AL Dental Jurisprudence cheat sheet

The Alabama Dental Practice Act is codified in Title 34 (Professions and Businesses), Chapter 9, of the Code of Alabama; the Board's administrative rules appear in Alabama Administrative Code Chapter 270-X.

The Board of Dental Examiners of Alabama regulates dentists, dental hygienists, and dental assistants; the Act defines each licensee category and the settings in which each may practice.

Statutory definitions control scope questions: 'practice of dentistry' includes diagnosis, treatment planning, and procedures on human teeth and associated structures, and unlicensed practice is a separate violation from practicing outside one's license.

Board authority includes adopting rules, issuing and renewing licenses, administering examinations, investigating complaints, and imposing discipline; rulemaking generally follows the Alabama Administrative Procedure Act notice-and-comment process.

The Board may inspect dental facilities and records, subpoena witnesses and documents, and compel testimony in aid of investigations.

Board members are appointed by the Governor, include dentist and public/hygienist representation, and serve fixed staggered terms with defined removal provisions.

The Act authorizes the Board to set fees, establish license and renewal cycles, and adopt continuing education requirements by rule.

Violations of the Act may be prosecuted criminally by district attorneys in addition to Board administrative action; injunctive relief is available against unlicensed practice.

Licensure pathways include examination (regional/clinical testing agencies accepted by the Board), licensure by credentials for dentists licensed in another jurisdiction, and faculty or specialty-limited licenses where authorized.

Dental hygienists may qualify for licensure by examination or by credentials; local anesthesia and nitrous oxide administration require additional Board-recognized training and permit authority.

Licenses are renewed annually on a date set by Board rule; late renewal triggers a penalty fee, and practicing on an expired license is unlicensed practice subject to discipline.

Continuing education is required each renewal cycle, with a set number of hours and mandated subject areas (e.g., infection control and jurisprudence) specified by Board rule; licensees must retain certificates of completion.

CE credit is generally accepted only from Board-approved providers; self-study or online hours are capped by rule, and excess hours do not carry forward unless the rule says so.

Inactive or retired status may be available on application; reactivation typically requires a fee plus evidence of current CE and, in some cases, reexamination.

Reciprocal or credential-based licensure requires verification of the out-of-state license, examination history, and absence of pending disciplinary actions.

Licensee must notify the Board of address changes and of any disciplinary action taken by another jurisdiction within the time set by rule.

Dentists hold the broadest scope: diagnosis, treatment planning, prescribing, surgery, restorative, prosthetic, endodontic, periodontal, and orthodontic treatment, and supervision of all auxiliaries.

Dental hygienists perform prophylaxis, scaling and root planing, periodontal assessment, fluoride and sealant application, radiographs, and patient education; each task may require a specific supervision level.

Dental assistants perform reversible supportive tasks (suctioning, retraction, material mixing, radiographs if certified) and chairside assistance; expanded-function duties require Board-approved formal training.

Coronal polishing, sealants, and topical fluoride may be delegated to assistants or hygienists only as the rules specify, and never to unlicensed personnel.

Only a licensed dentist may diagnose, cut hard or soft tissue, extract teeth, place or adjust permanent restorations, and perform endodontic or surgical procedures.

Local anesthesia and nitrous oxide sedation may be administered by a hygienist only with the required permit, training, and dentist supervision.

A dentist may not delegate a procedure to an auxiliary whose license or certification does not authorize it; the delegating dentist remains responsible for the patient's care.

Scope questions are resolved by the statutory definition of dentistry plus the specific rule for the procedure; ambiguity is resolved against delegation.

Direct supervision: the dentist is physically present in the office, has examined the patient, and is available during the procedure; the dentist must authorize the procedure in advance.

Indirect supervision: the dentist has examined the patient and authorized the procedure but is not required to be on the premises; availability by phone may be specified.

General supervision: the dentist authorizes treatment but need not have examined the patient for that specific visit; used for certain hygiene and preventive services.

Personal supervision: the dentist is physically present and directly observing or performing the delegated step; required for the most sensitive delegated tasks.

Delegation requires that the auxiliary hold the license or certification for the task; a dentist may not delegate to an uncertified assistant work reserved to a hygienist.

The dentist must be reachable and must provide for emergency management whenever auxiliaries treat patients under indirect or general supervision.

Written office protocols and standing orders may authorize specific hygiene services (e.g., sealants, fluoride) under the supervision level the rule assigns.

Delegation outside the permitted supervision level is unprofessional conduct and grounds for discipline of both the delegator and the delegatee.

Standard precautions apply to all patients regardless of diagnosis: hand hygiene, gloves, masks, eye protection, and gowns when splash or spatter is anticipated.

Critical and semicritical instruments must be cleaned, then sterilized by autoclave, dry heat, or chemical vapor; biological monitoring (spore testing) is performed at the interval set by rule.

Sterilizers must be monitored with mechanical, chemical, and biological indicators, and records retained; failed biological tests require quarantine and retesting of loads.

Single-use items (needles, scalpel blades, certain barriers) are never reprocessed; sharps go into puncture-resistant containers.

Clinical contact surfaces are barrier-protected or disinfected between patients with an EPA-registered hospital disinfectant; housekeeping surfaces follow the office schedule.

Dental unit waterlines must be maintained per manufacturer instructions with periodic testing and documented treatment to control biofilm.

Staff must be trained in infection control at hire and periodically, and the office must maintain a written infection control program available for Board inspection.

Vaccination (e.g., hepatitis B) and post-exposure evaluation and follow-up are required components of the office safety program under OSHA-aligned standards.

A legible record must be maintained for each patient and include history, examination findings, diagnosis, treatment rendered, dates, materials, and the identity of the provider.

Records must be retained for the period set by Board rule (commonly several years after the last treatment or after the patient reaches majority), and must be produced on Board request.

Informed consent requires disclosure of diagnosis, proposed treatment, material risks and benefits, alternatives including no treatment, and the opportunity to ask questions; consent is documented.

Consent for minors or incapacitated adults is obtained from a parent, legal guardian, or person authorized by law.

Patient information is confidential and may be disclosed only with authorization, as required by law (e.g., abuse reporting, court order), or for treatment and payment purposes.

Patients are entitled to a copy or summary of their records on request, subject to lawful fees and applicable redaction rules.

Alteration or destruction of records to avoid an investigation is itself a disciplinary offense; corrections must be dated and identified, not obliterated.

Photographs and radiographs are part of the record and are subject to the same retention, consent, and disclosure rules.

Grounds for discipline include fraud in licensure, unlicensed practice, practicing beyond scope, negligence or incompetence, and violation of Board rules or the Act.

Additional grounds include impairment by alcohol or drugs, conviction of a crime involving moral turpitude, and aiding unlicensed practice by another.

The Board's process typically moves from complaint, investigation, and notice of charges to a contested hearing with the right to counsel, followed by findings and an order.

Available sanctions include reprimand, probation with conditions, suspension, revocation, civil penalty, and required remediation or CE.

Failure to cooperate with an investigation, or failure to comply with a Board order, is an independent ground for further discipline.

Disciplinary actions are reportable to national practitioner databases, and licensees must self-report adverse actions taken in other states.

Emergency or summary suspension may be ordered where continued practice poses an immediate risk to the public, followed by a hearing.

Judicial review of a final Board order is available through the state courts under the Alabama Administrative Procedure Act standard.

A dentist may prescribe only in the course of legitimate dental treatment and must hold a current Alabama controlled substances registration in addition to DEA registration for controlled drugs.

Schedule II prescriptions are subject to strict limits and may not be refilled; records of receipt and dispensing must be maintained and reconciled.

Prescription drug monitoring program (PDMP) queries are required in defined circumstances before prescribing controlled substances, and prescribing patterns are subject to Board review.

A dentist must not prescribe to a person not a patient of record, must not self-prescribe controlled substances outside legitimate treatment, and must not prescribe for a family member except in limited documented situations.

Anesthesia and sedation permits are tiered (e.g., minimal/nitrous, moderate/conscious sedation, deep sedation/general anesthesia) and each tier requires specific training, equipment, and monitoring.

Sedation requires pre-operative evaluation, appropriate fasting and escort requirements, continuous monitoring (pulse oximetry, blood pressure, capnography where required), and emergency drugs and equipment on site.

The operating dentist must hold the permit for the level of sedation used and must remain physically present during deep sedation or general anesthesia.

Records must document drugs administered, dosages, monitoring data, recovery, and discharge instructions; adverse events are reportable to the Board as required.

Advertising must be truthful and not misleading; claims of specialty require the dentist to be board-certified or to hold the recognized specialty credential, and 'specialist' or 'practice limited to' language is restricted.

Solicitation of patients through false, deceptive, or sensational statements, or guarantees of results, is unprofessional conduct.

Fee advertising must disclose the full fee for the advertised service or clearly state that additional charges apply; discounted or coupon offers must state material conditions.

A dentist may not split fees with a non-dentist or pay for patient referrals in a manner that violates the Act's fee-splitting prohibition.

Dental practice entities must be owned and controlled by licensed dentists; non-dentist investment is limited to arrangements that do not constitute the unlicensed practice of dentistry or improper fee splitting.

The name of the practice must not be misleading about the identity or licensure of the practitioners, and the responsible dentist must be identified.

Offices must display required licenses and registrations and must report changes in ownership, location, or practice entity to the Board.

Billing for services not rendered, or misrepresenting the provider of record on a claim, is both fraud and a disciplinary offense.