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)(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)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)6.6. For a charitable institution open to the general public or to members of a religious sect or order. 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 NoteNOTE: 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 NoteNOTE: 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)3.3. Subgingival sustained release chemotherapeutic agents specified by the examining board by rule. 447.06(3)(a)1.1. “Collaborative management agreement” means an agreement under par. (d). 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)4.4. Oral health instruction and disease prevention education, including nutritional counseling and dietary analysis. 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)11.11. Fabrication of athletic mouth guards and soft occlusal guards. 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)(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. 447.06(3)(c)1.1. Except as provided in subd. 2., a dental therapist licensed under this chapter may provide dental therapy services in this state only under the direct supervision or indirect supervision of a qualifying dentist with whom the dental therapist has entered into a collaborative management agreement. 447.06(3)(c)2.a.a. Once a dental therapist licensed under this chapter has provided dental therapy services for at least 2,000 hours under direct supervision or indirect supervision, the dental therapist may provide dental therapy services in this state under the general supervision of a qualifying dentist with whom the dental therapist has entered into a collaborative management agreement. 447.06(3)(c)2.b.b. For purposes of the 2,000 hours requirement under subd. 2. a., hours may include hours of providing dental therapy services in this state under direct supervision or indirect supervision of a qualifying dentist as described in subd. 1. or hours of providing dental therapy services under direct supervision or indirect supervision while licensed as a dental therapist outside this state, but may not include any hours completed prior to graduating from the dental therapy education program. 447.06(3)(c)3.3. Notwithstanding subds. 1. and 2., the level of supervision for a dental therapist may be further limited under the terms of a collaborative management agreement under par. (d) 1. b. 447.06(3)(c)4.4. A supervising dentist shall accept responsibility for all services performed by a dental therapist pursuant to a collaborative management agreement. If services needed by a patient are beyond the dental therapist’s scope of practice or authorization under the collaborative management agreement, the dental therapist shall, to the extent required under the collaborative management agreement, consult with the supervising dentist as needed to arrange for those services to be provided by a dentist or another qualified health care provider. 447.06(3)(d)1.1. Prior to providing any dental therapy services, a dental therapist shall enter into a written collaborative management agreement with a qualifying dentist who will serve as a supervising dentist under par. (c). The agreement must be signed by the dental therapist and the qualifying dentist and address all of the following: 447.06(3)(d)1.a.a. The practice settings where services may be provided and the patient populations that may be served. 447.06(3)(d)1.b.b. Consistent with and subject to pars. (bm) and (c), any conditions or limitations on the services that may be provided by the dental therapist, the level of supervision required, and any circumstances requiring consultation prior to performing services. 447.06(3)(d)1.f.f. A quality assurance plan for monitoring care provided by the dental therapist. 447.06(3)(d)1.h.h. Criteria or protocols relating to the provision of care to patients with specific medical conditions, treatments, or medications. 447.06(3)(d)1.i.i. Policies relating to supervision of dental hygienists and other staff. 447.06(3)(d)1.j.j. A plan for the referral of patients to other dental or health care providers or clinics when services needed are beyond the scope of practice or authorization of the dental therapist.
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Chs. 440-480, Regulation and Licensing
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