MD Dental Hygiene Jurisprudence cheat sheet

The Maryland Dental Practice Act is codified in Health-General Article, Title 4, Subtitles 1 through 3, and is administered by the State Board of Dental Examiners within the Maryland Department of Health.

The Board consists of dentist members, dental hygienist members, and consumer members appointed by the Governor; a dental hygienist seat exists specifically to represent hygiene practice.

Statutory authority is split: the General Assembly sets scope and penalties in statute, while the Board adopts regulations in COMAR Title 10, Subtitle 44 to implement it.

"Practice of dental hygiene" is defined in statute and includes removal of calcareous deposits and stains, topical fluoride application, and other procedures authorized by the Board.

"Supervision" is defined by regulation in graded tiers (direct, general, and collaborative or unsupervised settings), and each procedure is assigned a required tier.

The Board may adopt emergency regulations and issue declaratory rulings; a declaratory ruling binds the Board as to the requesting party on the facts presented.

Violations of the Act are charged under specific statutory sections; the Board's authority includes reprimand, probation, suspension, revocation, and civil fines.

The Act requires dentists and hygienists to report certain adverse events and to cooperate with Board investigations; failure to respond to a Board inquiry is itself a ground for discipline.

Under general supervision the dentist has authorized the procedure and diagnosed the patient, but need not be physically present in the office when the hygienist performs it.

Under direct supervision the dentist must be physically present in the office suite and evaluate the patient's condition before and after the procedure.

Procedures typically requiring direct supervision include administration of local anesthesia and nitrous oxide-oxygen sedation, which require additional certification and current competency.

Local anesthesia administration by a hygienist requires a Board-approved course, current basic life support certification, and compliance with the Board's anesthesia regulations.

Hygienists may perform scaling and root planing, polishing, fluoride and sealant application, radiographs, and periodontal data collection within the scope defined by statute and regulation.

A hygienist may not diagnose, prescribe, cut hard or soft tissue requiring a licensed dentist, or perform procedures outside the delegated scope even with patient consent.

Public health hygienists may practice in specified settings such as schools and health departments under a reduced supervision arrangement defined in regulation.

Delegation to a dental assistant of a procedure reserved to the hygienist is not permitted; task assignment follows the license held by each provider.

Licensure requires graduation from an accredited dental hygiene program, successful completion of a Board-approved clinical and written examination, and a criminal history records check.

Licenses renew on a fixed cycle set by the Board, and renewal requires attestation of continuing education completion plus payment of the renewal fee.

Continuing education must include Board-mandated topic hours, which have included infection control and, at times, opioid or pain management content; verify current hour counts on the Board site.

Failing to renew before expiration places the license in a lapsed status, and practicing on a lapsed license is unlicensed practice subject to discipline.

Reinstatement after lapse generally requires payment of late fees, evidence of continuing education for the missed cycle, and possibly additional Board review.

A license is not transferable, and a hygienist may practice only under the name and license number on record with the Board.

Out-of-state applicants may qualify by credentials or licensure reciprocity where the Board determines the other jurisdiction's standards are substantially equivalent.

The Board may require a licensee to submit to examination or evaluation when a physical or mental condition may impair safe practice.

The Board adopts CDC and OSHA-referenced infection control standards by regulation; compliance with standard precautions is mandatory for all patient contact.

Hand hygiene is performed before and after glove use, and gloves are changed between patients and whenever torn or contaminated.

Critical items such as scalers and curettes must be cleaned and sterilized by heat; single-use items are never reprocessed.

Sterilization monitoring requires mechanical indicators, chemical indicators on each load, and biological spore testing at the interval set by regulation or policy.

Occupational Safety and Health Administration bloodborne pathogens rules require a written exposure control plan, hepatitis B vaccination offer, and post-exposure evaluation.

Sharps are discarded immediately in closable, puncture-resistant containers located at the point of use; recapping by hand is avoided.

Maryland requires an annual or biennial infection control continuing education component and documentation of training for all clinical staff.

Hepatitis B, tuberculosis, and other communicable disease status may limit practice; the Board may impose restrictions to protect patients.

Informed consent requires disclosure of diagnosis, proposed treatment, alternatives, and material risks, documented in the record before treatment begins.

Patients have the right to refuse treatment, to be informed of the consequences of refusal, and to receive a copy of their records on request.

Abandonment occurs when a provider unilaterally ends the relationship without notice, an opportunity to find care, or transfer of records.

Falsifying a record, treating beyond competence, or practicing while impaired are separate grounds for discipline regardless of patient outcome.

Patient solicitation through deceptive advertising, fee-splitting, or guaranteeing outcomes violates the Act's professional conduct provisions.

Confidentiality extends to all patient information, and disclosure is permitted only with authorization, for treatment or payment, or when required by law.

A hygienist who observes conduct raising a serious risk to patients has a professional obligation to report it to the Board.

Dual relationships and conflicts of interest must be disclosed and avoided where they could impair clinical judgment.

The delegating dentist retains responsibility for the patient and for ensuring the delegatee is licensed and competent for the assigned task.

Delegation is limited to tasks enumerated by statute or regulation for that license type; a dentist cannot delegate by agreement what the Act reserves.

The hygienist must refer findings outside hygiene scope, such as suspected pathology or need for restorative care, to the supervising dentist promptly.

When a patient presents with a condition requiring urgent medical attention, the hygienist arranges referral and documents the advice given.

A hygienist practicing under general supervision must have a written or documented collaborative arrangement with the authorizing dentist.

In public health or institutional settings, the collaborating dentist or medical director must be identified and reachable under the applicable regulation.

Records of delegated procedures must identify the performing provider and the supervising dentist, not only the practice.

A hygienist may not supervise another hygienist or assistant unless a specific regulation authorizes that role.

Each entry should include date, provider identity, procedure performed, teeth or sites involved, anesthesia used, and patient response.

Records must be legible, contemporaneous, and permanent; corrections are made by dated addendum, never by obliterating the original entry.

Periodontal charting, radiographs, and informed consent forms are part of the dental record and are retained for the period required by law.

Maryland law sets a minimum retention period for patient records; records of minors are retained longer, and the Board may require retention on closure of a practice.

Records must be released to the patient or the patient's authorized representative within the timeframe set by law, and a reasonable copying fee may be charged.

HIV-related and other specially protected information is subject to stricter disclosure rules under Maryland confidentiality statutes.

Electronic records require access controls, audit trails, and backup sufficient to prevent loss; the same confidentiality standard applies as for paper.

Altering a record after notice of a complaint is a separate violation and is often treated more severely than the underlying error.

A complaint is screened by Board staff, and if it alleges a violation within jurisdiction, an investigation and possible charge letter follow.

Licensees receive notice of charges and an opportunity for a hearing; hearings are contested cases under the Maryland Administrative Procedure Act.

The Board may impose an emergency suspension before hearing when continued practice poses an imminent danger to the public.

Available sanctions include reprimand, probation with conditions, suspension, revocation, civil fines, and required remedial education or monitoring.

Grounds for discipline include unprofessional conduct, practicing beyond scope, fraud in licensure, impairment, and failure to comply with continuing education.

A final disciplinary action is reported to the National Practitioner Data Bank and appears on the Board's public license verification.

Appeals go to the circuit court on the administrative record, and the Board's factual findings are upheld if supported by substantial evidence.

Practicing during a suspension or after revocation is a criminal offense as well as a licensing violation.

The Maryland Dental Practice Act is codified in Health-General Article, Title 4, Subtitles 1 through 3, and is administered by the State Board of Dental Examiners within the Maryland Department of Health.

The Board consists of dentist members, dental hygienist members, and consumer members appointed by the Governor; a dental hygienist seat exists specifically to represent hygiene practice.

Statutory authority is split: the General Assembly sets scope and penalties in statute, while the Board adopts regulations in COMAR Title 10, Subtitle 44 to implement it.

"Practice of dental hygiene" is defined in statute and includes removal of calcareous deposits and stains, topical fluoride application, and other procedures authorized by the Board.

"Supervision" is defined by regulation in graded tiers (direct, general, and collaborative or unsupervised settings), and each procedure is assigned a required tier.

The Board may adopt emergency regulations and issue declaratory rulings; a declaratory ruling binds the Board as to the requesting party on the facts presented.

Violations of the Act are charged under specific statutory sections; the Board's authority includes reprimand, probation, suspension, revocation, and civil fines.

The Act requires dentists and hygienists to report certain adverse events and to cooperate with Board investigations; failure to respond to a Board inquiry is itself a ground for discipline.

Under general supervision the dentist has authorized the procedure and diagnosed the patient, but need not be physically present in the office when the hygienist performs it.

Under direct supervision the dentist must be physically present in the office suite and evaluate the patient's condition before and after the procedure.

Procedures typically requiring direct supervision include administration of local anesthesia and nitrous oxide-oxygen sedation, which require additional certification and current competency.

Local anesthesia administration by a hygienist requires a Board-approved course, current basic life support certification, and compliance with the Board's anesthesia regulations.

Hygienists may perform scaling and root planing, polishing, fluoride and sealant application, radiographs, and periodontal data collection within the scope defined by statute and regulation.

A hygienist may not diagnose, prescribe, cut hard or soft tissue requiring a licensed dentist, or perform procedures outside the delegated scope even with patient consent.

Public health hygienists may practice in specified settings such as schools and health departments under a reduced supervision arrangement defined in regulation.

Delegation to a dental assistant of a procedure reserved to the hygienist is not permitted; task assignment follows the license held by each provider.

Licensure requires graduation from an accredited dental hygiene program, successful completion of a Board-approved clinical and written examination, and a criminal history records check.

Licenses renew on a fixed cycle set by the Board, and renewal requires attestation of continuing education completion plus payment of the renewal fee.

Continuing education must include Board-mandated topic hours, which have included infection control and, at times, opioid or pain management content; verify current hour counts on the Board site.

Failing to renew before expiration places the license in a lapsed status, and practicing on a lapsed license is unlicensed practice subject to discipline.

Reinstatement after lapse generally requires payment of late fees, evidence of continuing education for the missed cycle, and possibly additional Board review.

A license is not transferable, and a hygienist may practice only under the name and license number on record with the Board.

Out-of-state applicants may qualify by credentials or licensure reciprocity where the Board determines the other jurisdiction's standards are substantially equivalent.

The Board may require a licensee to submit to examination or evaluation when a physical or mental condition may impair safe practice.

The Board adopts CDC and OSHA-referenced infection control standards by regulation; compliance with standard precautions is mandatory for all patient contact.

Hand hygiene is performed before and after glove use, and gloves are changed between patients and whenever torn or contaminated.

Critical items such as scalers and curettes must be cleaned and sterilized by heat; single-use items are never reprocessed.

Sterilization monitoring requires mechanical indicators, chemical indicators on each load, and biological spore testing at the interval set by regulation or policy.

Occupational Safety and Health Administration bloodborne pathogens rules require a written exposure control plan, hepatitis B vaccination offer, and post-exposure evaluation.

Sharps are discarded immediately in closable, puncture-resistant containers located at the point of use; recapping by hand is avoided.

Maryland requires an annual or biennial infection control continuing education component and documentation of training for all clinical staff.

Hepatitis B, tuberculosis, and other communicable disease status may limit practice; the Board may impose restrictions to protect patients.

Informed consent requires disclosure of diagnosis, proposed treatment, alternatives, and material risks, documented in the record before treatment begins.

Patients have the right to refuse treatment, to be informed of the consequences of refusal, and to receive a copy of their records on request.

Abandonment occurs when a provider unilaterally ends the relationship without notice, an opportunity to find care, or transfer of records.

Falsifying a record, treating beyond competence, or practicing while impaired are separate grounds for discipline regardless of patient outcome.

Patient solicitation through deceptive advertising, fee-splitting, or guaranteeing outcomes violates the Act's professional conduct provisions.

Confidentiality extends to all patient information, and disclosure is permitted only with authorization, for treatment or payment, or when required by law.

A hygienist who observes conduct raising a serious risk to patients has a professional obligation to report it to the Board.

Dual relationships and conflicts of interest must be disclosed and avoided where they could impair clinical judgment.

The delegating dentist retains responsibility for the patient and for ensuring the delegatee is licensed and competent for the assigned task.

Delegation is limited to tasks enumerated by statute or regulation for that license type; a dentist cannot delegate by agreement what the Act reserves.

The hygienist must refer findings outside hygiene scope, such as suspected pathology or need for restorative care, to the supervising dentist promptly.

When a patient presents with a condition requiring urgent medical attention, the hygienist arranges referral and documents the advice given.

A hygienist practicing under general supervision must have a written or documented collaborative arrangement with the authorizing dentist.

In public health or institutional settings, the collaborating dentist or medical director must be identified and reachable under the applicable regulation.

Records of delegated procedures must identify the performing provider and the supervising dentist, not only the practice.

A hygienist may not supervise another hygienist or assistant unless a specific regulation authorizes that role.

Each entry should include date, provider identity, procedure performed, teeth or sites involved, anesthesia used, and patient response.

Records must be legible, contemporaneous, and permanent; corrections are made by dated addendum, never by obliterating the original entry.

Periodontal charting, radiographs, and informed consent forms are part of the dental record and are retained for the period required by law.

Maryland law sets a minimum retention period for patient records; records of minors are retained longer, and the Board may require retention on closure of a practice.

Records must be released to the patient or the patient's authorized representative within the timeframe set by law, and a reasonable copying fee may be charged.

HIV-related and other specially protected information is subject to stricter disclosure rules under Maryland confidentiality statutes.

Electronic records require access controls, audit trails, and backup sufficient to prevent loss; the same confidentiality standard applies as for paper.

Altering a record after notice of a complaint is a separate violation and is often treated more severely than the underlying error.

A complaint is screened by Board staff, and if it alleges a violation within jurisdiction, an investigation and possible charge letter follow.

Licensees receive notice of charges and an opportunity for a hearing; hearings are contested cases under the Maryland Administrative Procedure Act.

The Board may impose an emergency suspension before hearing when continued practice poses an imminent danger to the public.

Available sanctions include reprimand, probation with conditions, suspension, revocation, civil fines, and required remedial education or monitoring.

Grounds for discipline include unprofessional conduct, practicing beyond scope, fraud in licensure, impairment, and failure to comply with continuing education.

A final disciplinary action is reported to the National Practitioner Data Bank and appears on the Board's public license verification.

Appeals go to the circuit court on the administrative record, and the Board's factual findings are upheld if supported by substantial evidence.

Practicing during a suspension or after revocation is a criminal offense as well as a licensing violation.