Chapter 447

447.058(2)(b) (b) A mobile dentistry program registrant shall submit an application for renewal, and the applicable renewal fee determined by the department under s. 440.03 (9) (a), to the department on a form provided by the department on or before the applicable renewal date specified under s. 440.08 (2) (a).

447.058 History History: 2013 a. 244.

447.058 Cross-reference Cross-reference: See also ch. DE 10, Wis. adm. code.

447.059 447.059 Administering certain vaccines.

447.059(1) (1) A dentist may administer without a prescription order a vaccine against SARS-CoV-2 coronavirus or influenza only if he or she satisfies all of the following:

447.059(1)(a) (a) The dentist successfully completes 8 hours in a course of study and training approved by the examining board in vaccination storage, protocols, administration technique, emergency procedures, and record keeping.

447.059(1)(b) (b) The dentist has in effect liability insurance that covers the dentist against loss, expense, and liability resulting from errors, omissions, or neglect in the administration of vaccines against SARS-CoV-2 coronavirus and influenza in an amount that is not less than $1,000,000 for each occurrence and $2,000,000 for all occurrences in any one policy year.

447.059(1)(c) (c) The dentist maintains proof of completing a course of study and training specified in par. (a) and satisfying the requirement specified in par. (b).

447.059(2) (2) A dentist may not administer a vaccine under sub. (1) to a child who is under the age of 6 unless all of the following apply:

447.059(2)(a) (a) The vaccine is administered pursuant to a prescription order issued within the 29 days immediately preceding the day on which the vaccine is administered.

447.059(2)(b) (b) The dentist successfully completes a course of instruction approved by the examining board that includes the administration of vaccines against SARS-CoV-2 coronavirus and influenza to children under the age of 6.

447.059(2)(c) (c) The dentist maintains proof of completing a course of instruction specified in par. (b).

447.059(3) (3) Upon request, a dentist shall provide copies of proof required under subs. (1) (c) and (2) (c) to the department or the examining board.

447.059(4) (4) A dentist who administers a vaccine under sub. (1) shall update the Wisconsin Immunization Registry established by the department of health services within 7 days of administering the vaccine.

447.059 History History: 2021 a. 8.

447.06 447.06 Practice limitations.

447.06(1) (1) No contract of employment entered into between a dentist or dental therapist and any other party under which the dentist or dental therapist renders dental services may require the dentist or dental therapist to act in a manner that violates the professional standards for dentistry or dental therapy set forth in this subchapter. Nothing in this subsection limits the ability of the other party to control the operation of the dental practice in a manner in accordance with the professional standards for dentistry or dental therapy set forth in this subchapter.

447.06 Note NOTE: Sub. (1) is shown as amended by 2023 Wis. Acts 87 and 88 and as merged by the legislative reference bureau under s. 13.92 (2) (i).

447.06(1g) (1g) No contract of employment entered into between a dentist and any other party under which the dentist is employed to practice dentistry may require a dentist to meet a minimum quota for the number of patients seen or the number of procedures performed.

447.06(1m) (1m) No contract of employment entered into between a dental therapist and any other party under which the dental therapist is employed to practice dental therapy may require a dental therapist to meet a minimum quota for the number of patients seen or the number of procedures performed.

447.06(1r) (1r) No contract of employment entered into between a dental hygienist and any other party under which the dental hygienist is employed to practice dental hygiene may require a dental hygienist to meet a minimum quota for the number of patients seen or the number of procedures performed.

447.06(2) (2) 

447.06(2)(a) (a) A hygienist may practice dental hygiene or perform remediable procedures only as an employee or as an independent contractor and only as follows:

447.06(2)(a)1. 1. In a dental office.

447.06(2)(a)2. 2. For a school board, a governing body of a private school, as defined in s. 115.001 (3d), or a governing body of a tribal school, as defined in s. 115.001 (15m).

447.06(2)(a)3. 3. For a school for the education of dentists, dental therapists, or dental hygienists.

447.06(2)(a)4. 4. For a state or federal prison, county jail or other federal, state, county or municipal correctional or detention facility, or a facility established to provide care for terminally ill patients.

447.06(2)(a)5. 5. For a local health department, as defined in s. 250.01 (4).

447.06(2)(a)6. 6. For a charitable institution open to the general public or to members of a religious sect or order.

447.06(2)(a)7. 7. For a nonprofit home health care agency.

447.06(2)(a)8. 8. For a nonprofit dental care program serving primarily indigent, economically disadvantaged or migrant worker populations.

447.06(2)(a)9. 9. At a facility, as defined in s. 50.01 (1m), an adult family home certified under s. 50.032 or licensed under s. 50.033, an adult day care center, as defined in s. 49.45 (47) (a), a community rehabilitation program, a hospital, as defined in s. 50.33 (2), or a facility that is primarily operated to provide outpatient medical services.

447.06(2)(b) (b) A dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1. only as authorized by a dentist or dental therapist [or dental therapy] who is present in the facility in which those practices or procedures are performed, except as provided in par. (c).

447.06 Note NOTE: Par. (b) is shown as amended by 2023 Wis. Acts 87 and 88 and as merged by the legislative reference bureau under s. 13.92 (2) (i). The language in brackets was inserted by 2023 Wis. Act 87 but rendered without effect by the treatment by 2023 Wis. Act 88. Corrective legislation is pending.

447.06(2)(c) (c) A dental hygienist may practice dental hygiene or perform remediable procedures under par. (a) 1. if a dentist or dental therapist [or dental therapy] is not present in the facility in which those practices or procedures are performed only if all of the following conditions are met:

447.06 Note NOTE: Par. (c) (intro.) is shown as amended by 2023 Wis. Acts 87 and 88 and as merged by the legislative reference bureau under s. 13.92 (2) (i). The language in brackets was inserted by 2023 Wis. Act 87 but rendered without effect by the treatment by 2023 Wis. Act 88. Corrective legislation is pending.

447.06(2)(c)1. 1. The dental hygiene practices or remediable procedures are performed under a written or oral prescription.

447.06(2)(c)2. 2. The dentist or dental therapist who made the written or oral prescription has examined the patient at least once during the 12-month period immediately preceding:

447.06(2)(c)2.a. a. The date on which the written or oral prescription was made; and

447.06(2)(c)2.b. b. The date on which the dental hygiene practices or remediable procedures are performed.

447.06(2)(c)3. 3. The written or oral prescription specifies the practices and procedures that the dental hygienist may perform with the informed consent of the patient or, if applicable, the patient’s parent or legal guardian.

447.06(2)(d) (d) A dental hygienist may not diagnose a dental disease or ailment, determine any treatment or any regimen of any treatment outside of the scope of dental hygiene, prescribe or order medication or perform any procedure that involves the intentional cutting of soft or hard tissue of the mouth by any means.

447.06(2)(e) (e) Pursuant to a treatment plan approved by a dentist, a dental hygienist may administer the following upon delegation by the dentist if the dentist remains on the premises in which the practices are performed and is available to the patient throughout the completion of the appointment:

447.06(2)(e)1. 1. Oral systemic premedications specified by the examining board by rule.

447.06(2)(e)2. 2. If the dental hygienist is certified under s. 447.04 (2) (c) 1., local anesthesia.

447.06(2)(e)3. 3. Subgingival sustained release chemotherapeutic agents specified by the examining board by rule.

447.06(2)(e)4. 4. If the dental hygienist is certified under s. 447.04 (2) (d) 1., nitrous oxide inhalation analgesia.

447.06(3) (3) 

447.06(3)(a) (a) In this subsection:

447.06(3)(a)1. 1. “Collaborative management agreement” means an agreement under par. (d).

447.06(3)(a)2. 2. “Dental health shortage area” has the meaning given in s. 36.60 (1) (ad).

447.06(3)(a)3. 3. “Direct supervision” means that the dentist is present in the dental office or other practice setting, personally diagnoses the condition to be treated, personally authorizes each procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel.

447.06(3)(a)4. 4. “General supervision” means that the dentist is not present in the dental office or other practice setting or on the premises at the time tasks or procedures are being performed by the dental therapist, but that the tasks or procedures performed by the dental therapist are being performed with the prior knowledge and consent of the dentist.

447.06(3)(a)5. 5. “Indirect supervision” means that the dentist is present in the dental office or other practice setting, authorizes each procedure, and remains in the office while the procedures are being performed by the allied dental personnel.

447.06(3)(a)6. 6. “Medical Assistance patient” means a patient who is a recipient of services under the Medical Assistance program under subch. IV of ch. 49.

447.06(3)(a)7. 7. “Qualifying dentist” means a dentist who is licensed in this state, who is actively practicing in this state, and who satisfies the requirement under par. (dr).

447.06(3)(a)8. 8. “Uninsured patient” means a patient who lacks dental health coverage, either through a public health care program or private insurance, and has an annual gross family income equal to or less than 200 percent of the federal poverty guidelines.

447.06(3)(b) (b) The scope of practice of a dental therapist shall, subject to the terms of a collaborative management agreement, be limited to providing the following services, treatments, and procedures:

447.06(3)(b)1. 1. Oral evaluation and assessment of dental disease and formulation of an individualized treatment plan.

447.06(3)(b)2. 2. Identification of oral and systemic conditions requiring evaluation or treatment by dentists, physicians, or other health care providers and managing referrals.

447.06(3)(b)3. 3. Comprehensive charting of the oral cavity.

447.06(3)(b)4. 4. Oral health instruction and disease prevention education, including nutritional counseling and dietary analysis.

447.06(3)(b)5. 5. Exposure and evaluation of radiographic images.

447.06(3)(b)6. 6. Dental prophylaxis, including subgingival scaling and polishing procedures.

447.06(3)(b)7. 7. Dispensing and administration via the oral or topical route of nonnarcotic analgesic, anti-inflammatory, and antibiotic medications as prescribed by a licensed health care provider.

447.06(3)(b)8. 8. Application of topical preventive or prophylactic agents, including fluoride varnish, antimicrobial agents, caries arresting medicaments, and pit and fissure sealants.

447.06(3)(b)9. 9. Pulp vitality testing.

447.06(3)(b)10. 10. Application of desensitizing medications or resins.

447.06(3)(b)11. 11. Fabrication of athletic mouth guards and soft occlusal guards.

447.06(3)(b)12. 12. Changing of periodontal dressings.

447.06(3)(b)13. 13. Administration of local anesthetic and nitrous oxide.

447.06(3)(b)14. 14. Simple extraction of erupted primary teeth.

447.06(3)(b)15. 15. Nonsurgical extraction of periodontally diseased permanent teeth with tooth mobility of +3 to +4 to the extent authorized in the dental therapist’s collaborative management agreement, except for the extraction of a tooth that is unerupted, impacted, or fractured or that needs to be sectioned for removal.

447.06(3)(b)16. 16. Emergency palliative treatment of dental pain limited to the procedures in this paragraph.

447.06(3)(b)17. 17. Preparation and placement of direct restoration in primary and permanent teeth.

447.06(3)(b)18. 18. Fabrication and placement of single-tooth temporary crowns.

447.06(3)(b)19. 19. Preparation and placement of preformed crowns on primary teeth.

447.06(3)(b)20. 20. Indirect and direct pulp capping on permanent teeth.

447.06(3)(b)21. 21. Indirect pulp capping on primary teeth.

447.06(3)(b)22. 22. Intraoral suture placement and removal.

447.06(3)(b)23. 23. Minor adjustment and repair of removable prostheses.

447.06(3)(b)24. 24. Placement and removal of space maintainers.

447.06(3)(b)25. 25. Pulpotomy on primary teeth.

447.06(3)(b)26. 26. Tooth reimplantation and stabilization.

447.06(3)(b)27. 27. Recementing of a permanent crown.

447.06(3)(b)28. 28. Any additional services, treatments, or procedures specified in the rules promulgated under s. 447.02 (1) (g).

447.06(3)(bm) (bm)

447.06(3)(bm)1. 1. Notwithstanding par. (b) 1. to 28., a dental therapist shall, except as provided in subd. 2., limit his or her practice of dental therapy to providing the services, treatments, and procedures covered by his or her dental therapy education program.

447.06(3)(bm)2. 2. If any service, treatment, or procedure under par. (b) 1. to 28. was not covered by a dental therapist’s dental therapy education program, the dental therapist may provide that service, treatment, or procedure if the dental therapist has subsequently received additional dental therapy educational training to provide that service, treatment, or procedure.