The Maryland Dentist and the Sealant Assistant
Dr. Nguyen has practiced general dentistry for 12 years in Maryland and holds an active Maryland license. She is moving to Philadelphia and has accepted an associate position starting Monday. She has submitted an application for Pennsylvania licensure by credentials, but the State Board of Dentistry has not acted. The practice owner tells her, "You can work for 60 days on your Maryland license; Pennsylvania has reciprocity." Meanwhile, Marco, a dental assistant with eight years of on-the-job experience, has been placing sealants and taking periapical radiographs. He completed a weekend online sealant course but no formal radiology course, and he is not a certified expanded function dental assistant (EFDA). The owner says the office is busy and "nobody checks that stuff." Dr. Nguyen is scheduled to see 14 patients on Monday and to supervise Marco's sealant appointments.
1. Can Dr. Nguyen begin practicing on Monday under her Maryland license? What licensure pathway applies?
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No. Pennsylvania does not grant automatic reciprocity based on another state's license. Licensure by credentials requires the Board to review education, examinations, licensure history, and practice experience and to vote approval; until that occurs, Dr. Nguyen is not licensed in Pennsylvania. Practicing on a Maryland license would be unlicensed practice of dentistry, and the owner would be aiding it. Pennsylvania has limited license categories, such as certain faculty or intern situations, but a general 60-day practice authorization is not one of them. Dr. Nguyen may not see patients, sign charts, or hold herself out as a Pennsylvania dentist. She should wait for the Board's decision and verify the license on the Board's website. The practice should also confirm that any supervised personnel hold the required Pennsylvania credentials.
2. May Marco place sealants and take radiographs under Pennsylvania law?
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Marco may not place sealants merely because he took a weekend online course. In Pennsylvania, sealant placement is an expanded function reserved to a dentist, a licensed dental hygienist, or a certified expanded function dental assistant (EFDA) who has completed required training. A weekend online course does not create EFDA certification. For radiographs, a dental assistant may expose radiographs only after completing a Board-approved radiology course and while under direct supervision; Marco lacks that course. He may perform only duties permitted to an unlicensed dental assistant, such as chairside assistance, suctioning, infection control, and sterilization. The owner's statement that "nobody checks" is not a legal defense; the Board can inspect and investigate.
3. What should the owner do before Monday, and what are the consequences of proceeding?
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The owner should not schedule Dr. Nguyen until she is licensed and should restrict Marco's duties to those permitted for an unlicensed assistant. Proceeding risks civil penalties, cease-and-desist orders, discipline for aiding unlicensed practice, and malpractice exposure. The office should verify credentials through the Board, document training, and obtain a written supervision policy. Dr. Nguyen should not "shadow" in a way that involves clinical decision-making or patient treatment before licensure. If the practice needs coverage, it should hire a Pennsylvania-licensed dentist or reschedule patients. The Board may also discipline the owner if the owner is a licensee; a non-dentist owner may be referred for unlicensed practice.