i), which provides that licensed dentists who hold general anesthesia permits or parenteral conscious sedation permits pursuant to N.J.A.C. 13:30-8.2 and 8.3 will be granted credit for all 20 hours of continuing education such licensees obtain for their respective permits, may have an additional economic impact upon such licensees to the extent that those hours may not be counted toward the Board's 40 credit hour requirement. N.J.A.C. 13:30-5.1(l), which requires licensees to apply to the Board, in writing, for a waiver of continuing education requirements and to submit documentation in support of such application upon Board request, may have an economic impact upon licensees to the extent that licensees requesting a waiver will incur administrative expenses in satisfying the requirements of the rule. N.J.A.C. 13:30-5.2 which sets forth continuing education requirements for licensed dental hygienists, will have an economic impact upon licensed dental hygienists who must earn 10 credit hours of continuing education during each biennial renewal period, as provided in N.J.A.C. 13:30-5.2(a), and upon licensed dental hygienists who must complete their continuing education requirements on a pro rata basis, as provided in N.J.A.C. 13:30-5.2(b). The requirements of N.J.A.C. 13:30-5.2(e) may also cause licensed dental hygienists to incur administrative expenses associated with maintaining the continuing education records required pursuant to the rule. N.J.A.C. 13:30- 5.3 imposes continuing education requirements upon registered dental assistants and limited registered dental assistants in orthodontics. N.J.A.C. 13:30- 5.3(a) will cause registered dental assistants and limited registered dental assistants to incur economic costs, to the extent that such registrants must complete 10 hours of continuing education during each biennial renewal period. Registrants may also incur administrative expenses as a result of N.J.A.C. 13:30-5.3(d) to the extent that registrants must maintain continuing education records as required by the rule.

The rules in Subchapter 6, which concern advertising and specialty practices and are proposed for readoption without change, may have an economic impact upon licensed dentists who wish to advertise their services. N.J.A.C. 13:30- 6.1, which concerns the announcement of a dental specialty, may have an economic impact upon licensed dentists, to the extent that a dentist who wishes to announce a dental specialty must make application to the Board for a specialty permit and may incur some administrative expenses in making such application. In addition, the provisions of N.J.A.C. 13:30-6.2, concerning professional advertising, may have an economic impact upon licensed dentists, to the extent that all advertisements must contain the licensee's name and the phrase "General Dentist" or, if the licensee holds a specialty permit, the phrase "N.J. Specialty Permit No. ____" pursuant to subsection (e). The inclusion of this information in all advertisements may cause licensees to incur the added expense associated with longer advertisements. Similarly, a licensed dentist who is not granted a specialty permit, but wishes to advertise services in a special area of dentistry, must also include the phrase "General Dentist" to all advertisements, pursuant to subsection (f). In addition, a dentist who advertises under a banner heading for any special area of dentistry in a directory must similarly disclose in the advertisement the phrase "General Dentist" pursuant to subsection (g). Subsection (i) also requires a licensed dentist who wishes to advertise that he or she has obtained member, master, fellow or diplomate status in an organization, to disclose not only whether the licensee is a general dentist or holds a specialty permit, but also the full name of the organization, and if the area of practice is not a recognized specialty, a statement to that effect. Subsections (l) and (m) of N.J.A.C. 13:30-6.2 require a licensed dentist to ensure that certain statements regarding fees are contained in advertisements, which may similarly increase the price of a licensee's advertisements. In addition, subsection (p) could impose an economic impact upon licensees, to the extent that licensees who are not associates may collectively advertise their services. If the design of the collective advertisement could be perceived as being a dental referral service, the advertisement must be accompanied by a mandatory disclosure statement that may increase the cost of licensee advertisements. N.J.A.C. 13:30-6.1(q) may also have an economic impact upon licensees, to the extent that licensees incur costs associated with the maintenance of such advertisement.

The provisions of Subchapter 8 will continue to have an economic impact upon applicants for licensure, licensees, registrants and dental clinic permit holders, to the extent that such persons will be required to remit to the Board the fees specified in N.J.A.C. 13:30-8.1. The proposed readoption of N.J.A.C. 13:30-8.2, concerning parenteral conscious sedation, and N.J.A.C. 13:30-8.3, concerning general anesthesia, will continue to impose an economic impact upon applicants seeking such permits. Applicants for parenteral conscious sedation or general anesthesia permits may experience an economic impact, to the extent that there are administrative costs associated with filing applications with the Board and with maintaining specific records on the use of parenteral conscious sedation and general anesthesia. In addition, permit holders are also required to obtain at least 20 hours of continuing education during the previous two year period in courses devoted to parenteral conscious sedation and general anesthesia, which may also have an economic impact upon permit holders. The proposed new rule at N.J.A.C. 13:30-8.6, concerning the procedures for biennial license and registration renewal, license and registration suspension, the reinstatement of suspended licenses and registrations, the designation of inactive status by a licensee or registrant and the return from inactive status, have an economic impact in that licensees and registrants would have to pay their respective renewal fees and, if applicable, late and reinstatement fees as set forth in N.J.A.C. 13:30- 8.1. In addition, under N.J.A.C. 13:30-8.1(e) and (f), a licensee or registrant who had been suspended for failure to renew would have an economic impact by having to pay past renewal fees in addition to the current renewal fee and a reinstatement fee as well as completing the continuing education units required for each biennial renewal period, and in cases where the license or registration has been suspended for more than five years, the licensee or registrant would have an economic impact by being subject to an examination or other requirements to demonstrative his or her proficiency. Similarly, a licensee or registrant who wishes to return to active status from inactive status would be subject to a similar economic impact by paying the renewal fee and a reinstatement fee as well as completing the continuing education units required for up to two biennial renewal periods, and in cases where the license or registration has been suspended for more than five years, the licensee or registrant would have an economic impact by being subject to an examination or other requirements to demonstrate his or her proficiency.

The proposed readoption with amendments N.J.A.C. 13:30-8.7, concerning patient records, may have an economic impact upon licensed dentists, to the extent that licensees incur administrative costs associated with maintaining contemporaneous, permanent patient records. In addition, N.J.A.C. 13:30- 8.7(e) may have an economic impact upon patients and licensees to the extent that licensees may charge a fee for the reproduction of patient records. Moreover, subsection (g), which establishes the procedures that must be followed when a licensee ceases to engage in the practice of dentistry, may have an economic impact upon licensed dentists, to the extent that licensees are required to publish a notice of the cessation of practice in a newspaper, at least once a month for the first three months after the cessation of the practice. The proposed readoption with amendment of N.J.A.C. 13:30-8.9 will continue to have an economic impact upon licensed dentists to the extent that subsection (a) requires all dental facilities to display on all exterior signs the names of the licensees who are responsible for the administration of the facility. The Board believes that the proposed readoption with amendment of N.J.A.C. 13:30-8.10, concerning dental insurance forms, may also have an economic impact upon licensees, to the extent that licensees incur administrative costs in maintaining insurance claim records and mandate promotional charges be disclosed to third party payors. N.J.A.C. 13:30-8.11, which concerns the marking of removable prostheses, will continue to have an economic impact upon licensees to the extent that licensees may charge a reasonable fee for the permanent marking of dental prostheses. In addition, the proposed readoption with amendments of N.J.A.C. 13:30-8.12, which requires licensees to notify the Board of a change of address, will have an economic impact upon licensees, to the extent that licensees incur administrative costs in notifying the Board of such changes. The Board believes that the readoption with amendments of N.J.A.C. 13:30-8.13, concerning permissible business structures and the prohibition of referral fees, will continue to have an impact upon licensees to the extent that licensees may choose to organize their professional practices in any form specified in subsection (a). Moreover, the proposed readoption of N.J.A.C. 13:30-8.13 will continue to have an economic impact upon licensees to the extent that subsections (d) and (e) prohibit a licensee from receiving or paying any referral fees. The proposed amendment adding subsection (f) to allow dentists to provide professional services as independent contractors may have an economic impact on both those dentists who provide the services and those who contract with them.

The proposed readoption of N.J.A.C. 13:30-8.15, concerning a patient's dentist of record and fee reimbursements, will continue to have an economic impact upon licensed dentists to the extent that any dentist found to have rendered deficient treatment, as well as the owner of the facility in which the deficient treatment was rendered, will be jointly and severally responsible for reimbursing the patient or third party payor for any fees charged. In addition, the proposed readoption with amendments of N.J.A.C. 13:30-8.17, concerning the delegation of certain physical modalities to unlicensed dental assistants, may have an economic impact upon licensed dentists, to the extent that licensees may have delegated limited tasks to unregistered dental assistants who are now prohibited. Dentists may choose to hire licensed or registered auxiliaries to perform these tasks. Unregistered dental assistants may experience an economic impact by their more restricted practice if it results in fewer hours worked. The proposed readoption without amendment of N.J.A.C. 13:30-8.21, concerning the divestiture of interest in a professional corporation by a disqualified licensee, may continue to have an economic impact upon licensees who are disqualified from the practice of dentistry pursuant to Board order. In addition, pursuant to subsection (b), a disqualified licensee must divest his or her interest within 90 days of the entry of a Board order. The proposed readoption without amendment of N.J.A.C. 13:30-8.22, concerning the use of diagnostic tests for traumatically induced temporomandibular dysfunction, will continue to have an economic impact upon licensees, to the extent that licensees may only charge patients for the performance of acceptable panographic x-rays or transcranial temporomandibular joint x-rays, and after conservative treatment and specified time frames, magnetic resonance imaging and tomography to determine the presence of temporomandibular dysfunction from traumatic injury. Moreover, subsection (c) provides that a licensee may not charge a patient, nor may he or she bill a third party payor for the following diagnostic tests: mandibular tracking; surface EMG; sonography; Doppler ultrasound; needle EMG; electroencephalogram; thermograms/thermographs; video fluoroscopy; and reflexology.

Federal Standards Statement

A Federal standards analysis is not required because the rules proposed for readoption with amendments are governed by N.J.S.A. 45:6-1 et seq., and are not subject to any Federal standards or requirements. Although the rules in N.J.A.C. 13:30 are not subject to any mandated Federal requirements or standards, where deemed appropriate, the Board has voluntarily required licensees and establishment owners to comply with applicable Federal laws and regulations. Specifically, the Board proposes to readopt N.J.A.C. 13:30- 1A.2, concerning the scope of practice of licensed dental hygienists, which allows a dental hygienist to place intrasulcular therapeutic medications, as directed by a dentist, provided that the medications have been approved by the Food and Drug Administration. Proposed new N.J.A.C. 13:30-8.13(f) would require dentists who provide professional services as independent contractors to comply with State and Federal laws regarding such arrangements.

Jobs Impact

The rules proposed for readoption with amendments will enable the Board to continue to evaluate the qualifications of all applicants for licensure and registration to ensure that only qualified persons are eligible to engage in the practice of dentistry, the practice of dental hygiene, and the practice of dental assisting in the State. In addition, the rules proposed for readoption with amendments will continue to provide the Board with a mechanism to limit licensure and registration to those individuals who adhere to appropriate professional practice standards. The rules proposed for readoption with amendments may have an impact upon jobs in the State, to the extent that applicants for licensure and registration, licensees, registrants or dental clinic permit holders fail to comply with the requirements established in N.J.A.C. 13:30.

Agriculture Industry Impact

The Board does not anticipate that the rules proposed for readoption with amendments will have any impact on the agriculture industry of the State.

Regulatory Flexibility Analysis

The Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., requires the Board to give a description of the types and an estimate of the number of small businesses to which the proposed readoption with amendments will apply. Currently, the Board has approximately 17,460 licensees, registrants and dental clinic permit holders. If, for purposes of the Act, Board licensees, registrants and permit holders are considered "small businesses" within the meaning of the Act, then the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping and other compliance requirements of the proposed readoption, including the kinds of professional services likely to be needed to comply with these requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the proposed readoption, to outline the manner in which it has designed the proposed readoption to minimize any adverse economic impact upon small businesses and to set forth whether the proposed readoption establishes differing compliance requirements for small businesses.

The proposed readoption with amendments of Subchapter 1 will continue to impose numerous compliance requirements upon licensees, registrants and permit holders. N.J.A.C. 13:30-1.2 requires an applicant for a license to practice dentistry to submit a completed application form and remit payment of the prescribed fee. The completed application must contain a certified transcript from the applicant's dental school, a passport size photograph of the applicant signed by the applicant and notarized, results from the North East Regional Board, New Jersey Jurisprudence and National Board Dental examinations, verification of licensure in other states or jurisdictions, and results of a criminal history background check. N.J.A.C. 13:30-1.2(b) also provides that an applicant seeking recognition of the North East Regional Board examination after five years must submit an application to the Board which contains evidence that the applicant holds a license in good standing in any state or jurisdiction where the applicant is currently licensed. Subsection (c) also requires an applicant who has graduated from a dental school that has not been approved by the Commission on Dental Accreditation to complete at least two years of study at a school that has been approved by the Commission. In addition, subsection (d) requires a candidate for dental licensure who has successfully completed the North East Regional Board examination five years or more prior to the date of application to submit a completed application, the required fee and the specific information required under the rule. Likewise, subsection (e) requires a candidate for dental licensure by credentials, who is licensed to practice dentistry in another state or jurisdiction, to submit a completed application, the required fee and the specific information required under the rule. Under subsection (f), the Board may also require candidates applying under subsections (d) and (e) to submit satisfactory proof of continued competency to practice dentistry. N.J.A.C. 13:30-1.3 requires an applicant seeking a resident permit to submit a completed application and remit payment of the prescribed fee. N.J.A.C. 13:30-1.5 provides that a retired licensee may not resume the active practice of dentistry unless the licensee submits evidence to the Board verifying that completion of continuing education requirements, pays the reinstatement fee, and, if applicable, demonstrates proficiency.

Subchapter 1A will impose numerous compliance requirements upon licensees. Specifically, N.J.A.C. 13:30-1A.1 requires all persons desiring to practice dental hygiene to submit a completed application and the prescribed fee. A completed application must include a certified transcript from applicant's educational program, a passport size photograph signed by the applicant and notarized, the results of the National Dental Hygiene Board, the North East Regional Board and the New Jersey Jurisprudence examinations, a certification from the board of dentistry in every state of jurisdiction in which the applicant holds a license to practice dental hygiene, and the results from a criminal history background check. An applicant seeking waiver of the North East Regional Board examination must submit an application to the Board pursuant to N.J.A.C. 13:30-1A.1(d). An applicant seeking recognition of North East Regional Board examination results after five years must submit an application to the Board which contains evidence that the applicant's license to practice dental hygiene in every state or jurisdiction where the applicant is currently licensed is in good standing, pursuant to N.J.A.C. 13:30- 1A.1(e). N.J.A.C. 13:30-1A.2(b) and (c) require a licensed dental hygienist to work only under the supervision or direct supervision of a licensed dentist. N.J.A.C. 13:30-1A.2(d) prohibits a licensed dentist from supervising more than three licensed dental hygienists at one time. N.J.A.C. 13:30-1A.2(g) permits a dental hygienist to provide a written work order for emergency repair of dental prosthesis, provided that the prosthesis does not require any intra-oral procedure and is inserted, upon completion, by a licensed dentist.

Subchapter 2 imposes various compliance requirements upon registered dental assistants, limited registered dental assistants, and licensed dentists. N.J.A.C. 13:30-2.2 requires applicants for registration as dental assistants to have satisfied the requisite educational requirements specified in subsection (a). In addition, applicants for registration must submit a completed application and must remit the required fee pursuant to N.J.A.C. 13:30-2.2(b). The applicant must also submit evidence that his or her registration in every state or jurisdiction where the applicant is registered is in good standing, the results of a criminal history background check, and evidence of having satisfied the Board's educational requirements. N.J.A.C. 13:30-2.3 requires applicants for registration as limited registered dental assistants in orthodontics to satisfy the educational requirements outlined in subsection (a). Subsection (b) of N.J.A.C. 13:30-2.3 requires an applicant to submit a completed application and remit the required application fee. The applicant must submit evidence that his or her registration in every state or jurisdiction where the applicant is registered is in good standing, an affidavit of good moral character, and evidence of having satisfied the Board's educational requirements. N.J.A.C. 13:30-2.4(a) requires a registered dental assistant to work only under the direct supervision of a licensed dentist. In addition, N.J.A.C. 13:30-2.4(b) permits a registered dental assistant to provide a written work order for emergency repair of a dental prosthesis, provided that the prosthesis does not require any intra-oral procedure and is inserted, upon completion, by a licensed dentist. N.J.A.C. 13:30-2.5 requires a limited registered dental assistant in orthodontics to work only under the direct supervision of a New Jersey licensed dentist who has obtained permission from the Board to announce a specialty in orthodontics. Pursuant to N.J.A.C. 13:30-2.5(b), a limited registered dental assistant may provide a written work order for emergency repair of a dental prosthesis provided that the prosthesis does not require any intra-oral procedure and is inserted, upon completion, by a licensed dentist. N.J.A.C. 13:30-2.6 requires a licensed dentist to provide direct supervision for any dental assistant who has not obtained a registration from the Board if the individual performs certain activities in the dentist's office.

Subchapter 3 will impose various compliance requirements upon licensed dentists seeking limited teaching certificates. N.J.A.C. 13:30-3.1 requires a dentist who is not licensed in this State and who wishes to teach dentistry in the State to secure a limited teaching certificate from the Board. Pursuant to subsection (c), an applicant for such a certificate must submit a certified transcript from the applicant's dental school verifying the applicant's dental degree. N.J.A.C. 13:30-3.2 requires an applicant to submit a completed and notarized application to the Board, which must include two character references. N.J.A.C. 13:30-3.3 prohibits the holder of a teaching certificate from engaging in the private practice of dentistry.

Subchapter 4 imposes numerous reporting and compliance requirements on the holders of industrial or corporate dental clinic permits. Specifically, N.J.A.C. 13:30-4.2 requires all industrial or corporate agencies that wish to operate a dental clinic in New Jersey to submit an application to the Board. The agency must define in the application the type of services to be provided by the clinic. If an agency wishes to operate more than one dental clinic, subsection (d) of N.J.A.C. 13:30-4.2 requires the agency to obtain a separate permit for each facility. N.J.A.C. 13:30-4.3 requires an applicant for an industrial or corporate clinic to submit detailed information regarding the clinic facility, the personnel employed by the clinic, and the services to be performed at the clinic. N.J.A.C. 13:30-4.4 prohibits a permit holder from transferring the clinic permit. N.J.A.C. 13:30-4.5 requires a permit holder to renew the permit annually and to submit an annual renewal fee. N.J.A.C. 13:30-4.6 prohibits an industrial or corporate clinic from making changes to its administrative organization, personnel, construction, physical plant or its stated objectives without first obtaining prior Board approval. N.J.A.C. 13:30-4.7 prohibits the performance of any dental procedures by dentists or auxiliary personnel who are not licensed in the State. Pursuant to N.J.A.C. 13:30-4.9, permit holders must also ensure that the services provided in the clinic are performed consistent with the requisite standard of care for Board licensees, and that clinic facilities are sufficient to meet patient needs. N.J.A.C. 13:30-4.10 requires the director of the clinic to be a New Jersey licensed dentist. N.J.A.C. 13:30-4.10(e) also requires that the permit holder provide the Board with the names and titles of all persons employed at the clinic at the time of permit renewal. In addition, subsection (h) requires the director of the clinic to provide the Board with the clinic's method of operation as to control, direction and authority in dental matters.

Subchapter 5 imposes numerous recordkeeping and compliance requirements upon licensees and continuing education program sponsors. N.J.A.C. 13:30-5.1 provides that all licensed dentists must submit a certification verifying the completion of 40 hours of continuing education every two years at the time of license renewal. In addition, a licensee who was initially licensed during the preceding biennial period must submit a certification verifying the completion of continuing education credits on a pro rata basis, as outlined in N.J.A.C. 13:30-5.1(a)3 and 4. N.J.A.C. 13:30-5.1(c) requires a licensed dentist to maintain a record of all continuing education activity completed, including a record of attendance at any course or program in which the licensee participated. The record of attendance must be maintained for two full biennial periods from the date of completion of the continuing education activity. Subsection (d) provides that a licensee shall submit, upon notice from the Board, documentary proof of completion of the required continuing education credits. N.J.A.C. 13:30-5.1(f) provides that continuing education program sponsors may obtain prior approval for a course provided the sponsor submits to the Board documentation that the course satisfies the Board continuing education requirements. According to subsection (g), any application for pre- approval must be submitted to the Board at least 45 days prior to the date of the program. N.J.A.C. 13:30-5.1(k) provides that a licensed dentist may not carry over more than seven continuing education credits earned in excess of the required 40 credits into the next biennial license renewal period. N.J.A.C. 13:30-5.1(m) requires a licensee to apply to the Board in writing when requesting a waiver of the continuing education requirements of N.J.A.C. 13:30-5.1. N.J.A.C. 13:30-5.2 requires all licensed dental hygienists to submit a certification to the Board verifying the completion of 10 hours of continuing education every two years. Pursuant to subsection (a), a licensed dental hygienist may not obtain more than one-half of the required hours of continuing education from home study courses. Subsection (e) requires a licensed dental hygienist to maintain a record of all continuing education activity and to submit a certification verifying the completion of the required number of continuing education credits to the Board upon request. In addition, subsection (e) provides that a licensee must maintain a record of attendance for all courses and programs for two full biennial periods from the date of completion of the continuing education activity. N.J.A.C. 13:30-5.3(a) requires all registered dental assistants and limited registered dental assistants in orthodontics to submit a certification verifying the completion of 10 hours of continuing education every two years at the time of registration renewal. In addition, subsection (a) provides that no more than one-half of the required hours of continuing education may be obtained through home study courses. Subsection (d) requires all registrants to maintain a record of all continuing education activity and requires registrants to submit the record to the Board upon request. In addition, subsection (d) requires registrants to maintain a record of attendance for two full biennial periods from the date of completion of the continuing education activity.

Subchapter 6 will impose numerous reporting and compliance requirements upon licensed dentists who seek to advertise their services. N.J.A.C. 13:30- 6.1(a) requires any licensee who seeks to announce to the public that he or she is a specialist in one or more areas of dentistry to first obtain a permit from the Board. Subsection (b) requires a licensee to display the specialty permit in all office locations. In addition, if a licensee discontinues the specialty practice, he or she must remit the specialty permit to the Board. Subsection (e) prohibits a licensed dentist from advertising in such a way as to cause any inference or implication, in any advertisement, that another licensed dentist who is associated with the practice, but who is not permitted to announce a specialty, is also qualified for the announcement of the specialty practice. N.J.A.C. 13:30-6.2(b) provides that a licensee who advertises must do so in a dignified manner. In addition, subsection (c) prohibits a licensed dentist from utilizing an advertisement that contains any statement that is false, fraudulent or misleading. Subsection (c) also prohibits a licensed dentist from utilizing any advertisement which promotes a professional service which the licensee knows or should know is beyond the licensee's ability to perform or which uses techniques of communication which appear to intimidate, exert undue pressure or undue influence over a prospective patient. A licensed dentist may also not utilize any advertisement that contains a personal testimonial attesting to the technical quality of the services or treatment rendered by the licensee, nor may a licensee utilize any advertisement in which personally identifiable facts about a patient are communicated without the patient's consent. A licensed dentist may also not suppress, omit or conceal any material fact in any advertisement. N.J.A.C. 13:30-6.2(e) requires all advertisements made by a licensed dentist to include the phrase "general dentist" or a reference to the dentist's specialty permit number. Subsection (f) provides that any dentist, other than one granted permission to announce a specialty, who wishes to advertise a dental specialty, must place in the advertisement the phrase "General Dentist" immediately preceding each specialty claim. The licensee may not use the terms "specialist" or any other words that connote that the licensee is a specialist. Subsection (g) provides that a dentist may advertise under a banner heading for any specialty area of dentistry in any directory, provided that the licensee includes the phrase "General Dentist" in the advertisement. Similarly, a licensee who wishes to advertise services in an area other than a Board recognized specialty may not use the term "specialist" or any other words that connote that the licensee is a specialist in that area. N.J.A.C. 13:30-6.2(i) provides that a licensee may not advertise master, member, fellow or diplomate status in any dental organization unless the advertisement contains a disclosure that the licensee is a general dentist or holds a specialty permit. If the advertisement concerns an area of practice that is not a recognized specialty, the licensee must also disclose such fact in the advertisement. Subsection (j) prohibits a licensee from using a patient's photograph as part of an advertisement unless the licensee has obtained the patient's permission to use the photograph. Subsection (j) also provides that a licensee may use a photograph of a model as part of an advertisement provided that the advertisement clearly discloses that the photograph does not represent work actually performed by the licensee. Subsection (k) prohibits a licensee from engaging in uninvited, in-person solicitation of actual or potential patients who are vulnerable to undue influence because of their particular circumstances. Subsection (l) provides that any advertisement making reference to a fee or the provision of a fee service must contain a fixed or stated range of fees for a specifically described professional service. Subsection (n) requires all licensee advertisements to contain the name, address and telephone number of the licensee, professional service corporation or trade name under which the practice is conducted, and to set forth the names of all licensees who are principals, partners or officers in the professional service facility that is identified in the advertisement. Subsection (p) provides that two or more licensees who are not associates may collectively advertise. If the advertisement could create the appearance of being a dental referral service, the advertisement must contain certain disclosures. Subsection (p) also provides that any such advertisement must contain the name, address, telephone number and license number of at least one licensee who is a participant in the collective advertising program. The licensee so listed must provide the Board with a list of all other program participants upon oral or written request from the Board. If more than 50 percent of the patients who respond to a collective advertisement are directed to one licensee or one dental practice, the advertisement must disclose this fact. Subsection (q) requires all licensees to maintain copies of all advertisements for a period of three years. A video or audiotape of every advertisement communicated by electronic media, or a printed copy of all advertisements communicated on the Internet must also be retained by the licensee.

Subchapter 8 imposes numerous reporting, recordkeeping and compliance requirements upon licensed dentists. N.J.A.C. 13:30-8.2(c) prohibits a dentist from using parenteral conscious sedation unless the dentist has obtained a parenteral conscious sedation (PCS) permit from the Board. A dentist wishing to obtain a PCS permit must apply to the Board and must present evidence of having completed 80 hours of didactic instruction and supervised clinical training in PCS within three years preceding the date of application, as well as emergency training, pursuant to N.J.A.C. 13:30-8.2(d) and (e). In addition, every applicant for a PCS permit must also certify that his or her office is equipped with properly functioning equipment, as well as auxiliary personnel who are appropriately trained, pursuant to subsections (f) and (g). Subsection (k) also requires a permit holder to conduct a thorough evaluation of the patient prior to the administration of PCS. A PCS permit holder must also certify to the Board at the time of license renewal that he or she has completed 20 credit hours of continuing education courses devoted to PCS during the preceding two years. N.J.A.C. 13:30-8.3(c) prohibits a licensed dentist from administering general anesthesia unless such licensee obtains a general anesthesia permit from the Board. In order to obtain a permit, a licensee must submit: evidence of three years of postdoctoral training in oral surgery; evidence of having completed a one year course in anesthesiology; or evidence of having obtained diplomate status in oral surgery, fellow status in the American Dental Society of Anesthesiology, member status of the American Society of Oral Surgeons, or member status of the New Jersey Society of Oral Surgeons. In addition, every applicant for a general anesthesia permit must also certify that his or her office is equipped with properly functioning equipment, as well as auxiliary personnel who are appropriately trained, pursuant to subsections (e) and (f). Subsection (j) also requires a permit holder to certify to the Board at the time of license renewal that he or she has completed 20 credit hours of continuing education courses devoted to general anesthesia during the preceding two years. A licensee must also conduct a thorough evaluation of the patient prior to the administration of general anesthesia pursuant to subsection (l). A licensee must also obtain emergency training pursuant to N.J.A.C. 13:30-8.3(n).

N.J.A.C. 13:30-8.6 requires that licensees and registrants renew their respective licenses and registrations on a biennial basis by submitting a renewal application and payment of fees. In the event that an individual fails to renew his or her license or registration, subsection (c) also requires the payment of a late fee if the renewal is done within 30 days after the license's or registration's expiration date. Subsection (d) provides for the automatic suspension of the license or registration that is not renewed within 30 days of its expiration date, and subsections (e) and (f) provide the requirements for reinstatement of a license or registration that is suspended pursuant to subsection (d). N.J.A.C. 13:30-8.6(g) establishes the requirements for individuals who elect that their licenses or registrations be on inactive status. N.J.A.C. 13:30-8.6 (h) and (i) establish requirements for inactive and retired licensees to return to active status.

N.J.A.C. 13:30-8.7 requires a licensed dentist to maintain a contemporaneous, permanent patient record for each person receiving dental services. Licensees must also maintain records relating to charges made to patients and third party carriers for professional services. Pursuant to subsection (b), if a licensee utilizes a computer to maintain a patient record, the licensee must ensure that the computer system contains an internal, permanently activated date recordation for all entries and the capability to print a hard copy of all data. In addition, subsection (b) requires a licensee utilizing a computer for the maintenance of patient records to identify each patient record by the patient's name and at least one other form of identification, and to post record entries at least once a month. A licensee must prepare a back-up copy of all computerized patient records at least quarterly. Subsection (c) requires each dentist or dental auxiliary to sign or initial each entry on the patient record pertaining to the treatment that he or she rendered. Subsection (d) requires a licensee to maintain all patient records, including radiographs, for seven years from the date of last entry. Diagnostic and study models used for definitive treatment must be maintained for at least three years from the date the models are made. N.J.A.C. 13:30- 8.7(e) provides that a licensee must provide a patient with his or her record within 14 days of the receipt of a written request and limits the allowable fees charged for their reproduction. If the record is illegible or prepared in a language other than English, the licensee must provide a typed or written transcription of the record at no additional cost to the patient. Subsection (f) requires a licensee to maintain the confidentiality of patient records unless the Board directs the release of the record, the release of information is required by statute or rule, or the licensee, in the exercise of his or her professional judgment, believes the release of the information to another licensed health care professional providing services to the patient is necessary. Subsection (g) requires a licensee who anticipates that he or she will cease to engage in the practice of dentistry for more than six months to establish a procedure by which patients may obtain treatment records, to publish a notice of the cessation of the practice and to file a notice of the record retrieval procedure with the Board. A licensee must also make reasonable efforts to directly notify any patient treated during the preceding six months of the cessation of the practice and the record retrieval procedure.

N.J.A.C. 13:30-8.8 requires a licensee to report to the Board in writing, within seven days, any incident occurring in a dental facility which requires the removal of a patient to a hospital for observation or treatment. Licensees must also report to the Board in writing, within seven days, any death that may be related to dental treatment. N.J.A.C. 13:30-8.9(a) requires all dental facilities to display on all exterior signs those names of the licensees who are responsible for the administration of the practice. N.J.A.C. 13:30- 8.9(b) requires every dental facility where two or more dental licensees provide services, to display in the office, the names and professional status of all licensees associated with the facility. In addition, subsection (c) requires all licensees working within a facility to wear an identification badge indicating his or her name, as well as his or her professional status. N.J.A.C. 13:30-8.10 prohibits a licensee from submitting any claim, bill or governmental assistance claim to a third party payor for dental services rendered to any patient which involves dishonesty, fraud, deception or misrepresentation. A licensee may not, pursuant to N.J.A.C. 13:30-8.10(b), submit any claim or bill which contains a treatment date that does not accurately reflect the date when services were actually provided, a description of a dental service which does not accurately reflect the work performed, any service that cannot be justified by the licensee as necessary and proper, any statement material to the claim which is known to be false or misleading, or a charge for any service or procedure the amount of which has been advertised as free or complimentary or for an amount that exceeds the advertised charge for discounted services or procedures. Subsection (c) requires a licensee who intends to waive the co-payment for a patient enrolled in any dental plan to disclose such fact on any claim or bill submitted to the third party payor. Subsection (e) requires all licensees to maintain insurance records consistent with the requirements of the patient records rule at N.J.A.C. 13:30-8.7. N.J.A.C. 13:30-8.11(b) requires a licensee to mark every complete maxillary and mandibular denture or removable partial denture prosthesis with the name and social security number of the patient for whom the denture or prosthesis is prepared. Subsection (d) provides that if identification marks, in the professional judgment of the licensee, may not practically or safely be placed on the denture or prosthesis, such marks may be omitted provided the licensee includes the reason for the omission in the patient's record.

N.J.A.C. 13:30-8.12(a) requires a licensee to notify the Board in writing of any change of address. The licensee must send such notice to the Board, by certified mail, return receipt requested, no later than 30 days following the change of address. N.J.A.C. 13:30-8.13(b) provides that licensed dentists may engage in the practice of dentistry in any permissible business format in which licensees are not shielded from liability for their own breaches of professional duties and they retain responsibility for the quality of care and the appropriateness of their professional decisions. N.J.A.C. 13:30-8.13(c) also provides that licensed dentists may be employed by a permissible business format which includes one or more closely allied health care professionals, provided their professional practice is not supervised and evaluated by a professional who is not a dentist. Subsection (d) and (e) prohibit licensed dentists from receiving or paying referral fees or from participating in any arrangement or agreement, with any person other than an associate, whereby any remuneration received by that person is to be determined or calculated as a fixed percentage of, or is otherwise dependent upon, the income or receipts derived from the practice of dentistry. Subsection (f) allows dentists to provide professional services as independent contractors provided the arrangement complies with all State and Federal laws. N.J.A.C. 13:30-8.14 requires every licensee, and his or her employees or agents licensed by the Department of Environmental Protection, to use a lead shield to protect a patient's torso and thyroid areas during all dental x-ray procedures. N.J.A.C. 13:30-8.15(b) requires the name of the patient's dentist of record to be conspicuously identified on the patient record. N.J.A.C. 13:30-8.15(d) provides that the dentist of record may not be changed, in a multi-dentist practice, unless the subsequent treating dentist acknowledges in writing, in the patient record, that he or she is currently the dentist of record for the patient.

N.J.A.C. 13:30-8.17(c) requires a dentist, prior to delegating to licensed and registered auxiliaries the administration of physical modalities, to examine the patient to ascertain the nature of the dental condition or disease. The dentist must also examine the patient prior to each visit and must determine all components of all treatment to be performed. The dentist must write the information regarding the components of the treatment in the patient's chart prior to the patient's treatment. Subsection (c) requires a licensed dentist to evaluate a patient prior to any subsequent scheduled application of the modality, and to be physically present in the dental office at all times that the treatment orders are being carried out. N.J.A.C. 13:30-8.17(d) prohibits a licensee from permitting an unlicensed assistant to use any physical modalities other than the administration of hot and cold packs. Subsection (e) requires a licensed dentist to identify the specific modality applied on all health insurance claim forms pertaining to physical modalities. N.J.A.C. 13:30-8.19 restricts licensees in the naming of their practices. N.J.A.C. 13:30-8.21 requires a licensee who is disqualified pursuant to Board order to divest his or her interest in a professional corporation for which the holding of a license issued by the Board is required, within 90 days of the entry of the Board order. Subsection (c) provides that if all shareholders of the professional corporation are disqualified pursuant to Board order, all employees of the professional corporation must cease to engage in professional practice until the corporation's membership is restructured. N.J.A.C. 13:30-8.22 provides that a licensee may charge a patient or may bill a third party for diagnostically acceptable panographic x-rays or transcranial temporomandibular joint x-rays and, after set periods of time, for magnetic resonance imaging and tomography to determine the presence of temporomandibular dysfunction from traumatic injury. Subsection (c) provides that a licensee may not charge a patient, nor may he or she bill a third party payor for the following diagnostic tests: mandibular tracking; surface EMG; sonography; Doppler ultrasound; needle EMG; electroencephalogram; thermograms/thermographs; video fluoroscopy; and reflexology. Subsection (d) provides that a licensee may perform the tests outlined in subsection (c) at no charge to the patient or to the third party payor, only after obtaining written informed consent from the patient.

The Board does not believe that licensees, registrants and permit holders will have to engage professional services in order to comply with the proposed new rule or the rules proposed for readoption with amendments. In addition, the Board does not believe that there will be any significant, additional economic impact upon licensees as a result of proposed readoption with amendments. The costs of compliance with the proposed new rule and readoption with amendments are discussed in the Economic Impact section above.

The Board believes that the new rules and rules proposed for readoption with amendments should be uniformly applied to all licensees, registrants and permit holders in order to ensure the health, welfare and safety of the general public in the provision of dental services, and, therefore, no differing compliance requirements for any licensees, registrants or permit holders are provided.

Smart Growth Impact

The Board does not believe that the rules proposed for readoption with amendments, repeal and new rules will have any impact upon the achievement of smart growth or upon the implementation of the State Development and Redevelopment Plan.

Full text of the rules proposed for readoption may be found in the New Jersey Administrative Code at N.J.A.C. 13:30.

Full text of the rules proposed to be repealed may be found in the New Jersey Administrative Code at N.J.A.C. 13:30-1A.3, 1A.4, 2A and 8.5.

Full text of the proposed amendments and new rule follows :

<< NJ ADC 13:30-1.2 >>

13:30-1.2 Application for licensure to practice dentistry

(a) (No change.)

(b) To qualify as a candidate for dental licensure, an applicant shall submit a completed application to the Board which shall contain the following information and materials:

1. A <<-certification by->> <<+certified transcript from+>> the secretary or dean of a dental school, college or department of a university approved by the Commission on Dental Accreditation verifying that the applicant has obtained a dental degree from such institution;

2. A passport size photograph of the applicant <<-certified by the secretary or dean of the dental school, college or department of the university from which the applicant has obtained a dental degree->> <<+ signed by the applicant and notarized+>>;

3. Results from the successful completion of the <<-Northeast->> <<+ North East+>> Regional Board <<-Examination->> <<+examination+>>. If an applicant fails any portion of the <<-Northeast->> <<+North East+>> Regional Board <<-Examination->> <<+examination+>> three consecutive times, the Board may require the applicant to sit for and pass a remedial course in the subject area at a dental school, college or department of a university approved by the Commission on Dental Accreditation. The Board shall recognize successful completion of the <<-Northeast->> <<+North East+>> Regional Board examination for up to five years<<-. After five years, the Board shall review each request on a case-by-case basis consistent with the following:->>

<<-i. The Board may recognize successful completion of the Northeast Regional Board Examination after five years. As part of its review, the Board shall consider and evaluate any prior record of disciplinary action or pending disciplinary action against the candidate or investigation of the candidate in any other state and the applicant's complete professional employment history.->><<+;+>>

<<+4. Results of the successful completion of parts I and II of the National Board Dental examination;+>>

<<-4.->><<+5.+>> (No change in text.)

<<-5. Results of the successful completion of parts I and II of the National Board Dental Examination;->>

6. (No change.)

7. <<-An affidavit of good moral character; and->> <<+Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.;+>>

<<+8. The applicant's complete professional employment history; and+>>

<<-8.->><<+9.+>> (No change in text.)

<<-(c) Notwithstanding the provisions of (b) above, an applicant for licensure to practice dentistry who graduated from a dental school more than two years prior to the date of application, shall submit a certification verifying the completion of 40 hours of continuing education within two years prior to application, consistent with the requirements of N.J.A.C. 13:30- 5.1.->>

<<-(d)->><<+(c)+>> (No change in text.)

<<+(d) A candidate for dental licensure who has successfully completed the North East Regional Board examination five years or more prior to the date of application shall submit a completed application to the Board which shall contain the following information and materials:+>>

<<+1. A certified transcript from the secretary or dean of a dental school, college or department of a university approved by the Commission on Dental Accreditation verifying that the applicant has obtained a dental degree from such institution;+>>

<<+2. A passport size photograph of the applicant signed by the applicant and notarized;+>>

<<+3. Results of the successful completion of parts I and II of the National Board Dental examination;+>>

<<+4. Results from the successful completion of the New Jersey Jurisprudence examination taken within one year of the date of application;+>>

<<+5. A certification by the board of dentistry in every state or jurisdiction in which the applicant holds a dental license verifying that the applicant's license in that state or jurisdiction is in good standing. The applicant shall hold an active dental license in at least one state or jurisdiction upon application to the Board;+>>

<<+6. Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.;+>>

<<+7. The applicant's complete professional employment history; and+>>

<<+8. The application fee as set forth in N.J.A.C. 13:30-8.1.+>>

<<+(e) A candidate for dental licensure by credentials, who is licensed to practice dentistry in another state or jurisdiction, shall submit a completed application to the Board which shall contain the following information and materials:+>>

<<+1. Evidence demonstrating that the applicant has actively practiced dentistry in a single state or jurisdiction for at least five years prior to the date of application;+>>

<<+2. A certified transcript from the secretary or dean of a dental school, college or department of a university approved by the Commission on Dental Accreditation verifying that the applicant has obtained a dental degree from such institution;+>>

<<+3. A passport size photograph of the applicant signed by the applicant and notarized;+>>

<<+4. Results of the successful completion of parts I and II of the National Board Dental examination;+>>

<<+5. Results of the successful completion of a clinical examination administered or recognized by another state or jurisdiction that is comparable to the North East Regional Board examination;+>>

<<+6. Results from the successful completion of the New Jersey Jurisprudence examination taken within one year of the date of application;+>>

<<+7. A certification by the board of dentistry in every state or jurisdiction in which the applicant holds a dental license verifying that the applicant's license in that state or jurisdiction is in good standing;+>>

<<+8. Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.;+>>

<<+9. The applicant's complete professional employment history; and+>>

<<+10. The application fee and the fee for licensure by credentials as set forth in N.J.A.C. 13:30-8.1.+>>

<<+(f) The Board may require candidates applying for dental licensure pursuant to (d) and (e) above to submit satisfactory proof of continued competency to practice dentistry.+>>

<< NJ ADC 13:30-1.3 >>

13:30-1.3 Resident permit

(a) Prior to obtaining licensure, a graduate of a dental school approved by the Commission on Dental Accreditation who has passed Part I and Part II of the National Board Dental <<-Examination->> <<+examination+>> may serve as a resident in a <<+public or private licensed+>> hospital <<+or other public or private institution+>> approved by the Commission on Dental Accreditation upon obtaining a resident permit from the Board. A resident permit shall be renewed annually for the length of the residency program<<+, to a maximum of three years pursuant to N.J.S.A. 45:6-20+>>.

(b) An applicant for a resident permit shall submit to the Board a completed application which shall contain the following:

1. A <<-certification by->> <<+certified transcript from+>> the secretary or dean of a dental school, college or department of a university approved by the Commission on Dental Accreditation verifying that the applicant has obtained a dental degree from such institution;

2. (No change.)

3. <<-An affidavit of good moral character->> <<+Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.+>>; and

4. (No change.)

<< NJ ADC 13:30-1.4 >>

13:30-1.4 Exemption from licensure

(a) The following individuals shall not be required to obtain a license to practice dentistry pursuant to N.J.S.A. 45:6-19:

1. (No change.)

2. Dentists discharging their duties in the United States Army, Navy, Air Force, Public Health Service or Veterans <<-Bureau->> <<+ Administration+>>;

3. (No change.)

4. Licensed dentists of other states or jurisdictions appearing as instructors of continuing education courses approved by the Board pursuant to N.J.A.C. 13:30-5.1; <<-and->>

5. Licensed dentists of other states or jurisdictions engaged as expert witnesses in disciplinary matters or court actions in New Jersey<<-.->><<+; and+>>

<<+6. Residents holding permits issued pursuant to N.J.S.A. 45:6-20 and N.J.A.C. 13:30-1.3.+>>

<< NJ ADC 13:30-1.5 >>

13:30-1.5 Retired <<-or inactive->> licensure

<<-(a)->> A licensee who has practiced dentistry for at least 25 years may, upon application to the Board, be licensed as a retired dentist. A retired licensee shall not engage in the practice of dentistry for the entire biennial period in which he or she has been granted retired status. A retired licensee may resume the practice of dentistry upon <<-submission of evidence to the Board of having completed the continuing education requirements of N.J.A.C. 13:30-5.1(a)1->> <<+fulfilling the requirements of N.J.A.C. 13:30- 8.6(h) or (i), whichever is appropriate+>>.

<<-(b) A licensee may, upon application to the Board and payment of the fee set forth in N.J.A.C. 13:30-8.1, renew his or her license by choosing inactive status. A licensee electing to renew his or her license as inactive shall not engage in the practice of dentistry for the entire biennial period. An inactive licensee may resume the practice of dentistry upon submission of evidence to the Board of having completed the continuing education requirements as set forth in N.J.A.C. 13:30-5.1(a)1.->>

<< NJ ADC 13:30-1A.1 >>

13:30-1A.1 Application for licensure as registered dental hygienist

(a) (No change.)

(b) An applicant for licensure as a dental hygienist shall submit a completed application to the Board which shall contain the following information and materials:

1. A <<-certification by->> <<+certified transcript from+>> the secretary or dean from an institution with an educational program in dental hygiene approved by the Commission on Dental Accreditation verifying that the applicant completed the educational program in dental hygiene;

2. A passport size photograph of the applicant <<-certified by the secretary or dean of the institution from which the applicant has completed the program in dental hygiene->> <<+signed by the applicant and notarized+>>;

3. (No change.)

4. The results of the successful completion of the <<-Northeast->> <<+ North East+>> Regional Board examination, except as provided in (d) and (e) below;

5.-6. (No change.)

7. <<-An affidavit of good moral character->> <<+Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.+>>; and

8. (No change.)

(c) (No change.)

(d) Upon a written request from an applicant, the Board may grant a waiver of <<-Northeast->> <<+North East+>> Regional Board performance testing. The candidate requesting such a waiver shall submit, at a minimum, the following:

1. (No change.)

2. A <<-certification by->> <<+certified transcript from+>> the secretary or dean from an institution with an educational program in dental hygiene approved by the Commission on Dental Accreditation verifying that the applicant completed the educational program in dental hygiene; <<+and+>>

3. Test results of any state or regional clinical examination other than the <<-Northeast->> <<+North East+>> Regional Board examination<<-; and->><<+.+>>

<<-4. Ten credits of continuing education in dental hygiene earned within two years prior to the application as set forth in N.J.A.C. 13:30-5.2.->>

(e) The Board shall recognize successful completion of the <<- Northeast->> <<+North East+>> Regional Board <<-Examination->> <<+ examination+>> for up to five years. After five years, the Board shall review each request for recognition of the <<-Northeast->> <<+North East+>> Regional Board examination on a case by case basis and may recognize successful completion of the examination provided the candidate submits, at a minimum, <<-the following:->>

<<-1. A->> <<+a+>> certification by the board of dentistry in every state or jurisdiction in which the applicant holds a license to practice dental hygiene verifying that the applicant's license in that state or jurisdiction is in good standing<<-; and->><<+.+>>

<<-2. Ten credits of continuing education in dental hygiene earned within two years prior to the application as set forth in N.J.A.C. 13:30-5.2.->>

(f) Notwithstanding the provisions of (b) above, an applicant for licensure as a dental hygienist who graduates from an educational program in dental hygiene approved by the Commission on Dental Accreditation <<-more than->> two <<+or more+>> years prior to the date of application <<+and who has not practiced dental hygiene during such time+>> shall <<-submit a certification verifying the completion of 10 credits of continuing education in dental hygiene as set forth in N.J.A.C. 13:30-5.2->> <<+demonstrate that he or she has maintained proficiency in dental hygiene+>>.

<< NJ ADC 13:30-1A.2 >>

13:30-1A.2 Scope of practice of licensed dental hygienist

(a) (No change.)

(b) A licensed <<-dentist->> <<+dental+>> hygienist practicing under the direct supervision of a licensed dentist may:

1. (No change.)

2. Perform root <<-planning->> <<+planing+>>;

<<+3. Etch teeth in preparation for bonding, sealants and desensitizing agents;+>>

<<-3.->><<+4.+>> (No change in text.)

<<+5. Place caries detecting agents;+>>

<<+6. Use instruments for caries detection. Such instruments shall not include lasers that are capable of altering, cutting, burning or damaging hard or soft tissue;+>>

Recodify existing 4.-5. as <<+7.-8.+>> (No change in text.)

<<-6.->><<+9.+>> Fabricate <<-athletic->> mouth guard appliances;

Recodify existing 7.-8. as <<+10.-11.+>> (No change in text.)

<<-9.->><<+12.+>> Place temporary <<-sedative->> restorations;

<<+13. Perform hand removal of soft temporary restorations;+>>

Recodify existing 10.-12. as <<+14.-16.+>> (No change in text.)

<<-13. Take impressions for diagnostic models and models to be used as counters for fixed or removable prostheses;->>

<<+17. Perform hand removal of crowns and bridges that have been temporarily cemented;+>>

<<+18. Take alginate impressions;+>>

<<-14.->><<+19.+>> Place amalgam <<-and->><<+, composite or+>> gold foil in a tooth for condensation by the dentist;

<<-15.->><<+20.+>> (No change in text.)

<<-16.->><<+21.+>> Perform bite registration procedures <<-to determine occlusal relationship of diagnostic models only->>;

Recodify existing 17.-18. as <<+22.-23.+>> (No change in text.)

<<-19. Remove->> <<+24. Place and remove+>> arch wires and ligature wires;

Recodify existing 20.-25. as <<+25.-30.+>> (No change in text.)

<<-26.->><<+31.+>> Hold a curing light for any dental procedure. Such curing light shall not include a laser <<+capable of altering, cutting, burning or damaging hard or soft tissue+>>;

<<-27.->><<+32.+>> (No change in text.)

<<-28.->><<+33.+>> Select shades of prosthetic appliances; <<- and->>

<<+34. Demonstrate home-use bleaching systems;+>>

<<+35. Apply hot or cold packs pursuant to the direction of a licensed dentist; and+>>

<<-29.->><<+36.+>> (No change in text.)

(c)-(i) (No change.)

<< NJ ADC 13:30-1A.3 >>

13:30-1A.3 <<-Inactive licensure->> <<+(Reserved)+>>

<< NJ ADC 13:30-1A.4 >>

13:30-1A.4 <<-Resumption of active practice by inactive dental hygienist->> <<+(Reserved)+>>

<< NJ ADC 13:30-2.2 >>

13:30-2.2 Application for registration as dental assistant

(a) An applicant desiring to secure registration as a dental assistant shall have:

<<-1. Successfully completed high school (or its equivalent) and shall have:->>

<<-i.->><<+1.+>> Satisfactorily completed and graduated, within the past 10 years, from an educational program for dental assistants approved by the Board and the Commission on Dental Accreditation and shall have taken the Registered Dental <<-Assisting->> <<+Assistant+>> Certification Examination administered by the Dental Assisting National Board (DANB) within 10 years prior to the date of application; <<+or+>>

<<+2. Successfully completed high school (or its equivalent) and shall have:+>>

<<-ii.->><<+i.+>> Obtained at least two years work experience as a dental assistant during the five-year period prior to making application for registration, passed the <<+Registered Dental Assistant+>> Certification Examination administered by DANB within 10 years prior to the date of application, successfully completed a Board-approved program in expanded functions, and passed the New Jersey Expanded Functions Examination administered by DANB; <<+or+>>

<<-iii.->><<+ii.+>> Obtained at least two years work experience as a dental assistant during the five-year period prior to making application for registration, passed the <<+Registered Dental Assistant+>> Certification Examination administered by DANB within 10 years prior to application, and passed the New Jersey Expanded Functions Examination administered by DANB<<-; or->><<+.+>>

<<-iv. Until February 1, 2001, obtained at least six months work experience, as defined in N.J.A.C. 13:30-2A.3, as a dental assistant, successfully completed a three-month internship program in the office and under the direct supervision of a New Jersey licensed dentist as set forth in N.J.A.C. 13:30-2A, passed the Certification Examination administered by DANB within 10 years prior to the date of the application, and passed the New Jersey Expanded Functions Examination administered by DANB.->>

(b) An applicant for registration as a dental assistant shall submit a completed application to the Board which contains the following information and materials:

1. (No change.)

2. Proof of the following, if applicable pursuant to (a) above:

i.-ii. (No change.)

iii. A certificate of successful completion of an approved program in expanded functions in dental assisting. The Board shall recognize the following as providers of approved programs in expanded functions:

(1)-(2) (No change.)

(3) In-service training programs conducted at the graduate level by agencies of the Federal, State, or local government, which are substantially similar to programs described in (b)2iii(1) and (2) above; <<+and+>>

<<-iv. A certificate of successful completion of a three-month internship program as set forth in N.J.A.C. 13:30-2A; and->>

<<-v.->><<+iv.+>> A certificate of successful completion of the Registered Dental Assistant Certification Examination administered by DANB;

3. <<-An affidavit of good moral character->> <<+Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.+>>; and

4. (No change.)

<< NJ ADC 13:30-2.3 >>

13:30-2.3 Application for registration as limited registered dental assistant in orthodontics

(a) An applicant desiring to secure registration as a limited registered dental assistant in orthodontics shall have:

1. Successfully completed high school (or its equivalent) and shall have<<-:->>

<<-i. Obtained->> <<+obtained+>> at least two years work experience as a dental assistant in orthodontics during the five-year period prior to making application for registration, passed the New Jersey Orthodontics Certification Examination administered by the Dental Assisting National Board (DANB) within 10 years prior to the date of application, successfully completed a Board-approved program in expanded functions in orthodontics, and passed the New Jersey Expanded Functions in Orthodontics Examination administered by DANB<<-; or->><<+.+>>

<<-ii. Until February 1, 2001, obtained at least six months work experience, as defined in N.J.A.C. 13:30-2A.3, as a dental assistant in orthodontics, successfully completed a three-month internship program in the office and under the direct supervision of a New Jersey licensed dentist as set forth in N.J.A.C. 13:30-2A, passed the New Jersey Orthodontics Certification Examination administered by DANB within 10 years prior to the date of application, and passed the New Jersey Expanded Functions in Orthodontics Examination administered by DANB.->>

(b) An applicant for registration as a limited registered dental assistant in orthodontics shall submit a completed application to the Board which contains the following information and materials:

1. (No change.)

2. Proof of the following, if applicable pursuant to (a) above:

i.-ii. (No change.)

iii. A certificate of successful completion of an approved program in expanded functions in orthodontics. The Board shall recognize the following as providers of approved programs in expanded functions:

(1)-(2) (No change.)

(3) In-service training programs conducted at the graduate level by agencies of the Federal, State, or local government, which are substantially similar to programs described in (b)2iii(1) and (2) above; <<+and+>>

<<-iv. A certificate of successful completion of a three-month internship program as set forth in N.J.A.C. 13:30-2A; and->>

<<-v.->><<+iv.+>> A certificate of successful completion of the limited registered dental assistant certification examination administered by DANB;

3. <<-An affidavit of good moral character->> <<+Results from a criminal history background check conducted by the State of New Jersey pursuant to N.J.S.A. 45:1-28 et seq.+>>; and

4. (No change.)

<< NJ ADC 13:30-2.4 >>

13:30-2.4 Scope of practice of registered dental assistant

(a) A registered dental assistant may perform the following duties under the direct supervision of a licensed dentist:

1.-2. (No change.)

3. Place temporary <<-sedative->> restorations;

4.-6. (No change.)

<<-7. Take impressions for diagnostic models and models to be used as counters for fixed or removable prostheses;->>

<<+7. Etch teeth in preparation for bonding, sealants and desensitizing agents;+>>

<<+8. Place caries detecting agents;+>>

<<+9. Use instruments for caries detection. Such instruments shall not include lasers that are capable of altering, cutting, burning or damaging hard or soft tissue;+>>

<<+10. Perform hand removal of soft temporary restorations;+>>

<<+11. Perform hand removal of crowns and bridges that have been temporarily cemented;+>>

<<+12. Prepare coronal surfaces for bonding and restoration, with pumice and water only, not to include a prophylaxis;+>>

<<+13. Take alginate impressions;+>>

<<-8.->><<+14.+>> Place amalgam <<-and->><<+, composite or+>> gold foil in a tooth for <<-consideration->> <<+condensation+>> by the dentist;

<<-9.->><<+15.+>> (No change in text.)

<<-10.->><<+16.+>> Perform bite registration procedures <<-to determine occlusal relationships of diagnostic models only->>;

Recodify existing 11.-12. as <<+17.-19.+>> (No change in text.)

<<-13. Remove->> <<+20. Place and remove+>> arch wires and ligature wires;

<<-14.->><<+21.+>> Take impressions for and perform laboratory fabrication of <<-athletic->> mouth guards. This shall not include insertion of the appliance;

Recodify existing 15.-20. as <<+22.-27.+>> (No change in text.)

<<-21.->><<+28.+>> Hold a curing light for any dental procedure. Such curing light shall not include a laser <<+capable of altering, cutting, burning or damaging hard or soft tissue+>>;

<<-22.->><<+29.+>> (No change in text.)

<<-23.->><<+30.+>> Select shades of prosthetic appliances; <<- and->>

<<+31. Demonstrate home-use bleaching systems;+>>

<<+32. Apply hot or cold packs pursuant to the direction of a licensed dentist;+>>

<<+33. Administer a topical fluoride treatment on a patient after a licensed dentist or licensed dental hygienist has performed a prophylaxis; and+>>

<<-24.->><<+34.+>> (No change in text.)

(b)-(e) (No change.)

<< NJ ADC 13:30-2.5 >>

13:30-2.5 Scope of practice of limited registered dental assistant in orthodontics

(a) A limited registered dental assistant in orthodontics may perform the following duties under the direct supervision of a New Jersey licensed dentist who has obtained a Board permit number to announce a specialty in orthodontics pursuant to N.J.A.C. 13:30-6.1:

1. Take <<+alginate+>> impressions <<-for diagnostic models to be used as counters for fixed or removable prostheses->>;

2. <<-Take impressions for and perform laboratory fabrication of athletic->> <<+Fabricate+>> mouth guard<<-s->> <<+appliances+>>. This shall not include insertion of the appliance;

3.-6. (No change.)

7. Perform bite registration procedures <<-to determine occlusal relationships of diagnostic models only->>;

8.-9. (No change.)

10. Provide oral health education including dietary analysis and clinical instruction in order to promote dental health; <<-and->>

11. Remove such debris as is normally created in the course of treatment during or after dental procedures by vacuum devices, compressed air, mouthwashes and water<<-.->><<+; and+>>

<<+12. Apply hot or cold packs pursuant to the direction of a licensed dentist.+>>

(b) (No change.)

<< NJ ADC 13:30-2.6 >>

13:30-2.6 Scope of practice of unregistered dental assistant

(a) A dental assistant who has not obtained a registration from the Board may perform the following duties under the direct supervision of a licensed dentist:

1.-8. (No change.)

9. Hold a curing light in any dental procedure. Such curing light shall not include a laser <<+capable of altering, cutting, burning or damaging hard or soft tissue+>>;

10. (No change.)

11. Select shades for prosthetic appliances; <<-and->>

<<+12. Apply hot or cold packs pursuant to the direction of a licensed dentist; and+>>

<<-12.->><<+13.+>> (No change in text.)

(b) (No change.)

<<+SUBCHAPTER 2A. (RESERVED)+>>

SUBCHAPTER 3. APPLICANTS FOR LIMITED TEACHING CERTIFICATE IN A DENTAL SCHOOL

<< NJ ADC 13:30-3.1 >>

13:30-3.1 Qualifications of applicants

(a)-(b) (No change.)

(c) An applicant for a limited teaching certificate shall submit a <<- certification->> <<+certified transcript+>> from the secretary or dean of a dental school, college or department of a university approved by the Board or by the Commission on Dental Accreditation, verifying that the applicant has obtained a dental degree from such institution.

<<-(d) An applicant for a limited teaching certificate shall submit a certification verifying the successful completion of 20 hours of continuing education during the preceding year, consistent with the requirements of N.J.A.C. 13:30-5.1, provided, however, that no applicant shall receive credit for more than 10 hours of continuing education obtained as a result of a teaching appointment.->>

<< NJ ADC 13:30-3.2 >>

13:30-3.2 Application procedure

(a) The applicant for a limited teaching certificate shall:

<<-1. Obtain from the Executive Director of the Board an application for a limited teaching certificate;->>

<<-2.->><<+1.+>> Submit a completed <<+and notarized+>> application which shall include a <<-certification->> <<+certified transcript+>> of graduation from an accredited dental school by an authorized official of the dental school <<-and a certification verifying the completed continuing education requirements->>; <<+and+>>

<<-3. Give->> <<+2. Provide+>> two character references from licensed New Jersey dentists<<+.+>><<-; and->>

<<-4. Have the completed application notarized.->>

<< NJ ADC 13:30-4.1 >>

13:30-4.1 Industrial or corporate clinic defined

"An industrial or corporate clinic" means a privately owned clinic maintained and operated by an industrial corporation, an organization composed of the management of several industries, or a labor organization(s) or any combination<<-s->> thereof where dentistry in any or all of its branches is practiced, demonstrated or taught on a nonprofit basis for the benefit of the employees of the industries involved and their dependents or for the benefit of the members of the labor organization(s) and their dependents.

<< NJ ADC 13:30-5.1 >>

13:30-5.1 Continuing dental education requirements for dentists

(a) Continuing education shall be a mandatory requirement for license renewal, except that the Board shall not require completion of continuing dental education credits for initial registration of dentists. All licensed dentists <<+holding active licenses+>> shall submit a certification verifying completion of 40 hours of continuing dental education every two years at the time of registration renewal, except for the following:

<<-1. Any licensee who holds an inactive license or a retired license pursuant to N.J.A.C. 13:30-1.6 shall be exempt from the requirements of this subchapter, except as provided in (a)1i and ii below:->>

<<-i. Any inactive or retired licensee, any licensee who has had his or her license revoked or suspended, who has ceased practicing dentistry in all states or jurisdictions in which the licensee may practice and who desires to resume the practice of dentistry in New Jersey shall complete a minimum of 20 hours of continuing education for each year of inactive, retired, revoked or suspended licensure, not to exceed a cumulative total of 80 hours, 40 hours of which shall have been obtained within two years of the date of application for resumption of practice.->>

<<-ii. Any inactive or retired licensee, or any licensee who has had his or her license revoked or suspended, who has continued the practice of dentistry in any state or jurisdiction other than New Jersey and who desires to resume the practice of dentistry in New Jersey shall complete a minimum of 20 hours of continuing education for each year of inactive, retired, revoked or suspended registration, not to exceed a cumulative total of 40 hours, 20 hours of which shall have been obtained within two years of the date of application for resumption of practice.->>

<<-2. A licensee whose license has expired pursuant to N.J.A.C. 13:30- 1.7 shall complete a minimum of 40 hours of continuing education for each biennial period the license was expired.->>

<<-3. A->> <<+1. Except as set forth in (a)2 below, a+>> licensee who was initially licensed during the <<+first year of the+>> preceding biennial period<<-, except as provided in (a)4 below,->> shall submit a certification verifying the completion of <<+40 credits of+>> continuing dental education <<-credits on a pro rata basis as follows:->>

. <<+A licensee who was initially licensed during the second year of the preceding biennial period shall submit a certification verifying the completion of 20 credits of continuing dental education; and+>>

<<-4.->><<+2.+>> An individual who graduates from a dental school <<-or who completes a residency program->> <<+and is licensed+>> in the first year of the biennial period shall complete 20 credits of continuing education. An individual who graduates from a dental school <<-or who completes a residency program->> <<+and is licensed+>> in the second year of the biennial period shall be exempt from continuing education requirements for that biennial period.

(b) (No change.)

(c) It shall be the responsibility of each licensee to maintain a record of all continuing education activity completed and to be prepared to submit evidence of completion of the credit requirements to the Board upon request. <<+Records shall be maintained for two full biennial periods from the date of completion of the continuing education activity.+>> Each licensee shall obtain from the continuing education course sponsor <<-and retain for a period of four years->> a record of attendance which shall include, at a minimum, the following:

1.-7. (No change.)

(d)-(e) (No change.)

(f) If a continuing education sponsor desires prior approval for a course of acceptable subject matter and seeks to be assigned a designated number of continuing education credits by the Board, the program sponsor shall provide, in writing and on a form provided by the Board, <<+the curriculum vitae of all instructors and/or discussion leaders, the outline of the course, the course objectives and+>> information <<-required by the Board->> to document that the course meets the following requirements:

1.-3. (No change.)

(g) (No change.)

<<+(h) Continuing education course approval granted pursuant to this section shall be valid for two years from the date of approval provided that the course subject matter, course instructor and course length remain unchanged from the initial application.+>>

<<-(h)->><<+(i)+>> A licensee may obtain continuing education credits from any of the areas of study listed below. A licensee shall not <<- exceed->> <<+receive credit for more than+>> the maximum number of hours permitted in each area of study for each biennial period, as set forth in <<- (h)->><<+(i)+>>1 through 4 below.

1. Educational and scientific courses related to the practice of dentistry;

i. (No change.)

ii. The following shall satisfy the requirement of 40 hours of continuing education for a biennial registration period:

(1) (No change.)

(2) Attendance at, or completion of, an approved advanced education program leading to specialty certification in endodontics, oral <<+and maxillofacial+>> surgery, oral <<+and maxillofacial+>> pathology, orthodontics, pediatric dentistry, periodontics, prosthodontics<<+,+>> <<-or->> public health<<+, or oral and maxillofacial radiology+>>.

iii. A maximum of <<-15->> <<+five+>> hours of continuing education credit shall be given to a student or an instructor for basic Cardiopulmonary Resuscitation courses <<-or->> <<+and a maximum of 15 hours of continuing education credit shall be given to a student or an instructor for+>> Advanced Cardiac Life Support courses.

iv. A maximum of <<-10->> <<+20+>> hours of continuing education credit shall be given for <<-videotape, audiotape or->> <<+any form of+>> written or electronic <<-correspondence->> <<+media distance learning+>> courses. <<-The videotape, audiotape or correspondence->> <<+A written or electronic media distance learning+>> course shall include a written post-test, and such test shall be retained by the licensee as an additional record of completion of the course.

v. (No change.)

2. (No change.)

3. Teaching and research appointments:

i. A licensee involved in <<+new+>> teaching or research activities at least one full day or the equivalent of one full day per week per academic year and who holds at least a part-time faculty or research appointment shall receive four hours of continuing education credit annually for each full day of teaching or research activity or two hours annually for each half day of teaching or research activity. <<+For purposes of this section, "new" means a program, course or subject matter which the licensee has not taught or researched before in any educational or practice setting.+>>

ii. (No change.)

4. (No change.)

Recodify existing (i)-(l) as <<+(j)-(m)+>> (No change in text.)

<< NJ ADC 13:30-5.2 >>

13:30-5.2 Continuing education requirements for dental hygienists

(a) All licensed dental hygienists shall submit a certification verifying the completion of 10 hours of continuing education every two years at the time of <<-registration->> <<+license+>> renewal, except as provided in (b) and <<-(c) or (e)->> <<+(d)+>> below. No more than <<-four hours->> <<+one-half+>> of <<+the required+>> continuing education <<+hours+>> in the two<<+-+>>year period may be obtained through written or electronic <<-home study->> <<+media distance learning+>> courses.

<<-(b) A licensed dental hygienist who is inactive pursuant to N.J.A.C. 13:30-1A.3, or has had his or her license revoked or suspended, shall be exempt from the provisions of this section, except that any inactive, revoked or suspended dental hygienist who desires to resume the practice of dental hygiene shall complete a minimum of five hours of continuing education if such licensee is inactive, revoked or suspended for one year or less. If a licensee has been inactive, revoked or suspended for more than one year, the licensee shall complete a minimum of 10 hours of continuing education.->>

<<-(c) A licensed dental hygienist whose license has expired, pursuant to N.J.A.C. 13:30-1A.5, shall complete a minimum of 10 hours of continuing education for each biennial period the license was expired.->>

<<-(d)->><<+(b)+>> (No change in text.)

<<-(e)->><<+(c)+>> The following shall be considered acceptable forms of continuing education:

1.-2. (No change.)

3. Teaching and research appointments:

i. A licensee involved in <<+new+>> teaching or research activities at least one full day or the equivalent of one full day per week per academic year and who holds at least a part-time faculty or research appointment shall receive two hours of continuing education credit annually for each full day of teaching or research and one credit annually for each half day of teaching or research. <<+For purposes of this section, "new" means a program, course or subject matter which the licensee has never taught or researched before in any educational or practice setting.+>>

ii. (No change.)

<<-(f)->><<+(d)+>> (No change in text.)

<<-(g)->><<+(e)+>> A licensee shall maintain a record of all continuing education activity completed and shall submit a certification verifying the completion of the credit requirements to the Board upon request. <<+Records shall be maintained for two full biennial periods from the date of completion of the continuing education activity.+>> Each licensee shall obtain from the continuing education course sponsor <<-and retain for a period of four years->> a record of attendance which shall include, at a minimum, the following:

1.-7. (No change.)

<<-(h)->><<+(f)+>> (No change in text.)

<< NJ ADC 13:30-5.3 >>

13:30-5.3 Continuing education requirements for registered dental assistants and limited registered dental assistants in orthodontics

(a) All registered dental assistants and limited registered dental assistants in orthodontics shall submit a certification verifying the completion of 10 hours of continuing education every two years at the time of registration renewal. No more than <<-four hours->> <<+one-half+>> of <<+the required+>> continuing education <<+hours+>> in the two<<+-+>>year period may be obtained through written or electronic <<-home study->> <<+ media distance learning+>> courses.

(b) The following shall be considered acceptable forms of continuing education:

1.-2. (No change.)

3. Teaching and research appointments:

i. A registrant involved in <<+new+>> teaching or research activities at least one full day or the equivalent of one full day per week per academic year and who holds at least a part-time faculty or research appointment shall receive two hours of continuing education credit annually for each full day of teaching or research and one credit annually for each half day of teaching or research. <<+For purposes of this section, "new" means a program, course or subject matter which the registrant has not taught or researched before in any educational or practice setting.+>>

ii. (No change.)

(c) (No change.)

(d) A registrant shall maintain a record of all continuing education activity completed and shall submit a certification verifying the completion of the continuing education credit requirements to the Board upon request. <<+ Records shall be maintained for two full biennial periods from the date of completion of the continuing education activity.+>> Each registrant shall obtain from the continuing education course sponsor <<-and retain for a period of four years->> a record of attendance which shall include, at a minimum, the following:

1.-7. (No change.)

(e) (No change.)

<< NJ ADC 13:30-8.5 >>

<<+13:30-8.5 (Reserved)+>>

<< NJ ADC 13:30-8.6 >>

13:30-8.6 <<-(Reserved)->> <<+Biennial license and registration renewal; license and registration suspension; reinstatement of suspended license or registration; inactive status; return from inactive status+>>

<<+(a) All licenses and registrations issued by the Board shall be issued for a two-year biennial period. A licensee or a registrant who seeks license or registration renewal shall submit a renewal application and the renewal fee set forth in N.J.A.C. 13:30-8.1 prior to the expiration date of the license or registration.+>>

<<+(b) The Board shall send a notice of renewal to each licensee and registrant at the address of record registered with the Board at least 60 days prior to the expiration of the license or registration. If the notice to renew is not sent at least 60 days prior to the expiration date, no monetary penalties or fines shall apply to the holder for failure to renew.+>>

<<+(c) If a licensee or registrant does not renew the license or registration prior to its expiration date, the licensee or registrant may renew the license or registration within 30 days of its expiration by submitting a renewal application, a renewal fee and a late fee, as set forth in N.J.A.C. 13:30-8.1. During this 30-day period, the license or registration shall be valid, and the licensee or registrant shall not be deemed to be practicing without a license or registration, as applicable.+>>

<<+(d) A license or registration that is not renewed within 30 days of its expiration shall be automatically suspended. An individual who continues to practice with a suspended license or registration shall be deemed to be engaged in unlicensed practice.+>>

<<+(e) An individual whose license or registration has been automatically suspended for five years or less for failure to renew pursuant to (d) above may be reinstated by the Board upon completion of the following:+>>

<<+1. Payment of the reinstatement fee and all past delinquent biennial renewal fees pursuant to N.J.A.C. 13:30-8.1;+>>

<<+2. Completion of the continuing education units required for each biennial renewal period for which the licensee or registration was suspended, as applicable; and+>>

<<+3. Submission of an affidavit of employment listing each job held during the period of suspended license or registration which includes the name, address, and telephone number of each employer.+>>

<<+(f) In addition to the fulfilling the requirements set forth in (e) above, an individual whose license or registration has been automatically suspended for more than five years who wishes to have his or her license or registration reinstated shall reapply for licensure or registration, as applicable, and shall be subject to an examination and other requirements as determined by the Board prior to reinstatement of his or her license or registration.+>>

<<+(g) Renewal applications shall provide the licensee or registrant with the option of either active or inactive status. A licensee or registrant electing inactive status shall pay the applicable inactive renewal fee set forth in N.J.A.C. 13:30-8.1 and shall not engage in practice.+>>

<<+(h) A licensee or registrant who elected inactive or retired status and has been on inactive or retired status for five years or less may be reinstated by the Board upon completion of the following:+>>

<<+1. Payment of the reinstatement fee;+>>

<<+2. The completion of the continuing education units required for each biennial renewal period for which the licensee or registrant was on inactive status up to a maximum number of units required for two biennial renewal periods, or in the case of a licensee or registrant who is actively licensed or registered in another jurisdiction and demonstrates that he or she was continuously and actively engaged in that jurisdiction in the practice for which the individual is on inactive status in this State, the completion of the continuing education units required for one biennial renewal period; and+>>

<<+3. Submission of an affidavit of employment listing each job held during the period the licensee or registrant was on inactive status which includes the name, address, and telephone number of each employer.+>>

<<+(i) In addition to the fulfilling the requirements set forth in (h) above, a licensee or registrant who has been on inactive or retired status for more than five years who wishes to return to practice shall reapply for licensure or registration, as applicable, and shall demonstrate that he or she has maintained proficiency. An applicant who fails to demonstrate to the satisfaction of the Board that he or she has maintained proficiency while on inactive or retired status may be subject to an examination or other requirements as determined by the Board prior to reinstatement of his or her license or registration.+>>

<< NJ ADC 13:30-8.7 >>

13:30-8.7 Patient records

(a) A contemporaneous, permanent patient record shall be prepared and maintained by a licensee for each person seeking or receiving dental services, regardless of whether any treatment is actually rendered or whether any fee is charged. Licensees also shall maintain records relating to charges made to patients and third party carriers for professional services. All treatment records, bills and claim forms shall accurately reflect the treatment or services rendered. Such records shall include, at a minimum:

1.-3. (No change.)

4. A <<+diagnosis and a+>> treatment plan<<+, which shall also include the treatment risks, alternatives, and costs relative to the treatment that is recommended and/or rendered+>>;

5.-9. (No change.)

10. Payment vouchers received from third party payors; <<-and->>

11. A record of any recommendations or referrals for treatment or consultation by a specialist, including those which were refused by the patient<<-.->><<+; and+>>

<<+12. The name of the dentist of record consistent with the requirements of N.J.A.C. 13:30-8.15.+>>

<<+(b) Each dentist or dental auxiliary shall sign or initial each entry on the patient record pertaining to the treatment he or she rendered. If no such signature or initialing appears on the patient record, it shall be presumed that such treatment was rendered by the dentist of record, unless the latter shall establish, to the satisfaction of the Board, the identity of the individual who rendered such treatment.+>>

<<-(b)->><<+(c)+>> (No change in text.)

<<-(c)->><<+(d)+>> Patient records, including all radiographs, shall be maintained for at least seven years from the date of the last entry, except that diagnostic <<+and study+>> models <<-may->> <<+used for definitive treatment shall+>> be maintained <<-only->> for <<+at least+>> three years from the date the model is made. Working models <<-and preliminary models need not->> <<+may+>> be maintained.

<<-(d)->><<+(e)+>> Licensees shall provide patient records to the patient or the patient's authorized representative or another dentist of the patient's choosing in accordance with the following:

1.-2. (No change.)

3. The licensee may charge a reasonable fee for <<-the reproduction of records, which shall be no greater than an amount reasonably calculated to recoup the cost of copying or duplicating.->><<+:+>>

<<+i. The reproduction of records, which shall be no greater than $1.00 per page or $100.00 for the entire record, whichever is less. (If the record requested is less than 10 pages, the licensee may charge up to $10.00 to cover postage and the miscellaneous costs associated with retrieval of the record.); and/or+>>

<<+ii. The reproduction of radiographs or any other material within a patient record which cannot be routinely copied or duplicated on a commercial duplicating machine. That fee shall be no more than the actual cost of the duplication of the materials, or the fee charged to the licensee for duplication. In addition, the licensee may charge an administrative fee of $10.00 or 10 percent of the cost of reproduction, whichever is less, to compensate for office personnel time spent retrieving or reproducing the materials and overhead costs.+>>

<<+4. Licensees shall not charge a patient for a copy of the patient's record when the licensee has affirmatively terminated a patient from the practice.+>>

<<+5.+>> To the extent that the record is illegible or prepared in a language other than English, the licensee shall provide a typed or written transcription and/or translation at no additional cost to the patient.

Recodify existing (e)-(g) as <<+(f)-(h)+>> (No change in text.)

<< NJ ADC 13:30-8.9 >>

13:30-8.9 Display of names; identifying badges

(a) Every facility offering dental care to the public shall legibly display on all exterior signs or other means of exterior display <<-only those->> <<+the+>> names of the licensees who are responsible for the administration of the facility. <<+A dental facility may display on exterior signs or other means of exterior display the names of licensees associated with the facility.+>>

(b)-(c) (No change.)

<< NJ ADC 13:30-8.10 >>

13:30-8.10 Dental insurance forms

(a) (No change.)

(b) No licensee shall submit to a third party payor any claim, bill, or governmental assistance claim which contains any of the following:

1. Any treatment date which does not accurately reflect the date when the service and procedures were actually completed;

2. (No change.)

3. Any service or procedure which cannot be justified by the licensee as necessary and proper; <<-or->>

4. Any statement material to the claim which is known to be false or misleading<<-.->><<+; or+>>

<<+5. A charge for any service or procedure the amount of which has been advertised as free or complimentary or for an amount that exceeds the advertised charge for discounted services or procedures.+>>

(c)-(e) (No change.)

<< NJ ADC 13:30-8.12 >>

13:30-8.12 Notification of change of address; service of process

(a) A licensee shall notify the Board in writing of any change of <<+his or her+>> address <<-from the address currently registered with the Board and shown on the most recently issued license or certificate of registration. Such notice->> <<+of record. For purposes of this section, "address of record" means an address designated by a licensee which is part of the public record and which may be disclosed upon request. "Address of record" may be a licensee's home, business or mailing address, but shall not be a post office box unless the licensee also provides another address which includes a street, city, state and zip code. Notice+>> shall be sent to the Board by <<- certified->> mail <<-, return receipt requested,->> <<+or by electronic means+>> not later than 30 days following the change of address <<+of record+>>.

(b) (No change.)

<< NJ ADC 13:30-8.13 >>

13:30-8.13 Permissible business structures, prohibition on referral fees and fee splitting

(a) The following words and terms, when used in this section, shall have the following meanings, unless the context clearly indicates otherwise.

"Associate" means a health care professional who is a partner, an employee, a fellow shareholder in a professional service corporation or a fellow member of another permissible practice format, properly organized pursuant to law <<-, such as a limited liability corporation or partnership->>. ...

"Limited liability company" means a <<-business entity organized pursuant to->> <<+limited liability company formed under the laws of this State, pursuant to the New Jersey Limited Liability Company Act,+>> N.J.S.A. 42:2B-1 et seq.<<+, except where inconsistent with these rules.+>> ...

(b)-(e) (No change.)

<<+(f) Dentists may provide professional services in connection with a permissible dental practice as independent contractors provided the arrangement complies with all State and Federal laws.+>>

<< NJ ADC 13:30-8.15 >>

13:30-8.15 Dentist of record; fee reimbursement

(a)-(b) (No change.)

<<-(c) Each dentist or dental hygienist shall sign or initial each entry on the patient record pertaining to the treatment he or she rendered. If no such entry appears on the patient record, it shall be presumed that such treatment was rendered by the dentist of record, unless the latter shall establish, to the satisfaction of the Board, the identity of the individual who rendered such treatment.->>

Recodify existing (d)-(f) as <<+(c)-(e)+>> (No change in text.)

<< NJ ADC 13:30-8.17 >>

13:30-8.17 Delegation of physical modalities <<-to unlicensed dental assistants->>

(a) A dentist may <<-direct an unlicensed assistant to administer to the dentist's patients->> <<+delegate the administration of+>> certain physical modalities <<-in the limited circumstances->> <<+to licensed dental hygienists, registered dental assistants, limited registered dental assistants and unregistered dental assistants consistent with their particular scopes of practice as set forth in N.J.A.C. 13:30-1A.2, 2.4, 2.5 and 2.6 and as+>> set forth in this section.

(b) Physical modalities, for the purpose of this section, shall be limited to <<-heat,->> <<+hot and+>> cold <<+packs+>>, ultrasound, <<- and->> electrogalvanic stimulation<<-. An unlicensed assistant shall not be permitted to perform any rehabilitative exercise programs. No other physical modalities including->><<+,+>> transcutaneous electrical nerve stimulation ("T.E.N.S.") and phonophoresis<<-, shall be performed by an unlicensed assistant->>.

(c) A dentist may <<-direct->> <<+delegate+>> the administration of the physical modalities <<-by the unlicensed assistant->> <<+set forth in (b) above to licensed dental hygienists, registered dental assistants and limited registered dental assistants consistent with their particular scopes of practice as set forth in N.J.A.C. 13:30-1A.2, 2.4 and 2.5+>> provided all of the following conditions are satisfied:

1. (No change.)

2. The dentist shall examine the patient prior to each visit and shall determine all components of the treatment to be performed. This determination shall include all types of modalities to be employed, a delineation of the precise area to which the application of each modality shall be limited, the dosage, wattage, or other applicable setting, the length of the treatment, and any and all other factors peculiar to the risks of that modality such as strict avoidance of certain parts of the body or static placement of the applicator. This information shall be written on the patient's chart prior to each patient's treatment after the dentist has examined the patient, and it shall be made available at all times to the <<-unlicensed assistant->> <<+licensed dental hygienist, registered dental assistant or limited registered dental assistant+>> who is responsible for administering the modality. <<-A dentist who employs unlicensed assistants shall submit written notice to the Board of such employment prior to permitting an unlicensed assistant to perform physical modalities as provided in this section.->>

<<-3. The dentist shall provide instruction to and shall ascertain a satisfactory level of education, competence and comprehension of each unlicensed assistant in regard to all modalities used in that office prior to the use of any modality by an unlicensed assistant. The dentist shall prepare and maintain a written document listing the names of all such unlicensed assistants and outlining the instructions given to each unlicensed assistant. The dentist shall submit such document to the Board upon request.->>

<<-4.->><<+3.+>> (No change in text.)

<<-5.->><<+4.+>> The dentist shall be physically present in the dental office at all times that treatment orders are being carried out <<-by the unlicensed assistant->> and shall be within reasonable proximity to the treatment room.

<<+(d) A dentist may delegate the administration of hot or cold packs to unlicensed assistants. No other physical modalities as set forth in (b) above shall be performed by an unlicensed assistant.+>>

<<-(d)->><<+(e)+>> (No change in text.)

<< NJ ADC 13:30-8.19 >>

13:30-8.19 Practice name

(a) A licensee shall not engage in the practice of dentistry under a practice name which is misleading in any way as to the legal form of the practice or as to the persons who are partners, <<-officers,->> members or shareholders of the practice.

(b)-(c) (No change.)



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