MO Dental Jurisprudence cheat sheet

The Dental Practice Act is statutory law (Chapter 332, RSMo); the Missouri Dental Board adopts implementing rules in 20 CSR 2110 - a rule cannot exceed or contradict the statute.

Board composition and authority: the Dental Board licenses, investigates complaints, and recommends discipline; final disciplinary orders are issued through the Administrative Hearing Commission process.

Statutory definitions control: 'dentistry' includes diagnosis, treatment planning, surgery, and correction of dental disease, and unlicensed practice is a misdemeanor-level violation.

The Act sets the grounds for discipline (fraud in licensure, incompetence, unprofessional conduct, substance abuse impairment, conviction of certain crimes); Board rules define procedural detail.

Practice without a valid license or while suspended is prohibited; each patient contact can constitute a separate violation for penalty purposes.

The Act authorizes the Board to inspect and require records; patient dental records must be retained per Board rule and produced on request.

Advertising and fee statements are regulated: no false, deceptive, or misleading claims, and no guarantee of results.

The Act and rules apply to all settings - private office, corporate/DSO employment, institutional, and mobile/portable dentistry.

Licensure pathways: graduate of a CODA-accredited dental program plus successful completion of clinical and written board examinations (or accepted regional/ADEX-equivalent pathway per Board rule).

License renewal is biennial; failure to renew by the deadline places the license in lapsed status, and practicing on a lapsed license is unlicensed practice.

Renewal requires the CE attestation, the renewal fee, and disclosure of any required reporting items; late renewal may require a late fee and/or reinstatement steps.

A license may be reinstated after lapse by application, fee payment, and demonstration of continuing competence (including CE for the lapsed period).

Faculty, postgraduate, and volunteer licenses are limited licenses tied to a specific institution or setting; they do not authorize general private practice.

Anesthesia and sedation permits are separate credentials with their own training, inspection, and renewal requirements beyond the base license.

License status is public; employers and patients can verify standing through the state licensing lookup, and licensees must report address/name changes.

Practicing in Missouri generally requires a Missouri license; interstate telehealth or temporary practice is only permitted where a specific statutory exception applies.

CE is required for each biennial renewal cycle; the Board sets the minimum total hours and the required distribution among subject categories in rule.

CE credit is granted only for Board-acceptable providers/formats - documented attendance at recognized courses, not self-study without provider documentation.

Mandatory topic allocations typically include infection control and ethics/professional responsibility; verify current hour counts in 20 CSR 2110 before renewal.

Records: retain certificates of completion for the cycle; the Board may audit and require proof, and unverifiable hours are disallowed.

CE hours earned in excess of the cycle requirement generally do not carry forward unless the rule expressly permits it.

A CE deficiency at audit can result in disciplinary action; the licensee bears the burden of proving completion.

First-time renewal and reinstatement after lapse may carry specific CE conditions - check the Board's renewal instructions for the current cycle.

CE taken for another state's requirement counts only if it meets Missouri's content and provider criteria.

Diagnosis, treatment planning, and prescribing are reserved to the licensed dentist; delegable acts are defined by Board rule, not by office custom.

Supervision levels: direct supervision means the dentist is physically present and examines the patient before and after the delegated procedure; general supervision means the dentist authorized the procedure but need not be present.

Dental hygienists may perform prophylaxis, scaling, and related services under the supervision level specified in rule; some services require prior dentist examination.

Dental assistants may perform reversible, delegated tasks (e.g., radiographs, impressions, certain restorative functions) only with the training and supervision the rule requires.

Expanded-function/restorative duties for assistants require specific formal training and certification recognized by the Board.

Local anesthesia and nitrous oxide administration by hygienists or assistants require separate permits and specific supervision conditions.

The dentist remains legally responsible for all delegated acts and for ensuring the auxiliary's credential is current.

Prescribing controlled substances requires a valid DEA registration and compliance with Missouri prescription monitoring (dispensing report) requirements.

Grounds for discipline include incompetence, negligence, fraud/deceit in practice, practicing beyond scope, impairment, and failure to cooperate with a Board investigation.

Patient abandonment: a dentist may not terminate care without notice and a reasonable opportunity to arrange transfer; record retention obligations continue.

Informed consent is required before treatment; the record should document the discussion of risks, alternatives, and the patient's agreement.

Confidentiality: patient information may not be disclosed without authorization except as required or permitted by law (e.g., mandatory reporting, court order).

Mandatory reporting obligations apply to certain conduct - including impairment or abuse - and retaliation against a reporter is prohibited.

Disciplinary sanctions range from reprimand and probation to suspension, revocation, and civil penalties; the Board may impose conditions such as CE, monitoring, or practice restrictions.

Failure to maintain minimum standards of infection control is both a public health violation and a ground for discipline.

Billing fraud (services not rendered, upcoding) is unprofessional conduct and is independently reportable to enforcement authorities.