MD Dental Jurisprudence cheat sheet

The Maryland Dental Practice Act is codified in the Health Occupations Article, Title 4 (Dentistry), and is administered by the State Board of Dental Examiners within the Maryland Department of Health.

A licensed dentist may diagnose, treat, operate, or prescribe for any disease, pain, injury, deformity, or physical condition of the human oral cavity and adjacent structures; delegation of these acts is limited to licensed or certified personnel.

Dental hygienists in Maryland may practice under general supervision in specified settings (for example, schools, nursing homes, and health department clinics) and under direct supervision in a private dental office; local anesthesia and nitrous oxide administration require additional Board-recognized education and certification.

Dental assistants may perform expanded functions (such as coronal polishing, fluoride application, and radiographs) only after completing Board-approved education and holding the appropriate certification; intraoral procedures not authorized remain dentist-only acts.

Only a licensed dentist may prescribe drugs, order and interpret radiographs for diagnosis, perform surgical procedures on hard or soft tissue, and take final impressions for prostheses where the dentist designs the restoration.

A dentist must personally examine the patient before delegating treatment; the supervising dentist retains responsibility for all care delivered by auxiliaries and must be physically present when direct supervision is required.

Maryland requires a written collaborative or supervisory relationship for hygienists practicing in certain public health settings; the agreement must define the referral pathway for conditions outside the hygienist's scope.

Practicing outside the scope of the license, or aiding an unlicensed person to practice dentistry, is a ground for discipline regardless of patient consent or outcome.

A Maryland dental license requires graduation from a dental school accredited by the Commission on Dental Accreditation, successful completion of the Board-approved clinical examination, and passage of the National Board Dental Examination.

Applicants must submit fingerprints and pass a state and national criminal history background check; prior disciplinary actions in other jurisdictions must be disclosed on the application.

Dental licenses and hygienist licenses renew biennially; renewal requires completion of continuing education, including Board-mandated hours in specific topics such as infection control and opioid prescribing.

Continuing education credit must come from Board-recognized providers; excess credits from one cycle generally cannot be carried forward, and credits are reported under audit rather than submitted with renewal.

A lapsed license may be reinstated within a defined grace period by paying renewal and late fees; after that period, reinstatement may require additional CE or re-examination.

Inactive or retired status may be available on request; a licensee in inactive status may not practice dentistry in Maryland until restored to active status.

A licensee must notify the Board of a change of name or address within the timeframe set by regulation, and must report certain arrests, convictions, or disciplinary actions in other states.

Practicing on a lapsed or inactive license constitutes unlicensed practice and is subject to civil penalties and referral for criminal prosecution.

The standard of care is that degree of care and skill ordinarily exercised by competent dentists in the same or similar community under similar circumstances; expert testimony is generally required to establish breach.

Informed consent requires disclosure of the diagnosis, nature and purpose of the proposed treatment, material risks and benefits, reasonable alternatives including no treatment, and the likely consequences of declining.

Consent must be obtained by the treating dentist, documented in the record, and may be withdrawn by the patient at any time; consent obtained by an auxiliary is insufficient for invasive procedures.

A patient record must include a medical and dental history, clinical findings, radiographs, diagnosis, treatment plan, progress notes, informed consent documentation, and medication and laboratory records.

Records must be legible, dated, authenticated by the treating provider, and retained for the period required by Maryland law and Board regulation; retention obligations continue after a practice closes.

Corrections to a record must be made by dated addendum; altering or destroying entries after a complaint or litigation is a separate ground for discipline and may be evidence of spoliation.

Patients have a right to access and obtain copies of their records under Maryland law; a reasonable copying fee may be charged, and records must not be withheld to compel payment of an unrelated balance.

Prescribing controlled substances requires a documented evaluation, a treatment plan, and use of the state prescription drug monitoring program as required by Maryland law.

Maryland dentists must comply with CDC infection prevention guidance and OSHA bloodborne pathogens standards, including exposure control plans, hepatitis B vaccination offers, and post-exposure evaluation.

Hand hygiene with soap and water or an alcohol-based rub is required before and after patient contact and after glove removal; gloves are not a substitute for hand hygiene.

Critical and semicritical instruments must be cleaned and sterilized by heat (steam autoclave, dry heat, or unsaturated chemical vapor); monitoring includes mechanical, chemical, and biological indicators.

Biological spore testing of each sterilizer must be performed at the interval required by regulation (at least weekly) and results retained; a positive result requires quarantine of loads and sterilizer repair and retesting.

Single-use items, including needles and anesthetic cartridges, must not be reused; sharps must be placed in puncture-resistant containers located at the point of use.

High-level disinfection is required for semicritical items that cannot tolerate heat; environmental surfaces are cleaned and then disinfected with an EPA-registered hospital disinfectant.

Waterlines and dental unit water must meet the CDC recommended limit for heterotrophic bacteria; boil-water advisories require cessation of routine care and use of bottled or sterile water.

Patient safety obligations include maintaining emergency equipment and drugs, training staff in Basic Life Support, and reporting adverse events as required by Maryland law.

Grounds for discipline include fraud in obtaining a license, unprofessional conduct, gross negligence, incompetence, practicing while impaired, and violating the Dental Practice Act or Board regulations.

The Board may impose sanctions ranging from a reprimand and probation to suspension, revocation, civil penalties, and conditions on practice; it may also require remedial education or monitoring.

Maryland operates an impaired professional program; a licensee may self-refer for substance use or mental health treatment, and participation may affect the disciplinary outcome but does not automatically bar sanction.

Disciplinary proceedings require notice of charges and an opportunity for a hearing; the licensee may be represented by counsel, present evidence, cross-examine witnesses, and subpoena records.

The Board's final decisions are subject to judicial review under the Maryland Administrative Procedure Act; a licensee must generally exhaust administrative remedies before seeking court review.

Mandatory reporting obligations apply to licensees and to health care facilities that know of conduct constituting grounds for discipline; failure to report is itself a violation.

The Board publishes disciplinary actions and reports certain actions to national data banks; a Maryland action may trigger reciprocal action in other jurisdictions where the licensee is licensed.

Continuing to practice after a suspension or while a revocation is on appeal, absent a stay, is unlicensed practice and may result in additional sanctions and criminal referral.