2020 Colorado Revised Statutes
Title 12 - Professions And Occupations
Article 220. Dentists and Dental Hygienists
Section 12-220-502. Construction of dental devices by unlicensed technician.

(1) (a) A licensed dentist who uses the services of an unlicensed technician for the purpose of constructing, altering, repairing, or duplicating any denture, bridge, splint, or orthodontic or prosthetic appliance shall furnish the unlicensed technician with a written or electronic laboratory work order in a form approved by the board, which form shall be dated and signed by the dentist for each separate and individual piece of work. The dentist shall make the laboratory work order in a reproducible form, and the dentist and the unlicensed technician shall each retain a copy in a permanent file for two years. The permanent files of the licensed dentist and the unlicensed technician must be open to inspection at any reasonable time by the board or its duly constituted agent. The licensed dentist that furnishes the laboratory work order must have appropriate training, education, and experience related to the prescribed treatment and is responsible for directly supervising all intraoral treatment rendered to the patient.

(b) An unlicensed technician that possesses a valid laboratory work order may provide extraoral construction, manufacture, fabrication, supply, or repair of identified dental and orthodontic devices but shall not provide intraoral service in a human mouth except under the direct supervision of a licensed dentist in accordance with section 12-220-501 (3)(d).

2. If the dentist fails to keep permanent records of laboratory work orders as required insubsection (1)(a) of this section, the dentist is subject to disciplinary action as deemed appropriate by the board.

3. If an unlicensed technician fails to have in the technician's possession a laboratorywork order signed by a licensed dentist with each denture, bridge, splint, or orthodontic or prosthetic appliance in the technician's possession, the absence of the laboratory work order is prima facie evidence of a violation of this section and constitutes the practice of dentistry without an active license in violation of, and subject to the penalties specified in, section 12-220211.

Source: L. 2020: Entire article amended with relocations, (HB 20-1056), ch. 64, p. 255, § 1, effective September 14.

Editor's note: This section is similar to former § 12-220-139 as it existed prior to 2020. 12-220-503. What constitutes practicing unsupervised dental hygiene - rules. (1) Unless licensed to practice dentistry, a person is deemed to be practicing unsupervised dental hygiene when the person, within the scope of the person's education, training, and experience:

1. Removes deposits, accretions, and stains by scaling with hand, ultrasonic, or otherdevices from all surfaces of the tooth and smooths and polishes natural and restored tooth surfaces, including root planing;

2. Removes granulation and degenerated tissue from the gingival wall of a periodontalpocket;

3. Provides preventive measures including the application of fluorides, sealants, andother recognized topical agents for the prevention of oral disease;

4. Gathers and assembles information including, but not limited to:

1. Fact-finding and patient history;

2. Preparation of study casts for the purpose of fabricating a permanent record of thepatient's present condition; as a visual aid for patient education, dental hygiene diagnosis, and dental hygiene treatment planning; and to provide assistance during forensic examination;

3. Extra- and intra-oral inspection;

4. Dental and periodontal charting; and

5. Radiographic and X-ray survey for the purpose of assessing and diagnosing dentalhygiene-related conditions for treatment planning for dental hygiene services as described in this section and identifying dental abnormalities for immediate referral to a dentist;

5. Administers a topical anesthetic to a patient in the course of providing dental care;

6. Performs dental hygiene assessment, dental hygiene diagnosis, and dental hygienetreatment planning for dental hygiene services as described in this section and identifies dental abnormalities for immediate referral to a dentist; or

7. (I) Prescribes, administers, and dispenses fluoride, fluoride varnish, antimicrobial solutions for mouth rinsing, other nonsystemic antimicrobial agents, and related emergency drugs and reversal agents in collaboration with a licensed dentist. The board, by rule, may further define the permissible and appropriate emergency drugs and reversal agents. Dental hygienists shall maintain clear documentation in the patient record of the drug or agent prescribed, administered, or dispensed; the date of the action; and the rationale for prescribing, administering, or dispensing the drug or agent.

(II) A dental hygienist shall not prescribe, administer, or dispense the following:

1. Drugs whose primary effect is systemic, with the exception of fluoride supplementspermitted under subsection (1)(g)(III)(A) of this section; and

2. Dangerous drugs or controlled substances, as defined in section 18-18-102 (5).

(III) A dental hygienist may prescribe the following:

1. Fluoride supplements as follows, all using sodium fluoride: Tablets: 0.5 mg, 1.1 mg,or 2.2 mg; lozenges: 2.21 mg; and drops: 1.1 mL;

2. Topical anti-caries treatments as follows, all using sodium fluoride unless otherwiseindicated: Toothpastes: 1.1 % or less (or stannous fluoride 0.4%); topical gels: 1.1% or less (or stannous fluoride 0.4%); oral rinses: 0.05%, 0.2%, 0.44%, or 0.5%; oral rinse concentrate used in periodontal disease: 0.63% stannous fluoride; fluoride varnish: 5%; and prophy pastes containing approximately 1.23% sodium fluoride and used for polishing procedures as part of professional dental prophylaxis treatment;

3. Topical anti-infectives as follows: Chlorhexidine gluconate rinses: 0.12%; chlorhexidine gluconate periodontal chips for subgingival insertion into a periodontal pocket/sulcus; tetracycline impregnated fibers, inserted subgingivally into a periodontal pocket/sulcus; doxycycline hyclate periodontal gel, inserted subgingivally into a periodontal pocket/sulcus; and minocycline hydrochloride periodontal powder, inserted subgingivally into a periodontal pocket/sulcus; and

4. Related emergency drugs and reversal agents as authorized by the collaborating dentist.

2. A dental hygienist shall state in writing and require a patient to acknowledge bysignature that any diagnosis or assessment is for the purpose of determining necessary dental hygiene services only and that it is recommended by the American Dental Association, or any successor organizations, that a thorough dental examination be performed by a dentist twice each year.

3. Unsupervised dental hygiene may be performed by licensed dental hygienists withoutthe supervision of a licensed dentist.

4. (a) Notwithstanding section 12-220-104 (13) or 12-220-305 (1)(b), a dental hygienist may be the proprietor of a place where supervised or unsupervised dental hygiene is performed and may purchase, own, or lease equipment necessary to perform supervised or unsupervised dental hygiene.

(b) A dental hygienist proprietor, or a professional corporation or professional limited liability corporation of dental hygienists, in addition to providing dental hygiene services, may enter into an agreement with one or more dentists for the lease or rental of equipment or office space in the same physical location as the dental hygiene practice, but only if the determination of necessary dental services provided by the dentist and professional responsibility for those services, including but not limited to dental records, appropriate medication, and patient payment, remain with the treating dentist. It is the responsibility of the dental hygienist to inform the patient as to whether there is a supervisory relationship between the dentist and the dental hygienist. An agreement under this subsection (4)(b) does not constitute employment and does not constitute cause for discipline pursuant to section 12-220-201 (1)(h).

Source: L. 2020: Entire article amended with relocations, (HB 20-1056), ch. 64, p. 255, § 1, effective September 14.

Editor's note: This section is similar to former § 12-220-122 as it existed prior to 2020.