MI Dental Jurisprudence cheat sheet

Michigan's Public Health Code is codified at MCL 333.1101 et seq.; dental practice provisions sit in Article 15 (Part 166, MCL 333.16601–333.16648) and licensing/registration provisions in Article 16 (Part 161).

"Practice of dentistry" (MCL 333.16601) includes diagnosis, treatment, operation, or prescription for any disease, pain, injury, or condition of the human oral cavity and associated structures; it also covers fitting/repairing dental appliances and extracting teeth.

"Practice as a dental hygienist" is defined separately and is limited to services performed under the supervision of a licensed dentist (general supervision unless the Code specifies otherwise).

A person must hold a Michigan license or registration to practice dentistry, dental hygiene, or dental assisting; aiding and abetting unlicensed practice is itself a violation subject to disciplinary action.

The Michigan Board of Dentistry is created under Part 161 and consists of dentist, dental hygienist, and public members appointed by the Governor; the Board proposes rules and recommends discipline to the Department.

Disciplinary grounds (MCL 333.16221) include negligence, incompetence, lack of good moral character, substance abuse, fraud/deception, practicing outside scope, and failure to report required information.

Sanctions available to the Department (MCL 333.16226) range from a reprimand and probation to limitation, suspension, revocation, and fines; the Department may also order restitution and community service.

Mandatory reporting: a licensee who has knowledge that another licensee has committed a violation of the Code or rules must report to the Department (MCL 333.16243); a person who fails to report is subject to discipline.

Continuing-education and recordkeeping requirements are enforced through the Code's general licensing provisions, and violation of a Board rule promulgated under the Code is an independent ground for discipline.

The Michigan Administrative Code dental rules appear in R 338.11001 et seq. (Dentistry General Rules), promulgated by the Board of Dentistry under the Public Health Code's rulemaking authority.

The rules define levels of supervision: "direct" supervision requires the dentist to be physically present in the office; "general" supervision requires prior authorization and availability but not physical presence; "indirect" supervision requires the dentist to be on the premises.

The rules enumerate delegable procedures and the supervision level for each, including expanded functions for registered dental assistants (RDAs) and dental hygienists.

Dental hygienists may perform specific services (e.g., prophylaxis, scaling, fluoride application, sealants) under general supervision and additional services under direct supervision, as set out in the rules.

A registered dental assistant may perform listed expanded functions only after completing Board-approved education and holding RDA status; unregistered assistants are limited to basic supportive functions.

The rules require infection-control compliance consistent with CDC recommendations and Michigan OSHA standards, including sterilization, barrier use, and sharps handling.

Recordkeeping rules require a patient record documenting diagnosis, treatment plan, informed consent, treatment rendered, and prescriptions, retained for the period specified by rule and available for Board or Department inspection.

The rules address advertising and representation of credentials: a licensee may not use a title or designation implying certification or specialty that the licensee does not hold.

A dentist who employs or contracts with unlicensed personnel must ensure those persons do not perform functions reserved to licensees; delegation beyond the rules is a violation.

Dentist licensure requires graduation from a CODA-accredited dental school (or equivalent foreign training plus required supplemental education), passage of the National Board Dental Examination (INBDE), and passage of a Board-approved clinical examination (e.g., ADEX or a regional clinical exam).

Dental hygienist licensure requires graduation from an accredited dental hygiene program, passage of the National Board Dental Hygiene Examination, and a clinical examination; licensure by credentials is available for licensees from other jurisdictions meeting Board criteria.

Dental assistant registration requires completion of a Board-approved education program or equivalent training and passage of an approved examination; a limited license may be issued for specified purposes.

Applications are submitted to the Michigan Department of Licensing and Regulatory Affairs (LARA), Bureau of Professional Licensing; the Department reviews credentials and the Board may review questionable applications.

Criminal history background checks and fingerprinting are required for initial licensure; disqualifying convictions are evaluated under the Code's good-moral-character provisions.

License renewal for dentists and hygienists is on a three-year cycle; a specific number of continuing education hours is required per cycle, including mandated hours in infection control and ethics/pain management as specified by rule.

Continuing education must be from Board-approved providers, and licensees must retain certificates of completion for audit; falsifying CE documentation is a disciplinary offense.

Failure to renew timely results in a lapsed license; practicing on a lapsed license is unlicensed practice and subject to discipline and criminal penalties.

Reciprocity/licensure by credentials typically requires an active unencumbered license, a specified period of practice, and verification of examination scores; the Board may impose additional requirements.

Dentists hold a Michigan controlled-substance license (CSL) issued by LARA in addition to their professional license; a DEA registration is separately required to prescribe or dispense controlled substances.

Schedule II prescriptions must be written or electronically transmitted and are limited to a 90-day supply; refills are not permitted for Schedule II drugs.

Schedule III–V prescriptions may be refilled up to five times within six months of the issue date unless the prescriber specifies otherwise.

Michigan's MAPS (Michigan Automated Prescription System) is the state prescription drug monitoring program; prescribers must query MAPS before prescribing a controlled substance and must report dispensing data as required by MCL 333.7333.

Prescribers must obtain and document a MAPS report when prescribing a controlled substance, particularly opioids, and must review the patient's controlled-substance history before initiating therapy.

Michigan law requires prescribers to provide patients with information about the risks of opioid use and to document informed consent for opioid prescriptions under the state's opioid-prescribing statutes.

Standards of care require a documented dental diagnosis, a treatment plan, informed consent, and appropriate radiographs before invasive treatment; records must be legible, dated, and authenticated.

A dentist may not abandon a patient; termination of the dentist-patient relationship requires written notice, a reasonable opportunity to obtain alternative care, and provision of records on request.

Confidentiality is governed by HIPAA and Michigan's medical records statute; disclosure without patient authorization is permitted only for treatment, payment, operations, or as required by law.

Part 166 defines the scope of dentistry and dental hygiene; functions not within those definitions may not be performed by a licensee, and delegation is limited to what the Code and rules authorize.

The Code authorizes the Department to investigate complaints, issue subpoenas, and conduct administrative hearings; licensees must cooperate with investigations.

A licensee must notify the Department of a change of name or address within the time specified by rule; failure to do so is a licensing violation.

Impairment by alcohol or drugs, or mental/physical inability to practice with reasonable skill and safety, is a disciplinary ground under MCL 333.16221.

The Code permits the Department to summarily suspend a license when the public health, safety, or welfare requires emergency action, subject to a prompt hearing.

A licensee who is the subject of a malpractice payment or hospital disciplinary action may be subject to reporting requirements to the Department.

The rules specify that a dentist must examine the patient and prescribe the treatment plan before delegating any procedure to auxiliary personnel.

The rules require that a dentist or hygienist performing scaling and root planing have the education and training specified; unsupervised periodontal therapy is limited to licensed dentists and qualified hygienists.

The rules prohibit a licensee from practicing under a false or assumed name that misrepresents the nature of the practice, and require the name of the licensed dentist to appear on the practice.

The rules require sterilization monitoring (e.g., spore testing) at intervals specified and documentation of infection-control compliance.

Examination scores are typically valid for a limited period; applicants must apply within the Board-specified window after passing the clinical and national examinations.

The Board may deny licensure for conduct that would be grounds for discipline, even if the conduct occurred before licensure.

Continuing education hours earned in excess of the requirement may not be carried over to the next cycle unless the Board rule expressly permits it.

A licensee who is inactive or retired may hold an inactive status if the Board permits and must meet reactivation requirements including CE before returning to practice.

A dentist may not prescribe controlled substances for self-treatment or for family members except in a documented emergency with a limited quantity.

Electronic prescribing of controlled substances is permitted in Michigan when the system meets DEA requirements; paper prescriptions must include the required elements (patient, drug, quantity, directions, prescriber DEA and CSL numbers).

A dentist must maintain a controlled-substance inventory and dispensing records and must report theft or significant loss to DEA and the state as required.

The standard of care requires referral to a specialist when a condition exceeds the dentist's scope or competence; failure to refer may constitute negligence.

Informed consent must be documented for procedures with material risks and for off-label or experimental treatments; consent obtained under duress is invalid.