Type:Final

Date:05/31/2010

Report:Tab 3 dental final report dated 1 28 10.doc



Table of Contents

2010 Recommendations

Laws and Policies 3
Background 3
Joint Sunset Review History 4
Powers and Duties 9
Proposed Legislation 10
Administrative Problems Relating to the Statute 11
Audits 12
Administrative Procedures Act 12
Freedom of Information Act 12
Judicial Decisions, Federal Laws, Interagency Agreements,
Memoranda of Understanding, and Executive Orders 13

Performance 13
Mission 13
Objectives 13
Accomplishments 14
Challenges 15
Opportunities for Improvement 16
Coordination of Services with other Agencies 16
Customer Satisfaction 16
Internal Performance Measures 16

Delaware Institute for Dental Education and Research 17

Organization 18
Policymaking Structure 18
Removal of Members 20
Member Training 21
Member Compensation 21
Dental Hygiene Advisory Committee 21
Immunity 22

Staff 22
Staff Recruitment 23
Staff Responsibilities 24
Staff Training 25

Public Information 25

Licensing 26
Licensure - Dentists 26
Qualifications 27
Examinations 28
The State Dental Director 30
Volunteer License 30
Limited License 31
Anesthesia Permits 33
Unrestricted Permit 33
Restricted Permit I 34
Restricted Permit II 35
Exemptions 35
Licensure – Dental Hygienist 36
Qualifications 36
Examination 38
Renewal of a License to Practice Dentistry or Dental Hygiene 38
Reciprocity 39
Prescriptions 40
Discontinued Practice/Death/Transfer of Records 40

Complaints 40
How Complaints are Handled 40
Cease and Desist Authority Over Unauthorized Practice 42
Grounds for Discipline 42
Sanctions Imposed by the Board and Appeals 43
Violations and Penalties; Enforcement 44
Disciplinary Action by the Board 46
Enforcement and Prosecution for Violations 46
Limitation of Action for Dental Malpractice 47
Reports of Dental Malpractice Actions 47

Rules and Regulations of the Board 47

Fiscal 49
Revenue 49
Fees 49
Expenditures 50

Governing Statute

2010 Recommendations:
Board of Dental Examiners

The Joint Sunset Committee recommends continuance of the Board of Dental Examiners, but only upon its meeting certain conditions or making certain modifications as identified below.

A. The Joint Sunset Committee recommends the following statutory changes:

Amend the statute by striking 24 Del. C.§1131 in its entirety and stating in 24 Del. C. §1126 that the Division of Professional Regulation issues duplicate licenses.

Amend the statute by moving the other paragraphs in 24 Del. C. §1131 to §1129.

Amend the statute by deleting the outdated wording regarding the duties of the Secretary Treasurer of the Board to enforce provisions in 24 Del. C. § 1181.

Amend the statute to allow the Board the power to subpoena records of hospitals as the Committee has done for the Board of Medical Practice. Add to its powers and duties the following language: “To require the production of and receive information regarding changes in hospital privileges as a result of disciplinary or other adverse action taken by a hospital, or regarding disciplinary or other adverse action taken by a dental society against any person certified under this chapter to practice dentistry or dental hygiene.”

Amend the statute to reorganize and modernize statutory provisions similar to other Title 24 Boards.

Amend the provisions relating to name(s) used in the practice of dentistry.

Amend 24 Del. C.§1101(7) by inserting “and/or periodontal disease” after the word “caries”.

Amend the statute by removing the provision under 24 Del. C. §1106(a)(14) referencing preceptorships and reciprocity as there are no such programs offered by the Delaware Institute of Dental Education and Research (DIDER).

Amend the statute by deleting the provision under 24 Del. C. §1105 (b)(4) pertaining to the original members of the Dental Hygiene Advisory Committee.

Amend the statute by deleting the word “certificate” from 24 Del. C. § 1178.

Amend the statute by reorganizing the reinstatement provisions following suspension or probation from 24 Del. C. §1131 to 24 Del. C. §1129 for consistency.

Change the title of §1131 from “Reinstatement of a suspended license; removal from probationary status; replacement of license” to “Replacement of license”.

Amend the statute to require an applicant to affirm at the time of application that he/she is physically and mentally capable to engage in the practice of dentistry, and to submit to such examinations as deemed necessary to determine the applicant’s capability. Insert the following language from Board of Medical Practice:
(5) Submit to the Board a sworn or affirmed statement that the applicant is, at the time of application, physically and mentally capable of engaging in the practice of medicine according to generally accepted standards, and submit to such examination as the Board may deem necessary to determine the applicant's capability;”.

Amend the statute to reconfigure the examination provisions under 24 Del. C. §1123 and explicitly require that the college/university be accredited by the Commission on Dental Accreditation of the American Dental Association.

Amend the statute to clarify reciprocity provisions that a reciprocal applicant shall have a degree from a dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association.

Amend the statute to clarify that a licensee who fails to renew on or before the renewal date, and any allowable extension, not to exceed 1 year, will be considered a new applicant.

Amend the statute to provide established requirements for re-examination or other assessment of formal competency when a licensee fails to renew and his/her license has been expired for a period of 5 or more years.

Amend the statute to increase monetary penalties under 24 Del. C. §1129, §1175, §1177, §1178 and striking §1176 and renumbering sections.

Amend the statute to clarify the qualifying language in the exception provision that dentists in another state can make clinical demonstrations without a license, for educational purposes.

Amend the statute by adding language under §1122(b)(2) that gives the Board authority to determine, after a hearing, whether administrative penalties are grounds to deny licensure. This discretion to license after a hearing is language consistent with other Title 24 boards and commissions.

Amend the statute by deleting the sunset provision in Subchapter VI and change the title of Subchapter VI to read: “Out-of-State Volunteer License”.

Amend the statute (29 Del. C. § 8735) to allow the Division of Professional Regulation to issue licenses with specific provisions listed.

Amend the statute by removing the reference (24.Del. C § 1123 (2)) to the passing score on the National Board of Dental Examiners’ examination as the national board is moving to a pass/fail score.

Amend the statute to grant the Board the authority to conduct criminal background checks for applicants. Statutory language shall be the same as that of the Board of Medical Practices. (24 Del. C. Subchapter IV. Note Subchapter IV is currently being amended. The language inserted in the Board of Dental Examiners’ chapter shall include Subchapter IV as amended in the 145th General Assembly)

24 a). Amend the statute to include the following language:
§_____Duty to Self-Report
(a) A licensee shall self-report to the Board:
(1) An arrest and/or the bringing of an indictment or information charging the licensee with a crime substantially related to the practice of dentistry and dental hygiene as defined in the Board’s rules and regulations.
(2) The conviction of the licensee, including any verdict of guilty, or plea of guilty or no contest, of any crime substantially related to the practice of dentistry and dental hygiene as defined by the Board in its rules and regulations.
(b) The report required by this section shall be made in writing within 30 days of the date of the arrest, bringing of the indictment or information or of the conviction.
(1) Failure to make a report constitutes grounds for discipline under 24 Del. C.§1128.

25. Amend the statute by adding the following language to 24 Del. C. § 1105(c)
(4) Voting on disciplinary actions involving hygienists; and
(5) Voting on other matters involving the policy and practice of dental hygiene as defined in §1101(7) and further defined in the Board’s rules and regulations. The Committee shall not vote on matters involving changing the scope of practice as defined in §1101 (7).

26. Amend the statute by deleting 24 Del. C. § 1105(b)(4) and renumbering the subsequent provisions accordingly. (4) Persons who are members of the Committee on May 15, 1997, shall complete their terms.

Amend the statute to include a provision that a dentist and a dental hygienist from the same practice or two dentists from the same practice may not serve on the Board at the same time.

Amend the statute to include a provision that two dental hygienists from the same practice may not serve on the Advisory Committee at the same time.

Amend the statute to include a provision that a dentist and a dental hygienist from the same practice may not serve on the Board and/or the Advisory Committee at the same time.

Amend the statute to provide that the Board has the authority to establish by rule and regulation three levels of supervision.

Amend the statute by incorporating language into the Code that allows dentists to have direct supervision of dental assistants.

Amend the statute to provide a definition for “dental assistant”.

Amend the statute to provide definitions for “dental technician” and “dental auxiliary personnel.” Clarify the difference between the roles of a “dental technician” and “dental auxiliary personnel”.

Amend the statute to include a duty to report as is included in the Medical Practices Act (24 Del. C. Ch. 17). Further amend the statute to reflect any applicable changes to Duty to Report portion of the Board of Medical Practices (24 Del. C. Ch. 17).

Amend the statute by changing the name of the Board from “The Board of Dental Examiners” to “The Board of Dentistry and Dental Hygiene” wherever it appears in the chapter.

36. Amend the statute to provide the Board with the authority to establish by rule and regulation the requirements and standards for permits that authorize dentists to administer anesthetic agents.

The Joint Sunset Committee recommends that the Board of Dental Examiners do the following:

Amend the rules/regulations by removing the reference (Reg. 8.0) to the passing score on the National Board of Dental Examiners’ examination as the national board is moving to a pass/fail score.

Delete Regulation 4.0 relating to acupuncture.

Strongly encourage the Board to ensure that Delaware’s minimum standards of practitioner competency and delivery of dental and dental hygiene services are in line with those nationally to ensure the highest level of public protection.

The Board of Dental examiners shall inform the JSC of any progress made either in implementation or consideration of an ongoing assessment of continuing competence and quality of care provided by dentists.

The dentists and the dental hygienists discuss the delivery of local anesthesia by dental hygienists and report back to the JSC.

“General supervision” will remain as it is currently defined and applied in Regulation, until the Board provides the JSC with information defining how dental hygienists can/will practice in a public setting (i.e. schools, nursing homes, etc.) (Regulation 1.3 General Supervision - A dentist may or may not be present in the office while the work is performed. The dentist authorizes the work to be performed. Emergency care and consultant services are provided by an "on-call" dentist not present in the treatment facility, if the primary dentist is not present.)

The dentists and dental hygienists continue to meet to discuss the dental hygienists’ examination/licensure, including issues concerning whether a dental hygienist can be newly licensed in Delaware, either upon satisfactory completion of a regional exam or satisfactory completion of the Delaware exam and report back to the JSC regarding these discussions.





Laws and Policies
Background
Dentists have been regulated in Delaware for over 100 years. With the enactment in 1885 of "An Act relating to the Practice of Dentistry in the State of Delaware." it became "...unlawful for any person who is not, at the time of the passage of this act a recognized practitioner of dentistry in this state, and so recognized by the profession, to practice dentistry unless he or she shall have obtained a certificate as hereinafter provided, or shall hold a diploma from a reputable dental college, and so decided by the Board herein created." Chapter 496, Vol. 17, Laws of Delaware The Act created a five member Board of Dental Examiners and established standards for licensing Violators of the Act were subject to fines from fifty to three hundred dollars, or jail terms of not more than six months.

Since 1885, the law has been amended many times with the intent to further protect the public, improve the quality of dental practice, and clarify the administration of the law. 1985 JSC Final Report, pg. 2

Chapter 11 of Title 24 of the Delaware Code regulates the practice of dentistry and dental hygiene in the State. Under State law, any person practicing dentistry or dental hygiene must hold a valid license from the Board of Dental Examiners. Dentists have been regulated in Delaware since 1885; dental hygienists since 1933. 1995 JSC Final Report, pg. 4

Statute defines the practice of dentistry as: 24 Del. C § 1101(8)

The evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of the dentist's education, training and experience, in accordance with the ethics of the profession and applicable law.

A person shall be construed to practice dentistry who by verbal claim, sign, advertisement, opening of an office, or in any other way, including use of the words "dentist," "dental surgeon," the letters "D.D.S.," "D.M.D.," or other letters or titles, represents the dentist's to be a dentist or who holds himself or herself out as able to perform, or who does perform, dental services or work.

A person shall be regarded as practicing dentistry who is a manager, proprietor, operator or conductor of a place for performing dental operations or who for a fee, salary or other reward paid, or to be paid either to himself or herself or to another person, performs or advertises to perform dental operations of any kind.

Statute defines the practice of dental hygiene as: 24 Del. C § 1101(7)

The removal of calculus deposits, plaque and stains from all surfaces of the teeth, and making instrumental examinations of the oral cavity, and assembling all necessary information for use by the dentist in diagnosis and treatment planning, and

The performance of such prophylactic or preventive measures in the case of teeth, including the application of chemicals to the teeth and periodontal tissues, designed and approved for the prevention of dental caries, as the Board may authorize; but

The "practice of dental hygiene" shall not include any other operation on the teeth or tissues of the mouth.

There are 457 licensed dentists in Delaware, all of but 80 of whom have Delaware mailing addresses. Fourteen dental residents, who have been issued permits by the Board, are practicing under supervision at Christiana Hospital (the only residency program). There are currently no limited dentist or volunteer dentist licensees. There are 708 licensed dental hygienists in Delaware; 164 have non-Delaware mailing addresses. Email, Kay Warren, Jan. 13, 2010

Joint Sunset Committee Review History
The Board of Dental Examiners was reviewed by the Joint Sunset Committee in 1985 and again 1995.

Below are the JSC 1995 recommendations and a brief explanation of compliance or non-compliance: JSC Initial Questionnaire, pgs. 13-18

1. The conflicting language in Secs. 1101 and 1104(b) be reconciled. Also Sec. 1105, 24 Del. C., could be stricken from the statute. The Division of Professional Regulation has the power to reimburse Board members following guidelines covering all boards and commissions.
The Board is in compliance.

2. The mandate that the Governor appoint Dental Board members recommended by the Executive Council of the Delaware State Dental Society be stricken from Sec. 1103, 24 Del. C. (Board of Dentistry and Dental Hygiene).
The Board is in compliance.

3. The statute be amended to allow the Dental Hygiene Advisory Board to vote on the qualifications of candidates who apply for licensure to practice dental hygiene; to vote on the composition of the state dental hygiene clinical/practical examination; and to vote on the requirements for renewal of dental hygiene licenses.
The Board is in compliance pursuant to 24 Del C. §1105.

4. The statute be amended to permit the three members of the Dental Advisory Board to be paid for Board of Dental Examiners' meetings which they attend.
The Board is in compliance pursuant to 24 Del. C §1105.

5. Chapter 11, 24 Del. C., be amended to refer to a license to practice dentistry where appropriate throughout the Chapter.
The Board is in compliance. All references to “certificates” were replaced by “license”.

6. The powers and duties of the Board be included in one Section of Chapter 11, 24 Del. C., and not scattered throughout the Chapter.
The Board is in compliance pursuant to 24 Del. C. §§1106(a) and (b).

Sec. 1109, 24 Del. C. be stricken and the statute amended to refer to the financial responsibility of the Division of Professional Regulation.
The Board is in compliance pursuant to 24 Del. C. §1125.

Sec. 1108, 24 Del. C. be amended by striking the mandate that the Board make an annual report of moneys received and disbursed during the preceding year to the Governor and the Delaware State Dental Society.
The Board is in compliance.

9. Language for reciprocity candidates be stricken which requires the Secretary-Treasurer of the Board of Dental Examiners in the applicant's state to attest to the applicant's "moral character."
The Board is in compliance.

10. The citizenship requirement for reciprocity candidates be stricken from the statute.
The Board is in compliance.

11. Obsolete language in Sec. 1123(b)(2), 24 Del. C., regarding graduation from dental school after 1910 but before April 6, 1939, be stricken from the statute.
The Board is in compliance.

12. The Sunset Committee send a letter to the Board of Dental Examiners asking them to discuss recognition of regional examinations in order to facilitate reciprocity.
The Board is not in compliance. The response to the JSC Initial Questionnaire stated that a review of the Board’s meeting minutes indicate that the Board has not addressed recognition of regional exams.

13. The Board consider offering the practical examinations for dentists and dental hygienists at approximately 6 month intervals.
The Board is in compliance.

14. Secs. 1125 and 1126, 24 Del. C., be rewritten and updated to reflect the current responsibilities of the Division of Professional Regulation.
The Board is in compliance.

15. The responsibility of the Division of Professional Regulation regarding duplicate certificates be referenced in Sec. 1126, 24 Del. C.
The Board is not in compliance. The provisions for duplicate licenses are under §1131(c) as follows:
(c) A new license to replace any license lost, destroyed or mutilated may be issued subject to the rules of the Board. A charge shall be made for such issuance.

In practice, the Division of Professional Regulation issues duplicate licenses and this is a change the Board is proposing under §1131.

16. All references in Chapter 11, 24 Del. C. to specific fees be stricken from the statute. It is the responsibility of the Division of Professional Regulation to establish all fees. (Secs. 1125(e) and (f), 1126, 1127, 1128, 1153, 1156(a), 1171, 1172, 1173, 1175, 1176, 1177, 1178, 1179, 24 Del. C.)
The Board is in compliance.

17. Sec. 1127, 24 Del. C. be stricken from the statute.
The Board is in compliance.

18. Sec. 1131, 24 Del. C. be amended to define "moral turpitude" and the one or more specific infectious diseases for which one's license may be revoked.
The Board is in compliance.

19. The restraint of trade subsections, which are grounds for revocation or suspension of a license, be stricken from Sec. 1131, 24 Del. C. They are prohibitions against advertising (6), advertising prices (7), advertising a tooth (8), using advertising solicitors (9), advertising under a corporate name (10).
The Board is in compliance.

20. Sec. 1132, 24 Del. C. (Cancellation of Certificate) be rewritten and updated to conform to the language of other regulatory boards. "Moral turpitude" should be defined.
The Board is in compliance.

21. The complaint language of Sec. 1135, 24 Del. C., be updated to reference the Administrative Procedures Act and the responsibility of the Division of Professional Regulation to investigate the complaints.
The Board is in compliance pursuant to §1127.

22. Sec. 1152, 24 Del. C. be rewritten and outdated language stricken.
The Board is in compliance.

23. Sec. 1152, 24 Del. C. be updated to strike the one year of practical work experience for dental hygiene applicants.
The Board is in compliance.

24. Sec. 1153, 24 Del. C. be updated to strike the citizenship requirement for dental hygiene reciprocity applicants and to define "good moral character."
The Board is in compliance.

25. The Corps of Oral Hygienists is no longer active and has recommended that Subchapter VI, 16 Del. C., be stricken from the statute.
The Board is in compliance.

26. Outdated wording regarding the duties of the Secretary-Treasurer of the Board to enforce provisions of Chapter 11, 24 Del. C. be stricken from Sec. 1181, 24 Del. C.
The Board is not in compliance and the Board, in its draft revisions to the statute, is proposing this language be stricken.

27. The statute be amended to allow the Board the power to subpoena records of hospitals as the Committee has done for the Board of Medical Practice.
The Board is not in compliance. The Board in its draft revisions to the statute is proposing to add to its powers and duties the following language: “To require the production of and receive information regarding changes in hospital privileges as a result of disciplinary or other adverse action taken by a hospital, or regarding disciplinary or other adverse action taken by a dental society against any person licensed under this chapter to practice dentistry or dental hygiene.”

28. The Board rewrite its Rules and Regulations to refer to the specific Code section which they are effectuating. The Board does not have the statutory authority to create the positions of "dental technician" and "dental auxiliary personnel." The three levels of supervision defined in the Rules and Regulations have no connection to the statute.
The Board is not in compliance and will be proposing to add a power and duty in the statute and determine what changes need to be made in the board’s rules and regulations.

29. The statute governing the practice of dentistry and dental hygiene in the state of Delaware is in serious need of updating. This has been recognized by the Board who appointed a committee whose members have redrafted Chapter 11, 24 Del. C.
The Board is in compliance..

30. The statute is not gender neutral throughout. At one point, language referring to dental hygienists stated "she," now all references are to "he" or "his."
The Board is in compliance.

It is necessary to point out that the 1995 JSC Final Report also included the following JSC Recommendation, which was somehow omitted in the Report’s listing of recommendations: 1995 JSC Final Report Dentistry and Dental Hygiene, pg. 14

The Joint Sunset Committee has recommended, as a condition for continuation of the Board of Dental Examiners, that the Director of Professional Regulation appoint a 3- member appeals' panel, composed of 1 dentist, 1 registered dental hygienist, and 1 public member, who would hear any appeals arising from the examination process.

The text below is from the Final Report with regard to this issue: 1995 JSC Final Report Dentistry and Dental Hygiene, pgs. 13-14


The Board's examination, grading, and appeal procedures have been the subject of a lawsuit brought by an applicant whom the Board failed.

Judge Norman Barron found that the applicant's right to due process was violated when the Board members, who administered and graded the applicant's examination, also conducted the hearing and voted after the hearing not to grant the applicant a license.

Judge Barron stated that "....the government may not, by its sheer size and girth, diminish certain individual rights. One of those rights is the right to procedural due process, which includes a fair hearing in a fair tribunal." Barron found the applicant had "no such opportunity." Specifically, "Without commenting on the examination itself or the methods the examiners used to grade it, the Court holds that Brown's constitutional right to procedural due process was violated when the five individuals who graded his exam conducted the hearing whose purpose it was to provide a fair review. It takes no special training to discern unfair bias under these conditions."

Barron remanded the case to the Board "with instructions first to promulgate regulations for conducting appeals which comport with the basic tenets of constitutional due process and second to provide Brown with the opportunity to have his case reviewed in accordance with such regulations." The decision is dated May 23, 1994.

The Board met at a special meeting on June 14, 1994 to grade the dental applicants' practical examinations (which included the appellant's, whom the Board passed). The Board also voted to enter Executive Session "to receive legal advice regarding pending and potential litigation." The Minutes record no votes taken in Executive Session.

At some point the Board chose to appeal Judge Barron's decision to the Delaware Supreme Court on July 19, 1994. No record exists of the vote. Superior Court modified its Opinion and Order by staying the matter pending the appeal to the Supreme Court. The Supreme Court ruled that the applicant had "received all the relief he sought in his appeal to the Superior Court."

The Board responded to the Notice to "Show Cause why the appeals should not be dismissed as being moot."

The Supreme Court ordered Superior Court to vacate its May 23, 1994, order on the grounds that the applicant had received a license to practice dentistry. Because of the Supreme Court order the issue of the violation of the applicant's due process rights has been left unaddressed by the Board.

The Sunset Committee had long discussions on how to best resolve this issue. The Committee considered various solutions including having the Board accept a regional practical examination. The Committee asked the Director of the Division of Professional Regulation to submit a proposal for an appeals' panel.

After receiving input from the Board, Dental Society, Dental Hygiene Association and Advisory Board, the Sunset Committee made the following Recommendation:

The Joint Sunset Committee has recommended, as a condition for continuation of the Board of Dental Examiners, that the Director of Professional Regulation appoint a 3- member appeals' panel, composed of 1 dentist, 1 registered dental hygienist, and 1 public member, who would hear any appeals arising from the examination process.

As envisioned, the Director would appoint the panel prior to the administration of the first examination each year and the panel would serve through the conclusion of any appeals originating from examinations administered during the calendar year of their appointment.

The two professional members each would have 3 years' of experience and not have served on the Board of Dental Examiners or Dental Hygiene Advisory Committee for at least 5 years preceding appointment; nor be an officer in a professional association. The usual conflict of interest language would cover the public member. A new panel would be appointed each year and all appeals would be conducted in accordance with the Administrative Procedures Act.

The Committee will have the legislation introduced this Session.

The Board is in compliance. Email, Kay Warren, January 20, 2010

Powers and Duties
The powers and duties of the Board are: 24 Del. C. §1106

Promulgate rules and regulations, including regulations specifically identifying those crimes which are substantially related to the practice of dentistry and dental hygiene and continuing education standards required for license renewal for dentists and dental hygienists.

Designate the application form to be used by all applicants, and to process all applications;

Designate the written, standardized examination administered by the National Board of Dental Examiners to be taken by all persons applying for licensure;

Prepare and administer a practical examination in dentistry and dental hygiene;

Designate a written jurisprudence examination on the Delaware laws pertaining to dentistry to be taken by all persons applying for licensure;

Provide for the administration of all applicable examinations, including notice and information to applicants;

Evaluate the credentials of all persons applying for a license to practice dentistry and dental hygiene in order to determine whether such persons meet the qualifications for licensing set forth in statute;

Grant licenses to and renew licenses of all persons who meet the qualifications for licensure and/or renewal of licenses;

Establish by rules and regulation the continuing education standards required for license renewal for dentists and dental hygienists;

Evaluate certified records to determine whether an applicant for licensure who has been previously licensed, certified or registered in another jurisdiction to practice dentistry or dental hygiene has engaged in any act or offense that would be grounds for disciplinary action under Delaware statute and whether there are disciplinary proceedings or unresolved complaints pending against such applicants for such acts or offenses;

Conduct hearings and issue orders in accordance with procedures established pursuant to this statute;

Where it has been determined after a disciplinary hearing that penalties or sanctions should be imposed, to designate and impose the appropriate sanction or penalty after time for appeal has lapsed;

Work in conjunction with the Board of Directors of the Delaware Institute of Dental Education and Research (DIMER), to develop programs to encourage and allow dentists to practice in under-served areas of the State, as designated by the Delaware Health Care Commission, in lieu of hospital-based residency training as a condition of licensure. Such programs may include preceptorships and reciprocity; and

Issue a volunteer license pursuant to statute to an individual who is duly licensed as a dentist or dental hygienist in this State or to any individual who has ever been so licensed provided proof of continued competence is provided to the satisfaction of the Board. Such individuals shall certify on the license application that the individual will perform no dental or dental hygiene services for any direct compensation and that the individual volunteers his or her time exclusively in a nonprofit dental clinic or nonprofit dental service designated by the Delaware Health Care Commission and approved by the Delaware Board of Dental Examiners. A volunteer license shall be issued at no charge to a qualified individual approved by the Board. All other costs associated with meeting the requirements for such license will remain the responsibility of the applicant. The applicant for a volunteer license shall be responsible for completing the continuing education required for an active Delaware licensee by the Board and shall adhere to all standards of practice and supervision required of a Delaware licensed dentist or dental hygienist. Any dentist or dental hygienist having a volunteer license shall not practice dentistry or dental hygiene in this State in any setting other than in an approved nonprofit dental clinic or nonprofit dental service.

Proposed Legislation
The Board is proposing legislation that would: JSC Initial Questionnaire, pgs. 7-8

Clarify general practice residencies and allow for specialty residences acceptable to the board;

Grant authority to conduct criminal background checks for applicants;

Reconfigure the examination provisions and denote the dual responsibility of the board and the Division;

Grant authority to establish in rule and regulation the requirements and standards for permits to administer anesthetic agents;

Add a provision that requires the applicant to affirm at the time of application that he/she is physically and mentally capable to engage in the practice of dentistry, and to submit to such examinations as deemed necessary to determine the applicant’s capability;

Reconfigure the examination provisions under §1123 and explicitly require that the college/university be accredited by the Commission on Dental Accreditation of the American Dental Association. Remove the reference to the passing score on the National Board of Dental Examiners’ examination as the national board is moving to a pass/fail score.

Clarify reciprocity provisions that a reciprocal applicant shall have a degree from a dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association;

Clarify that a licensee who fails to renew on or before the renewal date, and any allowable extension, not to exceed 1 year, will be considered a new applicant.

Establish requirements for re-examination or other assessment of formal competency when a licensee fails to renew and his/her license has been expired for a period of 5 or more years;

Increase monetary penalties under §1129, §1175, §1177, §1178 and striking §1176 and renumbering sections;

Clarify the qualifying language in the exception provision that dentists in another state can make clinical demonstrations without a license, for educational purposes;

Revise the provisions relating to name(s) used in the practice of dentistry.

Administrative Problems Relating to the Statute:
The following provisions of the statute are administratively problematic: JSC Initial Questionnaire, pgs. 8-9

Remove the provision under §1106(a)(14) referencing preceptorships and reciprocity as there are no such programs offered by the Delaware Institute of Dental Education and Research (DIDER).

Add language under §1122(b)(2) that gives the Board authority to determine, after a hearing, whether administrative penalties are grounds to deny licensure. This discretion to license after a hearing is language consistent with other Title 24 boards and commissions.

Reorganize reinstatement provisions following suspension or probation from §1131 to §1129 for consistency.

Change the title of §1131 from “Reinstatement of a suspended license; removal from probationary status; replacement of license” to “Replacement of license”.

Clarify the title of Subchapter VI as it relates to “Out-of-State Volunteer License”
Provisions.

Delete the provision under §1105 (b)(4) pertaining to the original members of the Dental Hygiene Advisory Committee.

Audits
The Board has never been audited by the State Auditor or another external organization.

Administrative Procedures Act
The Board is subject to the Administrative Procedures Act and promulgates rules and regulations pursuant to the APA. The Board is assigned a Deputy Attorney General. A thorough review of the statute and the Board’s rules and regulations was conducted by the Board and the Deputy Attorney General over the last year to work on legislative changes. JSC Initial Questionnaire, pg. 9

Freedom of Information Act JSC Initial Questionnaire, pg. 9-10
All FOIA requests are handled by the Deputy Director, Division of Professional Regulation in coordination with the Division Director and in accordance with the Department of State’s FOIA Policy.

Meeting agendas are posted online through the State of Delaware Government Information Center and in the customer service area of the Division of Professional Regulation. Meeting agendas are posted seven days prior to the meeting date in accordance with the Administrative Procedures Act. Agendas can be viewed online at the Division of Professional Regulation’s website.

Meeting minutes are transcribed for each board and commission meeting and maintained electronically in the board’s office. Minutes are prepared for approval by the board at the next regularly scheduled meeting. Approved minutes are posted to the online meeting calendar five business days after the meeting in accordance with the Freedom of Information Act. The public can download copies of the approved meeting minutes online or request a hard copy by contacting the board office.

Executive Session meeting minutes are recorded within the Board’s regular meeting minutes which are available to the public.

Executive Sessions of the Board of Dental Examiners for the past three calendar years are as follows:

2007 – (three executive sessions, as follows):
12/13/2007 – Purpose to review January examination documentation
10/11/2007 – Purpose to review examination documentation
09/13/2007 – Purpose to review exam process and procedures

2008 – (three executive sessions, as follows):
03/6/2008 – Purpose to discuss proposed changes to the dental and dental hygiene exam.
04/10/2008 – Purpose to discuss proposed changes to the dental and dental hygiene exam.
12/4/2008 – Purpose to review exam process for January 2009

2009 – (one executive session, as follows):
08/26/2009 – Purpose to discuss the dental and dental hygiene exam.

Judicial Decisions, Federal Laws, Interagency Agreements, Memoranda of Understanding and Executive Orders
The Board stated the there are no federal laws, Interagency Agreements, Memorandum of Understanding, Executive Orders or state or federal judicial decisions, that impact the Board. JSC Initial Questionnaire, pg. 11

Performance
Mission
The mission of the Board pursuant to statute is “to protect the general public, specifically those persons who are the direct recipients of services regulated by this chapter, from unsafe and unprofessional practices. The Board’s enabling legislation accurately describes its mission. JSC Initial Questionnaire, pg. 21

The mission of the Division of Professional Regulation is to ensure the protection of the public's health, safety and economic well-being through administrative and investigative services to Governor-appointed boards/commissions

Objectives JSC Initial Questionnaire, pg. 21
The primary objective of the Board of Dental Examiners, to which all other objectives and purposes are secondary, is to protect the general public, specifically those persons who are the direct recipients of services regulated by this chapter, from unsafe and unprofessional practices.

The secondary objectives of the Board are to maintain minimum standards of practitioner competency and to maintain certain standards in the delivery of services to the public. In meeting its objectives, the Board shall develop standards assuring professional competence; shall monitor complaints brought against practitioners regulated by the Board; shall adjudicate at formal hearings; shall promulgate rules and regulations; and shall impose sanctions where necessary against licensees or former licensees.

Accomplishments
The Board indicated that its most significant accomplishments are as follows: JSC Initial Questionnaire, pgs. 19-20

During the 140th General Assembly, SB 73 was enacted to allow dentists licensed elsewhere to perform clinical demonstrations in Delaware which were in connection with research and development of dental products. Out-of-state dentists may already perform clinical demonstrations before dental societies, conventions, associations of dentists and dental colleges.

The Board implemented SB 391 which was enacted by the 140th General Assembly to codify recommendations of the Dental Care Access Improvement Committee which recommended strategies to help reduce the current and projected shortage of dentists in Delaware, and provide flexibility for programs to be established to help the state meet its dental health needs in the future.

The Board adopted the Voluntary Treatment Option Program for Chemically Dependent or Impaired professionals under the board’s regulatory authority. The rules and regulations were adopted in 2001.

The Board implemented the 1995 Joint Sunset Committee Recommendations pursuant to SS 1 to SB 240 which was enacted by the 141st General Assembly.

During the 142nd General Assembly, HB 176 was enacted to change the passing score on the national examination for dentists from 80 to 75.

During the 142nd General Assembly, SB 229 was enacted and created a uniform approach throughout Title 24 requiring that the refusal, revocation or suspension of licenses for professions and occupations regulated under Title 24 be based upon conviction of crimes that are “substantially related” to the profession or occupation at issue, replacing the former felony language. The bill required the boards of affected professions and occupations to promulgate regulations that specifically identify the crimes that are "substantially related" to the profession or occupation within 180 days of the enactment of the bill. The Board promulgated Rule and Regulation 11.0 (Crimes substantially related to the practice of dentistry and dental hygiene) effective July 2005.

Implemented SB 165 to establish retention and disposition provisions for patient dental records consistent with similar provisions in the Medical Practices Act.

Implemented HB 67 that established a Volunteer License category for qualified dentist and dental hygienist who volunteer their time in non-profit dental clinics or non-profit dental services within the State which are approved by the Delaware Health Care Commission and by the Board of Dental Examiners.

Implemented SB 206 to give protection to active duty military, activated reservists or members of the National Guard from having their professional licenses expire during active military deployments.

The Board updated its website on the Division of Professional Regulation’s website to make it more user-friendly for the public to access licensee and disciplinary information and for applicants and licensees to access licensure requirements, laws and rules and regulations.

The Board promulgated rules and regulations on April 1, 2006 to clarify continuing professional education requirements relating to cardiopulmonary resuscitation (CPR) for dentists and dental hygienists and to require continuing education on an Anesthesia topic for holders of Unrestricted Permits and Restricted I Permits.

Implemented SB 403 to allow Title 24 boards and commissions to waive convictions substantially related to the professions under certain conditions. These conditions included that after a hearing, the Board, by an affirmative vote of a majority of the quorum, may waive §1122(c)(4) of Title 24 if certain conditions are met.

Implemented HB 36 giving all boards and commissions cease and desist authority to address unlicensed practice and to impose fines for those who violate cease and desist orders subject to hearing procedures.

Implemented HB 392 creating a volunteer license. This Act will be reviewed for its effectiveness after two years of its passage and if not re-enacted, the Act will expire two years from the date of enactment.

The Board streamlined the renewal process by offering online renewal with the use of payment by credit card and the ability of licensees to attest to their continuing education online subject to post renewal audit.

In 2008, the Board delegated authority to the Division of Professional Regulation to issue licenses to applicants under specific circumstances or in coordination with the board’s credentialing committee. The Board ratifies the issuance of licenses at the next scheduled meeting.

In 2008, electronic notification of the receipt of dentist and dental hygiene licensure applications and the ability to track the progress of the application became available on line.

Implemented HB 135 that created a limited license for a Director or Chairperson of a Dental or Oral and Maxillofacial Surgery Residency Program. The limited license requirements do not include the practical exam.

Challenges
The Board indicted that its faces the following challenges: JSC Initial Questionnaire, pg. 21
Determine criteria (substantially equivalent or non-substantially equivalent) to evaluate residency programs other than general practice residency programs completed outside of Delaware, to include specialty residencies. This could create reciprocal standards.

Examine the feasibility of accepting regional examination standards.

Establish requirements for re-examination or other assessment of formal competency when a licensee fails to renew and his/her license has expired.

Opportunities for Improvement
The Board indicated the opportunities for improvement are as follows: JSC Initial Questionnaire, pgs. 20-21

Reorganize and modernize statutory provisions similar to other Title 24 Boards.

Ensure that Delaware’s minimum standards of practitioner competency and delivery of dental and dental hygiene services are in line with those nationally to ensure the highest level of public protection.

Revise rules and regulations.

To require federal and state criminal background checks for new applicants.

Finalize and submit to legislature the proposed statute changes that have been developed during the Board’s legislative committee meetings.

Coordination of Services with other Agencies
The Division, on behalf of the Board, coordinates with the Department of Justice, Office of the Attorney General for legal representation. JSC Initial Questionnaire, pg. 21

Customer Satisfaction
The Board indicated that its primary customers are: JSC Initial Questionnaire, pg. 22

Dentists and Dental Hygienists applicants and licensees

The public

The Division of Professional Regulation evaluates its customer satisfaction a number of ways. Walk-in customers to the Division complete a customer satisfaction log to evaluate the level of service that they receive by staff. New licensees, licensees who renew online, complainants and respondents involved in the complaint process and board members are asked to complete an online survey to rate the level of satisfaction with the Division’s services. The initial customer survey results gave the Division an overall customer satisfaction rating of 4.50 out of 5.0. Customer satisfaction data is used to identify areas of improvement. In FY 2009, the satisfaction rating was 4.45 out of 5.0.

Internal Performance Measures
The Board does not have an internal process to evaluate its performance. The Division of Professional Regulation conducts formal and informal performance reviews of staff providing support to the Board. In addition, the Division develops performance measures through the strategic planning process to evaluate and monitor the progress and performance of the administrative and investigative support provided to the boards and commissions. The Board is beginning to develop a strategic plan. JSC Initial Questionnaire, pg. 22

Delaware Institute for Dental Education and Research
The DIDER website provided the following information: http://dhss.delaware.gov/dhss/dhcc/dider.html

Created in statute 1981, the Delaware Institute for Dental Education and Research (DIDER) traditionally has had the sole function of supporting the general practice residency program at Christiana Care Health System. This has been and continues to be considered important because of the relatively unique requirement in the Delaware dental code that requires one year of general practice residency training as a condition of licensure to practice dentistry in Delaware.

In 2001 the administration of DIDER was placed within the offices of the Delaware Health Care Commission. This, coupled with the expansion of its Board, has given DIDER greater ability to function in a manner that serves its broader public purposes and to function in concert with the Delaware Institute for Medical Education and Research (DIMER) and other state health care policy activities. Prior to its placement within the Commission, for example, DIDER had no offices and received no funding for staff and supplies.

The statutory purposes of DIDER Board are to support, encourage and promote:
Accredited general practice residencies in dentistry;
Expansion of opportunities for Delaware residents to obtain dental education and training at all levels;
A strengthening of the factors favoring the decision of qualified dental personnel to practice in Delaware, including, but not limited to, tools such as loan repayment programs;
Dental needs of the community at large and particularly those who do not have ready access to dental care;
Expansion of opportunities for Delaware residents to obtain training at a reasonable cost;
Incentives for qualified personnel in the dental professions to practice in Delaware;
Support of graduate and postgraduate training programs, including emphasis on those programs targeted to meet the state’s health care needs.

In 2005, the DIDER Board identified access to dental school as a key priority in achieving its mission, and began reviewing options for providing opportunities for Delawareans to attend dental school. Using the model developed by the Delaware Institute for Medical Education and Research (DIMER), the Board conducted discussions with several dental schools in the region and Temple University emerged as the ideal partner.

In 2006, DIDER signed an agreement with the Maurice H. Kornberg School of Dentistry at Temple University which guarantees admission to six qualified students from Delaware in each entering class of dental students. In 2009, the partnership with Temple University guarantees admission to five qualified students from Delaware in its entering class of dental students. This relationship provides Delaware residents with an opportunity to receive quality education and training at a highly regarded regional dental school. The partnership also promotes opportunities for participating dental students to complete externship and residency training programs at facilities in Delaware.

Delaware residents are eligible to participate regardless of the location of their undergraduate educational institution. Students must meet Temple University’s academic requirements and this program does not guarantee admittance. All Delawareans who are accepted and choose to attend Temple will be automatically admitted to the DIDER program; they are not required to fill out any additional applications.

Additionally, through the generosity of the Delaware State Legislature, DIDER will provide funding each academic year for tuition stipends to be divided among the Delaware residents who attend Temple. For the foreseeable future, each student from Delaware will receive, at a minimum, a tuition stipend of $1,000 per academic year. Any remaining funds will be allocated based on financial need – to be determined using Temple’s financial aid formulas. … The tuition stipends are guaranteed for four years as long as students remain in good standing with the University and are contingent upon available funding.

Below is a list provided by the Delaware Higher Education Commission: Responses to JSC 2nd Questionnaire, DE Higher Education Commission, pg. 5
FY07 12 awards $75,000
FY08 15 awards $150,000
FY09 19 awards $225,000

Organization
Policymaking Structure
Statute mandates that the Board consist of 9 members, appointed by the Governor, who are residents of this State, 5 of whom shall be licensed dentists and who have been actively practicing dentistry in this State for a period of 5 years immediately preceding appointment to the Board; 1 member shall be a dental hygienist who has been actively practicing dental hygiene in this State for a period of 5 years immediately preceding appointment to the Board; and 3 public members who shall have been residents of this State for a period of 5 years immediately preceding appointment to the Board. Senate confirmation is not required.

Unlike most other Boards, this Board does not have a statutory requirement to include dental and public representation from each of the three counties. The current Board has 4 dentists from New Castle County, one dentist from Sussex County, and no dentist from Kent County. The public members are representative of the three counties.

The public members shall not be, nor ever have been, dentists or dental hygienists, nor members of the immediate family of a dentist or dental hygienist; shall not have been employed by a dentist; and shall not have a material interest in the providing of goods and services to dentists or dental hygienists, nor have been engaged in an activity directly related to dentistry or dental hygiene. The public members shall be accessible to inquiries, comments and suggestions from the general public. No public member shall have been licensed in any health related field or be licensed to practice law.

Additionally, no person shall be eligible for appointment to the Board who is in any manner connected with or interested in any dental college or the dental department of any college or university or the dental supply business. 24 Del. C. § 1102

Statute also provides that each member shall serve a 3 year term, and may succeed himself or herself for 1 additional term. No member who has been twice appointed to the Board or who has served on the Board for 6 years within any 9-year period, shall again be appointed to the Board until an interim period of at least 1 year has expired since such person last served.

Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member and may succeed himself or herself for only one additional full term. Each term of office shall expire on the date specified in the appointment; however, the Board member shall remain eligible to participate in Board proceedings unless and until replaced by the Governor. 24 Del. C. § 1102

Delaware Board of Dental Examiners JSC Initial Questionnaire, supplemental attachment
As of 12/09/09

Neil McAneny, DDS, President
Newark, DE
Legislative/Rules Committee Chair
Exam Committee Chair
Orig. Appt. Date: 1/15/2007 Exp Date: 1/15/10 (First Term)

Blair Jones, DMD, Secretary
Lewes, DE
Orig. Appt. Date: 10/19/2007 Exp Date: 10/19/2010 (First Term)

Robert C. Director, DDS
Wilmington, DE
Filling term for David Deakyne, DMD Exp Date: 1/15/10 (Filling for Deakyne)
Orig. Appt. Date: 12/3/2009

David Williams, DMD
Wilmington, DE
Orig. Appt. Date: 10/15/2003 Exp. Date: 1/8/2010 (Second Term)

John J. Lenz, DDS
Wilmington, DE Exp. Date: 10/02/2011 (First Term)
Orig. Appt. Date: 10/2/2008

John M. Kirby, Public Member
Milford, DE
Orig. Appt. Date: 1/15/2004 Exp. Date: 1/15/2010 (Second Term)

James King, Public Member
Dover, DE
Orig. Appt. Date: 2/26/2007 Exp Date: 2/26/2010 (First Term)

Danna Levy, Public Member
Wilmington, DE
Orig. Appt. Date: 1/8/2007 Exp Date: 1/8/2010 (First Term)

Laureen Coyle, RDH
Exam Committee
Dover, DE
Orig. Appt. Date: 10/19/2007 Exp Date: 10/19/2010 (First Term)

Statute provides that the Board shall hold regularly scheduled business meetings at least once in each quarter of a calendar year and at such times as the President deems necessary, or at the request of a majority of the Board members. Over the last three years, the Board has held ten regularly scheduled meetings per year and typically has not met in July and August. JSC 2nd Questionnaire, pg. 4

The President and Secretary are elected by the Board members. Each officer serves for 1 year and shall not succeed himself or herself for more than 2 consecutive terms.

A majority of the members constitutes a quorum for the purpose of transacting business. No disciplinary action shall be taken without the affirmative vote of 5 members of the Board. When members of the Dental Hygiene Advisory Committee participate in voting as specified in statute, the Board composition shall be 12 voting members, so that 7 members shall constitute a quorum.

Removal of Members JSC Initial Questionnaire, pg. 26
Members can be removed by the Governor. Statute also provides that members shall be suspended or removed by the Governor for misfeasance, nonfeasance, malfeasance, misconduct, incompetency or neglect of duty. A member subject to a disciplinary hearing shall be disqualified from Board business until the charge is adjudicated or otherwise concluded. A Board member may appeal any suspension or removal to Superior Court.

Any member who is absent without adequate reason for 3 consecutive meetings, or fails to attend at least half of all regular business meetings during any calendar year, shall be guilty of neglect of duty.

The Division of Professional Regulation indicated that it communicates with the Governor’s Office on a regular basis concerning vacancies and reappointments for the 34 boards and commissions. In addition, Board members receive attendance letters from the Director, Division of Professional Regulation when attendance is a concern. No member has ever been removed as described.

Member Training JSC Initial Questionnaire, pg. 26
Statute provides that the Division of Professional Regulation shall provide training to Board members at least once every fiscal year. The training shall outline the legal responsibilities of Board members to protect the health, safety and welfare of the general public. This training is mandatory. Title 29, Del. C. § 8735(k)

The Division provides orientation and annual training for board/commission members. Members are provided with a resource manual.

Member Compensation JSC Initial Questionnaire, pg. 26
Members are compensated for Board meeting attendance at a rate of $50 per meeting, but not more than $500 in any calendar year. Members are reimbursed for mileage at the State rate.

Dental Hygiene Advisory Committee
The Dental Hygiene Advisory Committee is also established by statute. The Advisory Committee advises the Board on matters pertaining to the policy and practice of dental hygiene. Statute provides that the Committee be comprised of 3 licensed dental hygienists, appointed by the Governor, who are residents of this State and who have been actively practicing dental hygiene in this State for 2 years immediately preceding appointment to the Committee. 24 Del. C. § 1106 Each member serves a term of 3 years and remains eligible to participate in proceedings unless and until replaced by the Governor. All terms are staggered so that 1 new member is added and 1 member is retired each year.

Dental Hygiene Advisory Committee
As of 10/16/09

Fay S. Rust, RDH
Georgetown, DE
Orig. Appt. Date: 6/14/1999 Exp. Date: 10/02/2011 (Fourth Term)

Bonnie L. Thomas, RDH
Dover, DE
Orig. Appt. Date: 1/24/2006 Exp. Date: 8/27/2010

Currently there is one dental hygienist vacancy that has been vacant since December 2008. JSC Initial Questionnaire, pg. 26

Members can be removed by the Governor. Statute also provides that members shall be suspended or removed by the Governor for misfeasance, nonfeasance, malfeasance, misconduct, incompetency or neglect of duty.

Members are compensated for Board meeting attendance at a rate of $50 per meeting, but not more than $500 in any calendar year. Members are reimbursed for mileage at the State rate.

The Dental Hygiene Advisory Committee shall participate with members of the Board in: 24 Del. C § 1105(c)

Voting on the qualifications of candidates who apply for licensure to practice dental hygiene;

Voting on the composition of the State dental hygiene clinical/practical examination;

Voting on the requirements for renewal of dental hygiene licenses.

Immunity
Statute provides that the members of the State Board of Dental Examiners of Delaware, dental ethics committee and dentists who are members of hospital and Delaware State Dental Society committees whose function is the review of dental records and of dentists' work with a view to quality of care and utilization of hospital facilities, home visits and office visits shall severally not be subject to, and shall be immune from, claim, suit, liability, damages or any other recourse, civil or criminal, arising from any act or proceeding, decision or determination undertaken, performed or reached in good faith and without malice by any such member or members acting individually or jointly in carrying out the responsibilities, authority, duties, powers and privileges of the offices conferred by law or duly adopted rules and regulations of the aforementioned committees and hospitals, good faith being presumed until proven otherwise, with malice required to be shown by a complainant.

The records and proceedings of any such committees or organizations are confidential records which shall not constitute public records or be available for general inspection by the public. All hearings on complaints shall be opened to the public only at the request of the respondent.

Additionally, statute provides that no person who provides information to any such committees or organizations or who testifies as a witness, shall be held liable in any cause of action arising out of the providing of such information or the giving of such testimony, provided that such person does so in good faith and without malice. 24 Del. C. § 1191

Staff JSC Initial Questionnaire, pgs. 26-28
Prior to November 1, 2007, one administrative staff person (merit employee) was assigned to provide all services to the board, other than investigations. In November 2007, the Division implemented a new organizational structure to optimize administrative functions that support the boards and commissions, licensees and the public. An evaluation of business processes, staffing and systems was conducted to identify how best to increase responsiveness, service continuity during staff absences and process standardization. Three service teams, an information center team and the existing operations support team make up the restructured administrative unit.

The Board is supported by a 5 member service team consisting of an Executive Director, a team leader and three staff members assigned to credentialing, licensee and board liaison services. (4 merit and 1 contractual employee) The contractual employee provides administrative support to the Board. The Service Team currently has a vacant Administrative Specialist III that is unable to be filled due to the State’s hiring freeze. This position is considered vacant and has not been eliminated due to the current budget crunch. JSC 2nd Questionnaire, pg. 4
The Division has an investigative unit that assigns investigators to assist the board in handling complaints filed against licensees. The Service Team provides administrative services to eleven other professional boards and commissions and the Investigative Unit handles complaints for all professional boards and commissions.

In addition to the three service teams, a new information center team was created to increase responsiveness by focusing on incoming phone and email inquiries. The team is centrally located in the Division office and equipped with a state-of-the-art customer relationship management (CRM) application. The CRM enables service tickets to be created, tracked and routed. The system is also equipped with an electronic knowledge base which could be populated with information on each profession to allow customers to search for information on the division’s website.

In FY 2007, the Division of Professional Regulation was authorized four new administrative positions to respond to increased demand and reduce the Division’s reliance on contractual employees to handle critical administrative and licensing workloads.

Additionally, the Division expanded the use of its enterprise database application by significantly increasing online services through its website. Specifically, the public can view licensee information, related laws and rules online and download complaint forms, licensees can update their profiles and renew licenses using a credit card and applicants can check the status of licensure applications online and complete fillable forms.

These changes have resulted in greater responsiveness all around, more customer options, including self-service and greater flexibility and shifting of resources.

Staff Recruitment
Staff is hired through the State of Delaware Merit System competitive hiring process, which is coordinated through the Department of State’s Human Resources Office and the Office of Management and Budget, Human Resources Office. Specifically, there is statewide recruitment, the Office of Management and Budget evaluates applicants to determine if they meet minimum qualifications, prepares the certification list of eligible persons and interviews are conducted by the Division of Professional Regulation. Both the Department of State Human Resources Office and the Division of Professional Regulation conduct orientations with all new employees. JSC Initial Questionnaire, pg. 28



















Staff Responsibilities JSC Initial Questionnaire, pg. 28

Credentialing Services
Administrative Specialist II
Board Liaison Services (2)
Administrative Specialist II (contractual);
Administrative Specialist II
Licensee Services
Administrative Specialist II
    -Review applications
    -Complete licensing system checklist and coordinate with board services
    -Issue licenses
    -Respond to customer inquiries-Level 2
    -Issue temporary permits
    -Coordinate testing and applicant results
    -Website updates
    -Maintain licensing database.
    -Attend/schedule/notice meetings & hearings
    -Prepare board agenda and minutes
    -Process board member payments
    -Monitor formal complaints (from DAG)
    -Manage all board correspondence
    -Website updates
    -Conduct research/ legislative initiatives.
    Respond to customer inquiries – Level 2
    -Maintain licensing database.
    -Proctor exams
    -Issue licenses and temporary permits
    -Complete license verifications
    -Review paper renewals
    -Release renewal holds
    -Respond to customer inquiries – Level 2
    -Update web site
    -Maintain licensing database

Based on the new Service Team structure, the above reflects the tasks that each staff member performs in each work category for eleven professions. Each profession within the service team was assigned an overall workload rating. Based on the workload rating of the Board of Dental Examiners, 10-15% of each staff’s time is spent providing the above administrative activities to the board.

Staff Training
Training opportunities for staff are available through in-house training, offerings by the Office of Management & Budget, Human Resources Management, national conferences and committees, education reimbursement for higher education and participation in the State’s Supervisory Development and Career Enrichment Programs. JSC Initial Questionnaire, pgs. 27-28

Public Information JSC Initial Questionnaire, pgs. 22-23
The Board has a web presence on the Division of Professional Regulation’s website at dpr.delaware.gov which provides laws, rules and regulations, frequency asked questions, licensure and renewal requirements. The public can search for licensees at a “Verify License Online” link to determine the licensure status and whether the licensee has public disciplinary action. Information is available to the public about the complaint process and a complaint form can be downloaded. Rule and regulation changes and hearings are noticed in the media and through the Register of Regulation pursuant to the Administrative Procedures Act.

The Board has held numerous public legislative committee meetings to discuss proposed changes to its statute and rules and regulations. Board meeting agendas and minutes are available online.

Below is a list of various interest groups that are affected by the Board’s actions or that represent others served by or affected by the Board’s actions: JSC Initial Questionnaire, pgs. 22-23
Delaware State Dental Society
Delaware Society of Oral and Maxillofacial Surgeons
Christiana Care Dental Residency Program
Delaware Dental Hygienists’ Association (DDHA)
Kent/Sussex Dental Hygienists’ Association
New Castle County Dental Hygienists’ Association
Various Dental Clinics (operating to serve low income and those without insurance, i.e. Delmarva Rural Ministries)

Below is a list of national organizations and other government entities that serve as an information clearinghouse or regularly interact with the Board: JSC Initial Questionnaire, pg. 23
Division of Public Health, Dental Office
Delaware Institute of Dental Education and Research
American Dental Association
American Academy of Dental Examiners
Commission on Dental Accreditation
American Dental Hygienists’ Association
National Board of Dental Examinations

Licensing
Pursuant to statute, the Board is authorized to issue a license to each applicant who meets the statutory requirements for licensure as a dentist or dental hygienist and who pays the established fees.

In addition, in 2008 the Division approached each board and commission under its regulatory authority to request they consider delegating authority to issue licenses/permits/certificates in those cases where the licensing requirements are straightforward and when there are no questions, issues or concerns on the application. Any questions, issues or concerns with an application require the Board’s review at its next regularly scheduled meeting.

If there are no issues, the Board allows the Division to issue a license after a thorough review of the licensing documents and review by one board member on the credentialing committee, without requiring the licensee to wait for the next scheduled Board meeting. At the following meeting, those applicants issued a licenses by the Division are on the agenda and the Board ratifies the licenses. At any time, the Board may review an application. The Board agreed to delegate licensing authority to the Division along with one member of the credentialing committee in April 2009. JSC 2nd Questionnaire, pg. 5

Statute provides that no person shall practice dentistry or dental hygiene or hold himself or herself out to the public in this State as being qualified to practice dentistry or dental hygiene or use in connection with the person's name, or otherwise assume or use, any title or description conveying or tending to convey the impression that the person is qualified to practice dentistry or dental hygiene unless such person has been duly licensed in Delaware. 24 Del. C § 1121(a)

Whenever a license to practice as a dentist or dental hygienist in Delaware has expired or has been suspended or revoked, it shall be unlawful for the person to practice dentistry or dental hygiene in Delaware. 24 Del. C § 1121(e)

Licensure - Dentists
There are currently 456 active licensed Dentists.

Statute defines the practice of dentistry as: 24 Del. C. § 1101(8)

… the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of the dentist's education, training and experience, in accordance with the ethics of the profession and applicable law.

A person shall be construed to practice dentistry who by verbal claim, sign, advertisement, opening of an office, or in any other way, including use of the words "dentist," "dental surgeon," the letters "D.D.S.," "D.M.D.," or other letters or titles, represents the dentist's to be a dentist or who holds himself or herself out as able to perform, or who does perform, dental services or work.

A person shall be regarded as practicing dentistry who is a manager, proprietor, operator or conductor of a place for performing dental operations or who for a fee, salary or other reward paid, or to be paid either to himself or herself or to another person, performs or advertises to perform dental operations of any kind.

Qualifications
An applicant who is applying for licensure as a dentist shall submit evidence, verified by oath and satisfactory to the Board, that such person: 24 Del. C § 1122(a)(c)(d)

Has received a degree in dentistry from an accredited dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association.

Before matriculating in a dental college or university, has completed at least 2 years of undergraduate study in an accredited college or university.

Has acquired 1 year's experience as a dental intern or resident in a school, institution or hospital approved by the Board or, in lieu thereof, has participated in a preceptorship or reciprocity program established in stautue, or has had 3 years of active dental practice in another state or territory of the United States.

Has achieved the passing score on all examinations prescribed by the Board.

Shall submit proof of current certification in cardiopulmonary resuscitation (CPR) technique in accordance with regulations adopted by the Board.

Shall not have been the recipient of any administrative penalties regarding the applicant's practice of dentistry, including but not limited to fines, formal reprimands, license suspension or revocation (except for license revocations for nonpayment of license renewal fees), or probationary limitations, or have entered into any "consent agreements" which contain conditions placed by a Board on the applicant's professional conduct and practice, including any voluntary surrender of a license while under investigation.

Shall not have any impairment related to drugs or alcohol that would limit the applicant's ability to undertake the practice of dentistry in a manner consistent with the safety of the public.

Shall not have a criminal conviction record nor pending criminal charge relating to an offense the circumstances of which substantially relate to the practice of dentistry. Applicants who have criminal conviction records or pending criminal charges shall require appropriate authorities to provide information about the record or charge directly to the Board in sufficient specificity to enable the Board to make a determination whether the record or charge is substantially related to the practice of dentistry. After a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum, may waive this provision, if it finds all of the following:
More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, sentence does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.
The applicant is capable of practicing dentistry in a competent and professional manner.
The granting of the waiver will not endanger the public health, safety or welfare.

Shall not have engaged in any of the acts or offenses that would be grounds for disciplinary action under this chapter, and shall have no disciplinary proceedings or unresolved complaints pending against the person in any jurisdiction where the applicant has previously been or currently is licensed.

Where the Board has found to its satisfaction that an applicant has been intentionally fraudulent, or that false information has been intentionally supplied, the Board shall deny the application and report its findings to the Attorney General for further action.

Dentist

# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009 (thru 7/20/09)
11
10
0
0
0
Calendar Year 2008
15
19
0
0
0
Calendar Year 2007
16
20
1
0
0
Calendar Year 2006
24
21
0
0
0

Examinations
An applicant for a license to practice dentistry in this State shall: 24 Del. C. § 1123
Successfully pass, with a score established by the Board, a practical examination prepared and administered by the Board. The practical test in dentistry and its methods of administration shall be validated as to content and scoring by a member of the faculty of an accredited school of dentistry. Such faculty member shall not be licensed to practice dentistry in Delaware and shall be agreed upon by the Division and the Board. An applicant who has failed the practical examination 3 times may not take the examination again unless the applicant can provide evidence of mitigating circumstances to the satisfaction of the Board.

Submit proof satisfactory to the Board that the applicant has successfully completed the National Board of Dental Examiners' examination in dentistry with a score of at least 75, when Parts I and II are averaged. (Of note: Reg. 8.0 requires that the applicant complete the National Board Examination with a score of at least 80 on each of Part 1 and Part 2 of the Examination [2/13/97]).

Successfully pass a written jurisprudence examination on Delaware laws pertaining to dentistry. All examinations shall be approved by the Division and the Board.

The Board’s practical exams for dental practitioners and dental hygienists are administered twice a year (typically in January and June) at Delaware Technical & Community College Dental Clinic at the Wilmington campus.

The Jurisprudence exams are given on demand at the request of the candidate after Board approval. The Jurisprudence exams are administered in conjunction with the practical exam at the Delaware Technical & Community College – Wilmington campus or at the Division of Regulation in Dover.

National exams are administered year round at Prometric Test Center sites located in the United States, its territories including Guam, Puerto Rico, the U.S. Virgin Islands and Canada. In Delaware there is one Prometric Test Center located in New Castle. JSC 2nd Questionnaire, pg. 4

Additionally, according to the American Dental Association’s website www.ada.org/prof/prac/licensure/index.asp Delaware, Florida, Nevada and the Virgin Island are considered independent and are the only states/possessions that prepare and administer their own clinical exam. JSC 2nd Questionnaire, pg. 6

No other regulated professions within Delaware, including doctors, nurses, psychologists, accountants, and veterinarians are required to pass a State Board prepared and administered practical exam as well as a national/regional exam as a condition of licensure. For example, the regulations promulgated by the Board of Medical Practices provide that “All candidates for regular licensure by examination are required to pass the FLEX.
National Boards, SPEX or USMLE FLEX Examination means the Federation Licensing Examination as promulgated by the Federation of State Medical Boards of the United States, Inc.; SPEX is the Special Proficiency Examination; and USMLE means United States Medical Licensing Examination which has replaced (FLEX) and (NBME) as the only allopathic examination given in the USA since 1994.” as provided for in regulation. Board of Medical Practices Regulations 3.1

Additionally, the Board of Veterinary Medicine requires that the applicant take “written national examinations for the profession, prepared by either the applicable national professional association or by a recognized legitimate national testing service, and determine whether applicants are qualified to take such examinations. The examinations shall be prepared for testing on a national basis, and not specifically prepared at the request of the Board for its individual use.” Veterinarians and veterinary technicians applying for licensure shall take the applicable national examination; and both applicants who qualify for original licensure and licensure by reciprocity shall have achieved the passing score on the national examination.” 24 Del. C. § 3306 (a)(3) Board of Veterinary Medicine

In the 1985 and 1995 JSC Final Reports, there were recommendations made requesting that the Board of Dental Examiners discuss the recognition of regional exams in order to facilitate reciprocity, therefore the issue of recognition of regional examinations has been before the Board of Dental Examiners for nearly 25 years. 1995 JSC Final Report, pg. 11 A search of legislation reveals that no legislation regarding this issue has ever been introduced.

The State Dental Director
Statute provides that the State Dental Director be a Delaware licensed dentist. In the event that the State Dental Director does not have a Delaware dental license when hired, the State Dental Director must obtain a Delaware license within 2 years of assuming the position. The Board may grant a temporary license for a period no longer than 2 years to the State Dental Director, provided the State Dental Director has met all licensure requirements except successful completion of the practical exam. The authority to practice dentistry under such a temporary license will be limited to the performance of the duties as the State Dental Director. 24 Del. C. § 1121(d)

Volunteer License
There are currently no active Volunteer licensees for Dentists or Dental Hygienist.

The volunteer license provision was established in July 2007. This provision sunsets on July 3, 2010, unless re-enacted. 76 Del. Laws, C. 309, § 2; formerly HB 392

Statute provides that a dentist /dental hygienist can apply for a volunteer license with the following restrictions: 24 Del. C. § 1197

Cannot practice dentistry for payment/profit;

License is site-specific to charitable clinics as approved by the Delaware State Board of Dental Examiners;
Must work under the supervision of the dentist in charge of the approved, site-specific clinic; and
Must renew license annually. A 2-year license will not be issued.

In order to apply for a volunteer license, an applicant must: 24 Del. C. § 1196
Submit proof of current license or proof of licensure within the past 2 years (from another U.S. state and/or Canadian province);
Submit record of continuing education (CE) credit that meets the State of Delaware's requirement for the preceding 2 years as determined in the Board's rules and regulations;
Submit to background check, both professional and criminal;
Pass the Jurisprudence test for the State of Delaware;
Show proof of 25 years of continuous licensure in another U.S. state or states and/or Canadian province or provinces; and
Have no verifiable complaints on the National Practitioner Data Bank.

In order to maintain a license under this section, an applicant, must complete a minimum of 125 hours of volunteer dentistry per year; and must follow any other requirements that any licensed dentist in this State must follow (e.g., CPR, CE requirements, etc.). 24 Del. C. § 1198

Every volunteer dentist and hygienist will be evaluated bimonthly for the first 6 months and once every 6 months after the initial 6-month period by the supervising dentist. If the supervising dentist finds that the volunteer dentist is incompetent and/or is a danger to the public, the supervising dentist shall immediately notify the Delaware State Board of Dental Examiners. The Board may suspend the license until a hearing is held based on the notification. 24 Del. C. § 1199

Penalties for violating the requirement of not practicing dentistry for profit will result in a $2500 fine for each offense. 24 Del. C. § 1199A

Volunteer Dentist & Dental Hygienist
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009 (thru 7/20/09
0
0
0
0
0
Calendar Year 2008
0
0
0
0
0

Limited License
There are currently no active Dentist-Limited licensees. A limited license entitles the applicant to practice dentistry only in the hospital or other institution designated on the license and only on bona fide patients of the hospital or institution and under the direction of a licensed dentist employed therein or on the staff thereof. The limited license is renewed annually.

Upon completion of an application and payment of the established fee, the Board may issue a limited license to an applicant for licensure as a dentist who has received a degree in dentistry from an accredited dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association; before matriculating in a dental college or university, has completed at least 2 years of undergraduate study in an accredited college or university and who furnishes proof satisfactory to the Board that the applicant has been appointed a dental intern in a hospital or other institution maintained by this State, by a county or municipality thereof, or in a hospital or dental infirmary incorporated under the laws of this State. 24 Del. C. § 1132

Dentist-Limited
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009 (thru 7/20/09
0
0
0
0
0
Calendar Year 2008
0
0
0
0
0
Calendar Year 2007
0
0
0
0
0
Calendar Year 2006
0
0
0
0
0

Additionally, statute provides for a limited license for a Director or chairperson of a hospital dental or hospital oral and maxillofacial surgery residency program. There are currently 14 active licensed Dentists-Limited Resident. This limited license entitles the applicant to practice dentistry or oral and maxillofacial surgery only in the hospital or other institution designated on the license and only on bona fide patients of the hospital or institution, and in an academic setting for teaching purposes. This limited license is also renewable annually.

The requirements are the same as listed above with the additional requirement that the applicant has acquired 1 year's experience as a dental intern or resident in a school, institution or hospital approved by the Board or, in lieu thereof, has participated in a preceptorship or reciprocity program established by statute, or has had 3 years of active dental practice in another state or territory of the United States. 24 Del. C § 1132A

Name of License #4 issued by the Board: Dentist-Limited Resident
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009 (thru 7/20/09
12
12
0
0
0
Calendar Year 2008
11
11
0
0
0
Calendar Year 2007
11
11
0
0
0
Calendar Year 2006
11
11
0
0
0

Anesthesia Permits
In 1985, The JSC recommended that the Board adopt regulations and procedures regarding administration of analgesia, sedation or anesthesia other than local. The Board complied and regulations set out the procedures for the issuance of 3 types of permits for dental offices where anesthesia is administered. The Board has drafted proposed statutory language addressing these permits. JSC 2nd Questionnaire, pg. 3

Unrestricted Permit
There are currently 25 active licensed Unrestricted Permits.

An unrestricted permit allows a qualified dentist to administer deep sedation and general anesthesia which also includes all conscious sedation techniques.

The qualifications for a dentist to receive an Unrestricted Permit are as follows: JSC 2nd Questionnaire, pgs. 1-2

Completed a minimum of two years of advanced training in anesthesiology and related academic studies (or its equivalent) beyond the undergraduate dental school level in a training program as described in Part II of the Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry; or

Is a Diplomat of the American Board of Oral and Maxillofacial Surgeons; or

Satisfactorily completed a residency in Oral and Maxillofacial Surgery at an institution approved by the Council of Dental Education, American Dental Association; or

Is a fellow of the American Dental Society of Anesthesiology; or

Employs or works in conjunction with a trained M.D. or D.O. who is a member of the anesthesiology staff of an accredited hospital, provided that such anesthesiologist must remain on the premises of the dental facility until any patient given a general anesthetic or deep sedation regains consciousness. A certified registered nurse anesthetist may be utilized for deep sedation or general anesthesia only if the dentist also possesses an Unrestricted Permit and

There is facility, equipment and staffing requirements which require onsite inspection by the Anesthesia Advisory Consultants, a team appointed by the Board of Dental Examiners; and

Is certified in Advanced Cardiac Life Support by the American Heart Association.

Unrestricted Permits
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009
(thru 7/20/09
2
0
0
0
0
Calendar Year 2008
4
4
0
0
0
Calendar Year 2007
0
0
0
0
0
Calendar Year 2006
1
1
0
0
0

Restricted Permit I
There are currently 15 active licensed Restricted Permit I’s.

A Restricted Permit 1 allows a dentist to administer conscious sedation to their patient induced by parenteral, enteral or rectal routes.

The qualifications for a dentist to receive a Restricted Permit I are as follows: JSC 2nd Questionnaire, pg. 2

A Restricted Permit 1 requires a licensed dentist to complete a minimum of 60 hours of instruction, including management of at least 20 patients.

-Must be certified in CPR as documented by the American Heart Association or the American Red Cross. Advanced Cardiac Life Support Certification is encouraged.

-Must have a properly equipped facility for the administration of Restricted Permit I Conscious Sedation and staffed with a supervised team of auxiliary personnel capable of reasonably handling procedures, problems and emergencies. The Board’s Anesthesia Advisory Consultants, as appointed by the Board, are required to inspect the facility and evaluate the competency of the team.

Restricted Permit I
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009
(thru 7/20/09
1
0
0
0
0
Calendar Year 2008
2
3
0
0
0
Calendar Year 2007
3
1
0
0
0
Calendar Year 2006
0
0
0
0
0

Restricted Permit II
There are currently 105 active licensed Restricted Permit II’s.

A Restricted Permit 1I allows a dentist to administer conscious sedation to their patient induced by nitrous oxide inhalation.

The qualifications for a dentist to obtain a Restricted Permit II are as follows: JSC 2nd Questionnaire, pg. 3
Complete a minimum of 14 hours of instruction, including supervised clinical experience in managing patients (in a course required to achieve competency in nitrous oxide inhalation).

Show proof of CPR as documented by the American Heart Association or the American Red Cross.

Restricted Permit II
# of License
Applications
Received
# of Licenses
Issued
# of License Applications
Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009
(thru 7/20/09
3
3
0
0
0
Calendar Year 2008
8
8
0
0
0
Calendar Year 2007
2
3
1
0
0
Calendar Year 2006
3
5
0
0
0

Exemptions
Statute provides that nothing in the governing statute shall be construed to prevent: 24 Del. C § 1133

A licensed dentist or dental hygienist serving in any branch of the United States Armed Services, Veterans' Administration or Public Health Service from discharging the dentist's or dental hygienist's official duties;

A licensed physician or surgeon from extracting teeth or treating pathological conditions of the mouth, teeth or oral tissues, or from radiographing such tissues, unless such person practices dentistry as a specialty;

A lawful practitioner of dentistry in another state, the District of Columbia or a territory of the United States from making a clinical demonstration before a dental society, convention, association of dentists or dental college or performing duties in connection with a specific case on which the practitioner may have been called to this State by a legally qualified practitioner of dentistry of this State.

A practitioner of dentistry who maintains a lawful dental license to practice in another state, the District of Columbia or a territory of the United States from making a clinical demonstration in connection with the lawful research and development of dental product or dental products manufactured by a dental manufacturer complying with guidelines set forth by the United States Food and Drug Administration.

A person otherwise qualified under this chapter from rendering dental services in a nonprofit, tax-exempt organization, as described the Internal Revenue Code, that does not charge for its services and is affiliated with a hospital, licensed by the Department of Health and Social Services, and accredited by the Joint Commission on Accreditation of Hospitals or the American Osteopathic Association.

Licensure – Dental Hygienist
There are currently 706 active licensed Dental Hygienists.

Statute defines the practice of dental hygiene to mean: 24 Del. C. § 1102(7)

…the removal of calculus deposits, plaque and stains from all surfaces of the teeth, and making instrumental examinations of the oral cavity, and assembling all necessary information for use by the dentist in diagnosis and treatment planning, and the performance of such prophylactic or preventive measures in the case of teeth, including the application of chemicals to the teeth and periodontal tissues, designed and approved for the prevention of dental caries, as the Board may authorize; but the "practice of dental hygiene" shall not include any other operation on the teeth or tissues of the mouth.

A dental hygienist licensed pursuant to statute shall practice dental hygiene only under the general supervision of a licensed dentist, in the office of the licensed dentist or in any public school or other public institution of this State.

Additionally, a licensed dental hygienist may practice under the general supervision of the State Dental Director, or the State Dental Director's designee, who is a licensed Delaware dentist, in schools and state institutions. A licensed dental hygienist may also practice under the general supervision of the State Dental Director, or the State Dental Director's designee, who is a Delaware licensed dentist, in federally qualified health centers, nonprofit organizations and other locations as designated by the Delaware Health Care Commission in consultation with DIDER. The protocols under which hygienists practice in these settings is established by the State Dental Director and is subject to the approval of the Delaware Board of Dental Examiners. 24 Del. C. § 1121(b)(c)

Qualifications
An applicant who is applying for licensure as a dental hygienist shall submit evidence, verified by oath and satisfactory to the Board, that such person has: 24 Del. C. § 1122 (b)(c)(d)
Graduated from high school or has received a general equivalency diploma (G.E.D.).

Graduated from a dental hygiene college or university program accredited by the Commission on Dental Accreditation of the American Dental Association of at least 2 academic years' duration; or

Graduated, prior to 1953, from a dental hygiene program of at least 1 year's duration, which program had been approved by the Board at the time of the person's graduation; and

Achieved the passing score on all examinations prescribed by the Board.

Shall submit proof of current certification in cardiopulmonary resuscitation (CPR) technique in accordance with regulations adopted by the Board.
Shall not have been the recipient of any administrative penalties regarding the applicant's practice of dentistry or dental hygiene, including but not limited to fines, formal reprimands, license suspension or revocation (except for license revocations for nonpayment of license renewal fees), or probationary limitations, or have entered into any "consent agreements" which contain conditions placed by a Board on the applicant's professional conduct and practice, including any voluntary surrender of a license while under investigation.

Shall not have any impairment related to drugs or alcohol that would limit the applicant's ability to undertake the practice of dental hygiene in a manner consistent with the safety of the public.

Shall not have a criminal conviction record nor pending criminal charge relating to an offense the circumstances of which substantially relate to the practice of dental hygiene. Applicants who have criminal conviction records or pending criminal charges shall require appropriate authorities to provide information about the record or charge directly to the Board in sufficient specificity to enable the Board to make a determination whether the record or charge is substantially related to the practice of dental hygiene. After a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum, may waive this provision, if it finds all of the following:
More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, sentence does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.
The applicant is capable of practicing dental hygiene in a competent and professional manner.
The granting of the waiver will not endanger the public health, safety or welfare.

Shall not have engaged in any of the acts or offenses that would be grounds for disciplinary action pursuant to statute, and shall have no disciplinary proceedings or unresolved complaints pending against the person in any jurisdiction where the applicant has previously been or currently is licensed.

Where the Board has found to its satisfaction that an applicant has been intentionally fraudulent, or that false information has been intentionally supplied, the Board shall deny the application and report its findings to the Attorney General for further action.

Dental Hygienist

# of License
Applications
Received
# of Licenses
Issued
# of License
Applications Rejected
# of Licenses
Suspended
# of Licenses Revoked
Calendar Year 2009 (thru 7/20/09)
35
24
0
0
0
Calendar Year 2008
32
30
1
0
1
Calendar Year 2007
35
34
2
0
0
Calendar Year 2006
35
30
0
0
0

Examinations
An applicant for a license to practice dental hygiene in this State shall: 24 Del. C. § 1123

Successfully pass, with a score established by the Board, a practical examination prepared and administered by the Board. The practical test in dental hygiene and its methods of administration shall be validated as to content and scoring by a member of the faculty of an accredited school of dentistry. Such faculty member shall not be licensed to practice dentistry in Delaware and shall be agreed upon by the Division and the Board. An applicant who has failed the practical examination 3 times may not take the examination again unless the applicant can provide evidence of mitigating circumstances to the satisfaction of the Board.

For licensure as a dental hygienist, submit proof satisfactory to the Board that the applicant has successfully passed the National Board of Dental Examiners' examination in dental hygiene.

For licensure as a dental hygienist, successfully pass a written jurisprudence examination on Delaware laws pertaining to dental hygiene. All examinations shall be approved by the Division and the Board.

Renewal of a License to Practice Dentistry or Dental Hygiene
Each license shall be renewed biennially, upon payment of the appropriate fee and submission of a renewal form provided by the Division, and proof that the licensee has met the continuing education requirements established by the Board and proof that the licensee has not been convicted of a crime substantially related to the practice of dentistry or dental hygiene unless a waiver is granted pursuant statute.

Pursuant to rules and regulations, a license to practice dentistry and dental hygiene may be renewed for a period of one year after the expiration date by submitting a renewal application online, paying a late fee, and submitting the required CPE documentation and CPR card. However, if the license has been lapsed for more than one year, the licensee must reapply as a new applicant or by reciprocity. JSC 2nd Questionnaire, pg. 3

All licenses issued pursuant to statute must be displayed in view of the public in the place of business of the licensee.

Reciprocity
Statute provides that the Board shall grant a license to practice dentistry or dental hygiene to each applicant pursuant to the following: 24 Del. C. § 1124

(a) Upon payment of the appropriate fee and submission and acceptance of a written application on forms provided by the Board, the Board shall grant a license to practice dentistry or dental hygiene to each applicant, who shall present proof of current licensure in "good standing" in another state, the District of Columbia, or territory of the United States, who meets the following criteria:

(1) Has maintained the applicant's license in "good standing" and has satisfied all requirements regarding administrative penalties, impairments, criminal conviction and disciplinary actions.

(2) Shall, subject to subsection (b) below, have passed a practical exam prepared and administered by the Board, submitted proof satisfactory to the Board that the dental applicant has successfully completed the National Board of Dental Examiners’ examination in dentistry with a score of at least 75 when parts I and II are averaged; for licensure as a dental hygienist, submit proof satisfactory to the Board that the applicant has successfully passed the National Board of Dental Examiners’ examination in dental hygiene; and for licensure as a dentist, successfully pass a written jurisprudence examination on Delaware laws pertaining to dentistry; for licensure as a dental hygienist, successfully pass a written jurisprudence examination on Delaware laws pertaining to dental hygiene.

(3) For licensure as a dentist, shall submit proof that the applicant has had 3 years of active dental practice in another state, the District of Columbia or a territory of the United States.

(4) Shall submit proof of current certification in cardiopulmonary resuscitation (CPR) technique in accordance with regulations adopted by the Board.

(b) An applicant for licensure as a dental hygienist, who shall have practiced for a minimum of 3 of the last 5 years in the state in which the applicant currently is or has been licensed, may be licensed provided that the applicant meets the qualifications of paragraphs (1), (2), and (4) above, except for the completion of the practical examination.

(c) All applicants for licensure under this section shall have remained academically current through continuing education or otherwise, as determined by the Board.

Of note: in the response to the 2nd questions for the Board of Massage and Bodywork, the Board indicated that it “wants to amend its reciprocity requirements to be consistent with other Title 24 Boards. Many other boards will grant a license to an out-of-state applicant where the applicant has a license in good standing and the state’s licensure standards are substantially similar to Delaware’s standards. Where the licensure standards are not substantially similar, the applicant must show a certain number of years of work experience after licensure. Often five years are required.” Why wouldn’t the reciprocity requirements for the Board of Dental Examiners also be consistent with other Title 24 Boards, which include physicians, nurses and veterinarians just to name a few?

Prescriptions
Pharmacists licensed by this State may fill prescriptions of licensed dentists for any drug necessary in the practice of dentistry, dental surgery or oral surgery. 24 Del. C. § 1137

Discontinued Practice/Death/Transfer of Records
Statute mandates procedures concerning the discontinuation of a dental practice, the death or a dentist, and when a patient changes dentists. Additionally, statute spells out the process for the transfer of patient records. 24 Del. C. § 1195

Complaints JSC Initial Questionnaire, pgs. 46-47
How Complaints Are Handled
The management of complaints is prescribed by statute. 29, Del C., §8735 (h) The Division investigates complaints from the public against licensed professionals and those practicing without a license. If it is determined that a complaint has merit and the facts are able to be substantiated, the investigation is forwarded to the Attorney’s General’s Office with a prosecution recommendation. Complaints that are unable to be substantiated or do not rise to the level of a violation of law or rule are closed at the division level. The Division director has authority to subpoena investigative material and witnesses. Investigations involve evidence gathering, witness interviews and rare undercover operations.

Currently, the Division’s investigative unit has a staff of nine License Investigators who provide investigative support to 34 boards and commissions within the Division of Professional Regulation. The Investigative Unit has a goal of completing investigations within 90 days of receipt. The average days to investigate Dental Complaints were 99 days in 2007, 64 days in 2008 and 109 days in 2009. The average days increased in 2009 due to the overall increase in number of complaints in 2008 and 2009 while staff levels remained the same. JSC Initial Questionnaire, pgs. 47-48

Calendar Year 2007
Calendar Year
2008
Calendar Year 2009 (to date)
Total Number of Complaints Received by the Board
16
(5 not accepted)
20
(4 not accepted)
20
(4 not accepted)
Total Number of Complaints Investigated
11
(7 were closed after investigation)
16
(10 were closed after investigation)
16
(4 were closed after investi-gation and 9 are still open as of 10/08/09)
Total Number of Complaints found to be Valid
4
6
3
Total Number of Complaints Forwarded to the Attorney General’s Office
4
1-pending
1-dismissed
6
3-pending
2 dismissed
3
3-pending
Total Number of Complaints Resulting in Disciplinary Action
2
Consent Agreements
1
Consent Agreement
0
(as of 10/08/09)

Of the 51 complaints received for investigation during the past 3 calendar years, the nature of the complaints is as follows: JSC Initial Questionnaire, pg. 48

2007
In 2007, a total of 16 complaints were received, 5 were not accepted. Eleven complaints were investigated and 7 of them were closed after the investigation determined that there were no violations while 4 were forwarded to the Attorney General’s Office. Of those 4 complaints, 1 is still pending, 1 was dismissed and 2 were offered consent agreements which were accepted.

Details of the 2007 complaints:
Of the 11 complaints that were accepted to investigate, the findings were unresolved pain and/or bruising after treatment, rude or insensitive remarks to the patient, and substandard treatment (incompetence.)
Of the 5 that were not accepted, 1 was a dispute over the cost of a cavity filling, 3 were billing disputes and 1 was for refusal to begin treatment.
Of the 4 complaints sent to the Attorney General’s office, 1 was for failing to include the dentist name while advertising in the newspaper which was dismissed, 1 was for illegal drug use where the Dental Hygienist consented and agreed to revocation of her license, 1 was for non-compliance with the Voluntary Treatment Option Program and is still pending and 1 was for working on an expired license and was given a consent agreement with a letter of reprimand.

2008
In 2008, a total of 20 complaints were received, 4 of which were not accepted. Sixteen complaints were investigated and 10 of them were closed after the investigation found that no violations had occurred while 6 were forwarded to the Attorney General’s Office. Of those 6 complaints, 2 were dismissed, 1 signed a consent agreement and 3 are still pending.

Details of the 2008 complaints:
Of the 16 that were investigated, the allegations were for causing severe pain, scolding and hollering at children, frequent visits for crown fittings, improper placement of crowns, licensee with shaky hands which turned out to be hypoglycemia, teeth whitening without a license and substandard care.
Of the 4 that were not accepted, 1 was a billing issue, 1 for denial of records and alleged assault by licensee (no conviction), 1 involved a licensee in Maryland and 1 refused to treat a patient.
Of the 6 that were sent to the Attorney General’s office, 1 was dismissed which alleged that the mental health resident had 3 teeth extracted without the family’s permission and one was offered a consent agreement with a letter of reprimand and a $250 fine for working on an expired license.
The other 3 complaints are all pending and the findings were teeth whitening without a license, working on an expired license, pulling the wrong tooth and causing pain and insensitive remarks.

2009
In 2009, a total of 20 complaints were received, 4 of which were not accepted. Sixteen complaints were accepted, 9 of which are under investigation, 4 closed and 3 pending at the Attorney General’s office.

Details of the 2009 complaints:
For the four complaints that are closed, the allegations were misdiagnosis, causing pain during treatment, a dental hygienist allegedly working on an expired license and misplaced dental implants. All were unfounded allegations.
Of the 9 open investigations, the allegations were for continuous discomfort from a root canal, lack of compassion for an upset 5 year old child, adding silver to patient’s “all porcelain” teeth without patient’s consent, working on expired license, smacking a minor’s hand to control the patient, physical abuse to a minor child to control the patient, giving general anesthesia without consent and extracting a tooth from a patient on blood thinner without consulting lab results or family physician.
Of the three complaints sent to the Attorney General’s office which are still pending, the findings were that a dental hygienist worked on an expired license, cheating on a dental exam and a tooth broke off during a procedure.
Of the four complaints not accepted, three were for billing issues and one was withdrawn.

Cease and Desist Authority over Unauthorized Practice
The Dental Board is authorized by statute 29 Del. C. §10161(c) (d) (e) to issue a cease and desist order, if unlicensed practice is found after an investigation by the Division, the filing of a formal complaint by the Attorney General, and a hearing before the Board. A cease and desist order requires the unlicensed person to cease the unlicensed activity. The statute further allows the board/commission to issue a fine and seek injunctive relieve should the unlicensed person continue practicing without a professional license in violation of the Board’s cease and desist order. JSC 2nd Questionnaire, pgs. 5-6

Grounds for Discipline
A dentist or dental hygienist shall be subject to disciplinary actions, if, after a hearing, the Board finds that the practitioner: 24 Del. C. § 1128

Has employed or knowingly cooperated in fraud or material deception in order to acquire a license as a dentist or dental hygienist, has impersonated another person holding a license or has allowed another person to use the practitioner's license, or has aided or abetted a person not licensed as a dentist or dental hygienist to represent himself or herself as a dentist or dental hygienist;

Has practiced dentistry or dental hygiene in an incompetent or grossly negligent manner or has otherwise been guilty of misconduct or unprofessional conduct. In addition to such acts or omissions as the Board may define as unprofessional conduct by rules and regulations, unprofessional conduct shall include, but shall not be limited to, practicing in a corporation or other business entity which actually limits or restricts the exercise and application of professional judgment by the dentist or dental hygienist to the detriment of the dentist's or dental hygienist's patients;

Has been convicted of any offense the circumstances of which substantially relate to the practice of dentistry or dental hygiene. A copy of the record of conviction certified by the clerk of the court entering the conviction shall be conclusive evidence thereof;

Has engaged in an act of consumer fraud or deception, engaged in the illegal restraint of competition, or participated in illegal price-fixing activities;

Has violated a provision of this chapter or any regulation established thereunder;

Has had the practitioner's license as a dentist or dental hygienist suspended or revoked, or has had other disciplinary action taken against the dentist or dental hygienist by the appropriate licensing authority in another jurisdiction; provided, however, that the underlying grounds for such action in another jurisdiction have been presented to the Board by certified record, and the Board has determined that the facts found by the appropriate authority in the other jurisdiction constitute 1 or more of the acts prohibited by this chapter. Every person licensed as a dentist or dental hygienist in this State shall be deemed to have given consent to the release of this information by the Board or other comparable agency in another jurisdiction and to waive all objections to the admissibility of previously adjudicated evidence of such acts or offenses;

Has failed to notify the Board that the practitioner's license as a dentist or dental hygienist in another state has been subject to discipline or has been surrendered, suspended or revoked. A certified copy of the record of disciplinary action, surrender, suspension or revocation shall be conclusive evidence thereof;

Has a physical condition such that the performance of dentistry or dental hygiene is or may be injurious or prejudicial to the public;

Has had the practitioner's United States Drug Enforcement Administration (DEA) privileges restricted or revoked; or

Has engaged in the excessive use or abuse of drugs.

Sanctions Imposed by the Board and Appeals
After the Board hears the evidence and deliberates in the public hearing, they may impose any of the following sanctions, singly or in combination, when it finds that one of the conditions or violations applies to a regulated practitioner: 24 Del. C. § 1129

Issue a letter of reprimand;

Censure a practitioner;

Place a practitioner on probationary status and require the practitioner to:
Report regularly to the Board upon the matters which are the basis of the probation;
Limit all practice and professional activities to those areas prescribed by the Board;

Suspend any practitioner's license;

Revoke any practitioner's license;

Impose a monetary penalty not to exceed $500 for each violation;

Take such other disciplinary action as the Board may deem necessary and appropriate.

The Board may withdraw or reduce conditions of probation when it finds that the deficiencies which required such action have been remedied.

Upon the filing of a formal complaint by the Attorney General's office, the Board may temporarily suspend a practitioner's license in advance of a final adjudication, but only in cases where there is clear and immediate danger to the health and safety and welfare of the public if the licensee is allowed to continue to practice. Such suspension may be appealed to Superior Court.

As a condition to reinstatement of a suspended license or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized by statute.

Pursuant to statute, 24 Del. C. § 1130(c) where the practitioner is in disagreement with the action of the Board, the practitioner may appeal the Board's decision to the Superior Court.

Violations and Penalties; Enforcement
Below are violations and penalties pursuant to statute: 24 Del. C. Subchapter IV

Name used in practice of dentistry
Whoever practices or offers to practice dentistry or dental surgery under any name except the practitioner's proper name, which is the name in the license granted to the practitioner as a dentist, as provided in this chapter; or whoever uses the name of any company, association, corporation, office, parlor, trade name, business name or a successor thereto, in connection with the practice of dentistry as defined in this chapter; shall be fined for the first offense not less than $100 nor more than $200 and for any subsequent offense shall be fined not more than $500, and the license shall be revoked by the Board.

Unlawful acts
Whoever employs a person who is not a licensed dentist to perform dental operations
as defined in this chapter or permits such persons to practice dentistry in the employer's office; or whoever practices dentistry under a false name or assumes a title or appends or prefixes to that person's name letters which falsely represent the person as having a degree from a chartered dental college, or makes use of the words "dental college" or "dental school" or equivalent words when not lawfully authorized so to do, or impersonates another at an examination held by the Board, or knowingly makes a false application or a false representation in connection with such examination; shall be fined not less than $100 nor more than $200.

Failure to display dentistry license
Whoever engages in the practice of dentistry and fails to keep displayed in the place where the person practices, and in such manner as to be easily seen and read, the license granted pursuant to the laws of this State shall be fined not less than $10 nor more than $50.

Practice of dentistry after cancellation of registration.
Any person whose registration as a practitioner of dentistry has been cancelled shall be deemed an unregistered person and subject as such to the penalties prescribed for the practice of dentistry by persons who are not duly registered.

Filing of false documents or forged affidavits
Whoever files or attempts to file as that person's own the diploma, certificate or license of another or a forged, false affidavit of identification or qualification is guilty of a felony and shall be fined not less than $500 nor more than $2,000 and imprisoned not more than 5 years.

Certain specific offenses
Whoever commits any of the specified offenses shall be fined for the first offense not less than $100 nor more than $200 and for any subsequent offense shall be fined not more than $500, and the person's license shall be revoked by the Board.

Sale or offer to sell, procurement, alteration or use of diploma, license or certificate
Whoever sells or offers to sell a diploma conferring a dental degree or a license or a certificate or procures such diploma or license or certificate with intent to use the same as evidence of the right to practice dentistry as defined by law, by a person other than the one to whom such diploma was issued or to whom such license was granted or any person who, with fraudulent intent, alters such diploma or license or certificate or attempts to use the same shall be fined not less than $100 nor more than $200. Note the word “certificate should be deleted from the statute.

Practice without registration or certificate; separate offenses
Whoever practices or attempts to practice dentistry or dental hygiene within this State without having been registered, or without having obtained a certificate to practice dentistry or dental hygiene or during the period of suspension or revocation of such certificate previously granted shall be fined not less than $100 nor more than $200, or imprisoned not less than 1 month nor more than 1 year, or both, and, upon a second or any subsequent offense, shall be fined not less than $200 nor more than $500 and imprisoned not less than 6 months nor more than 1 year.
Each act of practice or attempt to practice dentistry or dental hygiene under the disabilities described in this section and each day on which any person offers services as a practitioner under any name except the person's own shall be a separate offense.

Penalty in absence of specific designation.
Whoever violates any provision or law relating to the practice of dentistry or dental hygiene or the application for examination and licensing of dentists and registration of dental hygienists, for which no specific penalty has been prescribed, shall be fined not less than $50 nor more than $100.

Second or subsequent offenses.
Whoever is convicted of a second or subsequent offense of unlawful acts, failure to display dentistry license, the sale or offer to sell, procurement, alteration or use of diploma, license or certificate, or the absence of specific designation, shall be punished by the maximum fine prescribed in such section or by imprisonment for not less than 10 nor more than 60 days or by both such fine and imprisonment.

Disciplinary Action By The Board
For 2007 there were 2 disciplinary actions taken, one was a Decision and Order and the second resulted in a Consent Agreement: JSC Initial Questionnaire, pg. 48

For the complaint resulting in a Decision and Order, the dental hygienist’s license was revoked as the licensee pled guilty to a felony charge that was substantially related to the practice of dental hygiene. The licensee had attempted to call in prescription orders at two different pharmacies for the drug, Tramadol using a physician’s name and DEA prescription for a fictitious person. The licensee also admitted to being addicted to Tramadol.

The second disciplinary action for that year was for a dentist who practiced on an expired licensed for fourteen months. It resulted in a Consent Agreement with a Letter of Reprimand.

There was one disciplinary action taken by the Board in 2008.
The dental hygienist was fined $250 and given a letter of reprimand for practicing 22 months on an expired license.

Enforcement and Prosecution for Violations 24 Del. C. § 1181
Statute provides that the Secretary-Treasurer of the Board shall enforce the provisions of all laws relating to the practice of dentistry and dental hygiene in the State. In 1995, the Joint Sunset Committee recommended that outdated wording regarding the duties of the Secretary-Treasurer of the Board to enforce provisions of Chapter 11, 24 Del. C., be stricken from Sec. 1181, 24 Del. C. The Board is not in compliance.

Additionally, all violations of the laws relating to the practice of dentistry and dental hygiene shall be prosecuted in courts of this State by the Attorney General or one of the Attorney General's assistants.

Limitation of Action for Dental Malpractice
Statute provides a 2-year statute of limitations from date of injury for recovery of damages against a dentist, dental hygienist or dental assistant.

An exception is made for a minor under six, who has 3 years to bring an action or until his/her 6th birthday. An injured person whose personal injury was unknown or was not discovered within the 2- year period is granted an additional year to bring an action. 24 Del. C. § 1193

Reports of Dental Malpractice Actions
Statute provides that the Prothonotary in each county shall report to the Board the adjudication of any dental malpractice claim against a dentist or the settlement of any dental malpractice claim.

Rules and Regulations of the Board
The Board has the authority to promulgate rules and regulations pursuant to the Administrative Procedures Act. However, in the 1995 JSC Recommendations, the JSC recommended that “… the Board rewrite its Rules and Regulations to refer to the specific Code section which they are effectuating.” In more than 15 years, this recommendation has not been carried out, other than to included the following wording in the statute when providing that the Board has the authority to formulate rules and regulations: “Each rule or regulation shall implement or clarify a specific section of this chapter;”. 24 Del. C. § 1106(a)(1)

In the 1995 JSC review and recommendations, the JSC pointed out that the Board does not have the statutory authority to create the positions of "dental technician" and "dental auxiliary personnel." The three levels of supervision defined in the Rules and Regulations have no connection to the statute.”

In Reg. 1.0, the Board has defined three levels of supervision: direct, indirect and general. But, the references in the Chapter are only to “general supervision," i.e., "A dental hygienist licensed under this chapter shall practice dental hygiene only under the general supervision of a licensed dentist, in the office of the licensed dentist or in any public school or other public institution of this State" 24 Del. C. § 1121(b)(c)

Additionally, when referring to provisions of the Volunteer License, the word “supervision” is used without any clarification. 24 Del. C. § 1197(c) The only other reference in the Chapter is in Sec. 1157(d), 24 Del. C. "The Board may suspend or revoke, with power to reinstate, the license of any dentist who permits any dental hygienist, operating under his supervision, to perform any operation other than that permitted under this section."

In Regulation 1.4, the Board has created a new class, that of "dental technician." There is no authority in the Board's governing statute which allows the Board to create a new classification of worker and is defined as: “Any person not licensed to practice dentistry in this State, engaged in the business of constructing, altering, repairing or duplicating full dentures (“plates”), partial dentures, splints, orthodontic appliances, fixed bridges or any other prosthetic appliances.” There is no authority in the Board’s governing statute for the creation of this classification. The qualifications for a “dental technician” is not set out in either statute or Regulation.

Regulation 2.0 concerns "Auxiliary Personnel." The Board has created another class of worker, "dental auxiliary personnel." Again, there is no authority in the Board's governing statute which would allow the Board to create a new classification of worker.

Regulation 2.1.2 states the auxiliary personnel may perform procedures, except certain procedures "which require professional judgment and skill" and those allocated to registered dental hygienists.

The entire issue of the use and training of "dental auxiliary personnel" is entirely dependent on the determination of the individual dentist. In other words, a dental hygienist cannot practice unless he or she meets certain objective criteria and passes a standardized test and receives a license which he or she must renew every 2 years. The duties of the dental hygienist are prescribed by statute. On the other hand, dental auxiliary personnel, who are not licensed or in any way regulated, and who do not have to meet any standards or pay for a license or fulfill continuing education requirements, can be employed and trained by the dentist to perform many duties denied to hygienists. Auxiliary personnel take and develop x-rays, remove excess cements from dental restorations and remove temporary medicinal fillings or packs, among other duties. Regulation 2.4 “It is inconsistent to have various mandates in the statute which prohibit the practice of dentistry, but, nevertheless, attempt to allow practice by unlicensed persons in Board Rules and Regulations.” 1995 JSC Final Report, pg. 24 The scope of practice for auxiliary personnel, apparently, is determined by individual dentists.

Regulation 3.2 allows dental technicians to be employed as dental auxiliary personnel. What is not clear from reading the Rules and Regulations is whether a person, who obtains a prescription from a dentist for dentures, must use the services of the dental technician whose name the dentist has written on the prescription. It appears that some dentists employ technicians, who make the dentures on-site. This appears to be akin to doctors referring patients to physical therapists whose practice they owned. (This practice - self-referral - is now forbidden). 1995 JSC Final Report, pg. 24

Regulation 4.0 allows dentists in Delaware to perform acupuncture; but the Regulation states the Board considers it "to be an experimental procedure." Last session the General Assembly passed legislation to regulate the practice of acupuncture. The Board stated that it is not aware of any training that dentists receive regarding acupuncture on dental patients. A review of Board meeting minutes indicates that in 1973, acupuncture was discussed and the Board decided to promulgate a rule. The American Dental Association’s latest position statement regarding the use of acupuncture stated that a major and coordinated research effort would be needed to provide a valid scientific basis for the use of acupuncture in dentistry. Based on this, the Board will be revising its rules and regulations to remove the regulation related to acupuncture. Email, Kay Warren, Jan. 5, 2010

Rule 7. Anesthesia. The Board has promulgated Rules and Regulations for the use of anesthesia. The Board has designated three levels of permits.

In Regulation 7.4.2.1, the Board established an Advisory Committee of Consultants to inspect and evaluate the facilities, equipment and personnel of a licensed dentist who has applied for authorization to administer Conscious Sedation, Deep Sedation or General Anesthesia. The definitions used in the regulations are taken from a document dated July 1993. Perhaps there is a more recent document that can be used.

As previously noted in the licensing section of this Draft Report, the Board has drafted proposed statutory language addressing these permits.

Fiscal
Revenue
Revenue by Fiscal Year JSC Initial Questionnaire, pg. 28
Source(s) of FundsAmount
FY 10 (budgeted)*Special Funds $146,400.00
TOTAL
FY 09 (actual)Special Funds $16,653.00
TOTAL
FY 08 (actual)Special Funds $134,239.00 *
TOTAL
*Biennial renewal period.

Fees
The amount to be charged for each licensing fee shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board, as well as the proportional expenses incurred by the Division in its service on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for a purpose not specified in statute. The application fee shall not be combined with any other fee or charge. At the beginning of each licensure biennium, the Division, or any other state agency acting in its behalf, shall compute, for each separate service or activity, the appropriate Board fees for the licensure biennium. 24 Del. C. § 1125 This analysis was completed in May 2008 for fees effective July 1, 2008 – June 30, 2010. Beginning this biennial period, the Division moved to flat fees.

Fees collected by the Board: JSC Initial Questionnaire, pg. 29
Description of Fee
Current
Fee
$$
Number of
Persons or
Entities
Paying Fee
Fee
Revenue
$$
Where the Fee Revenue
is Deposited
(i.e., general fund, special fund)
Renewal-Dentists $211.00
Renewal-Dental Hygienist $53.00
Renewal-Permits $15.00
Renewal-Dentist Limited $39.00
Total 13 $837.00
Special Funds
Licensure-Dentist $211.00
Licensure-Dental Hygienist $53.00
Licensure-Permits $15.00
Licensure-Dentist Limited $39.00
Licensure-Dentist Limited Resident $59.00
Total 81 $6,396.00
Special Funds
Exam-Dentist $250.00
Exam-Dental Hygienist $100.00
Total 42 $6,950.00
Special Funds
Late Fee-Dentist $106.00
Late Fee-Dental Hygienist $27.00
Late Fee-Dentist Limited $20.00
Total 13 $493.00
Special Funds
License Verification $16.00 38 $607.00
Special Funds
Detailed Verification $27.00 0 0
Roster Fee $32.00 26 $1,306.00
Special Funds
Duplicate License $16.00 4 $64.00
Special Funds
*The above data reflects the time period 7/1/08-6/30/09.

Expenditures JSC Initial Questionnaire, pg. 30
Total Expenditures by Fiscal Year
Fiscal YearSource(s)Amount $$
FY 10(budgeted)*
TOTAL
FY 09(actual**) $8,827.52
TOTAL
FY 08(actual**) $12,122.13
TOTAL

* Unable to the provide expenditure information on a per board/commission basis. The budget for the Division of Professional Regulation encompasses all boards/commissions.

** This amount is the direct expenses for the Board of Dental Examiners, overhead costs are not included. The overhead costs are apportioned by the percentage of licensees to the total number of licensees in the Division of Professional Regulation; this is done biennially during the fee setting analysis.

In July 2008, the Division of Professional Regulation moved from prorated licensure fees to flat licensure fees. By making this move, the Division is able to better anticipate revenue for the boards/commissions.





JSC Final Report
Board of Dental Examiners May 2010

Governing Statute

TITLE 16

Health and Safety

Delaware Health Care Commission

CHAPTER 99. DELAWARE HEALTH CARE COMMISSION

Subchapter V. Delaware Institute for Dental Education and Research


§ 9940. Findings.

(a) The General Assembly finds and declares that the original purposes for DIDER enacted in 1981 remain sound and should be continued and strengthened.

(b) The General Assembly finds and declares that the original DIDER statute anticipated multiple purposes for the organization, but that administrative and other resources have limited DIDER to 1 purpose -- that of becoming a funding conduit for supporting hospital based residency training programs as required in Chapter 11, Title 24.

(c) The General Assembly finds and declares that DIDER can play a pivotal role in implementing many programs that could result in improved access to dental care for Delawareans.

(d) The General Assembly finds and declares that a new structure of the DIDER Board will more appropriately reflect DIDER's abilities to meet its responsibilities outlined in this legislation.

(e) The General Assembly finds and declares that placing the administration of DIDER within the Delaware Health Care Commission will enhance its ability to accomplish its goals and ensure that DIDER's future functions will be focused on promoting dental education and helping the State to meet its health care needs, in concert with DIMER and other state health care policy activities.

§ 9941. Creation of a Board.

(a) There is hereby established the Board of Directors of the Delaware Institute for Dental Education and Research ("Board") which shall serve as an advisory board to the Health Care Commission.

(b) The Board shall consist of 10 members. One shall be a public member, appointed by the Governor. Three shall be members of the Delaware State Dental Society, appointed by the Society. One shall be appointed by the Board of Directors of Christiana Care Health Services. One shall be a member of the Delaware Health Care Commission, appointed by the Health Care Commission. One shall be a member of the Board of Dental Examiners, to be appointed by the Board of Dental Examiners. One shall be a dental hygienist to be appointed by the Delaware Dental Hygienist Association. One shall represent the Delaware Higher Education Commission to be appointed by the Higher Education Commission. The Delaware State Dental Director shall serve as an ex officio member of the Board.

(c) All members, other than the ex officio member, shall be appointed for a term of 3 years, except the initial appointments. Of the appointed positions, 3 will initially be for 1 year, 3 will initially be for 2 years, and 3 will be for 3 years, to allow for staggered terms. Members may be re-appointed 3 times and may serve no longer than 9 years. Any member appointed to fill a vacancy shall be appointed only for the unexpired term.

(d) The Chair shall be elected by the members from among the Board members.

(e) No member of the Board shall receive compensation for that member's duties other than normal travel expenses incurred in carrying out the responsibilities as members.

(f) A majority of the members of the Board shall constitute a quorum and shall be sufficient for any action by the Board.

(g) The Board may establish working committees to assist in completing its work.

§ 9942. Purposes of the Board.

The purpose of the Board shall be to support, encourage and promote:

(1) Accredited general practice residencies in dentistry at any general hospital in the State that will provide a comprehensive postgraduate training program pursuant to the requirements of Chapter 11 of Title 24.

(2) Expansion of opportunities for Delaware residents to obtain dental education and training at all levels.

(3) A strengthening of the factors favoring the decision of qualified dental personnel to practice in Delaware, including, but not limited to, tools such as loan repayment programs as approved by the Delaware Health Care Commission.

(4) Dental needs of the community at large and particularly those who do not have ready access to dental care.

(5) Expansion of opportunities for Delaware residents to obtain training at a reasonable cost in the dental professions.

(6) Incentives for qualified personnel in the dental professions to practice in Delaware.

(7) Support of graduate and postgraduate training programs, including emphasis on those programs targeted to meet the State's health care needs.

§ 9943. Duties.

The Board shall be responsible for implementation of policies designed to accomplish the purposes set forth in § 9942 of this title, and shall report to the Commission on its progress. Its activities and responsibilities shall include:

(1) Working in conjunction with the Board of Dental Examiners, development of programs to encourage and allow dentists to practice in under-served areas of the State, as designated by the Delaware Health Care Commission, in lieu of hospital-based residency training as a condition of licensure. Such programs may include preceptorships and reciprocity.

(2) Loan repayment programs designed to attract dental personnel to Delaware's under-served areas, as approved by the Delaware Health Care Commission.

(3) Development of expanded opportunities for dental school graduates to obtain general practice training in Delaware. Examples of such opportunities may include, but not be limited to: satellite sites; partnerships with dental schools; and partnerships with local hospitals.

(4) Developing recruitment programs designed to attract dental personnel to Delaware.

(5) Developing plans for enhanced education opportunities for Delawareans interested in pursuing a dental education.

(6) Developing plans for improving access to dental care, particularly for the underserved populations.

The Board may develop working relationships and affiliation agreements with other institutions to facilitate carrying out the purposes of this chapter. Any such agreements shall be approved by the Delaware Health Care Commission, which shall be a signatory to any documents setting the terms of the agreement.


TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter I. Board of Dental Examiners


§ 1100. Objectives.

The primary objective of the Board of Dental Examiners, to which all other objectives and purposes are secondary, is to protect the general public, specifically those persons who are the direct recipients of services regulated by this chapter, from unsafe and unprofessional practices.

The secondary objectives of the Board are to maintain minimum standards of practitioner competency and to maintain certain standards in the delivery of services to the public. In meeting its objectives, the Board shall develop standards assuring professional competence; shall monitor complaints brought against practitioners regulated by the Board; shall adjudicate at formal hearings; shall promulgate rules and regulations; and shall impose sanctions where necessary against licensees or former licensees.

§ 1101. Definitions.

The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section except where the context clearly indicates a different meaning:

(1) "Board" shall mean the State Board of Dental Examiners established in this chapter.

(2) "Dental hygienist" shall mean a person who is qualified to practice dental hygiene as prescribed in this chapter.

(3) "Dentist" shall mean a person who is qualified to practice dentistry as prescribed in the chapter.

(4) "Division" shall mean the State Division of Professional Regulation.

(5) "Excessive use or abuse of drugs" shall mean any use of narcotics, controlled substances or illegal drugs without a prescription from a licensed individual with valid prescriptive authority or the abuse of alcoholic beverage or prescription or nonprescription drugs, such that it impairs a person's ability to perform the work of a dentist or dental hygienist.

(6) "Person" shall mean a corporation, company, association or partnership, as well as an individual.

(7) "Practice of dental hygiene" shall mean the removal of calculus deposits, plaque and stains from all surfaces of the teeth, and making instrumental examinations of the oral cavity, and assembling all necessary information for use by the dentist in diagnosis and treatment planning, and the performance of such prophylactic or preventive measures in the case of teeth, including the application of chemicals to the teeth and periodontal tissues, designed and approved for the prevention of dental caries, as the Board may authorize; but the "practice of dental hygiene" shall not include any other operation on the teeth or tissues of the mouth.

(8) "Practice of dentistry" is defined as the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of the dentist's education, training and experience, in accordance with the ethics of the profession and applicable law. A person shall be construed to practice dentistry who by verbal claim, sign, advertisement, opening of an office, or in any other way, including use of the words "dentist," "dental surgeon," the letters "D.D.S.," "D.M.D.," or other letters or titles, represents the dentist's to be a dentist or who holds himself or herself out as able to perform, or who does perform, dental services or work. A person shall be regarded as practicing dentistry who is a manager, proprietor, operator or conductor of a place for performing dental operations or who for a fee, salary or other reward paid, or to be paid either to himself or herself or to another person, performs or advertises to perform dental operations of any kind.

(9) "State" shall mean the State of Delaware.

(10) "Substantially related" means the nature of the criminal conduct, for which the person was convicted, has a direct bearing on the fitness or ability to perform 1 or more of the duties or responsibilities necessarily related to the practice of dentistry or dental hygiene.

§ 1102. Board of Dental Examiners; appointments; qualifications; term; vacancies; suspension or removal; unexcused absences; compensation.

(a) There is created a State Board of Dental Examiners which shall administer and enforce this chapter.

(b) The Board shall consist of 9 members, appointed by the Governor, who are residents of this State, 5 of whom shall be dentists licensed under this chapter and who have been actively practicing dentistry in this State for a period of 5 years immediately preceding appointment to the Board; 1 member shall be a dental hygienist who has been actively practicing dental hygiene in this State for a period of 5 years immediately preceding appointment to the Board; and 3 public members who shall have been residents of this State for a period of 5 years immediately preceding appointment to the Board. The public members shall not be, nor ever have been, dentists or dental hygienists, nor members of the immediate family of a dentist or dental hygienist; shall not have been employed by a dentist; and shall not have a material interest in the providing of goods and services to dentists or dental hygienists, nor have been engaged in an activity directly related to dentistry or dental hygiene. The public members shall be accessible to inquiries, comments and suggestions from the general public. No public member shall have been licensed in any health related field or be licensed to practice law. No person shall be eligible for appointment to the Board who is in any manner connected with or interested in any dental college or the dental department of any college or university or the dental supply business.

(c) Except as provided in subsection (d) of this section, each member shall serve a term of 3 years, and may succeed himself or herself for 1 additional term; provided, however, that where a member was initially appointed to fill a vacancy, such member may succeed himself or herself for only 1 additional full term. Any person appointed to fill a vacancy on the Board shall hold office for the remainder of the unexpired term of the former member. Each term of office shall expire on the date specified in the appointment; however, the Board member shall remain eligible to participate in Board proceedings unless and until replaced by the Governor.

(d) A person who has never served on the Board may be appointed to the Board for 2 consecutive terms; but, no such person shall thereafter be eligible for 2 consecutive appointments. No person who has been twice appointed to the Board or who has served on the Board for 6 years within any 9-year period shall again be appointed to the Board until an interim period of at least 1 year has expired since such person last served.

(e) Any act or vote by a person appointed in violation of this section shall be invalid. An amendment or revision of this chapter is not sufficient cause for any appointment or attempted appointment in violation of subsection (d) of this section, unless such an amendment or revision amends this section to permit such an appointment.

(f) A member of the Board shall be suspended or removed by the Governor for misfeasance, nonfeasance, malfeasance, misconduct, incompetency or neglect of duty. A member subject to disciplinary hearing shall be disqualified from Board business until the charge is adjudicated or otherwise concluded. A Board member may appeal any suspension or removal to the Superior Court.

(g) No member of the Board, while serving on the Board, shall hold elective office in any professional association of dentists or dental hygienists, including the Delaware State Dental Society and the Delaware Dental Hygienists' Association.

(h) The provisions set forth for "employees" in Chapter 58 of Title 29 shall apply to all members of the Board.

(i) Any member who is absent without adequate reason for 3 consecutive meetings or fails to attend at least half of all regular business meetings during any calendar year shall be guilty of neglect of duty.

(j) Each member of the Board shall be reimbursed, in accordance with the policy of the Division of Professional Regulation, for all expenses involved in each meeting, including travel; and, in addition, shall receive not more than $50 for each meeting attended but not more than $500 in any calendar year. After 10 meetings have been attended, the member shall not be compensated for any subsequent meetings attended in that year.

§ 1103. Organization; meetings; officers; quorum.

(a) The Board shall hold regularly scheduled business meetings at least once in each quarter of a calendar year and at such times as the President deems necessary, or at the request of a majority of the Board members.

(b) The Board annually shall elect a President and Secretary. Each officer shall serve for 1 year and shall not succeed himself or herself for more than 2 consecutive terms.

(c) A majority of the members shall constitute a quorum for the purpose of transacting business. No disciplinary action shall be taken without the affirmative vote of 5 members of the Board.

(d) When members of the Dental Hygiene Advisory Committee participate in voting on matters listed in § 1104(c)(1), (2) and (3) of this chapter, the Board composition shall be 12 voting members, so that 7 members shall constitute a quorum.

(e) Minutes of all meetings shall be recorded and copies shall be maintained by the Division of Professional Regulation. At any hearing where evidence is presented, a record from which a verbatim transcript can be prepared shall be made. The expense of preparing any transcript shall be incurred by the person requesting it.

§ 1104. Records.

The Division of Professional Regulation shall keep a register of all approved applications for license as a dentist or a dental hygienist and complete records relating to meetings of the Board, examinations, rosters, changes and additions to the Board's rules and regulations, complaints, hearings and such other matters as the Board shall determine. Such records shall be prima facie evidence of the proceedings of the Board.

§ 1105. Dental Hygiene Advisory Committee.

(a) There is created a State Dental Hygiene Advisory Committee which shall serve the Board on matters pertaining to the policy and practice of dental hygiene.

(b) The Committee shall consist of 3 licensed dental hygienists, appointed by the Governor, who are residents of this State and who have been actively practicing dental hygiene in this State for 2 years immediately preceding appointment to the Committee.

(1) No person shall be eligible for appointment to the Committee who is in any manner connected with or who has an interest in any dental hygiene college or the dental hygiene department of any college or university or any commercial dental enterprise.

(2) Each member shall serve a term of 3 years and remain eligible to participate in proceedings unless and until replaced by the Governor.

(3) All terms shall be staggered so that 1 new member is added and 1 member is retired each year.

(4) Persons who are members of the Committee on May 15, 1997, shall complete their terms.

(5) A member of the Committee shall be suspended or removed by the Governor for misfeasance, nonfeasance, malfeasance, misconduct, incompetency or neglect of duty.

(6) No member of the Committee shall hold elective office in any professional association of dental hygienists.

(7) Each member of the Committee shall be reimbursed, according to the policy of the Division of Professional Regulation, for all expenses involved in each meeting, including travel; and in addition, shall receive $50 for each meeting attended but not more than $500 in any calendar year. After 10 meetings have been attended, the member shall not be compensated for any subsequent meetings attended in that year.

(c) The Committee shall participate with members of the Board in:

(1) Voting on the qualifications of candidates who apply for licensure to practice dental hygiene;

(2) Voting on the composition of the State dental hygiene clinical/practical examination;

(3) Voting on the requirements for renewal of dental hygiene licenses.

§ 1106. Powers and duties of the Board.

(a) The Board of Dental Examiners shall have authority to:

(1) Formulate rules and regulations, with appropriate notice to those affected; all rules and regulations shall be promulgated in accordance with the procedures specified in the Administrative Procedures Act [Chapter 101 of Title 29] of this State. Each rule or regulation shall implement or clarify a specific section of this chapter;

(2) Designate the application form to be used by all applicants, and to process all applications;

(3) Designate the written, standardized examination administered by the National Board of Dental Examiners to be taken by all persons applying for licensure;

(4) Prepare and administer a practical examination in dentistry and dental hygiene;

(5) Designate a written jurisprudence examination on the Delaware laws pertaining to dentistry to be taken by all persons applying for licensure;

(6) Provide for the administration of all applicable examinations, including notice and information to applicants;

(7) Evaluate the credentials of all persons applying for a license to practice dentistry and dental hygiene in order to determine whether such persons meet the qualifications for licensing set forth in this chapter;

(8) Grant licenses to and renew licenses of all persons who meet the qualifications for licensure and/or renewal of licenses;

(9) Establish by rule and regulation continuing education standards required for license renewal for dentists and dental hygienists;

(10) Evaluate certified records to determine whether an applicant for licensure who has been previously licensed, certified or registered in another jurisdiction to practice dentistry or dental hygiene has engaged in any act or offense that would be grounds for disciplinary action under this chapter and whether there are disciplinary proceedings or unresolved complaints pending against such applicants for such acts or offenses;

(11) Refer all complaints from licensees and the public concerning licensed dentists and dental hygienists or concerning practices of the Board or of the profession to the Division of Professional Regulation for investigation pursuant to § 8735 of Title 29 and assign a member of the Board to assist the Division in an advisory capacity with the investigation of the technical aspects of the complaint;

(12) Conduct hearings and issue orders in accordance with procedures established pursuant to this chapter, Chapter 101 of Title 29 and § 8735 of Title 29. Where such provisions conflict with the provisions of this chapter, this chapter shall govern. The Board shall determine whether or not a dentist or dental hygienist shall be subject to a disciplinary hearing and, if so, shall conduct such hearing in accordance with this chapter and the Administrative Procedures Act [Chapter 101 of Title 29];

(13) Where it has been determined after a disciplinary hearing that penalties or sanctions should be imposed, to designate and impose the appropriate sanction or penalty after time for appeal has lapsed;

(14) Working in conjunction with the Board of Directors of the Delaware Institute of Dental Education and Research, develop programs to encourage and allow dentists to practice in under-served areas of the State, as designated by the Delaware Health Care Commission, in lieu of hospital-based residency training as a condition of licensure. Such programs may include preceptorships and reciprocity; and

(15) Issue a volunteer license to an individual who is duly licensed as a dentist or dental hygienist in this State or to any individual who has ever been so licensed provided proof of continued competence is provided to the satisfaction of the Board. Such individuals shall certify on the license application that the individual will perform no dental or dental hygiene services for any direct compensation and that the individual volunteers his or her time exclusively in a nonprofit dental clinic or nonprofit dental service designated by the Delaware Health Care Commission and approved by the Delaware Board of Dental Examiners. A volunteer license shall be issued at no charge to a qualified individual approved by the Board. All other costs associated with meeting the requirements for such license will remain the responsibility of the applicant. The applicant for a volunteer license shall be responsible for completing the continuing education required for an active Delaware licensee by the Board and shall adhere to all standards of practice and supervision required of a Delaware licensed dentist or dental hygienist. Any dentist or dental hygienist having a volunteer license shall not practice dentistry or dental hygiene in this State in any setting other than in an approved nonprofit dental clinic or nonprofit dental service.

(b) The Board of Dental Examiners shall promulgate regulations specifically identifying those crimes which are substantially related to the practice of dentistry and dental hygiene.



TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter II. Dentistry and Dental Hygiene


§ 1121. License required.

(a) No person shall practice dentistry or dental hygiene or hold himself or herself out to the public in this State as being qualified to practice dentistry or dental hygiene or use in connection with the person's name, or otherwise assume or use, any title or description conveying or tending to convey the impression that the person is qualified to practice dentistry or dental hygiene unless such person has been duly licensed under this chapter.

(b) A dental hygienist licensed under this chapter shall practice dental hygiene only under the general supervision of a licensed dentist, in the office of the licensed dentist or in any public school or other public institution of this State.

(c) A licensed dental hygienist may practice under the general supervision of the State Dental Director, or the State Dental Director's designee, who shall be a licensed Delaware dentist, in schools and state institutions. A licensed dental hygienist may also practice under the general supervision of the State Dental Director, or the State Dental Director's designee, who shall be a Delaware licensed dentist, in federally qualified health centers, nonprofit organizations and other locations as designated by the Delaware Health Care Commission in consultation with DIDER. The protocols under which hygienists practice in these settings will be established by the State Dental Director and shall be subject to the approval of the Delaware Board of Dental Examiners.

(d) The State Dental Director shall be a Delaware licensed dentist. In the event that the State Dental Director does not have a Delaware dental license when hired, the State Dental Director must obtain a Delaware license within 2 years of assuming the position. The Board may grant a temporary license for a period no longer than 2 years to the State Dental Director, provided the State Dental Director has met all licensure requirements except successful completion of the practical exam. The authority to practice dentistry under such a temporary license will be limited to the performance of the duties as the State Dental Director.

(e) Whenever a license to practice as a dentist or dental hygienist in this State has expired or has been suspended or revoked, it shall be unlawful for the person to practice dentistry or dental hygiene in this State.

§ 1122. Qualifications of applicant; report to Attorney General; judicial review.

(a) An applicant who is applying for licensure as a dentist under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person:

(1) Has received a degree in dentistry from an accredited dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association.

(2) Before matriculating in a dental college or university, has completed at least 2 years of undergraduate study in an accredited college or university.

(3) Has acquired 1 year's experience as a dental intern or resident in a school, institution or hospital approved by the Board or, in lieu thereof, has participated in a preceptorship or reciprocity program established under § 1105 of this title, or has had 3 years of active dental practice in another state or territory of the United States.

(4) Has achieved the passing score on all examinations prescribed by the Board.

(b) An applicant who is applying for licensure as a dental hygienist under this chapter shall submit evidence, verified by oath and satisfactory to the Board, that such person has:

(1) Graduated from high school or has received a general equivalency diploma (G.E.D.).

(2) Graduated from a dental hygiene college or university program accredited by the Commission on Dental Accreditation of the American Dental Association of at least 2 academic years' duration; or

(3) Graduated, prior to 1953, from a dental hygiene program of at least 1 year's duration, which program had been approved by the Board at the time of the person's graduation; and

(4) Achieved the passing score on all examinations prescribed by the Board.

(c) All applicants shall have complied with the following conditions:

(1) Shall submit proof of current certification in cardiopulmonary resuscitation (CPR) technique in accordance with regulations adopted by the Board.

(2) Shall not have been the recipient of any administrative penalties regarding the applicant's practice of dentistry or dental hygiene, including but not limited to fines, formal reprimands, license suspension or revocation (except for license revocations for nonpayment of license renewal fees), or probationary limitations, or have entered into any "consent agreements" which contain conditions placed by a Board on the applicant's professional conduct and practice, including any voluntary surrender of a license while under investigation.

(3) Shall not have any impairment related to drugs or alcohol that would limit the applicant's ability to undertake the practice of dentistry or dental hygiene in a manner consistent with the safety of the public.

(4) Shall not have a criminal conviction record nor pending criminal charge relating to an offense the circumstances of which substantially relate to the practice of dentistry or dental hygiene. Applicants who have criminal conviction records or pending criminal charges shall require appropriate authorities to provide information about the record or charge directly to the Board in sufficient specificity to enable the Board to make a determination whether the record or charge is substantially related to the practice of dentistry or dental hygiene. After a hearing or review of documentation demonstrating that the applicant meets the specified criteria for a waiver, the Board, by an affirmative vote of a majority of the quorum, may waive this paragraph (c)(4) of this section, if it finds all of the following:

a. More than 5 years have elapsed since the applicant has fully discharged all imposed sentences. As used herein, the term "sentence" includes, but is not limited to, all periods of modification of a sentence, probation, parole or suspension. However, sentence does not include fines, restitution or community service, as long as the applicant is in substantial compliance with such fines, restitution and community service.

b. The applicant is capable of practicing dentistry or dental hygiene in a competent and professional manner.

c. The granting of the waiver will not endanger the public health, safety or welfare.

(5) Shall not have engaged in any of the acts or offenses that would be grounds for disciplinary action under this chapter, and shall have no disciplinary proceedings or unresolved complaints pending against the person in any jurisdiction where the applicant has previously been or currently is licensed.

(d) Where the Board has found to its satisfaction that an applicant has been intentionally fraudulent, or that false information has been intentionally supplied, the Board shall deny the application and report its findings to the Attorney General for further action.

§ 1123. Examinations.

An applicant for a license to practice dentistry or dental hygiene in this State shall:

(1) Successfully pass, with a score established by the Board, a practical examination prepared and administered by the Board. The practical test in dentistry and dental hygiene and its methods of administration shall be validated as to content and scoring by a member of the faculty of an accredited school of dentistry. Such faculty member shall not be licensed to practice dentistry in Delaware and shall be agreed upon by the Division and the Board. An applicant who has failed the practical examination 3 times may not take the examination again unless the applicant can provide evidence of mitigating circumstances to the satisfaction of the Board.

(2) For licensure as a dentist, submit proof satisfactory to the Board that the applicant has successfully completed the National Board of Dental Examiners' examination in dentistry with a score of at least 75, when Parts I and II are averaged; for licensure as a dental hygienist, submit proof satisfactory to the Board that the applicant has successfully passed the National Board of Dental Examiners' examination in dental hygiene.

(3) For licensure as a dentist, successfully pass a written jurisprudence examination on Delaware laws pertaining to dentistry; for licensure as a dental hygienist, successfully pass a written jurisprudence examination on Delaware laws pertaining to dental hygiene. All examinations shall be approved by the Division and the Board.

§ 1124. Dentists and dental hygienists licensed in other jurisdictions.

(a) Upon payment of the appropriate fee and submission and acceptance of a written application on forms provided by the Board, the Board shall grant a license to practice dentistry or dental hygiene to each applicant, who shall present proof of current licensure in "good standing" in another state, the District of Columbia, or territory of the United States, who meets the following criteria:

(1) Has maintained the applicant's license in "good standing" and has satisfied all requirements of § 1122(c)(2)-(5) of this title.

(2) Shall, subject to subsection (b) of this section, have passed the examinations required in § 1123(a)(1), (2) and (3) of this title.

(3) For licensure as a dentist, shall submit proof that the applicant has had 3 years of active dental practice in another state, the District of Columbia or a territory of the United States.

(4) Shall submit proof of current certification in cardiopulmonary resuscitation (CPR) technique in accordance with regulations adopted by the Board.

(b) An applicant for licensure as a dental hygienist, who shall have practiced for a minimum of 3 of the last 5 years in the state in which the applicant currently is or has been licensed, may be licensed provided that the applicant meets the qualifications of paragraphs (1), (2), and (4) of subsection (a) of this section, except for the completion of the practical examination.

(c) All applicants for licensure under this section shall have remained academically current through continuing education or otherwise, as determined by the Board.

§ 1125. Fees.

The amount to be charged for each fee imposed under this chapter shall approximate and reasonably reflect all costs necessary to defray the expenses of the Board, as well as the proportional expenses incurred by the Division in its service on behalf of the Board. There shall be a separate fee charged for each service or activity, but no fee shall be charged for a purpose not specified in this chapter. The application fee shall not be combined with any other fee or charge. At the beginning of each licensure biennium, the Division, or any other state agency acting in its behalf, shall compute, for each separate service or activity, the appropriate Board fees for the licensure biennium.

§ 1126. Issuance and renewal of licenses.

(a) The Board shall issue a license to each applicant who meets the requirements of this chapter for licensure as a dentist or dental hygienist and who pays the fee established in § 1125 of this title.

(b) Each license shall be renewed biennially, in such manner as is determined by the Division, upon payment of the appropriate fee and submission of a renewal form provided by the Division, and proof that the licensee has met the continuing education requirements established by the Board and proof that the licensee has not been convicted of a crime substantially related to the practice of dentistry or dental hygiene unless a waiver is granted pursuant to § 1122(a)(3) of this title.

(c) The Board, in its rules and regulations, shall determine the period of time within which a licensed dentist or dental hygienist may still renew his or her license, notwithstanding the fact that such licensee has failed to renew on or before the renewal date, provided however that such period shall not exceed 1 year.

(d) All licenses issued under this chapter shall be displayed in view of the public in the place of business of the licensee.

§ 1127. Complaints.

(a) All complaints shall be received and investigated by the Division of Professional Regulation in accordance with § 8735 of Title 29, and the Division shall be responsible for issuing a final written report at the conclusion of its investigation.

(b) When it is determined that an individual is engaging or has engaged in the practice of dentistry or dental hygiene or is using the title "dentist" or "dental hygienist," and is not licensed under the laws of this State, the Board shall report to the office of the Attorney General for appropriate action.

§ 1128. Grounds for discipline.

A practitioner licensed under this chapter shall be subject to disciplinary actions set forth in § 1129 of this title, if, after a hearing, the Board finds that the dentist or dental hygienist:

(1) Has employed or knowingly cooperated in fraud or material deception in order to acquire a license as a dentist or dental hygienist, has impersonated another person holding a license or has allowed another person to use the practitioner's license, or has aided or abetted a person not licensed as a dentist or dental hygienist to represent himself or herself as a dentist or dental hygienist;

(2) Has practiced dentistry or dental hygiene in an incompetent or grossly negligent manner or has otherwise been guilty of misconduct or unprofessional conduct. In addition to such acts or omissions as the Board may define as unprofessional conduct by rules and regulations, unprofessional conduct shall include, but shall not be limited to, practicing in a corporation or other business entity which actually limits or restricts the exercise and application of professional judgment by the dentist or dental hygienist to the detriment of the dentist's or dental hygienist's patients;

(3) [Deleted.]

(4) Has been convicted of any offense the circumstances of which substantially relate to the practice of dentistry or dental hygiene. A copy of the record of conviction certified by the clerk of the court entering the conviction shall be conclusive evidence thereof;

(5) Has engaged in an act of consumer fraud or deception, engaged in the illegal restraint of competition, or participated in illegal price-fixing activities;

(6) Has violated a provision of this chapter or any regulation established thereunder;

(7) Has had the practitioner's license as a dentist or dental hygienist suspended or revoked, or has had other disciplinary action taken against the dentist or dental hygienist by the appropriate licensing authority in another jurisdiction; provided, however, that the underlying grounds for such action in another jurisdiction have been presented to the Board by certified record, and the Board has determined that the facts found by the appropriate authority in the other jurisdiction constitute 1 or more of the acts prohibited by this chapter. Every person licensed as a dentist or dental hygienist in this State shall be deemed to have given consent to the release of this information by the Board or other comparable agency in another jurisdiction and to waive all objections to the admissibility of previously adjudicated evidence of such acts or offenses;

(8) Has failed to notify the Board that the practitioner's license as a dentist or dental hygienist in another state has been subject to discipline or has been surrendered, suspended or revoked. A certified copy of the record of disciplinary action, surrender, suspension or revocation shall be conclusive evidence thereof;

(9) Has a physical condition such that the performance of dentistry or dental hygiene is or may be injurious or prejudicial to the public;

(10) Has had the practitioner's United States Drug Enforcement Administration (DEA) privileges restricted or revoked; or

(11) Has engaged in the excessive use or abuse of drugs.

§ 1129. Disciplinary sanctions.

(a) The Board may impose any of the following sanctions, singly or in combination, when it finds that one of the conditions or violations set forth in § 1128 of this title applies to a practitioner regulated by this chapter:

(1) Issue a letter of reprimand;

(2) Censure a practitioner;

(3) Place a practitioner on probationary status and require the practitioner to:

a. Report regularly to the Board upon the matters which are the basis of the probation;

b. Limit all practice and professional activities to those areas prescribed by the Board;

(4) Suspend any practitioner's license;

(5) Revoke any practitioner's license;

(6) Impose a monetary penalty not to exceed $500 for each violation;

(7) Take such other disciplinary action as the Board may deem necessary and appropriate.

(b) The Board may withdraw or reduce conditions of probation when it finds that the deficiencies which required such action have been remedied.

(c) Upon the filing of a formal complaint by the Attorney General's office, the Board may temporarily suspend a practitioner's license in advance of a final adjudication, but only in cases where there is clear and immediate danger to the health and safety and welfare of the public if the licensee is allowed to continue to practice. Such suspension may be appealed to Superior Court.

(d) As a condition to reinstatement of a suspended license or removal from probationary status, the Board may impose such disciplinary or corrective measures as are authorized under this chapter.

§ 1130. Hearing procedures.

(a) If a complaint is filed with the Board by the office of the Attorney General pursuant to § 8735 of Title 29 alleging violation of § 1128 of this title, the Board shall set a time and place to conduct a hearing on the complaint. Notice of the hearing shall be given and the hearing shall be conducted in accordance with the Administrative Procedures Act, Chapter 101 of Title 29.

(b) The technical rules of evidence shall not apply to hearings before the Board. If the Board finds, by a majority vote of all members hearing the case, that the complaint has been established by a preponderance of evidence, the Board shall take such action permitted under this chapter as it deems necessary. The Board's decision shall be in writing and shall include its reasons for such decision. The Board's decision shall be mailed immediately to the practitioner.

(c) Where the practitioner is in disagreement with the action of the Board, the practitioner may appeal the Board's decision to the Superior Court.

§ 1131. Reinstatement of a suspended license; removal from probationary status; replacement of license.

(a) As a condition to reinstatement of a suspended license or removal from probationary status, the Board may reinstate such license if after a hearing the Board is satisfied that the licensee has taken the prescribed corrective actions and otherwise satisfied all of the conditions of the suspension and/or the probation and can practice dentistry or dental hygiene with reasonable skill and safety to the public.

(b) Applicants for reinstatement shall pay the appropriate fees and submit documentation required by the Board as evidence that all the conditions of a suspension or probation have been met. Proof that the applicant has met the continuing education requirements of this chapter may also be required, as appropriate.

(c) A new license to replace any license lost, destroyed or mutilated may be issued subject to the rules of the Board. A charge shall be made for such issuance.

§ 1132. Limited license; fee.

(a) Upon completion of an application approved by the Board and payment of a fee established by the Division, the Board may issue a limited license to an applicant for licensure as a dentist who has fulfilled the requirements of § 1122(a)(1) and (2) of this title, and who furnishes proof satisfactory to the Board that the applicant has been appointed a dental intern in a hospital or other institution maintained by this State, by a county or municipality thereof, or in a hospital or dental infirmary incorporated under the laws of this State.

(b) The limited license shall entitle the applicant to practice dentistry only in the hospital or other institution designated on the license and only on bona fide patients of the hospital or institution and under the direction of a licensed dentist employed therein or on the staff thereof.

(c) The applicant for limited license shall comply with the provisions of § 1122(c)(1)-(6) of this title.

(d) The holder of a limited license shall be bound by all other applicable provision of this chapter.

(e) The limited license shall be renewed annually.

§ 1132A. Limited license -- Director or chairperson of a hospital dental or hospital oral and maxillofacial surgery residency program.

(a) Upon completion of an application approved by the Board and payment of a fee established by the Division, in accordance with § 1125 of this title, the Board may issue a limited license to an applicant for licensure as a dentist or oral and maxillofacial surgeon who has fulfilled the requirements of § 1122(a)(1), (2), and (3) of this title, who presents proof of current licensure in "good standing" in another state, the District of Columbia, or territory of the United States, and who furnishes proof satisfactory to the Board that the applicant has been appointed a director or chairperson of a hospital dental or hospital oral and maxillofacial surgery department, which has a residency program that is accredited by the Commissioner on Dental Accreditation of the American Dental Association, and is incorporated under the laws of this State.

(b) The limited license shall entitle the applicant to practice dentistry or oral and maxillofacial surgery only in the hospital or other institution designated on the license and only on bona fide patients of the hospital or institution, and in an academic setting for teaching purposes.

(c) The applicant for this limited license shall comply with the provisions of § 1122(c)(1)-(5) and (d) of this title.

(d) The holder of a limited license shall be bound by all other applicable provisions of this chapter.

(e) This limited license shall be renewed biennially.



TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter III. Other Provisions


§ 1133. Exemptions.

Nothing in this chapter shall be construed to prevent:

(1) A licensed dentist or dental hygienist serving in any branch of the United States Armed Services, Veterans' Administration or Public Health Service from discharging the dentist's or dental hygienist's official duties;

(2) A licensed physician or surgeon from extracting teeth or treating pathological conditions of the mouth, teeth or oral tissues, or from radiographing such tissues, unless such person practices dentistry as a specialty;

(3) A lawful practitioner of dentistry in another state, the District of Columbia or a territory of the United States from making a clinical demonstration before a dental society, convention, association of dentists or dental college or performing duties in connection with a specific case on which the practitioner may have been called to this State by a legally qualified practitioner of dentistry of this State.

(4) A practitioner of dentistry who maintains a lawful dental license to practice in another state, the District of Columbia or a territory of the United States from making a clinical demonstration in connection with the lawful research and development of dental product or dental products manufactured by a dental manufacturer complying with guidelines set forth by the United States Food and Drug Administration.

(5) A person otherwise qualified under this chapter from rendering dental services in a nonprofit, tax-exempt organization as described in §§ 501(c)(3), 509(a)(1) and 170(b)(1)(A)(iii) of the Internal Revenue Code [26 U.S.C. §§ 501(c)(3), 509(a)(1), and 170(b)(1)(A)(iii)] that does not charge for its services and is affiliated with a hospital, licensed by the Department of Health and Social Services, and accredited by the Joint Commission on Accreditation of Hospitals or the American Osteopathic Association.

§ 1134. Penalty.

A person not currently licensed as a dentist or dental hygienist under this chapter who engages in the practice of dentistry or dental hygiene or uses in connection with that person's name, or otherwise assumes or uses, any title or description conveying, or tending to convey, the impression that the person is qualified to practice dentistry or dental hygiene shall be guilty of a misdemeanor. Upon the first offense, the person shall be fined not less than $500 nor more than $1,000 for each offense. For a second or subsequent conviction, the fine shall be not less than $1,000 nor more than $2,000 for each offense. Justice of the Peace Courts shall have jurisdiction over all violations of this section.

§ 1135. Certain unlawful acts; supervision by dentists.

No person shall repair, construct, adjust or alter any appliance, denture or dental restoration except under the authorization and responsibility of a licensed practitioner of dentistry as defined by this chapter.

§ 1136. Prescriptions for dentists.

Pharmacists licensed by this State may fill prescriptions of dentists licensed by this State for any drug necessary in the practice of dentistry, dental surgery or oral surgery.

§ 1137. Prescription requirements.

No written prescription shall be prescribed if it does not contain the following information clearly written, clearly hand printed, electronically printed, or typed:

(1) The name, address and phone number of the prescriber;

(2) The name and strength of the drug prescribed;

(3) The quantity of the drug prescribed;

(4) The directions for use of the drug;

(5) Date of issue.



TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter IV. Violations and Penalties; Enforcement


§ 1171. Name used in practice of dentistry; penalty.

Whoever practices or offers to practice dentistry or dental surgery under any name except the practitioner's proper name, which is the name in the license granted to the practitioner as a dentist, as provided in this chapter; or whoever uses the name of any company, association, corporation, office, parlor, trade name, business name or a successor thereto, in connection with the practice of dentistry as defined in this chapter; shall be fined for the first offense not less than $100 nor more than $200 and for any subsequent offense shall be fined not more than $500, and the license shall be revoked by the Board.

§ 1172. Unlawful acts; penalty.

Whoever employs a person who is not a licensed dentist to perform dental operations as defined in this chapter or permits such persons to practice dentistry in the employer's office; or whoever practices dentistry under a false name or assumes a title or appends or prefixes to that person's name letters which falsely represent the person as having a degree from a chartered dental college, or makes use of the words "dental college" or "dental school" or equivalent words when not lawfully authorized so to do, or impersonates another at an examination held by the Board, or knowingly makes a false application or a false representation in connection with such examination; shall be fined not less than $100 nor more than $200.

§ 1173. Failure to display dentistry license; penalty.

Whoever engages in the practice of dentistry and fails to keep displayed in the place where the person practices, and in such manner as to be easily seen and read, the license granted pursuant to the laws of this State shall be fined not less than $10 nor more than $50.

§ 1174. Practice of dentistry after cancellation of registration.

Any person whose registration as a practitioner of dentistry has been cancelled under this chapter shall be deemed an unregistered person and subject as such to the penalties prescribed for the practice of dentistry by persons who are not duly registered.

§ 1175. Filing of false documents or forged affidavits; penalty.

Whoever files or attempts to file as that person's own the diploma, certificate or license of another or a forged, false affidavit of identification or qualification is guilty of a felony and shall be fined not less than $500 nor more than $2,000 and imprisoned not more than 5 years.

§ 1176. Certain specific offenses; penalty.

Whoever commits any of the offenses specified in § 1131 of this title shall be fined for the first offense not less than $100 nor more than $200 and for any subsequent offense shall be fined not more than $500, and the person's license shall be revoked by the Board.

§ 1177. Sale or offer to sell, procurement, alteration or use of diploma, license or certificate; penalty.

Whoever sells or offers to sell a diploma conferring a dental degree or a license or a certificate granted pursuant to this chapter or procures such diploma or license or certificate with intent to use the same as evidence of the right to practice dentistry as defined by law, by a person other than the one to whom such diploma was issued or to whom such license was granted or any person who, with fraudulent intent, alters such diploma or license or certificate or attempts to use the same shall be fined not less than $100 nor more than $200.

§ 1178. Practice without registration or certificate; separate offenses; penalty.

Whoever practices or attempts to practice dentistry or dental hygiene within this State without having been registered, or without having obtained a certificate to practice dentistry or dental hygiene or during the period of suspension or revocation of such certificate previously granted shall be fined not less than $100 nor more than $200, or imprisoned not less than 1 month nor more than 1 year, or both, and, upon a second or any subsequent offense, shall be fined not less than $200 nor more than $500 and imprisoned not less than 6 months nor more than 1 year.

Each act of practice or attempt to practice dentistry or dental hygiene under the disabilities described in this section and each day on which any person offers services as a practitioner under any name except the person's own shall be a separate offense.

§ 1179. Penalty in absence of specific designation.

Whoever violates any provision or law relating to the practice of dentistry or dental hygiene or the application for examination and licensing of dentists and registration of dental hygienists, for which no specific penalty has been prescribed, shall be fined not less than $50 nor more than $100.

§ 1180. Second or subsequent offenses.

Whoever is convicted of a second or subsequent offense under § 1172, 1173, 1177 or 1179 of this title shall be punished by the maximum fine prescribed in such section or by imprisonment for not less than 10 nor more than 60 days or by both such fine and imprisonment.

§ 1181. Enforcement of chapter; prosecution for violations.

(a) The Secretary-Treasurer of the Board shall enforce the provisions of all laws relating to the practice of dentistry and dental hygiene in this State.

(b) All violations of the laws relating to the practice of dentistry and dental hygiene shall be prosecuted in courts of this State by the Attorney General or one of the Attorney General's assistants.



TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter V. General Provisions


§ 1191. Immunity of officials reviewing dental records and dentists' work; confidentiality of investigative records; liability of informants.

(a) The members of the State Board of Dental Examiners of Delaware, dental ethics committee and dentists who are members of hospital and Delaware State Dental Society committees whose function is the review of dental records and of dentists' work with a view to quality of care and utilization of hospital facilities, home visits and office visits shall severally not be subject to, and shall be immune from, claim, suit, liability, damages or any other recourse, civil or criminal, arising from any act or proceeding, decision or determination undertaken, performed or reached in good faith and without malice by any such member or members acting individually or jointly in carrying out the responsibilities, authority, duties, powers and privileges of the offices conferred by law upon them under this chapter, or any other state law, or duly adopted rules and regulations of the aforementioned committees and hospitals, good faith being presumed until proven otherwise, with malice required to be shown by a complainant.

(b) The records and proceedings of any such committees or organizations as described in subsection (a) of this section shall be confidential records which shall not constitute public records or be available for general inspection by the public. All hearings on complaints shall be opened to the public only at the request of the respondent.

(c) No person who provides information to any such committees or organizations as described in subsection (a) of this section, or who testifies as a witness, shall be held liable in any cause of action arising out of the providing of such information or the giving of such testimony, provided that such person does so in good faith and without malice.

§ 1192. Reports of dental malpractice actions.

The Prothonotary in each county of the State shall report to the Board the adjudication of any dental malpractice claim against a dentist which was filed in the Prothonotary's office or the settlement of any dental malpractice claim which was filed in the Prothonotary's office.

§ 1193. Limitation of action for dental malpractice.

No action for recovery of damages against a dentist, dental hygienist or dental assistant for personal injury, including death, allegedly suffered in the course of dental treatment, shall be brought after the expiration of 2 years from the date upon which such injury occurred; provided, however, that:

(1) Solely in the event of a personal injury the occurrence of which during such period of 2 years was unknown to and could not in the exercise of reasonable diligence have been discovered by the injured person, such action may be brought prior to the expiration of 3 years from the date upon which such injury occurred, and not thereafter; and

(2) A minor under the age of 6 years shall have until the latter time for bringing such an action as provided for in subdivision (1) of this section or until the minor's 6th birthday to bring an action.

§ 1194. Appeal panel.

(a) Prior to the administration of the first practical examination each year by the Board, the Director of the Division of Professional Regulation shall appoint an appeal panel to hear appeals as a result of denial of licensure by the Board for failure of a practical examination. For appeals arising from the failure of the dental practical examination, the appeal panel shall consist of 2 dentists licensed to practice in this State and 1 public member. For appeals arising from the failure of the dental hygiene practical examination, the appeal panel shall consist of 1 dentist licensed to practice in this State, 1 dental hygienist and 1 public member.

(b) The licensed professional members of the respective panels shall have at least 3 years of experience practicing in their respective professions. A professional member shall not have served on the Board of Dental Examiners nor on the Dental Hygiene Advisory Committee for at least 5 years preceding the professional member's appointment to the panel; nor shall such professional member be an officer or other elected official in a professional association of dentists or dental hygienists. The public member shall not have been a dentist nor dental hygienist, nor a member of the immediate family of a dentist or dental hygienist, nor have been employed by a dentist, nor have a material interest in the providing of goods and services to dentists, nor have been engaged in an activity directly related to dentistry or dental hygiene.

(c) Each member of the appeal panel shall serve for a term of 1 year and shall be eligible for 1 additional reappointment to the appeal panel.

(d) In the event an applicant for licensure has failed a practical examination administered by the Board of Dental Examiners, the applicant has the right to appeal the decision by the Board. Such appeal shall be filed in writing with the Director of the Division of Professional Regulation within 20 days of the date of notification by the Board. Upon receipt of the applicant's written appeal of the Board's decision, the Director shall convene the appeal panel within 30 days. The Director shall notify the appellant by certified mail of the date set for the hearing.

(e) The conduct of all hearings and the issuance of orders shall be in accordance with procedures established pursuant to this section, Chapter 101 of Title 29 and § 8735 of Title 29. Where such provisions conflict with the provisions of this section, this section shall govern.

(f) The applicant may appeal any denial of licensure by the panel to the Superior Court within 30 days' notice of denial. Such appeal shall be on the record.

(g) In the event that an appeal is remanded from Superior Court, such appeal will be heard by the original appeal panel.

§ 1195. Dentist discontinuing practice or leaving state; death of a dentist; change of dentist and transfer of patient records; notification of patients.

(a) Every dentist licensed to practice under this chapter who is discontinuing a practice in this State or is leaving this State and who is not transferring patient records to another dentist shall notify that dentist's own patients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the dentist practices. The notice must be published at least 3 times over a 3 month period in advance of discontinuing the practice or leaving the State and must explain how a patient can procure that dentist's own patient records. All patients of record who have not requested their records 30 days before the closing of the practice shall be notified by first class mail by the dentist to permit the patients to procure their records. Any patient records that have not been procured within 7 years after the dentist discontinues practice or leaves the State may be permanently disposed of in a manner that ensures the confidentiality of the records.

(b) When a dentist licensed to practice under this chapter dies and has not transferred patient records to another dentist and has not made provisions for a transfer of patient records to occur upon the dentist's death, a personal representative of the dentist's estate shall notify the dentist's patients of record by publishing a notice to that effect in a newspaper of daily circulation in the area where the dentist practiced. The notice must be published at least 3 times over a 3 month period after the dentist's death and must explain how a patient can procure patient records. All patients of record who have not requested their records 30 days after publication shall be notified by first class mail by the personal representative of the estate to permit patients to procure their records. Any patient records that have not been procured within 7 years after the death of the dentist may be permanently disposed of in a manner that ensures confidentiality of the records.

(c) Whenever a patient changes from the care of one dentist to another dentist, the prior dentist shall transfer the records of the patient to the new dentist upon the written request of either the new dentist or the patient. If a patient changes care from one dentist to another dentist and fails to notify the prior dentist, or leaves the care of the prior dentist for a period of 7 years from the last entry date on the patient's record and fails to notify the prior dentist, or fails to request the transfer of records to the new dentist, then the prior dentist shall maintain said records for a period of 7 years from the last entry date in the patient's dental record after which time the records may be permanently disposed of in a manner that ensures confidentiality of the records.

(d) This section shall not apply to a dentist who has seen or treated a patient on referral from another dentist and who has provided a record of the diagnosis or treatment to another dentist, hospital or agency which has provided treatment for the patient.

(e) A dentist or the personal representative of the estate of a dentist who disposes of patient records in accordance with the provisions of this section is not liable for any direct or indirect loss suffered as a result of the disposal of a patient's records.


TITLE 24

Professions and Occupations

CHAPTER 11. DENTISTRY AND DENTAL HYGIENE

Subchapter VI. Volunteer License Provisions [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]


§ 1196. Volunteer license, application procedures [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]

In order to apply for a volunteer license, an applicant must:

(1) Submit proof of current license or proof of licensure within the past 2 years (from another U.S. state and/or Canadian province);

(2) Submit record of continuing education (CE) credit that meets the State of Delaware's requirement for the preceding 2 years as determined in the Board's rules and regulations;

(3) Submit to background check, both professional and criminal;

(4) Pass the Jurisprudence test for the State of Delaware;

(5) Show proof of 25 years of continuous licensure in another U.S. state or states and/or Canadian province or provinces; and

(6) Have no verifiable complaints on the National Practitioner Data Bank.

§ 1197. Restrictions under the volunteer license for practicing dentistry [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]

(a) Cannot practice dentistry for payment/profit;

(b) License is site-specific to charitable clinics as approved by the Delaware State Board of Dental Examiners;

(c) Must work under the supervision of the dentist in charge of the approved, site-specific clinic; and

(d) Must renew license annually. A 2-year license will not be issued.

§ 1198. Volunteer license; maintenance requirements [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]

In order to maintain a license under this section, an applicant:

(1) Must complete a minimum of 125 hours of volunteer dentistry per year; and

(2) Must follow any other requirements that any licensed dentist in this State must follow (e.g., CPR, CE requirements, etc.).

§ 1199. Evaluation of volunteer license [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]

(a) Every volunteer dentist and hygienist will be evaluated using an evaluation/review form by the supervising dentist. This form will be developed by the Delaware State Board of Dental Examiners and will be submitted bimonthly for the first 6 months and once every 6 months after the initial 6-month period.

(b) If the supervising dentist finds that the volunteer dentist is incompetent and/or is a danger to the public, the supervising dentist shall immediately notify the Delaware State Board of Dental Examiners. The Board may suspend the license until a hearing is held based on the notification. The complaint and hearing process in §§ 1127 through 1130 of this title is incorporated herein.

§ 1199A. Penalties, civil violation [Effective until July 3, 2010, subject to the provisions of 76 Del. Laws, c. 309, § 2]

Penalties for violating the requirement of not practicing dentistry for profit will result in a $2500 fine for each offense.


Regulations

Title 24 Regulated Professions and Occupations

DEPARTMENT OF STATE

Division of Professional Regulation

1100 Board of Dental Examiners


1.0 Supervision: Definitions - There are 3 recognized levels of supervision:

1.1 Direct Supervision - The dentist is present in the office, personally examines the patient and specifically authorized the work to be performed. The dentist checks the work before the patient leaves the office.

1.2 Indirect Supervision - A dentist is present in the office and generally authorizes the work to be performed. The dentist may examine the patient, either before or after work is performed. The dentist is available for consultation during the patient visit.

1.3 General Supervision - A dentist may or may not be present in the office while the work is performed. The dentist authorizes the work to be performed. Emergency care and consultant services are provided by an "on-call" dentist not present in the treatment facility, if the primary dentist is not present.

1.4 Dental Technician - Any person not licensed to practice dentistry in this State, engaged in the business of constructing, altering, repairing or duplicating full dentures ("plates"), partial dentures, splints, orthodontic appliances, fixed bridges or any other prosthetic appliances.

2.0 Auxiliary Personnel

2.1 Expanded Duties: A legally licensed and registered dentist may delegate to competent dental auxiliary personnel, those procedures for which the dentist exercises direct supervision and full responsibility except as follows:

2.1.1 Those procedures which require professional judgement and skill, such as diagnosis and treatment planning, and the cutting of hard and/or soft tissues, or any intra-oral procedure which would lead to the fabrication of an appliance and/or restoration which, when received by the patient, would come in direct contact with hard or soft tissue and which could result in tissue irritation or injury.

2.1.2 Those procedures allocated by the Dental Code to registered dental hygienists.

2.2 Interpretation of Regulation - Competency of the dental auxiliary personnel must be determined by the individual dentist in assigning specific duties. The dentist is given full responsibility in deciding the scope of work to be allocated to the auxiliary personnel.

2.3 Training of Auxiliary Personnel - Adequate training of dental auxiliary personnel will be the responsibility of the dentist.

2.4 Assignment of Duties - Following are some of the procedures that may be assigned to auxiliary personnel under the conditions and provisions stated above:

Take and develop x-rays. This involves placing an x-ray film in the patient's mouth and exposing that film.

Give and demonstrate home-care procedures to the patient, including those procedures the patient is expected to carry out in preventive care.

Placing a rubber dam.

Placing cotton rolls.

Taking impressions for study models.

Removal of excess cements from dental restorations and appliances with hand instruments only.

Removal of temporary medicinal fillings or packs under direct orders of the dentist.

2.5 Responsibilities - In summary, the Dental Board places full responsibility for the work done by auxiliary personnel directly upon the dentist. Violations of the regulations will be subject to penalties as spelled out in 24 Del.C. §1131(5).

3.0 Prescriptions to Dental Technicians

3.1 Written Prescriptions - Any dentist who uses the services of a dental technician in this State shall furnish him/her with a written prescription, which shall contain:

3.1.1 the name and address of the technician,

3.1.2 the patient's name and/or identification number,

3.1.3 the date on which the prescription was written,

3.1.4 a prescription of the work to be done,

3.1.5 specification of the type and quality of materials to be used and

3.1.6 signature of the dentist and his/her license number.

3.2 Record of Prescriptions - The dentist shall retain a duplicate copy thereof for inspection by the Board or its agent for a period of two years of the original.

3.3 The Dental Technician as an Auxiliary - Dentists employing a dental technician as an auxiliary within the confines of his/her office, may elect to maintain the required date of the prescription as an entry on the patient's record, in lieu of duplicating the prescription form to the technician.

4.0 Acupuncture

- is considered to be an experimental procedure to be researched by qualified investigators, only in institutions having a committee on human research, and only on patients who have given written informed consent.

5.0 Supervision

5.1 Conditions Applicable to General Supervision - A licensed dental hygienist, by virtue of having passed a licensure examination and being duly licensed by the State, is capable of performing those services allowed by law under supervision, the following conditions shall exist:

5.2 Advance Notice to Patient - The patient is notified, as soon as it is known, that the dentist will not be present, and is given the option to reschedule to a time when the dentist will be present in the office.

5.3 Dentist Review of Records - The dentist shall review the treatment records of each patient prior to and following the patient treatment.

5.4 Patient Contraindications - Patients for whom it is medically or dentally contraindicated, will not be scheduled when the dentist is not present.

5.5 Office Requirements - A second office employee shall be present in the treatment facility at all times when patient care is performed. This is both for safety and security reasons.

5.6 Practice in a Public Health Institution - A licensed dental hygienist, per 24 Del.C. §1157(c), may operate under the general direction of a dentist in an institution, provided that all of the conditions of general supervision are met.

6.0 Continuing Professional Education - Dentists

All persons licensed to practice dentistry in the State of Delaware shall be required to acquire 50 hours of continuing professional education (CPE) credit and to successfully complete a current course in cardiopulmonary resuscitation (CPR) every two (2) years. The CPR course must encompass hands on clinical participation. On-line courses will not be accepted to satisfy the CPR requirement. Examples of acceptable courses include, but are not limited to, courses offered by the American Red Cross and the American Heart Association. All dentists, upon initial licensure in Delaware and prior to registration renewal, shall be given a written notice of these CPE requirements.

6.1 Proof of successful completion of the requisite CPE credits is required for registration renewal every two years.

6.2 Said CPE requirements shall become effective May 1, 1988. Proof of CPE credits must be submitted by March 1 of every two (2) even years.

6.3 It shall be the responsibility of the candidate for re-licensure to submit to the Board of Dental Examiners, evidence of his/her compliance with these requirements. The Division of Professional Regulation shall notify the candidate at least 30 days in advance of the need to renew his/her license, and shall request that the candidate submit evidence of compliance with the CPE requirements stated herein, along with other fees and documents required. However, failure to be notified by such agency shall not relieve the licensee of this obligation.

6.4 Not more than ten (10) hours of the fifty (50) hour biennial CPE requirement may be satisfied by self-study without testing from sources approved by the Board which shall include but not be limited to:

6.4.1 Reading dental textbooks

6.4.2 Reading dental tape journals

6.4.3 Viewing and listening to dental audio-visual materials.

6.5 CPE credits may be granted upon proof of successful completion of:

6.5.1 Scientific CPE programs or courses and/or the scientific sessions of meetings sponsored or approved by:

6.5.1.1 American Dental Association, its constituents and components

6.5.1.2 American Dental Hygienists’ Association, its constituents and components

6.5.1.3 American Dental Assisting Association, its constituents and components

6.5.1.4 Recognized national, regional, state and local dental and dental hygiene specialty organizations

6.5.1.5 Recognized dental and dental hygiene study clubs

6.5.1.6 Accredited dental and dental hygiene CPE programs offered by dental and dental hygiene schools.

6.5.1.7 Approved hospital programs.

6.5.1.8 Such other organizations and associations as may be approved by the Board.

6.5.2 In addition to the maximum of ten (10 hours of the CPE requirement which may be satisfied by self-study without testing and certification, a maximum of twenty (20) hours of the total CPE requirements may be fulfilled by self-study with test and certificate of completion from bona fide dental educational sources including but not limited to:

6.5.2.1 Dental journals

6.5.2.2 Dental textbooks

6.5.2.3 Dental video and audio tape presentations

6.5.2.4 Dental mail-in courses

6.5.2.5 Dental courses presented on the Internet

6.5.2.6 Dental lectures and courses presented via electronic media including computer disks where CPE credits are not specified, one (1) hour of credit will be given for each hour of scientific session attended.

6.6 Special Provisions

6.6.1 A dentist, employed as a faculty member in a recognized school of dentistry, dental hygiene, dental assisting or any dentally-related field will be allowed not more than ten (10) hours credit for teaching per year.

6.6.2 A dentist presenting a CPE course shall be allowed the hours involved in preparation and presentation on a one-time-per-course basis for a maximum of ten (10) hours for the two-year period.

6.6.3 Table Clinics will be allowed, one (1) hour of credit per hour of presentation for a maximum of two (2) hours.

6.6.4 Twelve (12) hours of credit shall be allowed for a scientific article published in a component or state society journal. 25 hours of credit shall be allowed for a scientific article published in a national journal or for a published scientific textbook or a chapter therein.

6.6.5 Any public health dentally-related presentation will be allowed one (1) hour of credit per hour of participation for a maximum of two (2) hours for the two year period.

6.6.6 Practice management or personal self-improvement courses shall be limited to a total of ten (10) hours for the two (2) year period.

6.6.7 The Board reserves the right to approve any and all activities deemed appropriate for CPE credit. The Board also reserves the right and is the final word to disapprove any activities submitted for credit which it deems inappropriate.

6.6.8 All dentists licensed to practice in Delaware shall be given written notice of these CPE requirements when receiving their initial license.

6.6.9 For existing holders of an Unrestricted Permit for anesthesia, at least twelve (12) hours of the required CPE credits must be taken on an Anesthesia topic by the end of the six (6) year re-evaluation period (i.e. by the end of the third biennial licensure renewal period).

For existing holders of a Restricted I Permit, at least six (6) hours of the required CPE credits must be taken on an Anesthesia topic by the end of the six (6) year re-evaluation period (i.e. by the end of the third biennial license renewal period).

6.7 Exceptions

6.7.1 An exception will be granted to any dentist who can demonstrate to the Board an acceptable cause as to why he/she should be relieved of this obligation. Exemptions will be granted only in unusual or extraordinary circumstances. Licensees must petition the Board for exemptions. Should the Board deny the request, the licensee must complete the requirements. Examples of circumstances for which the Board might grant exemptions include prolonged illness, extended absence from the country, or the like.

6.7.2 An individual initially licensed by the Board within the last 2 years shall meet the following schedule of reporting CPE credits for license renewal:

6.7.2.1 If, as of March 1st of the year for license renewal, the licensee has been licensed for less than 1 year, zero hours of CPE is required for license renewal; for licensees who are 1 or more but less than 2 years from their initial licensure, one-half of the required CPE must be presented; for individuals 2 years or more from their initial licensure, the full CPE requirement must be presented for renewal.

6.8 Failure to Comply

When the Board deems someone to be deficient in CPE requirements, the following procedure shall be followed:

6.8.1 The licensee for renewal shall be notified by the Division of Professional Regulation ("Division") by certified mail that a deficiency exists. The deficiency shall be specifically described by the Division.

6.8.2 The licensee's registration will not be renewed until he/she submits proof that the described deficiency has been corrected. Upon submission of satisfactory proof of correction of said deficiency, the licensee shall be eligible for registration renewal.

6.9 Continuing Professional Education (CPE) - Dental Hygienists

All persons licensed to practice dental hygiene in the State of Delaware shall be required to acquire twenty-four (24) hours of CPE credit and successfully complete a current course in cardiopulmonary resuscitation (CPR) every two (2) years. The CPR course must encompass hands on clinical participation. On-line courses will not be accepted to satisfy the CPR requirement. Examples of acceptable courses include, but are not limited to, courses offered by the American Red Cross and the American Heart Association. All Dental hygienists, upon initial licensure and prior to registration renewal, shall be given written notice of these CPE requirements.

6.9.1 Proof of successful completion of the requisite CPE credits is required for registration renewal every two (2) years.

6.9.2 Said CPE requirements shall become effective May 1, 1988. Proof of CPE credits must be submitted by March 1st of every two (2) even years.

6.9.3 It shall be the responsibility of the candidate for re-licensure to submit to the Board of Dental Examiners, evidence of his/her compliance with these requirements. The Division of Professional Regulation shall notify the candidate at least 30 days in advance of the need to renew his/her license, and shall request that the candidate submit evidence of compliance with the CPE requirements state herein, along with other fees and documents required. However, failure to be notified by such agency shall not relieve the licensee of this obligation.

6.9.4 CPE credits may be granted upon proof of successful completion of programs including, but not limited to, the following categories:

6.9.4.1 Scientific CPE programs or courses and/or scientific sessions of meetings sponsored or approved by:

6.9.4.1.1 American Dental Hygienists Association, its constituents and components

6.9.4.1.2 American Dental Association, its constituents and components

6.9.4.1.3 American Dental Assisting Association, its constituents, and components

6.9.4.1.4 Recognized national, regional, state, and local dental and dental hygiene specialty societies

6.9.4.1.5 Recognized dental and dental hygiene study clubs

6.9.4.1.6 Accredited dental and dental hygiene schools

6.9.4.1.7 Approved hospital programs

6.9.4.1.8 Such other organizations and associations as may be approved by the Board

6.9.4.2 A maximum of five (5) hours of the total twenty-four (24) hour requirement may be satisfied by self-study without testing from sources approved by the Board which shall include but not be limited to:

6.9.4.2.1 Reading of dental or dental hygiene journals

6.9.4.2.2 Reading dental or dental hygiene textbooks

6.9.4.2.3 Viewing and listening to dental or dental hygiene audio-visual materials

6.9.4.3 In addition to the maximum of five (5) hours which may be satisfied by self-study without testing, a maximum of ten (10) hours of the total twenty-four (24) hour requirement may be fulfilled by self-study with test and certificate of completion from bona fide dental hygiene educational sources including but not limited to:

6.9.4.3.1 Dental or dental hygiene journals

6.9.4.3.2 Dental or dental hygiene textbooks

6.9.4.3.3 Dental or dental hygiene video and audio tape presentations

6.9.4.3.4 Dental or dental hygiene mail-in courses

6.9.4.3.5 Dental or dental hygiene courses presented on the Internet

6.9.4.3.6 Dental or dental hygiene lectures and courses presented via electronic media including computer disks

Where CPE credits are not specified, one (1) hour of CPE credit will be given for each hour of scientific session attended.

The final approval of acceptable dental hygiene CPE credits shall be made by the Board of Dental Examiners in consultation with the Dental Hygiene Advisory Committee.

6.10 Special Provisions

6.10.1 A dental hygienist, employed as a faculty member in a recognized school of dentistry, dental hygiene or dental assisting, will be allowed not more than five (5) hours credit for teaching per year.

6.10.2 A dental hygienist presenting a CPE course shall be allowed the hours involved in preparation and presentation on a one-time-per-course basis for a maximum of five (5) credits for the two-year period.

6.10.3 Table clinics will be allowed one (1) hour of credit per hour of presentation for a maximum of two (2) hours.

6.10.4 Twelve (12) hours of credit shall be granted for a scientific article published in a component or state society journal. Twelve (12) hours of credit shall be allowed for a scientific article published in a national journal or for a published scientific textbook or a chapter therein.

6.10.5 A dental hygienist giving public education instruction in a school will receive credit up to one (1) hour per year.

6.10.6 Practice management or personal self-improvement courses shall be limited to five (5) hours for the two (2) year period.

6.10.6.1 Practice management, personal self-improvement and computer courses shall be limited to 2.5 hours a year for a total of five(5) hours for the two year period.

6.10.7 The Board reserves the right to approve any and all activities deemed appropriate for CPE credit. The Board also reserves the right and is the final word to disapprove any activities submitted for credit which it deems inappropriate.

6.10.8 All dental hygienists licensed to practice in Delaware shall be given written notice of these CPE requirements when receiving their initial license.

6.11 Exceptions

6.11.1 An exception will be granted to any dental hygienist who can demonstrate to the Board an acceptable cause as to why he/she should be relieved of this obligation. Exemptions will be granted only in unusual or extraordinary circumstances. Licensees must petition the Board for exemptions. Should the Board deny the request, the licensee must complete the requirements. Examples of circumstances for which the Board might grant exemptions include prolonged illness, extended absence from the country, or the like.

6.11.2 An individual initially licensed by the Board within the last 2 years shall meet the following schedule of reporting CPE credits for license renewal:

6.11.2.1 If, as of March 1st of the year for license renewal, the licensee has been licensed for less than 1 year, zero hours of CPE is required for license renewal; for licensees who are 1 or more but less than 2 years from their initial licensure, one-half of the required CPE must be presented; for individuals 2 years or more from their initial licensure, the full CPE requirement must be presented for renewal.

6.12 Failure to Comply

When the Board deems someone to be deficient in CPE requirements, the following procedure shall be followed:

6.12.1 The licensee for registration renewal shall be notified by the Division by certified mail that a deficiency exists. The deficiency shall be specifically described by the Division.

6.12.2 The licensee's registration will not be renewed until he/she submits proof that the described deficiency has been corrected. Upon submission of satisfactory proof of correcting said deficiency, a licensee shall be eligible for registration renewal.

7.0 Anesthesia Regulations:

7.1 Definitions:

The following definitions are taken from the Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry, American Dental Association, Council on Dental Education (July 1993). These terms refer to the extent of a drug’s depressant effect upon the central nervous system and should not be confused with the route by which the drug is administered.

7.1.1 Analgesia -- the diminution or elimination of pain in the conscious patient.

7.1.2 Local Anesthesia -- the elimination of sensations, especially pain, in one part of the body by the topical application or regional injection of a drug.

7.1.3 Conscious Sedation -- a minimally depressed level of consciousness that retains the patient’s ability to independently and continuously maintain an airway and respond appropriately to physical stimulation and verbal command and that is produced by a pharmacologic or non-pharmacologic method or a combination thereof.

In accord with this definition, the conscious patient is also defined as “one who has intact protective reflexes, including the ability to maintain an airway, and who is capable of rational response to question or command.” The drugs and techniques used should carry a margin of safety wide enough to render unintended loss of consciousness unlikely.

For purposes of these regulations, Conscious Sedation Permits shall be divided into two classifications:

Restricted Permit I -- Conscious Sedation induced by parenteral or enteral or rectal routes. This is not to include the usual and customary pre-operative oral sedation.

Restricted Permit II -- Conscious Sedation induced by nitrous oxide inhalation.

7.1.4 Deep Sedation -- is a controlled state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently and/or to respond purposefully to verbal command, and is produced by a pharmacologic or non-pharmacologic method or combination thereof.

7.1.5 General Anesthesia -- is a controlled state of unconsciousness accompanied by partial or complete loss of protective reflexes, including inability to independently maintain an airway and respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or a combination thereof.

The same level of advanced training is necessary for the administration of both Deep Sedation and General Anesthesia.

7.1.6 Adverse Occurrences -- any mortality or other incident occurring in the out-patient facilities of such dentist which results in temporary or permanent physical or mental injury requiring hospitalization of said patient during, or as a direct result of, the conscious sedation, or deep sedation, or general anesthesia related thereto.

7.2 Conscious Sedation:

7.2.1 No dentist shall employ or use Conscious Sedation, Restricted Permit I or Restricted Permit II, for dental patients unless such dentist possesses a permit of authorization issued by the Delaware State Board of Dental Examiners. The dentist holding such a permit shall be subject to review and such permit must be renewed biennially.

7.2.2 In order to receive such a permit, the dentist shall produce evidence showing that he or she:

7.2.2.1 For Restricted Permit I Conscious Sedation:

7.2.2.1.1 Has completed a minimum of 60 hours of instruction, including management of at least 20 patients per participant (to achieve competency in this technique).

7.2.2.1.2 Must be certified in CPR as documented by the American Heart Association or the American Red Cross. Advanced Cardiac Life Support Certification is encouraged.

7.2.2.1.3 Must also have a properly equipped facility for the administration of Restricted Permit I Conscious Sedation, staffed with a supervised team of auxiliary personnel capable of reasonably handling procedures, problems and emergencies incident thereto. Adequacy of the facility and competence of the team is to be determined by the Anesthesia Advisory Consultants appointed by the Board. A certified registered nurse anesthetist may be utilized for Restricted Permit I Conscious Sedation only if the dentist also possesses such a permit.

7.2.3 A list of emergency drugs and equipment that should be on hand would consist of the following:

7.2.3.1 Agents capable of treating:

7.2.3.1.1 hypotension and bradycardia

7.2.3.1.2 allergy/bronchospasm

7.2.3.1.3 seizures

7.2.3.1.4 narcotic-induced respiratory depression (e.g., narcotic antagonists)

7.2.3.1.5 angina pectoris

7.2.3.1.6 adrenal insufficiency (e.g., steroids)

7.2.3.1.7 nausea

7.2.3.2 Equipment necessary to provide artificial respiration and assist in airway maintenance.

7.2.3.3 Equipment necessary to establish an intravenous infusion and to inject medications.

7.2.4 For Restricted Permit II Conscious Sedation:

7.2.4.1 Has completed a minimum of 14 instructional hours including supervised clinical experience in managing patients (in a course required to achieve competency in nitrous oxide inhalation sedation).

7.2.4.2 Must also show certification in cardio-pulmonary resuscitation as certified by the American Heart Association or the American Red Cross.

7.3 Deep Sedation and General Anesthesia (Unrestricted Permit):

7.3.1 No dentist shall employ or use deep sedation or general anesthesia for his/her dental patients unless such dentist possesses a permit of authorization issued from the Delaware State Board of Dental Examiners. This permit also includes all Conscious Sedation techniques. The dentist holding such a permit shall be subject to review and such permit must be renewed biennially.

7.3.2 In order to receive such a permit, the dentist must produce evidence showing that he/she:

7.3.2.1 Has completed a minimum of two years of advanced training in anesthesiology and related academic subjects (or its equivalent) beyond the undergraduate dental school level in a training program as described in Part II of the Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry or, is a Diplomat of the American Board of Oral and Maxillofacial Surgeons, or has satisfactorily completed a residency in Oral and Maxillofacial Surgery at an institution approved by the Council of Dental Education, American Dental Association, or is a fellow of the American Dental Society of Anesthesiology, or employs or works in conjunction with a trained M.D. or D.O. who is a member of the anesthesiology staff of an accredited hospital, provided that such anesthesiologist must remain on the premises of the dental facility until any patient given a general anesthetic or deep sedation regains consciousness. A certified registered nurse anesthetist may be utilized for deep sedation or general anesthesia only if the dentist also possesses an Unrestricted Permit.

7.3.2.2 Has a properly equipped facility for the administration of deep sedation and general anesthesia, staffed with a supervised team of auxiliary personnel capable of reasonably handling procedures, problems and emergencies incident thereto. Adequacy of the facility and competence of the anesthesia team is determined by the Anesthesia Advisory Committee Consultants appointed by Delaware State Board of Dental Examiners.

7.3.2.3 And is certified in Advanced Cardiac Life Support by the American Heart Association.

7.4 Facility and Staff Requirements:

7.4.1 Inspections: Prior to the issuance of a permit for Restricted Permit I (parenteral, enteral, or rectal Conscious Sedation) or an Unrestricted Permit (Deep Sedation or General Anesthesia), the Board shall require an on site inspection of the facility, equipment and personnel to determine if, in fact, the aforementioned requirements have been met. The evaluation shall be carried out in a manner described by the Board. The evaluation shall be carried out by the Anesthesia Advisory Consultants appointed by the Board. Each office that the dentist utilizes for Restricted Permit I Conscious Sedation or Deep Sedation or General Anesthesia requires individual inspection and must meet the requirements of that permit for which the dentist is applying.

7.4.2 Anesthesia Advisory Consultants:

7.4.2.1 The Board of Dental Examiners shall appoint a team of Advisory Consultants and alternates who will visit the facility concurrently to conduct the on-site inspection and evaluation of the facilities, equipment and personnel of a licensed dentist applying for written authorization to administer or to employ another to administer Restricted Permit I Conscious Sedation, or Deep Sedation or General Anesthesia (Unrestricted Permit). The Advisory Consultants shall also aid the Board in the adoption of criteria and standards relative to the regulation and control of Conscious Sedation, Deep Sedation and General Anesthesia. The Anesthesia Advisory Consultants shall utilize the “Guidelines for the use of conscious sedation, deep sedation and general anesthesia for Dentist”, as approved by the American Dental Association in October 1996, or any current update thereof. If the applicant has been satisfactorily evaluated by another similar organization (e.g., the Delaware Society of Oral and Maxillofacial Surgeons which uses the AAOMS Office Anesthesia Evaluation Manual Standards), then the Board may accept this evaluation and not require additional on-site evaluation.

7.4.2.2 If the results of the initial evaluation of an applicant are deemed unsatisfactory, upon written request of the applicant, a second evaluation shall be conducted by a different team of consultants.

7.4.3 Re-evaluation: The Board may at any time re-evaluate credentials, facilities, equipment, personnel and procedures of a licensed dentist who has previously received a written authorization or permit from the Board to determine if he/she is still qualified to have such written authorization. If the Board determines that the licensed dentist is no longer qualified to have such written authorization, it may revoke or refuse to renew such authorization, after an opportunity for a hearing is given to the licensed dentist.

7.5 Report of Adverse Occurrences:

7.5.1 All licensed dentists engaged in the practice of dentistry in the State of Delaware must submit a complete report within a period of thirty (30) days to the Delaware State Board of Dental Examiners of any mortality or other incident occurring in the out-patient facilities of such dentist which results in temporary or permanent physical or mental injury requiring hospitalization of said patient during, or as a direct result of, the Conscious Sedation or Deep Sedation or General Anesthesia related thereto.

7.5.2 Failure to comply with this rule when said occurrence is related to the use of Conscious Sedation or Deep Sedation or General Anesthesia may result in the loss of such permit described above, and will be considered unprofessional conduct.

7.6 Applications and Reapplications:

7.6.1 A dentist who desires to obtain a permit to administer Conscious Sedation, Deep Sedation, or General Anesthesia shall submit an application on the form provided by the Board, pay the permit fee, and meet the requirements for the permit described herein.

7.6.2 A dentist who desires to renew a permit shall submit a renewal application on the form provided by the Board and pay the permit renewal fee. Re-inspection of the facility, equipment, and staff shall not be necessary unless new techniques or criteria arise, as determined by the Board with the aid of the Anesthesia Advisory Committee.

7.6.3 A permit issued by the Board under these regulations will expire at the same time as the permit holder’s dental license and may be renewed biennially at the same time as the dental license is renewed.

8.0 Certificate Requirement

An applicant for a license to practice dentistry shall submit to the Board a Certificate issued by the National Board of Dental Examiners showing he/she has completed the National Board Examination with a score of at least 80 on each of Part I and Part 2 of the Examination. (2/13/97).

9.0 Voluntary Treatment Option for Chemically Dependent or Impaired Professionals

9.1 If the report is received by the chairperson of the regulatory Board, that chairperson shall immediately notify the Director of Professional Regulation or his/her designate of the report. If the Director of Professional Regulation receives the report, he/she shall immediately notify the chairperson of the regulatory Board, or that chairperson's designate or designates.

9.2 The chairperson of the regulatory Board or that chairperson's designate or designates shall, within 7 days of receipt of the report, contact the individual in question and inform him/her in writing of the report, provide the individual written information describing the Voluntary Treatment Option, and give him/her the opportunity to enter the Voluntary Treatment Option.

9.3 In order for the individual to participate in the Voluntary Treatment Option, he/she shall agree to submit to a voluntary drug and alcohol screening and evaluation at a specified laboratory or health care facility. This initial evaluation and screen shall take place within 30 days following notification to the professional by the participating Board chairperson or that chairperson's designate(s).

9.4 A regulated professional with chemical dependency or impairment due to addiction to drugs or alcohol may enter into the Voluntary Treatment Option and continue to practice, subject to any limitations on practice the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional, deem necessary, only if such action will not endanger the public health, welfare or safety, and the regulated professional enters into an agreement with the Director of Professional Regulation or his/her designate and the chairperson of the participating Board or that chairperson's designate for a treatment plan and progresses satisfactorily in such treatment program and complies with all terms of that agreement. Treatment programs may be operated by professional Committees and Associations or other similar professional groups with the approval of the Director of Professional Regulation and the chairperson of the participating Board.

9.5 Failure to cooperate fully with the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate in regard to the Voluntary Treatment Option or to comply with their requests for evaluations and screens may disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board chairperson or that chairperson's designate or designates shall cause to be activated an immediate investigation and institution of disciplinary proceedings, if appropriate, as outlined in section 9.8.

9.6 The Voluntary Treatment Option may require a regulated professional to enter into an agreement which includes, but is not limited to, the following provisions:

9.6.1 Entry of the regulated professional into a treatment program approved by the participating Board. Board approval shall not require that the regulated professional be identified to the Board. Treatment and evaluation functions must be performed by separate agencies to assure an unbiased assessment of the regulated professional's progress.

9.6.2 Consent to the treating professional of the approved treatment program to report on the progress of the regulated professional to the chairperson of the participating Board or to that chairperson's designate or designates or to the Director of the Division of Professional Regulation or his/her designate at such intervals as required by the chairperson of the participating Board or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate, and such person making such report will not be liable when such reports are made in good faith and without malice.

9.6.3 Consent of the regulated professional, in accordance with applicable law, to the release of any treatment information from anyone within the approved treatment program.

9.6.4 Agreement by the regulated professional to be personally responsible for all costs and charges associated with the Voluntary Treatment Option and treatment program(s). In addition, the Division of Professional Regulation may assess a fee to be paid by the regulated professional to cover administrative costs associated with the Voluntary Treatment Option. The amount of the fee imposed under this subparagraph shall approximate and reasonably reflect the costs necessary to defray the expenses of the participating Board, as well as the proportional expenses incurred by the Division of Professional Regulation in its services on behalf of the Board in addition to the administrative costs associated with the Voluntary Treatment Option.

9.6.5 Agreement by the regulated professional that failure to satisfactorily progress in such treatment program shall be reported to the participating Board's chairperson or his/her designate or designates or to the Director of the Division of Professional Regulation or his/ her designate by the treating professional who shall be immune from any liability for such reporting made in good faith and without malice.

9.6.6 Compliance by the regulated professional with any terms or restrictions placed on professional practice as outlined in the agreement under the Voluntary Treatment Option.

9.7 The regulated professional's records of participation in the Voluntary Treatment Option will not reflect disciplinary action and shall not be considered public records open to public inspection. However, the participating Board may consider such records in setting a disciplinary sanction in any future matter in which the regulated professional's chemical dependency or impairment is an issue.

9.8 The participating Board's chairperson, his/her designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional at any time during the Voluntary Treatment Option, restrict the practice of a chemically dependent or impaired professional if such action is deemed necessary to protect the public health, welfare or safety.

9.9 If practice is restricted, the regulated professional may apply for unrestricted licensure upon completion of the program.

9.10 Failure to enter into such agreement or to comply with the terms and make satisfactory progress in the treatment program shall disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board shall be notified and cause to be activated an immediate investigation and disciplinary proceedings as appropriate.

9.11 Any person who reports pursuant to this section in good faith and without malice shall be immune from any civil, criminal or disciplinary liability arising from such reports, and shall have his/her confidentiality protected if the matter is handled in a nondisciplinary matter.

9.12 Any regulated professional who complies with all of the terms and completes the Voluntary Treatment Option shall have his/her confidentiality protected unless otherwise specified in a participating Board's rules and regulations. In such an instance, the written agreement with the regulated professional shall include the potential for disclosure and specify those to whom such information may be disclosed.

10.0 Eligibility to Take the Practical (Clinical) Examination

Authority:

Pursuant to Title 24, Section 1106(a)(1), The Board of Dental Examiners is empowered to formulate rules and regulations to implement or clarify Chapter 11 relating to dentistry and dental hygiene.

Purpose:

This regulation clarifies eligibility to take the practical (clinical) examination in dentistry and dental hygiene administered by the Board.

10.1 No person shall be eligible to take the practical (clinical) examination in dentistry administered by the Delaware Board of Dental Examiners unless the applicant has received a degree in dentistry from an accredited dental college or university accredited by the Commission on Dental Accreditation of the American Dental Association.

10.2 No person shall be eligible to take the practical (clinical) examination in dental hygiene administered by the Delaware Board of Dental Examiners unless the applicant has graduated from a dental hygiene college or university program accredited by the Commission on Dental Accreditation of the American Dental Association of at least 2 academic years’ duration or has graduated, prior to 1953, from a dental hygiene program of at least 1 year’s duration which program had been approved by the Board at the time of the person’s graduation.

10.3 The Board reserves the right to waive the requirement set forth above in sections 10.1 and 10.2 if the Applicant can establish to the satisfaction of the Board’s Credentialing Committee that he or she is a student in good standing in an educational facility accredited by the Commission on Dental Accreditation of the American Dental Association and will graduate within sixty (60) days of the administration of the practical (clinical) examination with a degree in dentistry or dental hygiene.

11.0 Crimes Substantially Related to the Practice of Dentistry and Dental Hygiene.

Authority:

Pursuant to 74 Del. Laws. c.262, (Senate Bill No. 229 of the 142nd General Assembly, 2004, as amended), the Board was directed to promulgate regulations specifically identifying those crimes which are substantially related to the practice of dentistry and dental hygiene.

Purpose:

The Board of Dental Examiners believes that the State of Delaware has a compelling public policy interest in ensuring that its licensed professionals not only have specified levels of educational and professional competence but also possess sufficient character and judgment necessary to practice safely in their chosen fields and to do so in a manner which will not undermine the community’s confidence in the expertise and professionalism of the members of the profession. Licensed professionals, particularly those in health care related fields, often come into contact with clients and patients and other members of the public at times when they may be sick, infirmed or otherwise extremely vulnerable to undue influence or other forms of misuse, fraud and abuse. It is therefore critical that all reasonable steps are taken to determine, to the extent possible, that the regulation of such professionals takes into consideration not only the individual’s technical competence but his or her demonstrated propensity to behave in a way that does not expose the client population to risk or diminish legitimate expectations of honest and honorable behavior by such licensed health care professionals. Therefore, the Board finds that for purposes of licensing, renewal, reinstatement and discipline, the conviction of any of the following crimes, or of the attempt to commit or a conspiracy to commit or conceal the following crimes or substantially similar crimes in another state or jurisdiction, is deemed to be substantially related to the practice of Dentistry and Dental Hygiene in the State of Delaware without regard to the place of conviction:

Definitions.

“Conviction”, unless otherwise defined by specific statute, means a verdict of guilty by whether entered by a judge or jury, or a plea of guilty or a plea of nolo contendere or other similar plea such as a “Robinson” or “Alford” plea unless the individual has been discharged under §4218 of Title 11 of the Delaware Code (probation before judgment) or under §1024 of Title 10 (domestic violence diversion program) or by §4764 of Title 16 (first offenders controlled substances diversion program).

“Substantially similar crimes in another state or jurisdiction” includes all crimes prohibited by or punishable under Title 18 of the United Stated Code Annotated (U.S.C.A.) such as, but not limited to, Federal Health Care offenses.

11.1 Any crime which involves the use of physical force or violence toward or upon the person of another and shall include by way of example and not of limitation the following crimes set forth in Title 11 of the Delaware Code Annotated:

Assaults and Related Offenses

11.1.1. §601. Offensive touching;

11.1.2. §602. Menacing;

11.1.3. §603. Reckless endangering in the second degree;

11.1.4. §604. Reckless endangering in the first degree;

11.1.5. §605. Abuse of a pregnant female in the second degree;

11.1.6. §606. Abuse of a pregnant female in the first degree;

11.1.7. §611. Assault in the third degree;

11.1.8. §612. Assault in the second degree;

11.1.9. §613. Assault in the first degree;

11.1.10. §614. Assault on a sports official;

11.1.11. §615. Assault by abuse or neglect;

11.1.12. §616. Gang Participation;

11.1.13. §621. Terroristic threatening;

11.1.14. §622. Hoax devices

11.1.15. §625. Unlawfully administering drugs;

11.1.16. §626. Unlawfully administering controlled substance or counterfeit substance or narcotic drugs;

11.1.17. §627. Prohibited acts as to substances releasing vapors or fumes;

11.1.18. §628. Vehicular assault in the second degree;

11.1.19. §629. Vehicular assault in the first degree;

11.1.20. §630. Vehicular homicide in the second degree;

11.1.21. §630A. Vehicular homicide in the first degree;

11.1.22. §631. Criminally negligent homicide;

11.1.23. §632. Manslaughter;

11.1.24. §633. Murder by abuse or neglect in the second degree;

11.1.25. §634. Murder by abuse or neglect in the first degree;

11.1.26. §635. Murder in the second degree;

11.1.27. §636. Murder in the first degree;

11.1.28. §645. Promoting suicide;

Abortion and Related Offenses

11.1.29. §651. Abortion;

11.1.30. §653. Issuing abortional articles;

Sexual Offenses

11.1.31. §763. Sexual harassment;

11.1.32. §764. Indecent exposure in the second degree;

11.1.33. §765. Indecent exposure in the first degree;

11.1.34. §766. Incest;

11.1.35. §767. Unlawful sexual contact in the third degree;

11.1.36. §768. Unlawful sexual contact in the second degree;

11.1.37. §769. Unlawful sexual contact in the first degree;

11.1.38. §770. Rape in the fourth degree;

11.1.39. §771. Rape in the third degree;

11.1.40. §772. Rape in the second degree;

11.1.41. §773. Rape in the first degree;

11.1.42. §776. Sexual extortion;

11.1.43. §777. Bestiality;

11.1.44. §778. Continuous sexual abuse of a child;

11.1.45. §780. Female genital mutilation;

Kidnapping and Related Offenses

11.1.46. §781. Unlawful imprisonment in the second degree;

11.1.47. §782. Unlawful imprisonment in the first degree;

11.1.48. §783. Kidnapping in the second degree;

11.1.49. §783A. Kidnapping in the first degree;

11.1.50. §785. Interference with custody;

Coercion

11.1.51. §791. Acts constituting coercion.

11.2. Any crime which involves dishonesty or false, fraudulent or aberrant behavior and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:

Arson and Related Offenses

11.2.1. §801. Arson in the third degree;

11.2.2. §802. Arson in the second degree;

11.2.3. §803. Arson in the first degree;

11.2.4. §804. Reckless burning or exploding;

11.2.5. §805. Cross or religious symbol burning;

11.2.6. §811. Criminal mischief;

Criminal Trespass and Burglary

11.2.7. §820. Trespassing with intent to peer or peep into a window or door of another;

11.2.8. §821. Criminal trespass in the third degree;

11.2.9. §822. Criminal trespass in the second degree;

11.2.10. §823. Criminal trespass in the first degree;

11.2.11. §824. Burglary in the third degree;

11.2.12. §825. Burglary in the second degree;

11.2.13. §826. Burglary in the first degree;

11.2.14. §828. Possession of burglar’s tools or instruments facilitating theft;

Robbery

11.2.15. §831. Robbery in the second degree;

11.2.16. §832. Robbery in the first degree;

11.2.17. §835. Carjacking in the second degree;

11.2.18. §836. Carjacking in the first degree;

Theft and Related Offenses

11.2.19. §840. Shoplifting; class G felony;

11.2.20. §840A. Use of illegitimate retail sales receipt or Universal Product Code Label;

11.2.21. §841. Theft;

11.2.22. §842. Theft; lost or mislaid property; mistaken delivery;

11.2.23. §843. Theft; false pretense;

11.2.24. §844. Theft; false promise;

11.2.25. §845. Theft of services;

11.2.26. §846. Extortion;

11.2.27. §848. Misapplication of property;

11.2.28. §849. Theft of rented property;

11.2.29. §850. Use, possession, manufacture, distribution and sale of unlawful telecommunication and access devices;

11.2.30. §851. Receiving stolen property;

11.2.31. §853. Unauthorized use of a vehicle;

11.2.32. §854. Identity theft;

11.2.33. §859. Larceny of livestock;

11.2.34. §860. Possession of shoplifter’s tools or instruments facilitating theft;

Forgery and Related Offenses

11.2.35. §861. Forgery; class F felony;

11.2.36. §862. Possession of forgery devices;

Offenses Involving Falsification of Records

11.2.37. §871. Falsifying business records;

11.2.38. §872. Falsifying business records;

11.2.39. §873. Tampering with public records in the second degree;

11.2.40. §876. Tampering with public records in the first degree;

11.2.41. §877. Offering a false instrument for filing;

11.2.42. §878. Issuing a false certificate;

Bribery Not Involving Public Servants

11.2.43. §881. Bribery;

11.2.44. §882. Bribe receiving;

Frauds on Creditors

11.2.45. §891. Defrauding secured creditors;

11.2.46. §892. Fraud in insolvency;

11.2.47. §893. Interference with levied-upon property;

Other Frauds and Cheats

11.2.48. §900. Issuing a bad check;

11.2.49. §903. Unlawful use of credit card;

11.2.50. §903A. Reencoder and scanning devices;

11.2.51. §906. Deceptive business practices;

11.2.52. §907. Criminal impersonation;

11.2.53. §907A. Criminal impersonation, accident related;

11.2.54. §907B. Criminal impersonation of a police officer;

11.2.55. §908. Unlawfully concealing a will;

11.2.56. §909. Securing execution of documents by deception;

11.2.57. §910. Debt adjusting;

11.2.58. §911. Fraudulent conveyance of public lands;

11.2.59. §912. Fraudulent receipt of public lands;

11.2.60. §913. Insurance fraud;

11.2.61. §913A. Health care fraud;

11.2.62. §914. Use of consumer identification information;

11.2.63. §915. Use of credit card information;

11.2.64. §916. Home improvement fraud;

11.2.65. §917. New home construction fraud;

Offenses Relating to Recorded Devices

11.2.66. §920. Transfer of recorded sounds;

11.2.67. §921. Sale of transferred recorded sounds;

11.2.68. §922. Improper labeling;

Computer Related Offenses

11.2.69. §932. Unauthorized access;

11.2.70. §933. Theft of computer services;

11.2.71. §934. Interruption of computer services;

11.2.72. §935. Misuse of computer system information;

11.2.73. §936. Destruction of computer equipment;

11.2.74. §937. Unrequested or unauthorized electronic mail or use of network or software to cause same;

11.2.75 . §938. Failure to promptly cease electronic communication upon request;

Offenses relating to marriage.

11.2.76. §1001. Bigamy;

11.2.77. §1003. Contracting a bigamous marriage outside of the State.

11.3. Any crime which involves misuse or abuse of children or animals and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:

Child Welfare; Sexual Offenses, Animal Offenses

11.3.1. §1100. Dealing in children;

11.3.2. §1101. Abandonment of child;

11.3.3. §1102. Endangering the welfare of a child;

11.3.4. §1105. Endangering the welfare of an incompetent person;

11.3.5. §1106. Unlawfully dealing with a child;

11.3.6. §1107. Endangering children;

11.3.7. §1108. Sexual exploitation of a child;

11.3.8. §1109. Unlawfully dealing in child pornography;

11.3.9. §1111. Possession of child pornography;

11.3.10. §1112. Sexual offenders; prohibitions from school zones;

11.3.11. §1112A Sexual solicitation of a child;

11.3.12 . §1113 Criminal non-support and aggravated criminal non-support;

11.3.13. §1114. Body-piercing; tattooing or branding;

11.3.14. §1114A. Tongue-splitting;

11.3.15. §1116. Sale or distribution of tobacco products to minors;

11.3.16. §1325. Cruelty to animals;

11.3.17. §1326. Animals; fighting and baiting prohibited;

11.3.18. §1327. Maintaining a dangerous animal.

11.4. Any crime which involves offenses against the public order the commission of which may tend to bring discredit upon the profession and which are thus substantially related to one’s fitness to practice such profession and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:

Bribery and Improper Influence

11.4.1. §1201. Bribery;

11.4.2. §1203. Receiving a bribe;

11.4.3. §1205. Giving unlawful gratuities;

11.4.4. §1206. Receiving unlawful gratuities;

11.4.5. §1207. Improper influence;

11.4.6. §1211. Official Misconduct;

11.4.7. §1212. Profiteering;

Perjury, Escape and related offenses

11.4.8. §1221. Perjury in the third degree;

11.4.9. §1222. Perjury in the second degree;

11.4.10. §1223. Perjury in the first degree;

11.4.11. §1233. Making a false written statement;

11.4.12. §1239. Wearing a disguise during commission of a felony;

11.4.13. §1240. Terroristic threatening of public officials or public servants;

11.4.14. §1244. Felony hindering prosecution;

11.4.15. §1245. Felony false reporting an incident

11.4.16. §1246. Compounding a crime;

11.4.17. §1248. Felony obstructing control and suppression of rabies;

11.4.18. §1249. Felony abetting violation of driver’s license restrictions;

11.4.19. §1250. Offenses against law-enforcement animals;

11.4.20. §1252. Felony escape;

11.4.21. §1253. Escape after conviction.

11.4.22. §1254. Assault in a detention facility;

11.4.23. §1256. Felony promoting prison contraband;

11.4.24. §1257A. Felony use of an animal to avoid capture;

11.4.25. §1259. Sexual relations in a detention facility;

11.4.26. §1260. Felony misuse of prisoner mail;

Offenses Relating to Judicial and Similar Proceedings

11.4.27. §1261. Bribing a witness;

11.4.28. §1262. Bribe receiving by a witness;

11.4.29. §1263. Tampering with a witness;

11.4.30. §1263A. Interfering with child witness;

11.4.31. §1264. Bribing a juror;

11.4.32. §1265. Bribe receiving by a juror;

11.4.33. §1266. Tampering with a juror;

11.4.34. §1267. Misconduct by a juror;

11.4.35. §1269. Tampering with physical evidence.

11.5. Any crime which involves offenses against a public health order and decency which may tend to bring discredit upon the profession, specifically including the below listed crimes from Title 11 of the Delaware Code Annotated which evidence a lack of appropriate concern for the safety and well being of another person or persons in general or sufficiently flawed judgment to call into question the individuals ability to make health care decisions or advise upon health care related matters for other individuals.

Disorderly Conduct and Related Offenses

11.5.1. §1302. Riot;

11.5.2. §1304. Hate crimes;

11.5.3 . §1312A. Felony Stalking;

11.5.4. §1313. Malicious interference with emergency communications;

11.5.5. §1325. Felony Cruelty to Animals;

11.5.6. §1326. Animals, fighting and baiting prohibited.

11.5.7. §1327. Felony maintaining a dangerous animal;

11.5.8. §1332. Abusing a corpse;

11.5.9. §1333. Trading in human remains and associated funerary objects

11.5.10. §1335. Felony violation of privacy;

11.5.11. §1336. Wiretapping and electronic surveillance;

11.5.12. §1338. Bombs, incendiary devices, Molotov cocktails and explosive devices;

11.5.13. §1339. Adulteration;

Offenses Involving Public Indecency

11.5.14. §1351. Promoting prostitution in the third degree;

11.5.15. §1352. Promoting prostitution in the second degree;

11.5.16. §1353. Promoting prostitution in the first degree;

Obscenity

11.5.17. §1361. Obscenity; acts constituting.

11.6. Any crime which involves the illegal possession or the misuse or abuse of narcotics, or other addictive substances and those non-addictive substances with a substantial capacity to impair reason or judgment and shall include by way of example and not of limitation the following crimes listed in Chapter 47 of Title 16 of the Delaware Code Annotated:

11.6.1. §4751. Prohibited acts A;

11.6.2. §4752. Prohibited acts B;

11.6.3. §4752A. Unlawful delivery of noncontrolled substance;

11.6.4. §4753. Prohibited acts C;

11.6.5. §4753A. Trafficking in marijuana, cocaine, illegal drugs, methamphetamines, L.S.D., or designer drugs;

11.6.6. §4754. Prohibited acts D;

11.6.7. §4754A. Possession and delivery of noncontrolled prescription drug.

11.6.8. §4755. Prohibited acts E;

11.6.9. §4756. Prohibited acts;

11.6.10. §4757. Hypodermic syringe or needle; delivering or possessing; disposal; exceptions;

11.6.11. §4758. Keeping drugs in original containers;

11.6.12. §4761. Distribution to persons under 21 years of age;

11.6.13. §4761A. Purchase of drugs from minors;

11.6.14. §4767. Distribution, delivery, or possession of controlled substance within 1,000 feet of school property;

11.6.15. §4768. Distribution, delivery or possession of controlled substance in or within 300 feet of park, recreation area, church, synagogue or other place of worship;

11.6.16. §4774. Drug paraphernalia.

11.7. Any crime which involves the misuse or illegal possession or sale of a deadly weapon or dangerous instrument and shall include by way of example and not of limitation the following crimes listed in Title 11 of the Delaware Code Annotated:

Offenses Involving Deadly Weapons and Dangerous Instruments

11.7.1. §1442. Carrying a concealed deadly weapon;

11.7.2. §1443. Carrying a concealed dangerous instrument;

11.7.3. §1444. Possessing a destructive weapon;

11.7.4. §1445. Felony unlawfully dealing with a dangerous weapon;

11.7.5. §1447. Possession of a deadly weapon during commission of a felony;

11.7.6. §1447A. Possession of a firearm during commission of a felony;

11.7.7. §1448. Possession and purchase of deadly weapons by persons prohibited;

11.7.8. §1448A. Criminal history record checks for sales of firearms;

11.7.9. §1449. Wearing body armor during commission of felony;

11.7.10. §1450. Receiving a stolen firearm;

11.7.11. §1451. Theft of a firearm;

11.7.12. §1452. Unlawfully dealing with knuckles-combination knife;

11.7.13. §1453. Unlawfully dealing with martial arts throwing star;

11.7.14. §1454. Giving a firearm to person prohibited;

11.7.15. §1455. Engaging in a firearms transaction on behalf of another;

11.7.16. §1456. Unlawfully permitting a minor access to a firearm;

11.7.17. §1457. Felony Possession of a weapon in a Safe School and Recreation Zone;

11.7.18. §1458. Removing a firearm from the possession of a law enforcement officer;

11.7.19. §1459. Possession of a weapon with a removed, obliterated or altered serial number;

11.7.20. §1471. Prohibited Acts; Offenses Involving Organized Crime and Racketeering

11.7.21. §1504. Criminal Penalties for Organized Crime & Racketeering;

Offenses Involving Intimidation of Victims or Witnesses

11.7.22. §3533. Aggravated act of intimidation;

11.8 Other Crimes

Title 16 Health and Safety

11.8.1 §1136. Abuse or neglect of a patient or resident of a nursing facility;

11.8.2 §4751. Prohibited acts A;

11.8.3 §4752. Prohibited acts B;

11.8.4 §4752A. Unlawful Delivery of Noncontrolled Substance;

11.8.5 §4753. Prohibited acts C;

11.8.6 §4753A. Trafficking in Marijuana, Cocaine, Illegal Drugs, Methamphetamines, Lysergic Acid Diethylamide, Designer Drugs or 3,4-Methelenedioxymethamphetamine

11.8.7 §4754. Prohibited acts D

11.8.8 §4754A. Possession and Delivery of NonControlled Prescription Drug.

11.8.9 §4755. Prohibited Acts

11.8.10 §4756. Prohibited Acts

11.8.11 §4757. Hypodermic syringe or needle; delivering or possessing; disposal; exceptions; penalties

11.8.12 §4758. Keeping drugs in original containers;

11.8.13 §4761. Distribution to persons under 21 years of age; penalties;

11.8.14 §4761A. Purchase of drugs from minors; penalties;

11.8.15 §4767. Distribution, delivery, or possession of controlled substance within 1,000 feet of school property; penalties; defenses;

11.8.16 §4768. Distribution, delivery or possession of controlled substance in or within 300 feet of park, recreation area, church, synagogue or other place of worship; penalties; defenses;

11.8.17 §4771. Drug paraphernalia;

11.8.18 §4774. Penalties;

Title 23 Navigation and Waters

11.8.19 §2302. Operation of a vessel or boat while under the influence of intoxicating liquor and/or drugs;

11.8.20 §2305. Second, Third and Fourth Offense Penalties; jurisdiction;

Title 30 State Taxes

11.8.21 §571. Attempt to evade or defeat tax; class E felony;

11.8.22 §572. Failure to collect or pay over tax; class E felony;

11.8.23 §573. Failure to file return, supply information or pay tax; class A misdemeanor;

11.8.24 §574. Fraud and false statements; class E felony;

Title 31 Welfare

11.8.25 §1007. Felony Penalties;

Title 21 – Motor Vehicles

11.8.26 §2118A. Unlawful possession or manufacture of proof of insurance, penalties;

11.8.27 §2133. Penalties; jurisdiction of justices of the peace;

11.8.28 §2315. False statements; penalty;

11.8.29 §2316. Altering or forging certificate of title, manufacturer's certificate of origin, registration card, vehicle warranty or certification sticker or vehicle identification plate

11.8.30 §2620. False statements; incorrect or incomplete information;

11.8.31 §2751. Unlawful application for or use of license or identification card;

11.8.32 §2752. False statements;

11.8.33 §2760. Duplication, reproduction, altering, or counterfeiting of driver's licenses or identification cards;

11.8.34 §2814. Additional penalty when convicted of an offense which would render an individual a habitual offender;

11.8.35 §3107. False statements;

11.8.36 §4177. Felony Driving a vehicle while under the influence or with a prohibited alcohol content; evidence; arrests; and penalties;

11.8.37 §4177M. Operating a commercial motor vehicle with a prohibited blood alcohol concentration or while impaired by drugs;

11.8.38 §4202. Felony Duty of driver involved in accident resulting in injury or death to any person; penalty;

11.8.39 §4601. Introduction, sale, distribution or advertisement for sale to public of motor vehicle master keys; penalties;

11.8.40 §4603. Reporting of keys; penalties;

11.8.41 §4604. Possession of motor vehicle master keys, manipulative keys, key-cutting devices, lock picks or lock picking devices and hot wires; penalty; class E felony;

11.8.42 §6704. Receiving or transferring stolen vehicle; penalty;

11.8.43 §6705. Removed, falsified or unauthorized identification number on vehicle, bicycle or engine; removed or affixed license/registration plate with intent to misrepresent identity; penalty;

11.8.44 §6708. Possession of blank title; blank registration card; vehicle identification plate; warranty sticker and registration card; class E felony; penalty;

11.8.45 §6709. Removal of warranty or certification stickers; vehicle identification plates; confidential vehicle identification numbers; penalty; class E felony;

11.8.46 §6710. Unlawful possession of assigned titles, assigned registration cards, vehicle identification plates and warranty stickers; penalty; class E felony;

Title 3 – Agriculture

11.8.47 §1224. Unlawful Acts (Only to include crimes related to fraud and conspiracy);

11.8.48 §8713. Felony offenses

11.8.49 §10049. Fraudulent Written Statements;

11.8.50 §10050. Fraudulent Certificate of Registration or Eligibility Documents;

11.8.51 §904. Offenses Concerning Certain Persons;

Title 6 – Commerce and Trade

11.8.52 §4619. Felony Prohibition of Intimidation;

Title 7 – Conservation

11.8.53 §1717. Unauthorized Acts against a Service Guide or Seeing Eye Dog;

11.8.54 §6003. Felony Permits Required;

Title 11 – Crimes

11.8.55 §2402. Felony Interception of Communications Generally; Divulging Contents of Communications;

11.8.56 §2403. Manufacture, Possession or Sale of Intercepting Device;

11.8.57 §2410. Breaking and Entering, Etc. to Place or Remove Equipment;

11.8.58 §2412. Obstruction, Impediment or Prevention of Interception;

11.8.59 §2422. Divulging Contents of Communications;

11.8.60 §3534. Attempt to Intimidate;

11.8.61 §8523. Felony Violation of Reporting Provision;

11.8.62 §8562. Felony Failure of Child Care Provider to Obtain Information or Providing False Information;

11.8.63 §8572. Penalties for Providing False Information when Seeking School Employment;

11.8.64 §9016. Filing False Claim under Victims’ Compensation Fund

Title 12 – Descendants’ Estates

11.8.65 §210. Alteration, Theft or Destruction of Will

Title 16 – Health & Safety

11.8.66 §2513. Felony Penalties Relating To Improper Health-Care Decisions;

11.8.67 §7112. Felony Penalties for Violations of Chapter;

11.8.68 §7416. Penalties for Violating Statute Governing Radiation Control;

Title 24 – Professions and Occupations

11.8.69 §903. Deadly Weapons Dealers – Sale to Persons under 21 or Intoxicated Persons;

Title 31 – Welfare

11.8.70 §3913. Felony Violations – Knowing or Reckless Abuse of an Infirm Adult.

11.9. Any crime which is a violation of either Title 24, Chapter 11 (Board of Dental Examiners) as it may be amended from time to time or of any other statute which requires the reporting of a medical/dental situation or condition to state, federal or local authorities or a crime which constitutes a violation of the dental or hygiene practice act of the state in which the conviction occurred or in which the dentist or dental hygienist is licensed.

11.10. The Board reserves the jurisdiction and authority to modify this regulation as and if it becomes necessary to either add or delete crimes including such additions as may be required on an emergency basis under 29 Del.C. §10119 to address imminent peril to the public health, safety or welfare.