On April 28, Gov. Paul LePage (R-ME) signed into law L.D. 1230, “An Act to Improve Access to Oral Health Care,” thereby creating the role of dental hygiene therapist in the State of Maine. The bill passed with bipartisan support. The new law authorizes dental hygiene therapists to perform both preventive and routine restorative dental care under the supervision of a licensed dentist in the State of Maine.
L.D. 1230 was originally introduced during the 2013 legislative session but failed to pass the Maine Senate. As a result, the bill was carried over to the current legislative session for consideration. In the current session, the bill was sponsored by the Speaker of the House, Mark Eves (D-ME), and co-sponsored by 42 members of the State legislature, including Reps. Anne-Marie Mastraccio (D-ME) and Heather W. Sirocki (R-ME), both of whom are dental hygienists.
The following are brief excerpts from the law (using the language and terminology of the law) which delineate the supervision, scope of practice and educational requirements to become and practice as a licensed dental hygiene therapist in the State of Maine:
A dental hygiene therapist may practice only under the direct supervision of a dentist who is licensed in Maine. The new law refers to this individual as “the supervising dentist.” In addition, a written practice agreement is required which must be signed by both the dental hygiene therapist and the supervising dentist. The written practice agreement must include the following elements (this list is not exhaustive):
- The services and procedures and the practice settings for those services and procedures that the dental hygiene therapist may provide, together with any limitations on those services and procedures;
- Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed; and
- Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation prior to initiating care.
Scope of Practice
A dental hygiene therapist may provide the care and services listed below only under the direct supervision of a dentist licensed in Maine (this list is not exhaustive):
- Perform oral health assessments, pulpal disease assessments for primary and young teeth, simple cavity preparations and restorations and simple extractions;
- Prepare and place stainless steel crowns and aesthetic anterior crowns for primary incisors and prepare, place and remove space maintainers; and
- Conduct urgent management of dental trauma, perform suturing and extract primary teeth and perform nonsurgical extractions of periodontally diseased permanent teeth if authorized in advance by the supervising dentist;
Upon completion of 2,000 hours of supervised clinical practice, a dental hygiene therapist may provide services within their scope of practice under the direct supervision of a dentist licensed in Maine in certain settings such as hospitals, public schools, clinics and federally qualified health centers licensed in Maine.
Licensure and Educational Requirements
To qualify for licensure as a dental hygiene therapist, a person must pay the application fee, complete the appropriate forms and demonstrate to the Maine Board of Dental Examiners (Board) that the applicant:
- Possess a valid license to practice dental hygiene or independent practice dental hygiene or qualifies for licensure to practice by endorsement;
- Has successfully completed a dental hygiene therapy education program;
- Has been awarded a Bachelor of Science degree in dental hygiene. Note: in order to meet this requirement, an applicant must hold at least an associate degree in dental hygiene before entering a dental hygiene therapy education program, which may be completed concurrently or consecutively with a Bachelor of Science degree in dental hygiene;
- Has passed a comprehensive, competency-based clinical examination approved by the Board and administered independently by an institution providing dental hygiene therapy education and has passed an examination of the applicant’s knowledge of Maine laws and rules relating to the practice of dentistry; and
- Has completed 2,000 hours of supervised clinical practice under the supervision of a licensed dentist.
The Board has until January 1, 2015 to adopt rules establishing requirements for the dental hygiene therapy education program. Also, the Board has the option to approve a dental hygiene therapy education program until an education program has been accredited by the Commission on Dental Accreditation (CODA) or a successor organization. ADEA prepared a memo that provides additional details regarding the newly enacted law.