Florida Dental Hygiene Rules and Laws
Regulations governing the practice of dental hygiene are extensive and complex. They not only set forth various requirements for obtaining a license, they also establish specific rules regarding the manner in which dental hygienists may practice their profession.
Like many other states, Florida first enacted statutory provisions requiring licensure of dental hygienists in 1933. In 2004, however, the Florida Legislature radically simplified those licensing laws by amending Chapter 466, Florida Statutes.
Pragmatically, the Florida Department of Health’s Board of Dentistry (Board) has the primary responsibility for interpreting the legislative standards governing the practice of dentistry and dental hygiene, including the examination and licensing of dentists and dental hygienists . Generally speaking, the purpose of the regulatory board is to protect the health, safety and welfare of the public. To achieve this, the Board not only enforces laws and rules, but it also educates practitioners as to their rights and responsibilities and assists practitioners in understanding the laws and rules pertinent to their practice.
Recently, the Florida Legislature has undertaken substantial revisions to the laws governing the practice of dental hygiene. In 2015, it passed House Bill 222, which amended substantially Sections 466.027 and 466.023, Florida Statutes. This law was amended again in 2017 (as part of Senate Bill 464) which recently came into effect on July 1, 2017. As a result, dental hygienists and dentists will need to become familiar with the full set of changes, including both the noteworthy ones and those that are more subtle (i.e., administrative in nature).
Florida Dental Hygienist Licensure Requirements
In order to obtain a dental hygiene license in Florida, you must first satisfy specific academic and educational requirements. For instance, an applicant must satisfy one of the following three requirements:
(a) Have graduated from a full-time or equivalent accredited dental hygiene education program leading to an associate in arts degree or its equivalent which provides both a basic understanding of the biomedical and clinical sciences necessary to protect the public’s health and the technical proficiency required of a practicing dental hygienist. There may be no more than one unsuccessful sitting on the National Board examination.
(b) Have graduated from a full-time or equivalent accredited dental hygiene education program leading to a baccalaureate or master’s degree, or its equivalent, which provides both a broad knowledge in the biomedical and clinical sciences necessary to protect the public’s health and the technical proficiency required of a practicing dental hygienist. There may be no more than one unsuccessful sitting on the National Board examination.
(c) Previously have been licensed as a dental hygienist in another state or territory of the United States, the District of Columbia, or another country, if that person has actively practiced as a licensed dental hygienist in another state for at least the two (2) years immediately preceding the date upon which the application is submitted to the board. There may be no more than one unsuccessful sitting on the National Board examination.
Once the dental hygienist has satisfied the above requirements, he or she must successfully take and pass the National Board examination and the Florida Dental Hygiene Laws and Rules examination. Last, a dental hygienist must also take and pass the dental hygiene clinical practical examination. In order to pass this examination, a dental hygienist must take and pass each section of the examination and obtain a minimum clinical score of 75.
Dental Hygienist’s Scope of Practice
Dental hygienists in Florida must practice in accordance with the laws and administrative rules that govern the practice of dentistry. The laws, known as Florida Statutes Chapter 466, outline the scope of practice for licensed dental hygienists, and the rules, known as Florida Administrative Code Rule 64B5, further detail specific procedures that dental hygienists may or may not perform.
Dental hygienists in Florida must have a dentist supervising them directly or indirectly while they are practicing (aside from the performance of "routine tasks," as defined by the Florida Legislature). In order to supervise the work of a dental hygienist in Florida, the dentist must agree in writing to provide such supervision. At a minimum, the dentist must review the written records of every patient seen by the dental hygienist and must be available at the time the dental hygienist is rendering care to the patient. The Florida Dental Board may deny, revoke or suspend any license to practice dental hygiene of any person who violates any state dental hygiene statute or rule.
The scope of practice for dental hygienists in Florida is very specific. Dental hygienists may perform the following procedures without direct supervision by a dentist: Dental hygienists in Florida may perform the following procedures with the indirect supervision of a dentist: A dentist may ask a hygienist to perform any of the following procedures during expiration of an emergency involving the practice of dentistry but without the prior examination of a patient. The dentist must immediately follow up on his or her examination of the patient. Procedures that may be performed under these circumstances include: The following procedures may also be performed by dental hygienists in Florida with indirect supervision of a dentist, but only if the dentist and patient are both present in the office at the time the procedures are performed: The Florida Legislature has made clear that certain procedures may not be performed by dental hygienists in Florida at all. The prohibited procedures include: Florida law does not allow dental hygienists to order diagnostic, including molecular pathology, or laboratory tests or analysis, except as specifically allowed by the Board of Dentistry.
Dental Hygienist Continuing Education
To keep the public protected, the Board of Dentistry (the "Board") requires that dental hygienists participate in continuing education as a condition of license renewal in Florida. Rule 64B5-6.001(2), Florida Administrative Code ("FAC"), requires each dental hygienist to biennially complete 30 hours of continuing education credits ("CE"), including a 2-hour course on "Prevention of Medical Errors;" a 2-hour course on "Florida Dental Laws and Rules" or "Florida Medical Laws and Rules;" and a 1-hour course on the "Impact of Domestic Violence on Health Care."
All CE courses taken must have been preapproved by the Board or a provider recognized by the Board. To assist dental hygienists in satisfying CE requirements, the Board has listed CE sponsors and courses with pre-approval posted on its website at https://floridasdentistry.gov. The Board Approved Dental Hygiene Providers link will take you to their list of providers who have submitted bona fide continuing education courses, lectures, or seminars to the Board for CE Credit which have been reviewed and approved. The list does not guarantee that the Board sponsors these courses.
The following chart outlines requirements for approved CEs for dental hygienists in Florida:
Common Legal Issues for Dental Hygiene Professionals
As in any medical and dental profession, dental hygienists are not immune from legal issues. Dental hygienists may face claims of negligence, also called malpractice, from their own patients or patients of the dentist.
Dental hygienists may be named in claims against their employer if the allegation involves a vicarious liability theory; however they may also face direct allegations that they have engaged in negligent conduct. Dental hygienists face a variety of potential malpractice lawsuits that can include: Dental hygienists who are sued for malpractice can be defended by their professional liability carrier as long as the claim falls within coverage outlined in the insurance policy. For example, coverage will not exist if the dental hygienist was working as an assist to the dentist or otherwise outside the scope of duties of the dental hygienist as dictated by the policy . Coverage will only be triggered if the allegations against the dental hygienist arise out of the duties of a dental hygienist as outlined in the policy.
The most common types of claims against dental hygienists in Florida arise out of infection control. Infection control is the result of numerous state and federal laws and involves the sterilization and disinfection of dental tools, proper clothing and equipment of dental staff, and proper handling of hazardous materials. The Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have outlined the basic infection control steps, which include: Infection control issues are the most common lawsuit filed against dental hygienists. However, they are also the easiest lawsuit to defend. As a general rule, a hygiene practice should have a detailed infection control policies and procedures manual, provide training to all personnel, and document the training and implementation of all procedures.
Recent Amendments to the Florida Dental Hygiene Statutes and Rules
On July 1, 2017, the Florida Legislature added a new provision into the Florida Statutes that gives dental hygienists the ability to perform alternative duties in contingent situations. Contingent situations are defined as circumstances where specific requirements are met, including that the hygienist does not have a dental assistant, dental assistant or expanded function credentialing and training, and is located in an emergency setting. The law defines the types of duties a dental hygienist can perform as well as the types of settings within which they may be performed. Additionally, the law makes it a bit easier for dental hygienists to work with the public in the setting of educational programs, including those located within schools, universities and health facilities. Specifically, the requirements for supervision have been amended, and now only apply to procedures that require the administration of local anesthesia, nitrous oxide, analgesia, conscious sedation or general anesthesia. The new law makes it clear that it does not authorize the performance of duties that would otherwise violate the scope of practice or laws governing dentists.
Florida Dental Hygienist and Dental Hygiene Professional Resources
There are a number of professional and government organizations, committees, and programs available to help dental hygienists. Professional organizations, such as the Florida Dental Hygienists’ Association, Florida Dental Association, and American Dental Association, have resources on their websites, including articles on scaling and root planing in deep pockets, the minimum level of proficiency, and the standards of care for restorative hygiene. Consider joining a professional organization or association as a pre-qualification for employment . The State of Florida Department of Health has published laws and rules applicable to the practice of dentistry, dental hygiene and dental assisting. See Florida Board of Medicine. The Florida Department of Health also publishes administrative codes for all licensed health professions. See Florida Administrative Code. The Florida Department of Health also has a list of compliance and enforcement legal resources to assist health-care professionals when they are facing suspension, revocation or discipline from the Department of Health, including a list of free or low-cost legal aid assistance.
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