A. The Board and its Responsibilities

When Calling the Board Office, who should I ask for?

When you call the State Board office, the telephone may be answered by anyone at the office and most likely that person will be able to help you. If not, they will refer you to the appropriate individual. Because the Board staff is so small, it is not divided into departments. Everyone on the staff can answer general questions, whether they concern incorporating your dental practice, acquiring a duplicate license, classification of dental assistants, how to handle a problem patient, exam information, or verification of licenses. However, it is important to note that the staff cannot give you legal advice or insurance advice.

What is the difference between the Board and Dental Society or the Dental Hygiene Association?

The North Carolina Dental Society is a membership organization to which dentists may or may not belong and the Society exists for the benefit of its members, the dentists, just as the North Carolina Dental Hygiene Association is the membership organization for dental hygienists.

The Board is the state licensing agency responsible for regulating dentistry and dental hygiene in the public interest. The Board was created by the State Legislature and must enforce the laws enacted by the Legislature, while the Dental Society and the North Carolina Dental Hygiene Association are non-profit associations organized to represent the views of their members. It is the Board, not the Society, that has the power to enforce laws, but neither group can change the laws. That must be accomplished by the State Legislature.

Why does the Board have to become involved in every patient complaint, no matter how minor or frivolous the problem?

Many dentists feel that complaints that are obviously simple misunderstandings and are frivolous in nature should not be handled by the Board, that it has more important things to do. While this is true, the Board long ago adopted a policy that all written complaints received would merit the same degree of attention through the first several phases.

For every complaint, the dentist is advised of it and asked to respond. Then a Board investigator interviews both the dentist and the complainant in order to obtain all the details about the complaint. These steps are always taken, although most of the complaints that are unfounded are closed at this point.

Since the Board must act in the interest of the public, it must be certain of all the facts surrounding a complaint before closing one. There have been instances of a seemingly frivolous complaint leading to more serious charges upon a thorough investigation. On the other hand, situations that sounded ominous from reading the complaint have been found to be completely untrue after the investigation.

We simply ask that full cooperation be given in all investigative matters so the Board can be sure to conduct a complete and comprehensive investigation of all allegations. These procedures are essential to assure that the public we serve is being protected.

May individual Board members be contacted concerning on-going investigations?

Individual Board members should never be contacted with questions or concerns regarding an on-going investigation. During an investigation only one Board member has knowledge of the case. All questions and concerns regarding the case should be directed to the Board office.

Why is the Board involved in reviewing contractual arrangements between licensed dentists and unlicensed third parties who provide certain types of business and management services?

The Board is required by law to review certain contractual arrangements between licensed dentists and unlicensed third parties.  Specifically, the Management Arrangements Rule (the “MAR”) requires that the Board review certain contractual arrangements entered into by licensed dentists with third parties who provide certain types of business and management services.  

Our State Legislature has determined that the “practice of dentistry” extends to anyone who “owns, manages, supervises, controls or conducts any enterprise” where dentistry is practiced.  In other words, only dentists licensed in North Carolina may own, manage, supervise, conduct or control a dental practice located in this state.  Otherwise, there would be a risk to the public that unlicensed individuals or entities might interfere with licensed dentists exercising their professional judgment in the care of their patients.

In the interest of protecting the public, the Legislature has charged the Dental Board with the duty of reviewing certain contractual arrangements to ensure that a licensed dentist has not delegated or provided to an unlicensed individual or entity ownership, management, supervision, or control of a dental practice. 

Additionally, the Board has been charged by the Legislature with the duty to discipline any licensed dentist who aids, abets or assists the unlicensed practice of dentistry or permits the dentist’s name to be used in or has a professional connection with the illegal practice of dentistry.  Entering into contractual arrangements that fall outside the parameters set forth in the Dental Practice Act and the MAR could subject a licensed dentist to disciplinary action by the Board.

Therefore, as a means of protecting the public at large, the MAR requires the Board to receive and review contractual arrangements between licensed dentists and their professional entities or practices and management services providers to determine  whether these arrangements comply with the Dental Practice Act and the MAR.   

For more information on this review process, you can review the Management Arrangements tab.   

B. Dental Offices - Requirements and Procedures

Does my license have to be displayed?

The law provides that all licensees must display "in a conspicuous location" their license and current renewal certificate. Duplicate licenses and renewal certificates are available from the Board office upon request and payment of $25.00 per license or renewal certificate. The request for a duplicate MUST be made by the licensee only!

Is there a law against rewarding others for referring new patients to your practice?

Yes, there is. A law prohibits a health care provider from offering rewards for patient referrals. This is not to say that a "thank you" cannot be made; however, a pre-arranged agreement to compensate someone (financially, with a "gift," or by crediting their account, for instance) is unlawful.

Is on-site supervision by a licensed dentist required at all times?

The Board is aware that in many offices, hygienists and assistants are being asked to see patients when the dentist is not in the office. This practice, even for brief periods of time, violates the laws of North Carolina and if discovered, both dentist and hygienist could be sanctioned by the Board. Current laws require that the dentist be present IN THE OFFICE whenever anyone sees patients.

Am I required to transfer patient records and radiographs upon request, even if the patient has an outstanding balance?

A 1996 Board rule mandates the transfer of original or copies of x-rays and at least a summary of the patient's record at the patient’s request. A fee may be charged for the cost of duplicating records, but this fee may NOT be demanded prior to the release of the records.

Is it OK for employees to call in prescriptions for patients to the local pharmacy?

Yes. Acting on the dentist’s order, a staff person may phone in a prescription for a patient, documenting the prescription in the patient’s record. It is NOT permissible for a staff person to order controlled substances from a wholesaler using the dentist’s DEA number when the drugs are not authorized by the dentist.

What happens in the event of the death of a dentist before 
his practice is sold?

The Board will allow a reasonable period of time for the family to sell the practice, but no one other than a licensed dentist may continue to operate the practice in the interim or receive profits from it. The practice may not be controlled or managed by the family, nor may a dentist be hired to continue operating the practice until it is sold unless the dentist takes control of the entire practice and its profits. The office space and equipment may be leased for a pre-established fee.

May I use the name of a retired dentist as part of the practice name?

North Carolina law requires all dentists to practice under their own names. When a practice is sold, the buyer MUST change the name of the practice.  A dentist who retires from a practice and continues to perform consulting services may have his name included.

May a dentist or hygienist who holds a license in another state work in North Carolina?

Only after obtaining a license! A person who is licensed and in good standing in another state may be eligible for licensure by credentials. Sometimes a provisional may obtained while waiting to take the clinical exam or until requirements are met for credentials. But no one may practice in NC until they receive some type of licensure.

May a dentist refuse treatment to pregnant women on the basis of an inability to obtain radiographs?

A dentist should use his/her professional judgment when rendering care 
to all patients.  Pregnancy should not necessarily preclude dental 
treatment and care should be taken to minimize risk to the patient.

Must a dentist examine every patient who receives a routine prophylaxis?

Not necessarily.  The law requires that a hygienist work under "the dentist's order, control and approval."  The law, as it is worded, does give the dentist the prerogative to determine whether a complete examination is necessary at a given visit; however, that determination does not relieve him of his responsibility for the oral health care of the patient.  A patient may not be charged for an examination if the dentist does not examine the patient, and the examination must be thorough. 

C. Dental Hygienists

Does my license have to be displayed?

The law provides that all licensees must display "in a conspicuous location" their license and current renewal certificate. Duplicate licenses and renewal certificates are available from the Board office upon request and payment of a $25.00 fee for each license or renewal certificate. The request for a duplicate license must come from the licensee.

Has the law changed concerning the supervision of hygienists?

No, there have been no law changes at this time. A bill was introduced in the Legislature in 1997 and is currently in a Senate sub-committee that would effect some changes in the Dental Hygiene Act. The bill has NOTbeen ratified, however, and no changes have occurred. You will be notified by the Board office in the event there are law or rule changes which affect you.

May an applicant for a dental hygiene provisional license be asked to complete a "working interview" before a dentist offers him/her employment?

Absolutely not. A provisional license must be issued before the hygienist may treat any patient.

Can hygienists with provisional licenses do "fill-in" work?  

No. The license restricts the holder to a specific practice location, so "filling in" is not possible.

May dental hygienists apply the "Perio Chip" ?

Yes, the application of the Perio Chip or similar antimicrobial agents may be performed by dental hygienists, but not dental assistants.

May dental hygienists and DA II’S make impressions for bleaching trays, night guards or mouth protectors for athletes?

Yes, the Board has ruled that impressions for bleaching trays, night guards, etc. are essentially study model impressions and may be accomplished by dental hygienists and dental assistants.

May DentiPatch and other anesthetic patches be applied by dental hygienists or dental assistants?

Yes, these patches deliver topical anesthetics and under the direct supervision of a licensed dentist, any auxiliary (dental hygienist, Dental Assistant I or Dental Assistant II) may apply them.

D. Dental Assistants

May DentiPatch and other anesthetic patches be applied by dental hygienists or dental assistants?

Yes, these patches deliver topical anesthetics and under the direct supervision of a licensed dentist, any auxiliary (dental hygienist, Dental Assistant I or Dental Assistant II) may apply them.

May dental assistants who move to North Carolina from out-of-state take x-rays if they have taken a radiography course out-of-state?

Yes, but only after satisfactorily completing an equivalency exam in North Carolina.  The equivalency exam may be challenged after showing evidence of completion of "seven hours of instruction in the production and use of dental x-rays and an educational program of not less than seven hours in clinical dental radiology." You must be able to prove that you have the minimal amount of training to be eligible to take the radiology equivalency exam, or you may take a complete radiography course prior to taking the exam.

May a Dental Assistant II who has taken a course in coronal polishing serve as a "hygiene assistant" and perform polishing after scaling is done by a hygienist or dentist?

A Dental Assistant II who has completed a 7-hour course (3 hours didactic, 4 hours clinical) in coronal polishing may polish the clinical crowns of teeth, and may do so following scaling by a hygienist or dentist. The dental assistant is not permitted to polish subgingivally and no separate charge may be made for the polishing procedure.

May dental hygienists and DA II’S make impressions for bleaching trays, night guards or mouth protectors for athletes?

Yes, the Board has ruled that impressions for bleaching trays, night guards, etc. are essentially study impressions and may be accomplished by dental hygienists and Dental Assistants II.

E. Continuing Education

How will I report my continuing education hours?

Continuing education became mandatory January 1, 1995. Every year, dentists must complete 15 hours and hygienists must complete 6 hours. In addition, every licensee is required to maintain current CPR certification. The number of hours completed each year is reported on the license renewal form and no documentation of course work should be sent to the Board’s office. Each person is responsible for maintaining his/her own documentation for at least two years of CE courses completed and must show evidence of completing CE when requested by the Board.

Do correspondence courses through professional journals count toward the required CE hours?

The Board has determined that dentists and hygienists may obtain any or all of their required hours through correspondence or online courses which have post-tests and issue certificates of completion.

Which courses and sponsors are approved for CE hours?

1. Courses must be related to patient care. Courses stressing practice management or self-improvement, for example, could not count, while courses in sterilization and infection control, pharmacology, dental materials and dental procedures are acceptable.  The Board will accept some risk management courses.

2. Approved sponsors for CE hours include: those providers who are recognized by the American Dental Association’s Continuing Education Recognition Program, courses sponsored the Academy of General Dentistry, the American Dental or American Dental Hygienists’ Association, or components of such organizations, the North Carolina Area Health Education Centers, educational institutions with dental or dental hygiene schools or departments, and national, state, or local societies or associations. (Study clubs are considered "associations".)

3. Approved sponsors for dentists CE hours include: those recognized by the Continuing Education Program of the American Dental Association, the Academy of General Dentistry, North Carolina Area Health Education Centers, educational institutions with dental or dental hygiene schools or departments and national, state, or local societies or associations.

4. In May, 2011, the Board has changed their rules to require a hands-on or blended course; online courses will no longer be accepted.  The new rule
21 NCAC 16A  .0101 (5) reads:

"CPR certification" means that the licensee has successfully completed a CPR course that meets American Red Cross or American Heart Association standards for certification and that provides manikin testing on the subjects of cardio-pulmonary resuscitation.  The course must also cover the use of an automatic external defibrillator, unconscious and conscious choking and rescue breathing, provided that the foregoing requirements shall not be interpreted in any way that violates the Americans with Disabilities Act.  The manikin testing must be provided by an instructor who is physically present with the students.

CPR does not have to be repeated annually, if a 2 year certification is achieved; however the certification must always be current.

Do retired dentists and hygienists have to take continuing education?

The rule requiring continuing education of all licensees requires all licensed dentists and hygienists to take CE courses. If you have a license, you must complete the required number of hours. The only exception to this is for those dentists who have reached an advanced age and are retired or semi-retired and are exempted from CE by the Board. Only those individuals who request exemption and receive a Board letter indicating that they are exempt from the CE requirement are legally exempt.

The Board defines a "retired dentist" as one who never practices; and a "semi-retired, level I" dentist as one who practices 250 hours a year or less.  A "semi-retired, level II" dentist may practice up to 1000 hours per year, but is responsible for half (7.5 hours) of the required CE hours.  Both levels of semi-retired dentists require current CPR.

 

Functions of the Board of Dental Examiners
The administration of licensure examinations for dentists and dental hygienists
The promulgation of rules and enforcement of laws and regulations governing the practice of dentistry and dental hygiene in this state
The issuance and renewal of licenses to dentists and dental hygienists