North Carolina § 90-29 - Necessity for license; dentistry defined; exemptions.

§ 90-29. Necessity for license; dentistry defined; exemptions.

No person shall engage in the practice of dentistry in this State, or offer or attempt to do so, unless such person is the holder of a valid license or certificate of renewal of license duly issued by the North Carolina State Board of Dental Examiners. A person shall be deemed to be practicing dentistry in this State who does, undertakes or attempts to do, or claims the ability to do any one or more of the following acts or things which, for the purposes of this Article, constitute the practice of dentistry: Diagnoses, treats, operates, or prescribes for any disease, disorder, pain, deformity, injury, deficiency, defect, or other physical condition of the human teeth, gums, alveolar process, jaws, maxilla, mandible, or adjacent tissues or structures of the oral cavity; Removes stains, accretions or deposits from the human teeth; Extracts a human tooth or teeth; Performs any phase of any operation relative or incident to the replacement or restoration of all or a part of a human tooth or teeth with any artificial substance, material or device; Corrects the malposition or malformation of the human teeth; Administers an anesthetic of any kind in the treatment of dental or oral diseases or physical conditions, or in preparation for or incident to any operation within the oral cavity; provided, however, that this subsection shall not apply to a lawfully qualified nurse anesthetist who administers such anesthetic under the supervision and direction of a licensed dentist or physician, or to a registered dental hygienist qualified to administer local anesthetics. Expired pursuant to Session Laws 1991, c. 678, s. 2. Takes or makes an impression of the human teeth, gums or jaws; Makes, builds, constructs, furnishes, processes, reproduces, repairs, adjusts, supplies or professionally places in the human mouth any prosthetic denture, bridge, appliance, corrective device, or other structure designed or constructed as a substitute for a natural human tooth or teeth or as an aid in the treatment of the malposition or malformation of a tooth or teeth, except to the extent the same may lawfully be performed in accordance with the provisions of G.S. 90-29.1 and 90-29.2; Uses a Roentgen or X-ray machine or device for dental treatment or diagnostic purposes, or gives interpretations or readings of dental Roentgenograms or X rays; Performs or engages in any of the clinical practices included in the curricula of recognized dental schools or colleges; Owns, manages, supervises, controls or conducts, either himself, by and through another person or other persons, or by use of any electronic or other digital means, any enterprise wherein any one or more of the acts or practices set forth in subdivisions (1) through (10) above are done, attempted to be done, or represented to be done. Uses, in connection with his name, any title or designation, such as "dentist," "dental surgeon," "doctor of dental surgery," "D.D.S.," "D.M.D.," or any other letters, words or descriptive matter which, in any manner, represents him as being a dentist able or qualified to do or perform any one or more of the acts or practices set forth in subdivisions (1) through (10) above; Represents to the public, by any advertisement or announcement, by or through any media, the ability or qualification to do or perform any of the acts or practices set forth in subdivisions (1) through (10) above. The administration by dentists of diagnostic tests and antibody tests for coronavirus disease 2019 to patients only if such tests have been approved or authorized for emergency use by the United States Food and Drug Administration. The following acts, practices, or operations, however, shall not constitute the unlawful practice of dentistry: Any act by a duly licensed physician or surgeon performed in the practice of his profession; The practice of dentistry, in the discharge of their official duties, by dentists in any branch of the Armed Forces of the United States or in the full-time employ of any agency of the United States; The teaching or practice of dentistry, in dental schools or colleges operated and conducted in this State and approved by the North Carolina State Board of Dental Examiners, by any person or persons licensed to practice dentistry anywhere in the United States or in any country, territory or other recognized jurisdiction until December 31, 2002. On or after January 1, 2003, all dentists previously practicing under G.S. 90-29(c)(3) shall be granted an instructor's license upon application to the Board and payment of the required fee. The practice of dentistry in dental schools or colleges in this State approved by the North Carolina State Board of Dental Examiners by students enrolled in such schools or colleges as candidates for a doctoral degree in dentistry when such practice is performed as a part of their course of instruction and is under direct supervision of a dentist who is either duly licensed in North Carolina or qualified under subdivision (3) above as a teacher; additionally, the practice of dentistry by such students at State or county institutions with resident populations, hospitals, State or county health departments, area health education centers, nonprofit health care facilities serving low-income populations and approved by the State Health Director or his designee and approved by the Board of Dental Examiners, and State or county-owned nursing homes; subject to review and approval or disapproval by the said Board of Dental Examiners when in the opinion of the dean of such dental school or college or his designee, the students' dental education and experience are adequate therefor, and such practice is a part of the course of instruction of such students, is performed under the direct supervision of a duly licensed dentist acting as a teacher or instructor, and is without remuneration except for expenses and subsistence all as defined and permitted by the rules and regulations of said Board of Dental Examiners. Should the Board disapprove a specific program, the Board shall within 90 days inform the dean of its actions. Nothing herein shall be construed to permit the teaching of, delegation to or performance by any dental hygienist, dental assistant, or other auxiliary relative to any program of extramural rotation, of any function not heretofore permitted by the Dental Practice Act, the Dental Hygiene Act or by the rules and regulations of the Board; The temporary practice of dentistry by licensed dentists of another state or of any territory or country when the same is performed, as clinicians, at meetings of organized dental societies, associations, colleges or similar dental organizations, or when such dentists appear in emergency cases upon the specific call of a dentist duly licensed to practice in this State; The practice of dentistry by a person who is a graduate of a dental school or college approved by the North Carolina State Board of Dental Examiners and who is not licensed to practice dentistry in this State, when such person is the holder of a valid intern permit, or provisional license, issued to him by the North Carolina State Board of Dental Examiners pursuant to the terms and provisions of this Article, and when such practice of dentistry complies with the conditions of said intern permit, or provisional license; Any act or acts performed by a dental hygienist when such act or acts are lawfully performed pursuant to the authority of Article 16 of this Chapter 90 or the rules and regulations of the Board promulgated thereunder; Activity which would otherwise be considered the practice of dental hygiene performed by students enrolled in a school or college approved by the Board in a board-approved dental hygiene program under the direct supervision of a dental hygienist or a dentist duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of subdivision (3) above; Any act or acts performed by an assistant to a dentist licensed to practice in this State when said act or acts are authorized and permitted by and performed in accordance with rules and regulations promulgated by the Board; Dental assisting and related functions as a part of their instructions by students enrolled in a course in dental assisting conducted in this State and approved by the Board, when such functions are performed under the supervision of a dentist acting as a teacher or instructor who is either duly licensed in North Carolina or qualified for the teaching of dentistry pursuant to the provisions of subdivision (3) above; The extraoral construction, manufacture, fabrication or repair of prosthetic dentures, bridges, appliances, corrective devices, or other structures designed or constructed as a substitute for a natural human tooth or teeth or as an aid in the treatment of the malposition or malformation of a tooth or teeth, by a person or entity not licensed to practice dentistry in this State, when the same is done or performed solely upon a written work order in strict compliance with the terms, provisions, conditions and requirements of G.S. 90-29.1 and 90-29.2. The use of a dental x-ray machine in the taking of dental radiographs by a dental hygienist, certified dental assistant, or a dental assistant who can show evidence of satisfactory performance on an equivalency examination, recognized by the Board of Dental Examiners, based on seven hours of instruction in the production and use of dental x rays and an educational program of not less than seven hours in clinical dental radiology. A dental assistant, or dental hygienist who shows evidence of education and training in Nitrous Oxide - Oxygen Inhalant Conscious Sedation within a formal educational program may aid and assist a licensed dentist in the administration of Nitrous Oxide - Oxygen Inhalant Conscious Sedation. Any dental assistant who can show evidence of having completed an educational program recognized by the Board of not less than seven clock hours on Nitrous Oxide - Oxygen Inhalant Conscious Sedation may also aid and assist a licensed dentist in the administration of Nitrous Oxide - Oxygen Inhalant Conscious Sedation. Any dental hygienist or dental assistant who has been employed in a dental office where Nitrous Oxide - Oxygen Inhalant Conscious Sedation was utilized, and who can show evidence of performance and instruction of not less than one year prior to July 1, 1980, qualifies to aid and assist a licensed dentist in the administration of Nitrous Oxide - Oxygen Inhalant Conscious Sedation. The operation of a nonprofit health care facility serving low-income populations and approved by the State Health Director or his designee and approved by the North Carolina State Board of Dental Examiners. History (1935, c. 66, s. 6; 1953, c. 564, s. 3; 1957, c. 592, s. 2; 1961, c. 446, s. 2; 1965, c. 163, ss. 1, 2; 1971, c. 755, s. 2; 1977, c. 368; 1979, 2nd Sess., c. 1195, ss. 10, 15; 1991, c. 658, s. 1; c. 678, ss. 1, 2; 1997-481, ss. 5, 6; 2002-37, s. 8; 2011-183, s. 57; 2020-3, s. 3D.2(a); 2021-95, s. 1(a).) Disapproval of Certain Dental Board Rules - Session Laws 2016-31, s. 1, provides: "Pursuant to G.S. 150B-21.3(b1) , 21 NCAC 16Q .0101 (General Anesthesia and Sedation Definitions), as adopted by the North Carolina Board of Dental Examiners on December 12, 2015, and approved by the Rules Review Commission on March 17, 2016, is disapproved." At its March 17, 2016, meeting, the Rules Review Commission adopted several changes to the Dental Board's rules in 21 NCAC 16O and 16Q, governing nitrous oxide, sedation, and anesthesia. More than 10 objections were filed to the proposed amendments to 21 NCAC 16Q .0101, and that rule is presently subject to legislative review. In light of the pending legislative review, pursuant to G.S. 150B-21.3(b1) , the Dental Board sought to delay the effective date of certain rules until the conclusion of the review. Specifically the Board requested to delay the effective dates of the following rules: 21 NCAC 16Q .0201 (amendment); 21 NCAC 16Q .0202 (amendment); 21 NCAC 16Q .0204 (amendment); 21 NCAC 16Q .0205 (repeal); 21 NCAC 16Q .0206 (adoption); 21 NCAC 16Q .0207 (adoption); 21 NCAC 16Q .0301 (amendment); 21 NCAC 16Q .0302 (amendment); 21 NCAC 16Q .0304 (amendment); 21 NCAC 16Q .0305 (adoption); 21 NCAC 16Q .0306 (adoption); 21 NCAC 16Q .0401 (repeal); 21 NCAC 16Q .0402 (repeal); 21 NCAC 16Q .0404 (adoption); 21 NCAC 16Q .0405 (adoption); 21 NCAC 16Q .0406 (adoption); 21 NCAC 16Q .0407 (adoption); 21 NCAC 16Q .0408 (adoption); 21 NCAC 16Q .0501 (repeal); 21 NCAC 16Q .0601 - .0602 (repeal); and 21 NCAC 16Q .0703 (adoption). Session Laws 2016-31, s. 2, disapproved all of the rules listed in the letter except those listed in Session Laws 2016-31, s. 3, which were 21 NCAC 16Q .0204 (Procedure for General Anesthesia Evaluation or Inspection and Re-inspection), 21 NCAC 16Q .0205 (Results of Site Evaluation and Reevaluation), 21 NCAC 16Q .0306 (Procedure for Moderate Conscious Sedation Evaluation or Inspection and Re-Inspection), 21 NCAC 16Q .0408 (Procedure for Moderate Pediatric Conscious Sedation Evaluation or Inspection and Re-Inspection), 21 NCAC 16Q .0703 (Reports of Adverse Occurrences), 21 NCAC 16Q .0601 (Reports of Adverse Occurrences), and 21 NCAC 16Q .0602 (Failure to Report). Session Laws 2016-31, s. 4, provides: "Notwithstanding G.S. 150B-21.3(b) , the North Carolina Board of Dental Examiners shall not enforce the following rules which became effective April 1, 2016: 21 NCAC 16O .0301 (Nitrous Oxide Sedation); 21 NCAC 16O .0302 (Nitrous Oxide Monitoring); 21 NCAC 16O .0401 (Non-Delegable Functions). The Board shall continue to enforce these rules as they existed prior to the amendments which became effective on April 1, 2016." Editor's Note. - Session Laws 2020-3, s. 3A.1(a), provides: "Unless the context clearly indicates otherwise, the following definitions apply in this Part: "(1) CDC. - The federal Centers for Disease Control and Prevention. "(2) COVID-19. - Coronavirus disease 2019. "(3) COVID-19 diagnostic test. - A test the federal Food and Drug Administration has authorized for emergency use or approved to detect the presence of the severe acute respiratory syndrome coronavirus 2. "(4) COVID-19 emergency. - The period beginning March 10, 2020, and ending on the date the Governor signs an executive order rescinding Executive Order No. 116, Declaration of a State of Emergency to Coordinate Response and Protective Actions to Prevent the Spread of COVID-19. "(5) COVID-19 antibody test. - A serological blood test the federal Food and Drug Administration has authorized for emergency use or approved to measure the amount of antibodies or proteins present in the blood when the body is responding to an infection caused by the severe acute respiratory syndrome coronavirus 2." Session Laws 2020-3, s. 5, is a severability clause. Session Laws 2021-95, s. 6, provides: "The North Carolina State Board of Dental Examiners may adopt temporary rules to implement the provisions of this act." Effect of Amendments. - Session Laws 2011-183, s. 57, effective June 20, 2011, substituted "Armed Forces" for "military service" in subdivision (c)(2). Session Laws 2020-3, s. 3D.2(a), effective May 4, 2020, added subdivision (b)(14). Session Laws 2021-95, s. 1(a), effective July 23, 2021, inserted ", or to a registered dental hygienist qualified to administer local anesthetics” in subdivision (b)(6); and rewrote subdivision (b)(11). Legal Periodicals. - For 1997 legislative survey, see 20 Campbell L. Rev. 469 (1998).