NV Dental Jurisprudence cheat sheet

The Nevada Dental Practice Act is codified in NRS Chapter 631; regulations are in NAC Chapter 631.

The Nevada State Board of Dental Examiners consists of 9 members: 5 licensed dentists, 1 licensed dental hygienist, and 3 public members appointed by the Governor.

Board authority includes licensing, renewal, discipline, rulemaking, and investigating complaints; it does not set fee schedules for dental services.

Dentistry is defined as the diagnosis, treatment, and prevention of oral disease and conditions, including performing operations and prescribing drugs.

Dental hygiene is defined as preventive and therapeutic services under dentist supervision, including scaling, root planing, and applying sealants.

A dental assistant may perform basic supportive procedures under direct supervision; expanded functions require specific training and permits.

The Board may issue licenses to dentists, dental hygienists, and dental assistants; it also issues specialty licenses and sedation permits.

Unlicensed practice of dentistry is a misdemeanor for a first offense and may be enjoined by the Board through court action.

The Board must adopt regulations for infection control, continuing education, and standards of practice; violations can lead to license discipline.

Dental licenses expire on December 31 of odd-numbered years; renewal requires a fee and completion of continuing education.

Dentists must complete 30 hours of CE per renewal cycle, including 2 hours of infection control and 2 hours of ethics.

Dental hygienists must complete 30 hours of CE per renewal cycle, including 2 hours of infection control and 2 hours of ethics.

Dental assistants must complete 12 hours of CE per renewal cycle if they hold a permit; infection control and ethics hours are required.

CE hours must be from Board-approved providers; CPR certification must be current and is separate from CE hours.

Late renewal is allowed within a grace period with a penalty fee; practice after expiration without renewal is unlicensed practice.

Licensure by credentials requires an active license in another state with equivalent requirements and no disciplinary history.

The Board may require a criminal background check and fingerprinting for initial licensure and reinstatement.

Temporary licenses may be issued for dentists enrolled in a residency program or for limited teaching purposes.

Direct supervision means the dentist is physically present in the office and evaluates the patient before and after the procedure.

General supervision means the dentist has authorized the procedure but is not physically present; the dentist must be available for consultation.

Dental hygienists may perform prophylaxis, scaling, root planing, and sealants under general supervision in most settings; some tasks require direct supervision.

A dental hygienist may provide services without supervision in certain public health settings under a collaborative agreement with a dentist.

Dental assistants may perform coronal polishing and fluoride application under direct supervision after completing Board-approved training.

Expanded functions dental assistants may place and carve amalgam and composite restorations under direct supervision with a permit.

Only a licensed dentist may diagnose, prescribe, perform surgery, and administer general anesthesia or conscious sedation.

A dentist must examine the patient and approve the treatment plan before a hygienist provides services beyond a prophylaxis.

Informed consent requires a discussion of diagnosis, proposed treatment, risks, benefits, alternatives, and consequences of no treatment.

Consent must be documented in the patient record and may be verbal or written; written consent is required for surgery and sedation.

Patient records must be kept for at least 7 years after the last treatment or until the patient reaches age 21, whichever is longer.

Records must include patient identification, medical history, clinical findings, treatment rendered, medications, and informed consent documentation.

Patients have the right to access their records and to receive a copy upon request; a reasonable copying fee may be charged.

Records may be released to third parties only with patient authorization or as required by law, such as for insurance claims or court orders.

A dentist may not abandon a patient; termination of the dentist-patient relationship requires written notice and emergency care for 30 days.

HIPAA privacy rules apply in addition to Nevada law; the stricter standard governs when they conflict.

OSHA Bloodborne Pathogens Standard (29 CFR 1910.1030) requires an exposure control plan, training, and hepatitis B vaccination offered free to employees.

Personal protective equipment including gloves, masks, eye protection, and gowns must be provided and used for procedures with blood or saliva exposure.

Hand hygiene must be performed before and after patient contact and after removing gloves; alcohol-based hand rub is acceptable if hands are not visibly soiled.

Sharps must be disposed of in puncture-resistant, labeled containers located as close as feasible to the point of use.

Needles must not be recapped by hand unless a mechanical device or one-handed scoop technique is used.

Sterilization of critical and semicritical instruments requires autoclaving and monitoring with biological indicators at least weekly.

The Nevada Board requires compliance with CDC infection control guidelines and may inspect offices or require corrective action.

Employees with occupational exposure must be offered post-exposure evaluation and follow-up at no cost.

Dentists must be registered with the DEA to prescribe controlled substances and must have a Nevada controlled substance license.

Schedule II prescriptions must be written or electronically transmitted and may not be refilled.

Nevada requires prescribers to query the Prescription Monitoring Program (PMP) before prescribing an opioid for the first time and at least every 90 days thereafter.

Prescribers must report dispensing of controlled substances to the PMP within 24 hours or the next business day.

A dentist may prescribe controlled substances only for dental conditions and within the scope of practice.

Prescriptions must include the patient's name, drug name, strength, quantity, directions, date, and prescriber's DEA number.

Nevada limits opioid prescriptions for acute pain to a 7-day supply for initial prescriptions unless a longer period is documented.

Prescribing to oneself or family members without a legitimate patient relationship is prohibited and may constitute unprofessional conduct.

Unprofessional conduct includes practicing outside the scope of license, gross negligence, and incompetence.

Other grounds include fraud, deceit, misrepresentation, and falsifying patient records or insurance claims.

Practicing while impaired by alcohol or drugs is unprofessional conduct and may result in immediate suspension.

Failure to report another licensee who is impaired or incompetent may itself be a violation.

Sexual misconduct with a patient, or exploitation of the dentist-patient relationship, is grounds for discipline.

Charging for services not rendered or submitting false claims constitutes unprofessional conduct.

A dentist must maintain patient confidentiality except as authorized by law or required for treatment.

Advertising that is false, misleading, or deceptive is prohibited and may lead to disciplinary action.

The Board may investigate complaints upon its own motion or upon a sworn complaint by any person.

Investigations are conducted by the Board's executive director or an authorized investigator; the licensee must respond to subpoenas.

The Board may issue a summary suspension if there is an immediate danger to the public health, safety, or welfare.

Disciplinary actions include revocation, suspension, probation, reprimand, fines, and required remedial education.

A licensee is entitled to notice and a hearing before the Board; the hearing must comply with the Nevada Administrative Procedure Act.

The Board may enter into a settlement agreement or consent order with the licensee at any stage.

The Board may recover investigative costs and attorney fees from a licensee found in violation.

A licensee must report any disciplinary action taken by another state within 30 days.

Advertising must not be false, deceptive, or misleading; it must include the licensee's name and license type.

A dentist may advertise specialty practice only if certified or eligible for specialty licensure by the Board.

Fee splitting with a non-dentist for patient referrals is prohibited unless permitted by law.

Dentists may not pay or receive commissions for referrals of patients for dental services.

A dentist may not practice in a corporation unless it is a professional corporation owned by licensed dentists.

Offering free or discounted services for advertising purposes is permitted if not deceptive and if the terms are clearly disclosed.

A dentist must not guarantee treatment outcomes or use bait-and-switch advertising.

Fee schedules are set by the dentist and are not regulated by the Board; however, billing must be accurate and not fraudulent.