# Title 43 — Occupations and Professions

## Chapter 43-20 — Dental Hygienists and Assistants

### § 43-20-01. Name of chapter.

Repealed by S.L. 2009, ch. 369, § 31.
### § 43-20-01.1. Definitions.

As used in this chapter and chapter 43-28, unless the context otherwise requires:
1. "Dental anesthesia assistant" means an individual authorized to perform anesthesia-
related duties under the supervision of a dentist established by rule and does not
include individuals issued a permit by the board for the application of local anesthetic,
such as block or infiltration anesthesia.
2. "Dental assistant" means an individual who provides dental assistance under the
supervision of a dentist and within the scope of practice established by rule and
section 43-20-13.
3. "Dental hygienist" means an individual licensed to practice dental hygiene.
4. "Qualified dental assistant" means an individual registered as a qualified dental
assistant to provide dental assistance as established by rule.
5. "Qualified dental assistant limited radiology registrant" means an individual registered
with the board as a qualified dental assistant limited radiology registrant who may
carry out dental assisting duties, including taking radiographs, under the supervision of
a dentist as established by rule.
6. "Registered dental assistant" means an individual registered as a registered dental
assistant to provide dental assistance as established by rule.
### § 43-20-01.2. Dental hygienist licensing.

1. An individual seeking a license, registration, permit, credential, or endorsement related
to the practice of dental hygiene in this state shall apply to the executive director of the
board on forms prescribed by the board.
2. The application must:
a. Be verified under oath that all statements contained in the application are true to
the applicant's own knowledge;
b. Contain a recent autographed picture of the applicant; and
c. Include the application fee established by the board.
3. The board may, by rule, create or modify fees associated with any license, registration,
permit, credential, or endorsement. A fee created or modified under this section is not
a new fee for purposes of subsection 7 of section 54-35-27.
4. The board may grant a license to practice dental hygiene to an applicant who has met
the following requirements:
a. The applicant is a graduate of a dental hygiene school accredited by the
American dental association's commission on dental accreditation.
b. The applicant has passed an examination administered by the joint commission
on national dental examinations.
c. The applicant has passed a clinical competency examination administered by a
regional dental testing service or a licensing jurisdiction approved by the board by
rule.
d. The applicant has passed, within one year of making application, a written
examination on the laws and rules governing the practice of dentistry in this state.
e. Grounds for denial of the application under section 43-20-05 do not exist.
f. The applicant has met any requirement for licensure established by the board by
rule.

### § 43-20-01.3. Licensure by credential review.

Applications for licensure to practice dental hygiene by credential review must be made on
forms provided by the board. The board may issue a license and certificate of registration to
practice dental hygiene to an applicant who meets all of the following requirements:
1. The applicant, for at least three years immediately preceding application, has been
licensed in good standing and has been actively practicing dental hygiene in another
jurisdiction where the requirements are at least substantially equivalent to those of this
state.
2. Grounds for denial of the application under section 43-20-05 do not exist.
3. The applicant has paid to the board the fee established by the board by rule.
4. The applicant has delivered to the board a certificate from the examining or licensing
board of every jurisdiction in which the individual is licensed to practice, certifying that
the individual is a licensed and registered dental hygienist in good standing in that
jurisdiction.
5. The applicant has passed a written examination on the laws and rules governing the
practice of dentistry in this state administered by the board at a meeting.
6. The applicant has met any requirement for licensure established by the board by rule.
### § 43-20-01.4. License renewal - Audit.

1. Dental hygienist licenses expire on December thirty-first of every odd-numbered year.
2. Licenses may be renewed by December thirty-first of the odd-numbered year by
submitting a renewal application, a renewal fee established by the board by rule, and
proof of completion of the continuing education requirements established by the board
by rule, provided grounds for denial under section 43-20-05 do not exist as determined
by the board.
3. If the renewal application, renewal fee, and proof of completion of continuing education
are not received by December thirty-first of the odd-numbered year, the license expires
and the individual may not practice dental hygiene.
4. Within sixty days after December thirty-first of the odd-numbered year, an expired
license may be renewed if the individual submits the renewal application, renewal fee,
proof of completion of continuing education, and a late fee established by the board by
rule.
5. Between sixty-one days and one year after December thirty-first of the odd-numbered
year, an expired license may be renewed if the individual submits a renewal
application, pays the renewal fee, pays an amount equal to twice the late renewal fee,
and submits other documentation sought by the board confirming the individual retains
the skills necessary to practice.
6. If the renewal application, renewal fee, proof of completion of continuing education,
and late fee are not received within one year after December thirty-first of the
odd-numbered year, the license may not be renewed, and the individual must apply for
and meet the requirements for licensure to be granted a license.
7. The board may extend the renewal deadlines for an individual providing proof of
medical or other hardship rendering the individual unable to meet the deadline.
8. The board may audit continuing education credits. Each licensee shall maintain
certificates or records of continuing education activities for three years. Upon receiving
notice of an audit from the board, a licensee shall provide satisfactory documentation
of attendance at, or participation in, the continuing education activities listed on the
licensee's continuing education form. Failure to comply with the audit is grounds for
nonrenewal of or disciplinary action against the license.
### § 43-20-01.5. Volunteer license.

The board may establish rules governing the issuance of a volunteer license to
practice dental hygiene to an individual previously licensed in this state or an individual
who holds a license, in good standing, to practice dental hygiene issued by another
state.

### § 43-20-02. Dental hygienists - Qualifications - Examinations - Registration and license.

Repealed by S.L. 2009, ch. 369, § 31.
### § 43-20-02.1. Conviction not bar to licensure - Exceptions.

Conviction of an offense does not disqualify a person from licensure under this chapter
unless the board determines that the offense has a direct bearing upon a person's ability to
serve the public as a dental hygienist, or that, following conviction of any offense, the person is
not sufficiently rehabilitated under section 12.1-33-02.1.
### § 43-20-03. Dental hygienists - Practice by.

1. As used in this chapter, "dental hygiene" and the practice thereof means the removal
of accumulated matter from the natural and restored surfaces of teeth and from
restorations in the human mouth, the polishing of such surfaces, and the topical
application of drugs to the surface tissues of the mouth and to the surface of teeth if
performed under the supervision of a licensed dentist as established by the board by
rule.
2. Only a person licensed as a dental hygienist may be referred to as a dental hygienist.
3. The board may outline by rule additional tasks permitted to be performed by licensed
dental hygienists.
### § 43-20-04. License recorded - Fee.

Repealed by S.L. 1991, ch. 465, § 23.
### § 43-20-05. Licenses and registrations - Denial and discipline.

1. The board may deny an application for or take disciplinary action against a dental
hygienist's license or a registered or qualified dental assistant's registration, upon any
one or more of the following grounds:
a. Gross immorality or unprofessional conduct, which includes knowingly failing to
comply with commonly accepted national infection control guidelines and
standards.
b. Failure, neglect, or refusal to renew a license biennially.
c. Nonobservance or violation of this chapter, or of any board rule adopted under
this chapter.
d. Gross incompetency in the practice of dental hygiene.
e. Conviction of an offense determined by the board to have a direct bearing on the
individual's ability to serve the public as a dental hygienist or a registered or
qualified dental assistant, or the board determines, following conviction for any
offense, that the individual is not sufficiently rehabilitated under section
12.1-33-02.1.
f. Been adjudged mentally ill and not judicially restored by the regularly constituted
authorities, or having a physical or mental disability materially affecting the ability
to carry out the duties within the scope of practice in a competent manner.
g. The use of alcohol or drugs to such a degree as to interfere with the licensee's
ability to safely perform the duties within the scope of practice for dental hygiene
or dental assisting.
h. Engaged in fraud or deceit in obtaining a dental hygiene license or dental
assisting registration.
i. Disclosed confidential information.
j. Received a fee for the referral of patients to a dentist or dental hygienist.
k. Used unethical measures to draw dental patronage from the practice of another
licensee.
l. Fraudulently prescribed or dispensed drugs or medications.
m. Knowingly submitted misleading, deceptive, untrue, or fraudulent information on a
claim form, bill, or statement to a third party.

n. Advised or directed patients to dental laboratories or dental laboratory technicians
for a dental service or advised or directed patients to deal directly with
laboratories or dental laboratory technicians.
o. Violated the code of ethics adopted by the board by rule.
p. Had a registration or license suspended, revoked, or disciplined in another
jurisdiction.
q. Failed to report to the board in writing within sixty days a violation of this chapter
or chapter 43-28.
r. Practiced outside the scope of practice established by the board by rules and this
chapter.
s. Failed to fully and completely cooperate in any investigation initiated by the
board, including the failure to promptly provide any information legally sought by
the board, its investigative panel, its investigators, or its authorized agents.
t. Noncompliance with the terms of a program contracted for under section
43-28-06.
2. The procedure for taking disciplinary action under this section must be the same as
required by section 43-28-18.2.
### § 43-20-06. Inactive status.

Upon payment of a fee determined by the board, a dental hygienist may request to have the
dental hygienist's license placed on inactive status. While on inactive status, the dental hygienist
may not engage in the practice of dental hygiene in the state until the dental hygienist submits a
renewal application, pays the renewal fee, and meets any additional requirements established
by rule.
### § 43-20-07. Licensure by credential review.

Repealed by S.L. 2009, ch. 369, § 31.
### § 43-20-08. Unlawful to practice without license or registration.

A person may not practice dental hygiene or practice as a registered or qualified dental
assistant in the state, without first obtaining from the board a license or registration. A person
may not practice as a dental assistant outside the scope of practice established by the board by
rule and section 43-20-13.
### § 43-20-09. Violation a misdemeanor.

A person violating section 43-20-08 is guilty of a class B misdemeanor.
### § 43-20-10. State board of dental examiners - Authority - Duty.

The board has the power and it is its duty to enforce the provisions of this chapter. The
board has the power to make such rules and regulations, not inconsistent with this chapter, as
may, in its judgment, be necessary for the proper enforcement of this chapter, and the
examination of dental hygienists and registered and qualified dental assistants for their conduct
and practice. For purposes of this chapter, the board has the powers set forth in section
43-28-06.
### § 43-20-11. Practice of dental hygiene supplemental to practice of dentistry.

The practice of dental hygiene is hereby declared to be supplemental and auxiliary to the
practice of dentistry in North Dakota. All particulars, requirements, regulations, control, and
provisions of chapter 43-28 apply with equal force wherein and so far as they may be applicable
to the practice of dental hygienists, except as otherwise provided for in this chapter.
### § 43-20-12. Dental hygienist - Scope of permitted practice.

A licensed dentist may delegate to a competent dental hygienist those procedures over
which the dentist exercises full responsibility, except those procedures that require professional

judgment and skill in diagnosis, treatment planning, or the cutting of hard or soft tissue. The
board of dental examiners may adopt rules governing the scope of practice of dental hygienists.
### § 43-20-12.1. Continuing educational requirement for dental hygienists.

Repealed by S.L. 2009, ch. 369, § 31.
### § 43-20-12.2. Notice to board of change of address.

A licensed dental hygienist, registered dental assistant, or qualified dental assistant shall
notify the executive director of the board of dental examiners of any new address within thirty
days of the address change. The notice required under this section must be given by certified
mail, return receipt requested. A licensed dental hygienist, registered dental assistant, or
qualified dental assistant may not practice in this state for more than thirty days after the change
of address without complying with this section.
### § 43-20-12.3. Supervised administration of local anesthetic - Board rules.

A licensed dentist may delegate to a dental hygienist licensed by the board the
administration of block and infiltration anesthesia to a patient. The dental hygienist administering
local anesthetic under this section must be under the supervision of a dentist, as established by
rule, and the dental hygienist must complete the educational requirements as required by the
commission on dental accreditation and approved by the board. The board shall adopt rules to
implement this section.
### § 43-20-13. Dental assistant - Scope of permitted practice.

A dental assistant is an auxiliary to the practice of dentistry. To the extent applicable and to
the extent they are not inconsistent with this chapter, the requirements and rules adopted by the
board of dental examiners under chapter 43-28 apply to the practice of dental assistants. A
dentist may delegate to a dental assistant who is under that dentist's supervision procedures
over which the dentist exercises full responsibility as provided by rules adopted by the board.
### § 43-20-13.1. Registration renewal - Continuing education audit.

1. All dental assistant registrations, including any permits, credentials, or endorsements
issued by the board, expire on December thirty-first of every even-numbered year.
2. A registration may be renewed by submitting a renewal application, renewal fee
established by the board by rule, and proof of completion of the continuing education
requirements established by the board by rule, provided the registration is not revoked
or grounds for denial under section 43-20-05 do not exist.
3. If the renewal application, renewal fee, and proof of completion of continuing education
are not received by December thirty-first of the even-numbered year, the registration
expires and the individual may not practice as a registered or qualified dental
assistant.
4. Within sixty days after December thirty-first of the even-numbered year, an expired
registration may be renewed by submitting the renewal application, renewal fee, proof
of completion of continuing education, and a late fee established by the board by rule.
5. Between sixty-one days and one year after December thirty-first of the odd-numbered
year, an expired license may be renewed if the individual submits a renewal
application, pays the renewal fee, pays an amount equal to twice the late renewal fee,
and submits other documentation sought by the board confirming the individual retains
the skills necessary to practice.
6. If the renewal application, renewal fee, proof of completion of continuing education,
and late fee are not received within one year after December thirty-first of the
even-numbered year, the registration may not be renewed, and the individual must
apply for and meet the requirements for registration to be granted registration.
7. The board may extend the renewal deadline for an individual providing proof of
medical or other hardship rendering the individual unable to meet the deadline.

8. The board may audit continuing education credits. Each dental assistant who is
required to be registered with the board shall maintain certificates or records of
continuing education activities for three years. Upon receiving notice of an audit from
the board, a dental assistant shall provide satisfactory documentation of attendance at,
or participation in, the continuing education activities listed on the dental assistant's
continuing education form. Failure to comply with the audit is grounds for nonrenewal
or disciplinary action against the dental assistant.
### § 43-20-13.2. Registration of dental assistants.

To be registered as a registered dental assistant, qualified dental assistant, dental
anesthesia assistant, qualified dental assistant limited radiology registrant, or for any individual
to be issued a permit, credential, or endorsement by the board related to dental assisting, an
individual shall apply and meet the requirements established by the board by rule.
