CHAPTER Den 100  ORGANIZATIONAL RULES

 

Statutory Authority:  RSA 317-A:12

 

PART Den 101  DEFINITIONS

 

          Den 101.01 “Active license” means a New Hampshire license which has not been suspended, inactivated, revoked, or lapsed.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98

 

          Den 101.02  “Base” means a replacement material for lost dentin tooth structure.

 

https://gencourt.state.nh.us/rules/filing_history/sourceden.html

 

          Den 101.03  “Board” means the New Hampshire board of dental examiners established pursuant to RSA 317-A:2.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98

 

          Den 101.04 “Certification” means the process attesting that an individual has met certain predetermined standards specified by the certifying body.

 

Source.  #7969, eff 10-10-03

 

          Den 101.05  “Certified dental assistant” means a dental assistant who holds current certified dental assistant certification from the Dental Assisting National Board (DANB).

 

Source.  #12427, eff 12-6-17

 

          Den 101.06 “Clinical” means having to do with the direct observation and treatment of patients.

 

Source.  #8224, eff 12-8-04; renumbered by #12427 (formerly Den 101.05)

 

          Den 101.07  “Dental assistant” means any person who assists the dentist in carrying out the clinical duties of a dental office.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; ss by #9777-A, eff 9-3-10; ss by #9956, eff 7-16-11; renumbered by #12427 (formerly Den 101.06)

 

          Den 101.08  “Dental hygienist” means a person holding a current license issued by the board under RSA 317-A:21.

 

Source.  #4298, eff 7-28-87; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.07)

 

          Den 101.09  “Dentist” means a person holding a current license issued by the board under RSA 317-A:7 and RSA 317-A:20.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.08)

 

          Den 101.10  “Diagnosis” means the identification of a disease from its signs and symptoms.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; ss by #7556, eff 9-20-01; renumbered by #12427 (formerly Den 101.09)

 

          Den 101.11  “Direct supervision” means a dentist with an active license is in the dental office, authorizes the procedure and remains in the dental office while the procedures are being performed and evaluates the performance of the dental hygienist or dental assistant before dismissal of the patient.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; ss by #10990, eff 12-9-15; renumbered by #12427 (formerly Den 101.10)

 

          Den 101.12  “General supervision” means a dentist with an active license has authorized the procedures, and the procedures are being carried out in accordance with their diagnosis and treatment plan, and the procedures will be personally evaluated and reviewed by the dentist with the patient at least once in a 12 month period.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.11)

 

          Den 101.13 “Graduate dental assistant” means a dental assistant who has graduated from a Commission on Dental Accreditation (CODA) accredited school of dental assisting.

 

Source.  #12427, eff 12-6-17

 

          Den 101.14  “Indirect supervision” means a dentist with an active license is in the dental office, authorizes the procedures, and remains in the dental office while the procedures are being performed by the dental hygienist or dental assistant and evaluates the performance of the dental hygienist or dental assistant at a subsequent appointment.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.12)

 

          Den 101.15  “Letter of concern” means a written letter from the board drawing the licensee’s attention to specific acts or omissions that could place the licensee at risk of future disciplinary action. A letter of concern is non-disciplinary and is sent to the licensee following a communication of alleged misconduct, complaint, or investigation.

 

Source.  #12427, eff 12-6-17

 

          Den 101.16  “Licensure” means the process by which the board, to protect the public, grants written permission to persons meeting qualifications set forth in these rules to engage in the practice of dentistry or dental hygiene.

 

Source.  #7969, eff 10-10-03; renumbered by #12427 (formerly Den 101.13)

 

          Den 101.17  “Licensure by endorsement certification” means granting a license to practice dentistry or to provide dental hygiene services in New Hampshire based upon compliance with the applicable requirements of Den 300, and holding a current, unsuspended, unrestricted license to practice in another state.

 

Source.  #4298, eff 7-28-87; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; ss by #12427 (from Den 101.14)

 

          Den 101.18  “Licensure by examination” means granting a license to practice dentistry or to provide dental hygiene services in New Hampshire based upon compliance with the applicable requirements of Den 300, and passage of the American Board of Dental Examiners (ADEX) or any similar national or regional testing agency.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; ss by #10688, eff 10-7-14; renumbered by #12427 (formerly Den 101.15)

 

          Den 101.19  “Liner” means a material placed in a tooth for reasons other than to replace tooth structure.

 

Source.  #8099, eff 6-11-04; renumbered by #12427 (formerly Den 101.16)

 

          Den 101.20  “Monitor” means to observe for a special purpose.

 

Source.  #8099, eff 6-11-04; renumbered by #12427 (formerly Den 101.17)

 

          Den 101.21  “Moral turpitude” means baseness, vileness, or dishonesty to a high degree.

 

Source.  #8962, eff 8-16-07; renumbered by #12427 (formerly Den 101.18)

 

          Den 101.22 “Personally evaluated” means that a dentist with an active license performs an oral exam on the patient once in a 12 month period.

 

Source.  #12427, eff 12-6-17

 

          Den 101.23  “President” means president of the board chosen pursuant to RSA 317-A:4.

 

Source.  #287.2 eff 1-17-74; ss by #2981, eff 2-28-85; ss by #4262-a, eff 5-19-87; ss by #5110, eff 4-4-91; amd by #5722, eff 10-15-93; ss by #6908, eff 12-9-98; renumbered by #12427 (formerly 101.19)

 

          Den 101.24  “Public health supervision” means a dentist with an active license authorizes procedures which are to be carried out by a dental hygienist with an active license practicing in a school, hospital or other institution, or for a homebound person without the dentist having to be present provided the dentist reviews the records once in a 12 month period.

 

Source.  #6097, eff 9-29-95; ss by #6908, eff 12-9-98; ss by #10328-A, eff 5-7-13; renumbered by #12427 (formerly Den 101.20)

 

          Den 101.25  "Qualified" means meeting the requirements of Den 302.05.

 

Source.  #6097, eff 9-29-95; ss by #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.21)

 

          Den 101.26  “Registration” means to secure official entry on the roster of persons having a dental or dental hygiene license in New Hampshire.

 

Source.  #7671, eff 4-4-02; ss and moved by #8224, eff 12-8-04 (formerly Den 101.19); renumbered by #12427 (formerly Den 101.22)

 

          Den 101.27  “Supervision” means oversight by a dentist of the performance of duties authorized by the board to dental hygienists and dental assistants.

 

Source. #6908, eff 12-9-98; renumbered by #12427 (formerly Den 101.23)

 

          Den 101.28  “Temporary dental restoration” means a substance placed as an interim restoration to sedate or seal a tooth.

 

Source.  #8099, eff 6-11-04; renumbered by #12427 (formerly Den 101.24)

 

          Den 101.29  “Traditional dental assistant” means a dental assistant who is neither a certified dental assistant nor a graduate dental assistant.

 

Source.  #12427, eff 12-6-17

 

          Den 101.30  “Vice president” means the vice president of the board chosen pursuant to RSA 317-A:4.

 

Source. #8224, eff 12-8-04; renumbered by #12427 (formerly Den 101.25)

 

          Den 101.31  “Volunteer” means an individual who provides dental care without pay or compensation for work or service performed.

 

Source. #8224, eff 12-8-04; renumbered by #12427 (formerly Den 101.26)

 

PART Den 102  DESCRIPTION OF BOARD

 

          Den 102.01  Organization of Board.

 

          (a)  The board of dental examiners consists of 9 members, including 6 dentists, 2 hygienists, and one public member.  One of these serves as president and one as vice-president.  It is the duty of the board to examine, register and license applicants whom they find to be qualified to practice dentistry or dental hygiene in this state.  All board members are required by RSA 317-A:3 to be residents of the state.  The 6 dentist members are licensed to practice dentistry in this state.  The 2 dental hygienist members are licensed to practice dental hygiene in this state.  The board is also responsible for the administration of the practice of dental auxiliaries assisting licensed dentists practicing in the state.

 

          (b)  Members of the board are appointed as their terms expire by the governor, with the advice and consent of the council, for a period of 5 years and a limit of 2 consecutive terms, or until their successors are appointed and qualified.  Members of the board receive a per diem allowance for meetings and hearings. Members are reimbursed for expenses of travel.

 

          (c)  The board meets annually and at such times as its business requires.  A president is chosen at the annual meeting from the membership of the board.  A true record of all their official acts is preserved by the board's executive director.  The public records are open to inspection on the board's website once approved by the board and during office hours in the office of the board of dental examiners, 121 South Fruit Street, Concord. Notice of board meetings is posted in the board's administrative office and on the board’s website, www.nh.gov/dental.

 

          (d)  The board rules govern the conduct and qualifications of dentists, dental hygienists and dental assistants and establish requirements for continuing education as a prerequisite for renewal of licenses of dentists and dental hygienists.  The board is a member of the North East Regional Board of Dental Examiners (NERB), doing business as the Commission on Dental Competency Assessments (CDCA), the American Board of Dental Examiners (ADEX) and the American Association of Dental Boards (AADB).

 

          (e)  The board establishes standing committees and ad hoc committees to facilitate meeting the requirements of RSA 317-A.

 

          (f)  Standing committees shall include:

 

(1)  A malpractice committee which reviews insurance claims and legal judgments for medical injury and refers them to the full board pursuant to RSA 317-A:17 V; and

 

(2)  An anesthesia and sedation evaluation committee to ensure that dentists who have a permit to administer general anesthesia and/or sedation meet the requirements of Den 304.02.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6908, eff 12-9-98; amd by #7671, eff 4-4-02; ss by 9408-A, eff 3-10-09; amd by #9777-A, eff 9-3-10; ss by #10688, eff 10-7-14; ss by #10990, eff 12-9-15

 

          Den 102.02  Financial Interests.  Pursuant to RSA 15-A, board members shall file a statement of financial interest within 14 days of becoming a board member and thereafter annually by the third Friday of January.

 

Source.  #9408-A, eff 3-10-09

 

PART Den 103  ACCESS TO PUBLIC INFORMATION

 

          Den 103.01  Record of Official Actions.  Minutes shall be kept of all board meetings and all official actions taken by the board.  These minutes shall record those members who participate in each vote and shall separately record the position of any members who choose to dissent, abstain or concur.  Board minutes shall

be public records and shall be available for inspection during the board’s ordinary office hours within 144 hours from the date of the meeting or the vote in question.

 

Source.  #6908, eff 12-9-98

 

          Den 103.02  Custodian of Records.  The board’s administrative office staff shall be the custodian of its records and shall respond to requests to examine those portions of the board’s records which are subject to public inspection or which may otherwise be properly examined by the person requesting access.

 

Source.  #6908, eff 12-9-98

 

          Den 103.03  Copies of Records.  Persons desiring copies of board records shall submit a request in writing which identifies as particularly as possible the information being sought and which agrees to pay the board’s current copying fee.  If records are requested which contain both public and confidential information, the board shall delete the confidential information and provide the remaining information.

 

Source.  #6908, eff 12-9-98

 


CHAPTER Den 200  PRACTICE AND PROCEDURE

 

REVISION NOTE:

 

Document #8884-A & #8884-B, effective 5-17-07, made extensive changes to the wording, format, structure, and numbering of rules in Chapter Den 200.  Document #8884-A and #8884-B supersede all prior filings for the sections in this chapter.  The prior filings for former Chapter Den 200 include the following documents:

 

#287.2, eff 1-17-74

#2981, eff 2-28-85

#4509, 10-25-88

#5110, eff 4-4-91, EXPIRED: 4-4-97

#6541, eff 7-18-97

#6909, eff 12-9-98 , EXPIRED: 12-9-06

#7270, eff 5-12-00

#7660, eff 3-13-02

#7777, eff 10-10-02

#8513, eff 12-13-05

 

PART Den 201  PURPOSE AND SCOPE

 

          Den 201.01  Purpose.  The board shall conduct various proceedings for the purpose of acquiring sufficient information to make fair and reasoned decisions on matters within its statutory jurisdiction, including decisions on applications for licensure and complaints filed against licensees.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 201.02  Scope.  These rules shall be construed to secure the just, efficient and accurate resolution of all board proceedings.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 202  DEFINITIONS

 

          Den 202.01  Definitions.  Except where the context makes another meaning manifest, the following words have the meanings indicated when used in this chapter:

 

          (a)  “Adjudicative proceeding” means the procedure to be followed in contested cases, as set forth in RSA 541-A:31 through RSA 541-A:36.

 

          (b)  “Complaint” means a written allegation of professional misconduct against a licensee of the board.

 

          (c)  “Data” means all information other than argument, including oral or written descriptions, reports, maps, charts, drawings, photographs, audio or video recordings, computer programs, or computer printouts.

 

          (d)  “Disciplinary proceeding” means an adjudicatory process to determine what discipline is appropriate for violating RSA 317-A or its implementing rules.

 

          (e)  “File” means to place a document in the actual possession of the board.

 

          (f)  “Hearing” means the receipt and consideration by the board of data or argument, or both, by methods which are appropriate to the nature and scope of the issues being decided by the board.

 

          (g)  “Hearing counsel” means an individual appointed by the Board under Den 208.15(d) or Den 212.03 to prosecute or investigate misconduct allegations in the public interest.

 

          (h)  “Investigation" means a formal or informal search by the board for data concerning matters within its jurisdiction, the result of which is other than a final determination of a person's rights, duties or privileges.

 

          (i)  “Motion” means any request by a party to an existing proceeding for an order or relief relating to that proceeding.

 

          (j)  “Order” means a document issued by the board:

 

(1)  Establishing procedures to be followed in an adjudicative or nonadjudicative proceeding;

 

(2)  Granting or denying a petition or motion;

 

(3)  Requiring a person to do, or to abstain from doing, something; or

 

(4)  Determining a person's rights to a license or other privilege established by RSA 317-A or the rules of this chapter.

 

          (k)  “Petition” means an initial request to the board seeking action or relief, but does not include a license application, a complaint against a licensee, or a motion.

 

          (l)  “Presiding officer” means the board member or other individual to whom the board has delegated authority to preside over some or all aspects of an adjudicative or other proceeding.

 

          (m)  “Proposed decision” means an initial or recommended decision made by a presiding officer pursuant to Den 209.04 which is subject to review by the entire board.

 

          (n)  “Rulemaking” means the procedures for formulating agency rules set forth in RSA 541-A:3.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 203  Compliance with Procedural Rules or Orders

 

          Den 203.01  Failure to Comply with Procedural Rules or Orders.

 

          (a)  Failure to comply with the rules of this chapter shall be grounds for:

 

(1)  Refusing to accept or admit a noncompliant document for filing or refusing to consider a noncompliant oral petition or motion; or

 

(2)  Accepting or admitting a noncompliant application, petition, motion, or exhibit on the condition that conformity with specific procedural requirements be achieved by a specified date.

 

          (b)  When a noncompliant pleading or other tendered information is not accepted or admitted by the board, or when conditions for the acceptance or admission of noncompliant information are not met, the board shall make a decision on the pending matter without considering the noncompliant information, unless the board notifies the parties that it has waived the rule in accordance with Den 203.02.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 203.02  Waiver or Suspension of Procedural Rules Or Orders.  The board, upon its own initiative or upon the motion of any interested person, shall suspend or waive any procedural requirement or limitation imposed by this chapter upon reasonable notice to affected persons when the proposed waiver or suspension appears to be lawful, and would be more likely to promote the fair, accurate and efficient resolution of issues properly pending before the board than would adherence to a particular procedural rule or requirement. A motion for waiver or suspension of a procedural rule or order shall fully set forth the reasons for the requested relief.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 204  APPEARANCES BEFORE THE AGENCY

 

          Den 204.01  Representatives.

 

          (a)  A person appearing before the board shall represent or be represented by a person who:

 

(1)  Is an attorney holding a current and active New Hampshire license and has filed a written appearance with the board containing his or her business address and telephone number; or

 

(2)  Is not a New Hampshire licensed attorney and has not been convicted of a felony under the law of any state.

 

          (b)  Motions for leave to appear before the board shall:

 

(1)  Briefly describe the proposed representative's professional and character qualifications to ensure the representation does not constitute the unauthorized practice of law; and

 

(2)  Provide the proposed representative's daytime address and telephone number; and

 

(3)  Be signed by both the proposed representative and the party who would be represented.

 

          (c)  Corporations, partnerships and other legal entities which are not natural persons shall be represented by:

 

(1)  An attorney licensed in New Hampshire; or

 

(2)  An officer, director, or managing partner with express and unqualified written authority to act on behalf of the entity concerning the matter in question who has not been convicted of a felony in any state.

 

          (d)  Nothing in this section shall be construed to permit the unauthorized practice of law.

 

          (e)  The board shall, after notice and opportunity for hearing, prohibit or restrict an individual from acting as a representative upon a finding that the individual has engaged in conduct relating to representation before the board which would be sanctioned by a court if committed by an attorney appearing before the court.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 205  TIME PERIODS

 

          Den 205.01  Computation of Time.  Any time period specified in this chapter shall begin with the day following the act, event, or default, and shall include the last day of the period, unless it is Saturday, Sunday, or state legal holiday, in which event the period shall run until the end of the next day which is not a Saturday, Sunday, or state legal holiday.  When the period prescribed or allowed is less than 7 days, intermediate Saturdays, Sundays, and state legal holidays shall be excluded from the computation.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 205.02  Change in Allowed Times.  Except where a time period is fixed by statute, the board shall, upon motion or upon its own initiative, enlarge or shorten the time provided for the filing of any document, or advance or postpone the time set for any oral hearing, prehearing conference, or other activity, upon a finding that:

 

          (a)  The moving party did not comply with the time period due to accident, mistake, or misfortune; and

 

          (b)  The probable injury to the moving party outweighs any detriment likely to be suffered by any other party or the public interest responsibilities of the board.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 205.03  Limitations.  A motion to change time shall not be filed within 3 business days of the event in question.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 206  FILING AND SERVICE OF DOCUMENTS

 

          Den 206.01  Filing Documents with the Board.

 

          (a)  A document shall be considered filed when it is actually received at the board's office in Concord and conforms to the requirements of this chapter.

 

          (b)  A document tendered for filing which is patently and facially in violation of the board's rules shall not be accepted for filing. Such submissions shall be returned to the sender without prejudice to subsequent acceptance if the deficiencies are corrected and the document is refiled within any applicable time period.

 

          (c)  All correspondence, filings or communications intended for the board shall be addressed to the board's office in care of its administrative assistant.

 

          (d)  All petitions, motions, exhibits, memoranda or other documents filed in connection with a request for board action shall be filed with an original and one copy unless the board directs otherwise.

 

          (e)  Notwithstanding (d) above, only a single copy shall be filed of:

 

(1)  Transmittal letters, requests for public information, or other routine correspondence not directed at formal board action;

 

(2)  License applications; and

 

(3)  Complaints against licensees.

 

          (f)  Failure to furnish the required number of copies shall result in a tendered document being returned as unacceptable for filing.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 206.02  Subscription and Veracity of Documents.

 

          (a)  All complaints, petitions, motions, and replies filed with the board shall be signed and dated by the proponent of the document or, if the party appears by a representative, by the representative.

 

          (b)  The signature on a document filed with the board shall constitute a certification that:

 

(1)  The signer has read the document;

 

(2)  The signer is authorized to file it;

 

(3)  To the best of the signer's knowledge, information, and belief, there are good grounds to support it; and

 

(4)  The document has not been filed for purposes of delay or harassment.

 

          (c)  A willful violation of the representations contained in (b), above, shall, to the extent consistent with justice and the statutes administered by the board, be grounds for entering an order adverse to the party committing the violation.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 206.03  Service of Documents.

 

          (a)  Complaints against licensees shall be filed with the board without service upon the licensee against whom the allegations are made.

 

          (b)  Applications, petitions for rulemaking and petitions for declaratory rulings shall be filed with the board without service upon other persons. Provided, however, that when the relief sought by a petition for rulemaking or a petition for declaratory ruling would clearly and directly affect the interests of a person or group of persons, the board shall, by order, require service upon the affected person or persons.

 

          (c)  All objections, motions, replies, memoranda, exhibits, or other documents filed in connection with a request for board action shall be served by the proponent upon all interested parties by:

 

(1)  Depositing a copy of the document in the United States mail, first class postage prepaid, addressed to the last address given to the board by the party being served, no later than the day the document is filed with the board; or

 

(2)  Delivering a copy of the document in hand on or before the date it is filed with the board; or

 

(3)  In addition to one of the above, when appropriate for the efficiency of the process, the board shall order that service be rendered electronically, by facsimile or other expedited means.

 

          (d)  Notices, orders, decisions or other documents issued by the board in connection with requests for board action shall be served by the board upon all interested parties by either:

 

(1)  Depositing a copy of the document, first class postage prepaid, in the United States mail, addressed to the last address given to the board by the party being served;

 

(2)  Delivering a copy of the document in hand to the party; or

 

(3)  With the consent of the party, providing a copy of the document electronically.

 

          (e)  When a party has appeared by a representative, service shall be upon the representative. Provided, however, that the board shall order additional service upon a finding that such service would facilitate the fair and efficient conduct of the proceeding.

 

          (f)  Except for exhibits distributed at a prehearing conference or hearing, every document filed with the board, and required to be served upon the parties to an adjudicative proceeding, shall be accompanied by a certificate of service, signed by the person making service, attesting to the method and date of service, and the persons served.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; ss by #10990, eff 12-9-15

 

PART Den 207  PLEADINGS, COMPLAINTS AND MOTIONS

 

          Den 207.01  Pleadings.

 

          (a)  The only pleadings permitted shall be petitions and motions. Complaints against licensees and applications for licenses shall not be considered pleadings.

 

          (b)  Petitions shall contain:

 

(1)  The name and address of the petitioner;

 

(2)  The name and address of the petitioner's representative, if any;

 

(3)  A concise statement of the facts which warrant the relief requested from the board;

 

(4)  The description of the action which the petitioner wishes the board to take;

 

(5)  A citation to any statutes, rules, orders, or other authority which entitles the petition to the relief requested; and

 

(6)  The signature and date required by Den 206.02(a).

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; ss by #9408-A, eff 3-10-09

 

          Den 207.02  Complaints of Licensee Misconduct.

 

          (a)  Complaints alleging misconduct by licensees in violation of RSA 317-A:17 or Den 500 shall be in writing and filed at the board's offices in Concord, New Hampshire.

 

          (b)  A complaint shall contain the following information:

 

(1)  The name and address of the complainant;

 

(2)  The name and business address of the licensee against whom the complaint is directed; and

 

(3) The specific facts and circumstances which are believed to constitute professional misconduct.

 

          (c)  A complaint shall be treated as an ex parte request for the initiation of disciplinary proceedings by the board and shall be a confidential document subject to public disclosure only as provided by Den 212.04 (f).

 

          (d)  A complaint shall be dismissed at any time upon a determination that it:

 

(1)  Fails to state a cause of action;

 

(2)  Alleges a time-barred cause of action; or

 

(3)  The complainant has unreasonably failed to respond to a request for further information or has otherwise failed to cooperate with a board investigation or hearing.

 

          (e)  The dismissal or withdrawal of a complaint shall not preclude the board from independently pursuing some or all of the allegations of misconduct alleged by the complainant.

 

          (f)  Replies to complaints shall contain:

 

(1)  The name and address of the respondent;

 

(2)  The name and address of the representative of the respondent, if any;

 

(3) A statement admitting or denying each fact alleged in the complaint pursuant to Den 205.01(b)(3);

 

(4)  A concise statement of any additional or different facts which warrant the board acting in the manner requested by the respondent;

 

(5)  A citation to any statutes, rules, orders or other authority, not identified in the complaint, having a bearing upon the subject matter of the complaint;

 

(6)  A description of the action which the respondent wishes the board to take; and

 

(7)  The signature and date required by Den 206.02 (a).

 

          (g)  Replies shall be filed within 20 days from the date the complaint was received by the respondent unless otherwise ordered by the board.

 

          (h)  Any fact contained in the complaint which is not denied in the reply, shall be deemed admitted by the respondent. A statement that the respondent lacks sufficient knowledge to admit or deny shall be treated as a denial.  The complainant shall be presumed to deny all allegations in the reply, and no response shall be permitted to the reply.

 

          (i)  A dental record submitted with a reply to a complaint shall be:

 

(1)  A copy of the original record

 

(2)  Accompanied by:

 

a.  A typed rendition of the handwritten parts of the original record; and

 

b.  Dated radiographs of diagnostic quality, if part of the original record.

 

          (j)  At any stage of the board's evaluation of the allegations in a complaint, the board shall, subject to (k) below, and with the consent of the licensee, issue a final settlement decree or consent order which imposes discipline upon the licensee and terminates further disciplinary action in whole or in part.

 

          (k)  Action under (j) above, shall not be taken unless:

 

(1)  The complainant receives notice and an opportunity to submit written comments concerning the proposed settlement or consent decree;

 

(2)  There are no material facts in dispute between the licensee and the complainant;

 

(3)  The complainant's view of the facts, if true, would not, in the discretion of the board, result in the imposition of a greater disciplinary sanction against the licensee than that imposed by the proposed settlement or consent decree; and

 

(4)  The board determines that the interests of justice do not require a hearing.

 

          (l)  At any time during the board's evaluation of the allegations in a complaint, the board shall elect to defer further disciplinary action if the licensee and the complainant participate in confidential mediation on a timely and good faith basis with a qualified mediator who is not affiliated with the board.

 

          (m)  When mediation is conducted under (l), above, the mediator shall attempt informal resolution of the dispute between the complainant and the licensee, and, within 60 days from the issuance of a mediation order, submit a written report to the board which contains either:

 

(1)  A written settlement agreed to by the parties; or

 

(2)  A report of the circumstances which appear to prevent settlement of the issues between the parties.

 

          (n)  Upon receiving the mediator's report, the board shall discontinue its investigation or proceed with adjudicatory proceedings.

 

          (o)  Information concerning the substantive misconduct issues alleged by the complainant which either party discloses to the mediator during good faith mediation shall be accorded the same privilege available to settlement negotiations under NH Rule of Evidence 408 not withstanding Den 208.09.

 

          (p)  Unless previously dismissed or settled, a complaint shall be granted, denied, or deferred, in whole or in part, by the board based upon the board's confidential evaluation of the information available to it and the value of potential disciplinary sanctions.

 

          (q)  A complaint which raises issues of professional misconduct which might warrant disciplinary sanctions shall be granted by incorporating those issues into a notice of hearing which commences an adjudicatory hearing pursuant to Den 201.01.  In which case, disciplinary action against the licensee shall be taken or not taken based upon the board's evaluation of the evidence of professional misconduct submitted during the hearing.

 

          (r)  A complainant shall not be a party to a disciplinary hearing, but may petition the board to intervene.  When some or all of the allegations in a complaint are the subject of a disciplinary hearing, the notice of hearing shall inform the complainant that he or she may intervene in the proceeding subject to appropriate conditions or shall include findings demonstrating that the complainant has forfeited this right by failing to cooperate with previous board orders or investigatory requests.

 

          (s)  Anonymous complaints shall be pursued by the board pursuant to RSA 317-A:18 I and III, when it believes:

 

(1)  The allegations have merit;

 

(2)  The public welfare may be at risk; and

 

(3)  The complainant has legitimate reasons for acting anonymously.

 

          (t)  Pursuant to Den 203.02, the board shall waive or suspend procedural rules in Den 207.02 (s) that require the name and address of the complainant.

 

          (u)  Complaints shall be retained in the board's files as follows:

 

(1)  Complaints which result in discipline shall be retained in perpetuity; and

 

(2)  All other complaints shall be retained for 10 years, or longer if they are part of a developing pattern of behavior that might constitute professional misconduct pursuant to RSA 317-A:17 II (d).

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #9408-B, eff 3-10-09; amd by #9777-B, eff 9-3-10; ss by #10688, eff 10-7-14

 

          Den 207.03  Motions and Objections Thereto.

 

          (a)  Motions and objections shall be in writing unless the nature of the relief requested requires oral presentation upon short notice.

 

          (b)  Motions shall state clearly and concisely:

 

(1)  The purpose of the motion;

 

(2)  The relief sought by the motion;

 

(3)  The statutes, rules, orders, or other authority authorizing the relief sought by the motion;

 

(4)  The facts claimed to constitute grounds for the relief requested by the motion; and

 

(5)  The signature and date required by Den 206.02(a).

 

          (c)  Objections to motions shall state clearly and concisely:

 

(1)  The defense of the party filing the objection;

 

(2)  The action which the party filing the objection wishes the board to take on the motion;

 

(3)  The statutes, rules, orders, or other authority relief upon in defense of the motion; and

 

(4)  Any facts which are additional to or different from the facts stated in the motion; and

 

(5)  The signature and date required by Den 206.02(a).

 

          (d)  An objection shall specifically admit or deny each fact contained in the motion. Failure to deny a fact shall constitute the admission of that fact for the purposes of the motion.  In the event a party filing an objection lacks sufficient information to either admit or deny a fact contained in the motion, the party shall so state, specifically identifying such fact.

 

          (e)  Unless otherwise ordered by the board, motions shall be decided upon the writings submitted. Repetitious motions shall not be submitted.

 

          (f)  Unless otherwise ordered by the board, objections to motions shall be filed within 5 days after the filing of the motion.  Failure to object to a motion within the time allowed shall constitute a waiver of objection to the motion.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 207.04  Suspension Pending Completion of Disciplinary Proceedings.  Whenever in the judgment of the board the public health and safety shall so require, the board shall suspend or restrict the license of any licensee subject to proceedings before the board pending the completion of the disciplinary hearing.  No order or suspension made under this section shall be effective for more than 60 days and the board shall expedite all disciplinary proceedings upon such a suspension.  Upon any such suspension, the board shall provide a written basis for the finding of the suspension and the licensee shall be entitled to be heard before the board to challenge any such suspension.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 207.05  Voluntary Surrender by Licensees Under Disciplinary Investigation.  A licensee who is the subject of a complaint or an investigation into the allegations of misconduct on his or her part may, as part of a consent decree resolving the issues of the complaint or investigation, voluntarily surrender his/her license by delivering it to the board and stating in writing that:

 

          (a)  The surrender is freely rendered;

 

          (b)  The licensee is not being subjected to coercion or duress;

 

          (c)  The licensee is fully aware of the implications of surrendering his or her license;

 

          (d)  The licensee is aware that there is presently pending an investigation, the nature of which the licensee shall specifically set forth; and

 

          (e)  The licensee acknowledges that the material facts upon which the complaint is predicated are true.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-B, eff 3-7-15

 

          Den 207.06  Continuances.

 

          (a)  Any party or intervenor may make an oral or written motion that a hearing be delayed or continued to a later date or time.

 

          (b)  A motion for a delay or a continuance shall be granted if the presiding officer determines that a delay or continuance would assist in resolving the case fairly.

 

          (c)  If the later date, time and place are known when the hearing is being delayed or continued, the information shall be stated on the record.  If the later date, time and place are not known at that time, the presiding officer shall as soon as practicable issue a written scheduling order stating the date, time and place of the delayed or continued hearing.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 208  ADJUDICATIVE PROCEEDINGS

 

          Den 208.01  Applicability.  This part shall govern all proceedings conducted by the board except rulemaking and nonadjudicative investigations.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.02  Commencement of Proceedings.

 

          (a)  The board shall commence an adjudicative proceeding by issuing a notice to the parties at least 15 days before the first scheduled hearing date or first prehearing conference.

 

          (b)  The notice commencing an adjudicative proceeding shall:

 

(1)  Identify the parties to the proceeding as of the date of the order and specify a deadline for the submission of petitions to intervene;

 

(2)  Briefly summarize the subject matter of the proceeding, and identify the issues to be resolved;

 

(3)  Specify the legislative authority for the proposed action, and identify any applicable board rules;

 

(4)  Specify the date by which, and the address where, appearances or motions by representatives shall be filed;

 

(5)  Specify the date, time, and location of an initial prehearing conference or dates for an oral hearing;

 

(6)  Identify the presiding officer for the proceeding, if other than the chairman of the board;

 

(7)  Identify any special procedures to be followed;

 

(8)  Identify any confidentiality requirements applicable to the proceeding;

 

(9)  Contain such other information or attachments as are warranted by the circumstances of the case, including, but not limited to, orders consolidating or severing issues in the proceeding with other proceedings, and orders directing the production or exchange of documents;

 

(10)  Have a statement that each party has the right to have an attorney present to represent the party at the party’s expense; and

 

(11)  For proceedings before an agency responsible for occupational licensing as provided in paragraph VII-a, have a statement that each party has the right to have the agency provide a certified shorthand court reporter at the party’s expense and that any such request be submitted in writing at least 10 days prior to the proceedings.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.03  Docketing, Service of Notice, Public Notice.

 

          (a)  The board shall assign each adjudicative proceeding a docket number, and serve the hearing notice upon all parties to the proceeding and the board's legal counsel in the civil bureau, department of justice. The hearing notice shall be served upon the respondent, and the complainant, if any, by means of certified mail.

 

          (b) Service of all subsequent orders, decisions and notices issued by the board, including any amendments to the hearing notice, shall be served upon the parties, including any intervenors, by regular mail or, with the consent of the party or intervenor, by electronic means.

 

          (c) Orders, notices, and decisions of the board, and motions, memoranda, exhibits, and other documents and data submitted to the board in a docketed case shall be kept in a docket file and made available for public inspection in the board's office except to the extent that confidentiality has been otherwise provided for by law.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; ss by #10990, eff 12-9-15

 

          Den 208.04  Intervention.

 

          (a)  Petitions for intervention shall state with particularity:

 

(1)  The petitioner's interest in the subject matter of the hearing;

 

(2)  Why the interests of the parties and the orderly and prompt conduct of the proceeding would not be impaired; and

 

(3)  Any other reasons why the petitioner should be permitted to intervene.

 

          (b)  Petitions for intervention shall be granted if:

 

(1)  The petitioner has a substantial interest in the proceeding;

 

(2)  The petitioner has exercised due diligence with respect to requesting intervention;

 

(3)  Granting the petition is in the interest of justice; and

 

(4)  If granting intervention will not unduly delay the board’s proceeding.

 

          (c)  Petitions for intervention shall be granted subject to appropriate conditions or limitations which shall be subject to modification by the presiding officer any time during the proceeding.

 

          (d)  Once granted leave to intervene, an intervenor shall take the proceeding as he or she finds it and no portion of the proceeding shall be repeated because of the fact of intervention.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.05  Right to Counsel.  Any party in an adjudicative proceeding may be represented by counsel, but an attorney appearing on behalf of a party shall first file a letter announcing the fact of representation at the earliest date practical.  Requests for appointment of counsel shall not be entertained, and the board shall have no responsibility for the legal expenses of any licensee, applicant, intervenor or witness.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.06  Prehearing and Other Informal Conferences.

 

          (a)  At any time following the commencement of an adjudicative proceeding, the presiding officer, upon motion, or upon his or her own initiative, shall direct the parties to attend one or more prehearing conference when such a conference would aid in the disposition of the proceeding.

 

          (b)  The parties at a prehearing conference shall address:

 

(1)  The distribution of exhibits and written testimony, if any, to the parties;

 

(2)  Opportunities and procedures for simplification of the issues;

 

(3)  Possible amendments to the pleadings;

(4)  Opportunities and procedures for settlement;

 

(5)  Possible admissions of fact and authentication of documents to avoid unnecessary proof;

 

(6)  Possible limitations on the number of witnesses, and possible limitations on the scheduling of witnesses;

 

(7)  Possible changes to the standard procedures which would otherwise govern the proceeding; and

 

(8) Other matters which might contribute to the orderly, prompt and fair resolution of the proceeding.

 

          (c)  The board shall cause prehearing conferences to be recorded unless all parties wish to discuss possible settlement off the record. Matters decided at a prehearing conference shall be reflected in an appropriate order.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.07  Discovery and Disclosure.

 

          (a)  The board shall provide for the disclosure of any investigative report or other unprivileged information in the possession of the board, which is reasonably related to the subject matter of the proceeding. Neither the board nor any officer or employee thereof, shall be subject to further discovery.

 

          (b)  Parties shall attempt to agree among themselves concerning the mutual exchange of relevant information. If these efforts prove unsuccessful, a party wishing to initiate discovery against another party, shall, by motion, seek leave to do so and shall identify the exact type of discovery requested.

 

          (c)  Discovery shall be permitted against a party when:

 

(1)  The parties cannot adequately address specific relevant factual issues at the time fixed for the presentation of evidence, and addressing these issues at a subsequent time would place the requesting party at a material disadvantage;

 

(2)  The requested method of discovery is reasonable, and the requested discovery would not cause material unfairness or unreasonable expense to any party; and

 

(3)  The requesting party has acted diligently and the requested discovery would not unreasonably delay the proceeding.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.08  Subpoenas.

 

          (a)  Subpoenas for the attendance of witnesses or the production of evidence in investigations or adjudicative proceedings shall be issued upon the order of the board after approval by the department of justice pursuant to RSA 317-A:18, V.

 

          (b)  In adjudicative proceedings, a party requesting the board to authorize a subpoena shall attach a copy of the proposed subpoena to its motion. If the motion is granted, the requesting party shall be responsible for the service of the subpoena and payment of any applicable witness fee and mileage expenses.

 

          (c)  The person to whom the subpoena is directed may, within 7 days after service of the subpoena, or one day before the date specified in the subpoena for compliance therewith, whichever is later, file a motion to quash or modify the subpoena.  If the board denies the motion to quash or modify, in whole or in part, the person to whom the subpoena is directed shall comply with the subpoena, or any modification thereof, within the balance of time prescribed in the subpoena or within 3 days from the date of the board's order, whichever is later, unless the board expressly provides additional time to comply.

 

          (d)  A subpoena shall be served in any manner authorized by law.  The date, time, and method of service shall be written on the reverse of the original copy of the subpoena by the person making service who shall then file that copy with the board.

 

          (e)  Should a person fail to comply with a subpoena issued pursuant to this section, the board shall take one or more of the following actions:

 

(1)  Impose sanctions specific to any pending proceeding or investigation, including, but not limited to, entry of a default judgment as to some or all of the pending issues which is adverse to the noncompliant party;

 

(2)  Institute a separate investigation against any noncompliant individual who is subject to the board’s jurisdiction; or

 

(3)  Direct an interested party to seek or direct judicial enforcement of some or all of the subpoena.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.09  Evidence.

 

          (a)  The evidentiary privileges recognized by the law of New Hampshire, but not the NH Rules of Evidence, shall apply to proceedings under this chapter.

 

          (b)  All data which will reasonably assist the board arrive at the truth shall be admissible, but data which is irrelevant or immaterial; unduly repetitious or cumulative; or needlessly insulting or scandalous shall be excluded.

 

          (c)  The board may direct that some or all of the evidence be filed prior to hearing in written form.  However, unless the parties agree otherwise, oral testimony shall be required to allow appropriate cross examination and to avoid material prejudice, and to permit full and fair disclosure of disputed material facts.

 

          (d)  If the board officially notices a fact, it shall so state, and permit any party, upon timely request, the opportunity to show the contrary.

 

          (e)  Witnesses appearing before the board shall testify under oath or affirmation.

 

          (f)  The board shall cause an electronic or stenographic record to be made of hearings and prehearing conferences.  This record shall be transcribed upon the request of a party who pays the estimated cost of transcription in advance.  Provided, however, that if the board elects to transcribe some or all of the record for its own use, the transcribed portions shall be included in the public docket file.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.10  Burden of Proof.

 

          (a)  The party asserting the affirmative of a proposition shall have the burden of proving the truth of that proposition by a preponderance of the evidence.

 

          (b)  Without limiting the generality of paragraph (a), above, all moving parties and all petitioners shall have the burden of persuading the board that their motion or petition should be granted.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.11  Methods of Proceeding.  The method of proceeding under this part shall be determined as follows:

 

          (a)  In contested cases, and as otherwise required by law, the proceeding shall consist of a trial-type evidentiary hearing with an opportunity for the subsequent submission of memoranda.

 

          (b)  Where no facts material to the subject matter of the proceeding are in dispute, the proceeding shall, to that extent, be limited to the submission of memoranda wherein are argued the conclusions the parties wish the board to draw from the undisputed facts.

 

          (c)  Oral argument, other than opening and closing statements, shall be permitted only by leave of the board on consideration of a written motion which sets forth the purported need for such a procedure.  Written argument in the form of legal briefs or memoranda shall be permitted subject to filing schedules established by the board.

 

          (d)  The foregoing paragraphs shall not limit the board's authority to structure individual proceedings in a manner suitable to their particular subject matter and recognized due process requirements, or to require the submission of additional data at any time.

 

          (e)  An order scheduling supplemental argument or hearing, or otherwise reopening the record, may be issued by the presiding officer at any time prior to the issuance of a final order in a proceeding.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.12  Inquiry By Presiding Officer Or Board Members.  The presiding officer shall make such inquiry of witnesses, parties or counsel, as he or she believes necessary to develop a sound record for decision. Other board members participating in the proceeding shall also ask such questions and make such inquiries as they deem appropriate, subject to recognition by the presiding officer.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.13  Proposed Findings of Fact and Conclusions of Law.  The presiding officer shall direct any party to submit proposed findings of fact or conclusions of law if the presiding officer believes proposed findings or conclusions would be helpful to the board in deciding the case. If such an order is issued, individual rulings upon such proposed findings or conclusions shall be included as part of any proposed or final decision required to be issued in the proceeding.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.14  Ex Parte Communications.  Once an adjudicative proceeding has been commenced, no party shall communicate concerning the merits of the case except upon notice to all parties and in accordance with the rules of this chapter, nor shall any party cause another person or party to make such communications or otherwise engage in conduct prohibited by RSA 541-A:36.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 208.15  Adjudicatory Proceedings.

 

          (a)  Adjudication of misconduct allegations shall be conducted in accordance with this part, as supplemented by the hearing order and possible prehearing and other appropriate procedural orders served upon the parties, which shall establish the particular scheduling and filing requirements applicable to each case.

 

          (b)  A hearing notice shall be subject to substantive amendment by the board at any time prior to the issuance of a final order.  Provided, however, the parties shall receive at least 15 days notice and an opportunity to be heard on any new or materially different misconduct allegations to be decided in a particular disciplinary proceeding.

 

          (c)  Upon the filing of a complaint which complies with the provisions of Den 207.02, the presiding officer shall order the licensee or registrant to respond in writing to stated misconduct allegations by admitting or denying each allegation within 20 days of the filing of such allegations with the board.  The failure by the licensee or registrant to so respond within the specified time period shall result in the issuance of an order of default, and disciplinary sanctions shall be imposed against the licensee or registrant.

 

          (d)  The board shall appoint an investigator or prosecutor if the board concludes that it is necessary for:

 

(1)  A better understanding of the case; or

 

(2)  A more effective presentation of the case; or

 

(3)  The protection of the public welfare.

 

          (e)  Prehearing conferences in disciplinary proceedings shall be public except to the extent that settlement discussions or other matters entitled to confidentiality are addressed.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 208.16  Reciprocal Discipline.  Upon receipt of information indicating that a licensee licensed to practice in this state has been disciplined in another jurisdiction, the board shall commence an adjudicative proceeding to determine what, if any, discipline shall be imposed.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-B, eff 3-7-15

 

PART Den 209  PRESIDING OFFICER

 

          Den 209.01  Designation.

 

          (a)  Adjudicative proceedings commenced by the board shall be conducted by a presiding officer.

 

          (b)  The presiding officer in any adjudicatory hearing shall be the president, if available, or the vice president.

 

          (c)  If neither the president or vice president is available, the board shall appoint another member as presiding officer.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 209.02  Authority of Presiding Officer.

 

          (a)  The presiding officer shall possess all authority with respect to the procedural aspects of adjudicative proceedings which could be exercised by the board itself, including, but not limited to, the power to administer oaths and affirmations, direct the course of the proceeding, and decide scheduling, discovery, and other procedural issues.

 

          (b)  Except as provided by Den 209.04, the presiding officer shall receive no testimony or oral argument on the merits of the case unless a majority of the board members eligible to participate in the proceeding, including the presiding officer, are present. Board members need not be present during prehearing conferences or arguments on discovery or other procedural motions.

 

          (c)  Except in proceedings conducted pursuant to Den 209.04, the presiding officer shall, consistent with the fair and orderly conduct of the proceeding, permit board members who are present during any stage of an adjudicative proceeding to make reasonable inquiries of the parties and witnesses.

 

          (d)  The presiding officer shall not accept final offers of settlement or impose consent decrees.  When a settlement has been proposed in writing, the presiding officer shall refer it to the board for decision, but shall not stay the proceeding merely because the board is deliberating on a settlement proposal.

 

          (e)  The presiding officer shall not decide motions or enter orders which finally resolve any specific issue or issues designated by the board, and shall not stay the proceeding for more than 60 days.  Potentially dispositive motions may be referred to the board immediately or deferred until the close of the record, in the discretion of the presiding officer.

 

          (f)  If the presiding officer believes that a default or similar final order should be entered against a party, the presiding officer shall issue a written recommendation to the board, with service on the parties, and the board shall take appropriate action after allowing the parties l0 days to file objections thereto.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 209.03  Exceptions to Interlocutory Rulings By The Presiding Officer.

 

          (a)  The board shall not entertain interlocutory appeals of procedural or discovery orders made by the presiding officer. Contemporaneous exceptions to such rulings shall be unnecessary to preserve the objections of any party adversely affected.

 

          (b)  The parties may include objections to an adverse ruling of a presiding officer in any exceptions taken to a proposed decision under Den 209.04. When a proposed decision is not issued, such objections shall be presented to the board as a motion or as part of a closing memorandum submitted within 10 days from the close of the hearing or such further period as the presiding officer shall allow.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 209.04  Proposed Decisions By Presiding Officer.

 

          (a)  The board may direct that some or all of the evidence be filed prior to hearing in written form.  However, unless the parties agree otherwise, oral testimony shall be required to allow appropriate cross examination and to avoid material prejudice, and to permit full and fair disclosure of disputed material facts.  Only those board members present throughout the hearing shall rule on the credibility of witnesses.

 

          (b)  The parties may file exceptions and supporting memoranda of law for review by the board within 30 days from the date the proposed decision was served. Replies to exceptions and reply memoranda may be filed within 15 days from the date of the document being replied to.

 

          (c)  If a party wishes to present oral argument to the board it shall file a separate motion for oral argument within the time allowed for filing exceptions or replies to exceptions.

 

          (d)  When the board has directed a presiding officer to receive evidence and enter a proposed decision, there shall be no communications between the presiding officer and the board members concerning the merits of the case, and the board members shall not participate in the questioning of witnesses at the hearing, as would otherwise be permitted by Den 208.12.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 209.05  Withdrawal of Presiding Officer.

 

          (a)  Upon his or her own initiative or upon the motion of any party or intervenor, the presiding officer shall withdraw from any adjudicative proceeding for good cause.

 

          (b)  Among other reasons, good cause shall exist if the presiding officer:

 

(1)  Has a direct interest in the outcome of the matter, including but not limited to, a financial or family relationship with any party or intervenor;

 

(2)  Has made statements or engaged in behavior which objectively demonstrates that he or she has prejudged the facts of the case; or

 

(3)  Personally believes that he or she cannot fairly judge the facts of the case.

 

          (c)  Mere knowledge of the issues or acquaintance with any party, intervenor or witness shall not constitute good cause for withdrawal.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 210  RECONSIDERATION AND STAY

 

          Den 210.01  Motion for Reconsideration or Rehearing.

 

          (a)  Final adjudicative orders of the board, and orders denying petitions for declaratory rulings or rulemaking, shall take effect on the date they are served upon the parties pursuant to Den 206.03 (c).

 

          (b)  Within 30 days after service of a final adjudicative order, any party may file a motion for reconsideration or rehearing.  The board shall make no distinction between the terms "reconsideration" and "rehearing."

 

(c)  A motion for reconsideration shall:

 

(1)  Include any memorandum of law the moving party wishes to submit;

 

(2)  Identify each error of fact, error of reasoning, or erroneous conclusion contained in the final order which the moving party wishes reconsidered; and

 

(3)  Concisely state the correct factual finding, correct reasoning, and correct conclusion urged by the moving party.

 

          (d)  The board shall grant or deny the motion, or any part thereof, on its merits to the extent the motion has revealed errors of law, fact or policy in the board’s prior decision. The board shall also treat the motion as one for reopening and order the receipt of such additional data or additional argument as it considers necessary to evaluate any newly discovered evidence or to cure any alleged procedural errors.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 210.02  Reconsideration on the Board's Own Motion.  Within the time frame specified in Den 210.01(b), the board shall correct, reconsider, revise or reverse any final action on its own motion if the board discovers new facts that indicate such final action was incorrect.  If the board’s action is based upon the existing record, prior notice shall not be given to the parties. If further argument or data are necessary before making such an order, the board shall provide the parties with notice and an opportunity to be heard before any final revision is made in the board's previous action.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 210.03  Stay of Board Orders.

 

          (a)  Board actions shall be stayed only in response to a specific request from a party or on the board’s own motion. The mere filing of a motion for reconsideration shall not operate as a stay of any order, but it shall be permissible to combine a motion for stay with a motion for reconsideration.

 

          (b)  A motion for stay shall be considered only if it is filed within the time period for requesting reconsideration specified by Den 210.01(b), and shall demonstrate good cause sufficient to warrant the stay of an action by the New Hampshire superior court.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 210.04  Retention of Adjudicatory Decisions.  Board decisions which result from adjudicatory proceedings shall be retained by the board in perpetuity.

 

Source.  #9408-A, eff 3-10-09

 

PART Den 211  CONSOLIDATION AND SEVERANCE

 

          Den 211.01  Consolidation.  Board proceedings which involve the same, or substantially related issues, shall be consolidated for hearing or decision, or both, when fairness, accuracy and efficiency would be served by such an action.  Consolidation shall be ordered in response to a timely motion from a party or on the board’s own initiative.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 211.02  Severance.  The board shall sever one or more issues from a proceeding and dispose of those issues in another proceeding when doing so would materially promote the fairness, accuracy and efficiency of the proceeding.  Severance shall be ordered in response to a timely motion from a party or on the board’s own initiative.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

PART Den 212  NONADJUDICATIVE INVESTIGATIONS AND HEARINGS

 

          Den 212.01  Informal Investigations.

 

          (a)  Notwithstanding any other provision of this title, the board, within the limits of its authority, and acting through its members, officers and employees, or through independent contractors, shall make inquiry of any person and otherwise gather data, and prepare reports describing the data obtained whenever:

 

(1)  It receives data which leads it to believe that a violation of any statute administered by the board, or of any rule of the board, has occurred, or is likely to occur; or

 

(2)  It desires to obtain data for any other lawful purpose.

 

          (b)  Informal investigations shall include all techniques and methods for gathering information which are appropriate to the circumstances of the case, including:

 

(1)  Requests for additional information from the complainant;

 

(2)  Requests for release of relevant records belonging to or under the control of the complainant; and

 

(3)  Face to face meetings with potential witnesses and interested persons.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

          Den 212.02  Formal Investigations.

 

          (a)  When necessary to determine the merits of a matter, the board shall commence a formal investigation for the purpose of obtaining documents, recording testimony, and otherwise gathering information relevant to any matter within its jurisdiction.

 

          (b)  Formal investigations shall be commenced by the issuance of an order of investigation to the designated investigator and/or prosecutor containing:

 

(1)  The statutory or regulatory authority for the investigation;

 

(2)  Any statutes or rules believed to have been, or about to be, violated, or the possible regulatory action being contemplated by the board;

 

(3)  The identity of the persons, or class of persons, which are the subject of the investigation;

 

(4)  The general nature of the conduct being investigated;

 

(5)  The identity of the investigating officer or committee;

 

(6) The date upon which the investigating officer shall report his or her findings and recommendations to the board;

 

(7)  Any special authority conferred upon the investigating officer, including the authority to issue subpoenas on behalf of the board; and

 

(8)  Other provisions pertinent to the specifics of individual investigations deemed desirable by the board.

 

          (c)  The issuance of an order of investigation shall not commence a disciplinary hearing and shall not constitute an allegation of misconduct against a license holder.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

          Den 212.03  Investigators.  The board shall appoint a member of its staff, an attorney, any other qualified person, or a committee of qualified persons to conduct a formal or informal investigation.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

          Den 212.04  Investigations.

 

          (a)  The board shall conduct such investigations as it deems necessary to examine acts of possible misconduct which come to its attention through complaints or other means. Informal investigations pursuant to Den 212.01 shall be conducted at any time and without prior order of the board.  The board shall convert an informal investigation to a formal investigation at any time by following the procedures in Den 212.02(b).

 

          (b)  The type, form and extent of an investigation shall be determined by a majority of the board based upon, without limitation, the severity of the alleged misconduct, the availability of witnesses and information pertaining to the alleged misconduct, and the resources available to the board.

 

          (c)  When a misconduct investigation occurs, an investigator designated by the board shall contact such persons and examine such health care records and other documents as are reasonably necessary to make a recommendation as to whether further board action should be taken on the allegations in question.

 

          (d)  Investigations, including those based upon allegations in a complaint, may be conducted on an ex parte basis.

 

          (e)  The investigator shall make a written report of misconduct investigations which includes a recommendation to the board as to whether there is a reasonable basis to conduct further disciplinary proceedings.

 

          (f)  Investigatory reports and all information gathered by an investigator shall be confidential except that:

 

(1)  The investigator's report shall be made available to the parties in any adjudicative proceeding resulting therefrom; and

 

(2)  Information gathered in an investigation shall become subject to public disclosure if it is introduced as evidence in a disciplinary hearing;

 

(3)  Information gathered in disciplinary investigations shall be made available to:

 

a.  Law enforcement agencies;

 

b.  Certifying agencies of other jurisdictions;

 

c.  Board investigators or prosecutors;

 

d.  Expert witnesses or assistants retained by board prosecutors or investigators in the same or related disciplinary matters; or

 

e.  A licensee, complainant, or other person with knowledge of the subject matter of a particular misconduct allegation, when such disclosure would assist the board to investigate that allegation.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

          Den 212.05  Informational Hearings.

 

          (a)  The board shall conduct non-adjudicative informational hearings to assist it in gathering information necessary to the performance of its statutory duties.

 

          (b)  The board chair, acting chair, or another board member designated by the chair shall serve as the presiding officer at informational hearings and shall have authority to conduct all facets of the proceeding.

 

          (c)  Sworn testimony shall not be received at informational hearings unless an order of investigation has been issued by the board.

 

          (d)  The board shall establish the order and the length of the presentations made in informational hearings, and, consistent with any applicable statutes, limit the time allotted to each speaker.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

PART Den 213  RULEMAKING

 

          Den 213.01  How Adopted.  A board rule, or any amendment or repeal thereof, shall be adopted after notice and opportunity for a legislative-type informational hearing as provided by RSA 541-A:11. Rules shall be proposed by petition or on the board’s own initiative.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 213.02  Petition for Rulemaking.  Any person may request the board to commence a proceeding for the purpose of adopting, amending, or repealing a rule by filing a petition which contains:

 

          (a)  A statement of the reason for the petitioner's interest in the subject matter of the proposed rule;

 

          (b)  The text of the proposed rule or a statement of the particular results intended by the petitioner to flow from the implementation of the proposed rule;

 

          (c)  If the petitioner proposes to amend or repeal an existing rule, an identification of the particular rule sought to be amended or repealed; and

 

          (d)  Any data or argument the petitioner believes would be useful to the board in deciding whether to commence a rulemaking proceeding.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 213.03  Disposition of Petition For Rulemaking.

 

          (a)  The board shall request additional information or argument from the petitioner for rulemaking or from others if such additional information or argument is required to reach a decision.

 

          (b)  The board shall grant the petition for rulemaking unless the adoption, amendment or repeal sought would result in:

 

(1)  A rule that is not within the rulemaking authority of the board;

 

(2)  Duplication of a rule or of a statutory provision;

 

(3)  Inconsistency between the existing rules and the statutory mandate of the board;

 

(4)  Inconsistency of one administrative rule with another; or

 

(5)  Negatively impacting the board’s ability to carry out the mandates of RSA 317-A.

 

          (c)  Within 30 days of receipt of a sufficient petition the board shall dispose of it in the following manner:

 

(1)  By notifying the petitioner that the petition is granted and beginning rulemaking proceedings as required by RSA 541-A:4; or

 

(2)  By notifying the petitioner in writing that the petition is denied and the reasons for its denial.

 

          (d)  The denial of a petition for rulemaking shall not entitle the petitioner to a hearing.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07

 

          Den 213.04  Deficiencies in Petitions.

 

          (a)  If the board determines that any petition does not meet the requirements of this section, it shall immediately notify the petitioner, in writing, of the specific deficiencies; and

 

          (b)  Upon receipt of a corrected petition, the board shall take action as outlined in Den 213.02.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

PART Den 214  DECLARATORY RULINGS

 

          Den 214.01  Petitions for Declaratory Rulings.

 

          (a)  Petitions for a declaratory ruling on matters within the jurisdiction of the board shall be filed as a petition which meets the requirements of Den 207.01 (b) and also contains the following information:

 

(1)  The exact ruling being requested;

 

(2)  The statutory and factual basis for the ruling, including any supporting affidavits or memoranda of law;

 

(3)  A statement as to how and why the issuance of a ruling on this subject would benefit the petitioner, other interested persons, and the public at large;

 

(4)  The identity, including mailing addresses when reasonably available, of specific persons whose interests would be affected by the issuance or nonissuance of the ruling in question.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

          Den 214.02  Action on Petitions for Declaratory Rulings.

 

          (a)  If a petition for declaratory ruling indicates that other persons may be substantially affected by the proposed ruling, the board shall require service of the petition on such persons and advise them of their right to file a reply pursuant to Den 207.01(b).

 

          (b)  The petitioner shall provide such further information as the board shall direct after reviewing the petition.

 

          (c)  The board shall have no obligation to issue a declaratory ruling in response to a particular petition.

 

          (d)  Petitions shall be denied when:

 

(1)  The requested ruling would inappropriately impact upon pending administrative, judicial or legislative proceedings.

 

(2)  Other procedural options are available to the interested parties or the board.

 

(3)  They interfere with the board’s ability to meet the requirements of RSA 317-A.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-A, eff 5-17-07; amd by #9408-A, eff 3-10-09

 

PART Den 215  WAIVER OF SUBSTANTIVE RULES

 

          Den 215.01  Petitions for Waiver.

 

          (a)  Unless otherwise prohibited by statute, the board shall entertain a petition to waive or suspend any rule not covered by Den 203.02 by filing an original and 2 copies of a petition pursuant to Den 207.01(b) which clearly identifies the rule in question and sets forth specific facts and arguments which support the requested waiver.

 

          (b)  Petitions for waivers of substantive rules shall address all of the following:

 

(1)  Whether adherence to the rule would cause the petitioner unnecessary or undue hardship;

 

(2)  Whether the requested waiver is not necessary because of any neglect or misfeasance on the part of the petitioner;

 

(3)  Whether waiver of the rule would be consistent with the statutes and rules administered by the board;

 

(4)  Whether enforcement of the rule would injure third persons;

 

(5)  Whether waiver of the rule would injure third persons; and

 

(6)  Whether other good cause exists for waiving the rule.

 

          (c)  If examination of the petition reveals that other persons would be substantially affected by the proposed relief, the board shall require service of the petition on such person and advise them of their right to the petition pursuant to Den 206.03(b).

 

          (d)  The petitioner shall provide such further information or participate in such evidentiary or other proceedings as shall be ordered by the board after reviewing the petition and any replies received.

 

          (e)  A petition for waiver of a rule which does not allege material facts, which, if true, would be sufficient to support the requested waiver, shall be denied without prior notice or further hearing.

 

          (f)  The board shall initiate a waiver of a substantive rule upon its own motion by providing affected parties with notice and an opportunity to be heard, and issuing an order which finds that waiver would be necessary to advance the purpose of RSA 317-A.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #9408-B, eff 3-10-09; ss by #10793-A, eff 3-7-15

 

PART Den 216  EXPLANATION OF ADOPTED RULES

 

          Den 216.01  Requests for Explanation of Adopted Rules.  Any interested person may, within 30 days of the final adoption of a rule, request a written explanation of that rule by making a written request to the board including:

 

          (a)  The name and address of the person making the request; or

 

          (b)  If the request is that an organization or other entity, the name and address of such organization or entity and the name and address of the representative authorized by the organization or entity to make the request.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 

          Den 216.02  Contents of Explanation.  The board shall, within 90 days of receiving a request for an explanation of an adopted rule, provide a written response which:

 

          (a)  Concisely states the meaning of the rule adopted;

 

          (b)  Concisely states the principal reasons for and against the adoption of the rule in its final form; and

 

          (c)  States, if the board did so, why the board overruled any arguments and considerations presented against the rule.

 

Source.  (See Revision Note at chapter heading for Den 200) #8884-B, eff 5-17-07; ss by #10793-A, eff 3-7-15

 


CHAPTER Den 300  LICENSING REQUIREMENTS

 

REVISION NOTE:

 

            The Governor declared a State of Emergency in Executive Order 2020-04, which was effective 3-13-20.  The declaration and subsequent Emergency Orders issued pursuant to Executive Order 2020-04 affected various rules and statutes governing licensing under Chapter Den 300, such as Exhibit N to Emergency Order #29, effective 7-29-20, which amended Den 101.06 defining “clinical”, Den 301.01(a)(8)b. in Den 301.01 titled “Application for Dental Hygienist Licensure”, and Den 301.02(a)(8)b. in Den 301.02 titled “Application for Dental Licensure.”  These amendments remained in effect until December 31, 2020.  Exhibit Z of Emergency Order #29, effective April 14, 2021, subsequently amended these rules again.  The State of Emergency terminated at midnight on 6-11-21, and rules or statutes amended during the State of Emergency were restored.  To determine what rules in Den 300 were applicable during the State of Emergency, the user should check not only the source notes of the rules but also the Emergency Orders in effect at the time in question.

 

            Document #13232, effective 7-15-21, amended Den 301.01(a)(8)b. in Den 301.01 titled “Application for Dental Hygienist Licensure” as an emergency rule.  Pursuant to RSA 541-A:18, V, the emergency rule expired 1-11-22, and Den 303.01(a)(8)b. was effective again in its original form in Document #12428, effective 12-6-17.

 

            Document #13233, effective 7-15-21, amended Den 301.02(a)(8)b. in Den 301.02 titled “Application for Dental Licensure” as an emergency rule.  Pursuant to RSA 541-A:18, V, the emergency rule expired 1-11-22, and Den 301.02 was effective again in its original form in Document #12428, effective 12-6-17.

 

            Document #13251, effective 8-11-21, amended Den 304.05(f) in Den 304.05 titled “General Anesthesia, Deep Sedation and Moderate Sedation, and Moderate Sedation Only Permit Application Procedures and Evaluations” as an emergency rule.  Pursuant to RSA 541-A:18, V, the emergency rule expired 2-7-22, and Den 304.05 was effective again in its original form in Document #12428, eff 12-6-17.

 

Document #13367, effective 4-19-22, readopted with amendment Den 301.01, Den 301.02, Den 301.06 titled “License Activation”, Den 301.08 titled “Board Fees”, and Den 301.12 titled “Reinstatement of Lapsed Licenses” as regular rules.

 

         Den 301.01  Application for Dental Hygienist Licensure.

 

         (a)  Each applicant for a license to practice dental hygiene in the state of New Hampshire shall provide the following on the "Dental Hygienist Application for Licensure":

 

(1)  Applicant’s name;

 

(2)  Applicant’s date of birth;

 

(3)  Applicant’s place of birth;

 

(4)  Applicant’s social security number, as required by RSA 161-B:11, VI-a;

 

(5)  Any other name by which the applicant has been known;

 

(6)  Applicant’s current business and residential addresses, telephone numbers, and primary email address either business or personal;

 

(7)  Applicant’s educational background, including the name of the school of dental hygiene attended with date of graduation;

 

(8)  Whether the applicant has taken and passed the following examinations of the:

 

a.  Joint Commission on National Dental Examinations; and

 

b. American Board of Dental Examiners (ADEX) dental hygiene examination or other similar U.S. regional or state board including clinical procedure components or manikin examination;

 

(9)  A listing of the following:

 

a.  All places where the applicant has possessed a license to practice dental hygiene, including the state and license number, issue date, whether active or inactive, and dates of practice; and

 

b.  Professional employment history including the names of the employing dentists, the dates, and locations;

 

(10)  Whether the applicant:

 

a.  Has been convicted of a felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;

 

b.  Has been convicted of illegally practicing dental hygiene;

 

c.  Has ever been denied dental hygiene licensure;

 

d.  Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education; or

 

e.  Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending;

 

(11)  Whether the applicant has been advised by a health practitioner or mental health practitioner that a physical or mental illness impairs the ability to practice dental hygiene;

 

(12)  Whether the applicant has a physical or mental illness, or other condition, or addiction to alcohol, narcotics, or other mind altering drugs which impairs the applicant’s ability to practice dental hygiene;

 

(13)  A listing of the dental continuing education courses taken during the last 2 years;

 

(14)  At least 2 signed certifications of good professional character, at least one of which is by a licensed dentist in good standing if the applicant has previous dental employment;

 

(15)  Signed certification of graduation or, if not more than 3 months prior to the date the degree will be conferred, a certification of completion by the dean or registrar of the school of dental hygiene granting the applicant a degree; and

 

(16)  Whether the applicant’s basic life support for healthcare providers (BLS-HCP) is current, and if so, provide proof.

 

         (b)  An unmounted passport-type photograph of the applicant shall be:

 

(1)  Attached to the;

 

(2)  Taken not more than 6 months before the date on the application;

 

(3)  No smaller than 2 and 1/2 inches square; and

 

(4)  Impressed or stamped by a portion of the seal of the dental hygiene school from which the applicant graduated.

 

         (c)  The shall be signed by the applicant, notarized, and filed with the office of professional licensure and certification.  Deceptive or false statements, knowingly made by the applicant, shall result in denial of license.  By signing the, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against the applicant's license to practice dental hygiene and consents to a criminal background check.

 

         (d)  The shall be accompanied by the following documents:

 

(1)  A certified check or money order made payable to the “Treasurer, State of New Hampshire” for the application fee specified in Den 301.08;

 

(2)  Either of the following:

 

a.  An original or certified copy of the applicant's birth certificate written in English or translated to English; or

 

b.  A certified copy of the applicant’s valid passport written in English or translated to English; and

 

(3)  A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board;

 

         (e)  The following documents shall be filed with the board directly by the issuing agency:

 

(1)  An official copy of the applicant's school of dental hygiene transcript bearing the registrar's original signature and the school's seal;

 

(2)  The applicant's original grade card denoting successful completion of the examination of the Joint Commission on National Dental Examinations; and

 

(3)  A certified statement from the dental examining board of each state in which the applicant has been licensed as to whether the applicant's license to practice in that state, based on the records of the board;

 

a.  Has been subject to disciplinary action;

 

b.  Has disciplinary action pending;

 

c.  Has been under stayed probation; or

 

d.  Is under investigation.

 

         (f)  The board shall verify directly with the CDCA or similar regional or state board that the applicant has taken and passed the board examination, including a clinical procedure component, within the 3 years immediately prior to submitting the application, and deposits the required credentials with the board. Applicants who have successfully passed other regional boards shall provide verification directly to the board.

 

         (g)  Endorsement certification shall be considered for any person holding a current, unsuspended, unrestricted license to practice dental hygiene in another state and who has practiced clinical dental hygiene in one or more states for not less than 3 years immediately prior to submitting the application, and deposits the required credentials with the board.

 

         (h)  Applicants for endorsement certification shall have taken and passed the American Board of Dental Examiners (ADEX) dental hygiene examination, or other similar U.S. regional or state board for dental hygienists examination, including a clinical procedure component, with a passing score on each part of the examination.

 

         (i)  The education requirements, specified in RSA 317-A:21 shall apply to all applicants for licensure under this section.

 

         (j)  Pursuant to RSA 317-A:8, an applicant shall be a graduate of a dental hygiene school general dentistry program which:

 

(1)  Is of at least 2 years duration;

 

(2)  Is accredited by CODA; and

 

(3)  Awards the minimum degree of Associates in Science with a major in dental hygiene.

 

         (k)  When the required materials have been approved by the board, the applicant shall take a test on the contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through Den 500, the American Dental Association’s Principles of Ethics and Code of Professional Conduct, and the American Dental Hygienists’ Association Code of Ethics for Dental Hygienists.

 

         (l)  After passage of the test in (k) above, the board shall issue an active New Hampshire dental hygiene license upon payment of the full registration fee adopted in Den 301.08.

 

         (m)  Required materials that are subject to change shall be updated if more than 4 months old at time of completion of application.

 

         (n)  After 6 months, the board shall discard the applications of applicants who choose not to complete the application process.

 

Source.  Editorial Addition; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; ss by #5755, eff 12-14-93; amd by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13; ss by #10689, eff 10-7-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17;  amd by #13232, EMERGENCY RULE, eff 7-15-21, EXPIRED:  1-11-22; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300)

 

         Den 301.02  Application for Dental Licensure.

 

         (a)  Each applicant for a license to practice dentistry in the state of New Hampshire shall provide the following on the “Dentist Application for Licensure”:

 

(1)  Applicant’s name;

 

(2)  Applicant’s date of birth;

 

(3)  Applicant’s place of birth;

 

(4)  Applicant’s social security number, pursuant to RSA 161-B:11, VI-a;

 

(5)  Any other name by which the applicant has been known;

 

(6)  Applicant’s current residential address, telephone number, and primary email address either business or personal;

 

(7)  Applicant’s educational background, including:

 

a.  The names of the colleges attended;

 

b.  The date of graduation and degree, if any;

 

c.  The names of the dental schools attended;

 

d.  The dates of attendance and graduations;

 

e.  The types of post graduate dental programs completed; and

 

f.  The certificates or degrees, if any, including specialty training certificate;

 

(8)  Whether the applicant has taken and passed the examinations of the:

 

a.  Joint Commission on National Dental Examinations; and

 

b.  American Board of Dental Examiners (ADEX) examination, or other similar U.S. regional or state board clinical examination for dentists, including a clinical periodontal scaling component or the manikin examination;

 

(9)  A listing of the following:

 

a.  All places where the applicant has possessed a license to practice dentistry, including the state and license number, issue date, whether active or inactive, and dates of practice; and

 

b.  Professional employment history including the dates, locations, and status;

 

(10)  Whether the applicant:

 

a.  Has been convicted of a felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;

 

b.  Has been convicted of the illegal practice of dentistry;

 

c.  Has ever been denied dental licensure;

 

d.  Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education;

 

e.  Possessed a dental license that has been revoked, suspended, placed under probation or stayed probation, restricted, not renewed, involuntarily relinquished, or otherwise sanctioned, or is currently under review in any jurisdiction or state;

 

f.  Has had any physical or mental illness that impairs the ability to practice dentistry;

 

g.  Has been advised by a health practitioner or mental health practitioner that a physical or mental illness impairs the ability to practice dentistry;

 

h.  Has investigations or disciplinary actions pending against the applicant’s dental license;

 

i.  Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending;

 

j. Has had hospital privileges revoked, suspended, restricted, denied, not renewed, or involuntarily relinquished; or

 

k.  Has ever had a DEA license revoked, suspended, denied, placed on probation, restricted or otherwise sanctioned by a state or federal licensing regulatory board or agency, or which is currently involved in an investigation or disciplinary process;

 

(11)  Whether the applicant has an addiction to alcohol, narcotics, or other mind altering drugs which impairs the applicant’s ability to practice dentistry;

 

(12)  A listing of the dental continuing education courses taken during the last 2 years;

 

(13)  At least 3 signed certifications of good professional character, with at least 2 by licensed dentists in good standing, if the applicant has previous dental employment;

 

(14)  Signed certification of graduation or, if not more than 3 months prior to the date the degree will be conferred, a certification of completion by the dean or registrar of the dental college granting the applicant a degree; and

 

(15)  Whether the applicant’s CPR certification is current, and if so, provide proof.

 

(16)  Whether the applicant has a DEA number to prescribe schedule II-IV controlled substances and if yes:

 

a.  Provide the DEA number; and

 

b.  Indicate whether or not the DEA number will be associated with the applicant’s dental license.

 

         (b)  An unmounted passport-type photograph of the applicant shall be:

 

(1)  Attached to the;

 

(2)  Taken not more than 6 months before the date on the application;

 

(3)  No smaller than 2 and 1/2 inches square; and

 

(4)  Impressed or stamped by a portion of the seal of the dental school from which the applicant graduated.

 

         (c)  The shall be signed by the applicant, notarized, and filed with the office of professional licensure and certification. Deceptive or false statements, knowingly made by the applicant shall result in denial of license. By signing the, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against his or her license to practice dentistry and consents to a criminal background check.

 

         (d)  The shall be accompanied by the following documents:

 

(1)  A certified check or money order made payable to the “Treasurer, State of New Hampshire” for the application fee specified in Den 301.08;

 

(2)  Either of the following:

 

a.  An original or certified copy of the applicant's birth certificate written in English or translated to English; or

 

b.  A certified copy of the applicant’s valid passport written in English or translated to English; and

 

(3)  A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board.

 

         (e)  The following documents shall be filed with the board directly by the issuing agency:

 

(1)  An official copy of the applicant's dental school transcript and, if applicable, a copy of a specialty training certificate bearing the registrar's original signature and the school's seal or a letter on school letterhead sent directly to the board’s office.  An unofficial transcript and a diploma stamped with the dental school seal may be provided until the official transcript is ready;

 

(2)  The applicant's original grade card denoting successful completion of the examination of the Joint Commission on National Dental Examinations; and

 

(3)  A certified statement from the dental examining board of each state in which the applicant has been licensed as to whether the applicant's license to practice in that state based on the records of the board, as follows:

 

a.  Has been subject to disciplinary action;

 

b.  Has disciplinary action pending;

 

c.  Has been under stayed probation; or

 

d.  Is under investigation.

 

         (f)  The board shall verify directly with the CDCA or other similar U.S. regional or state board that the applicant has taken and passed the board clinical examination for dentists, including a clinical periodontal scaling component, within the 3 years immediately prior to submitting the application.

 

         (g) Endorsement certification shall be considered for each applicant who holds a current, unsuspended, unrestricted license to practice dentistry who deposits with the board the required credentials if:

 

(1)  The applicant has taken and passed the American Board of Dental Examiners (ADEX) examination, or other similar U.S. regional or state board clinical examination for dentists, including a periodontal scaling exam; and

 

(2)  Throughout the 3 years immediately prior to submitting the application, the applicant:

 

a.  Has practiced clinical dentistry in one or more states;

 

b.  Has been in dental specialty training;

 

c.  Has been in active military dental service; or

 

d.  Has been in any combination thereof.

 

         (h)  The education requirements specified in RSA 317-A:8 shall apply to all applicants for licensure under this section.

 

         (i)  Pursuant to RSA 317-A:8, an applicant shall be a graduate of a dental school general dentistry program which:

 

(1)  Is of at least 2 years duration;

 

(2)  Is accredited by the Commission on Dental Accreditation (CODA); and

 

(3)  Awards the degree of Doctor of Dental Medicine (DMD) or Doctor of Dental Surgery (DDS).

 

         (j)  When the required materials have been approved by the board, the applicant shall take a test on the contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through Den 500, the American Dental Association’s Principles of Ethics and Code of Professional Conduct, and the American Dental Hygienists’ Association Code of Ethics for Dental Hygienists.

 

         (k)  After passage of the test in (j) above, the board shall issue an active New Hampshire dental license upon payment of the full registration fee adopted in Den 301.08.

 

         (l)  Required materials that are subject to change shall be updated if more than 4 months old at the time of completion of application.

 

         (m)  After 6 months, the board shall discard the applications of applicants who choose not to complete the application process.

 

         (n)  If an applicant possesses a DEA number to prescribe schedules II-IV controlled substances pursuant to RSA 318-B:41, I(a), the applicant for licensure shall register with the New Hampshire Controlled Drug Prescription Health and Safety Program (PDMP), pursuant to RSA 126-A:91. If the applicant possesses a DEA number, the applicant shall provide it to the board. Failure to register within 90 days of the initial issuance of a license shall constitute professional misconduct within the meaning of RSA 317-A:17, II and shall be grounds for disciplinary action. A licensee shall not engage in the prescribing or dispensing of controlled substances in schedules II-IV without having registered with the New Hampshire PDMP.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; amd by #4257, eff 4-15-87; ss by #5110, eff 4-4-91; rpld by #5755, eff 12-14-93

 

New.  #5755, eff 12-14-93 (from Den 301.04); amd by #6186, eff 2-17-96; amd by #6541, eff 7-18-97; ss by #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7557, eff 9-20-01; amd by #7661, eff 3-13-02; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13; ss by #10689, eff 10-7-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #13233, EMERGENCY RULE, eff 7-15-21, EXPIRED:  1-11-22; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300)

 

          Den 301.03  Application for Dental Hygienist License Registration and Renewal.

 

          (a)  Each applicant for registration and renewal of a license to practice dental hygiene in the state of New Hampshire shall provide the following on the hygienist “Application for Registration and License Renewal” form, effective April 2017 and available on the board’s website:

 

(1)  Applicant’s mailing address if changed;

 

(2)  Applicant’s name;

 

(3)  Applicant’s dental hygienist license number;

 

(4)  Whether applicant’s hygienist license is active or inactive;

 

(5)  The original date of dental hygienist licensure;

 

(6)  Whether the applicant has practiced in the current biennium;

 

(7)  A listing of other states where the applicant holds a dental hygienist license, if any;

 

(8)  Applicant’s primary residence and telephone number;

 

(9)  Name of practice, address and telephone number of each practice employing the applicant, and primary email address either business or personal;

 

(10)  Whether the applicant:

 

a.  Has ever been convicted of any felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;

 

b.  Has ever been convicted of the illegal practice of dental hygiene;

 

c.  Has ever been denied dental hygienist licensure;

 

d.  Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education;

 

e.  Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending; or

 

f.  Has any physical, mental or other condition or addiction to alcohol, narcotics or other mind altering drugs that may impair an ability to practice dental hygiene;

 

(11)  Whether the applicant practices under public health supervision, pursuant to Den 302.02, and the name of the program;

 

(12)  Whether the applicant administers local anesthesia for dental patients in New Hampshire, and if yes, whether the applicant received a certificate of local anesthesia qualification;

 

(13)  Whether the applicant has completed 20 hours of continuing education within 2 years immediately preceding the application;

 

(14)  Whether the applicant, if he or she is an Expanded Function Dental Auxiliary (EFDA) pursuant to Den 302.07(b)(6), has completed 10 CEU’s in this biennium in restorative dentistry; and

 

(15)  Whether the applicant’s BLS-HCP training is current.

 

(b)  The form shall be completed and attested to by the applicant and filed with the board. Deceptive or false statements, knowingly made by the applicant shall result in denial of license.  By signing the form, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against the applicant's license to practice dental hygiene and consents to a criminal background check.

 

          (c)  If the answer to (a) (13) is ‘no’, then a 30-day extension period for late registration shall be available to complete the requirement.

 

          (d)  Pursuant to Den 301.08, there shall be a fee for late biennial registration.  The form used shall be the same as the regular renewal form.

 

      (e)  Applicants for renewal may complete their renewal applications online at https://nhlicenses.nh.gov.

 

          (f)  Pursuant to RSA 126-A:5, XVIII-a.(a) and RSA 317-A:12-a, hygienists shall complete, as part of their renewal application, the New Hampshire division of public health service’s health professions survey issued by the state office of rural health and primary care, department of health and human services, pursuant to He-C 801.

 

          (g)  The board shall provide hygienists with the opportunity to opt out of the survey.  Written notice of the opt-out opportunity shall be provided with the renewal application. The opt out form shall be available on the NH state office of rural health and primary care website at https://www.dhhs.nh.gov/dphs/bchs/rhpc/data-center.htm.

 

          (h)  Hygienists choosing to opt-out of the survey shall complete and submit the “New Hampshire Health Professions Survey Opt-Out Form,”  revised June 2020, to the state office of rural health and primary care, department of health and human services, via one of the following:

 

(1)  Mail;

 

(2)  Email; or

 

(3)  Fax.

 

          (i)  Information contained in the opt-out forms shall be kept confidential in the same accord with the survey form results, pursuant to RSA 126-A:5 XVIII-a(c).

 

Source.  #10068, eff 1-10-12; ss by #10689, eff 10-7-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #13116, eff 10-9-20

 

          Den 301.04  Application for Dentist License Registration and Renewal.

 

          (a)  Each applicant for registration and renewal of a license to practice dentistry in the state of New Hampshire shall provide the following on the dentist “Application for Registration and License Renewal” form, effective April 2017 and available on the board’s website:

 

(1)  Applicant’s mailing address if changed;

 

(2)  Applicant’s name;

 

(3)  Applicant’s license number;

 

(4)  Whether the applicant’s license is active or inactive;

 

(5)  Applicant’s original date of New Hampshire license;

 

(6)  Whether the applicant has practiced in the current biennium;

 

(7)  Whether the applicant practices as a specialist;

 

(8)  A listing of other states where the applicant holds a dental license, if any;

 

(9)  A listing of hospitals where the applicant holds staff privileges, if any;

 

(10)  Applicant’s primary residence and telephone number;

 

(11) Applicant’s practice addresses, telephone numbers, and primary email address either business or personal;

 

(12)  Whether the applicant:

 

a. Has been convicted of any felony, misdemeanor, or driving under the influence of alcohol or drugs which has not been annulled;

 

b.  Has ever been convicted of the illegal practice of dentistry;

 

c.  Has ever been denied dental licensure;

 

d.  Currently has or ever has had any professional license subjected by any professional licensing body in any jurisdiction or state to any investigation, sanction, or disciplinary action, including but not limited to revocation, suspension, probation or stayed probation, limitation or restriction, fine, reprimand, denied renewal, voluntary or involuntary relinquishment, or required submission to care, counseling, supervision, or further education;

 

e.  Possessed a dental license that has been revoked, suspended, placed under probation or stayed probation, restricted, not renewed, voluntarily or involuntarily relinquished, or otherwise sanctioned, or has disciplinary actions pending in any jurisdiction or state;

 

f.  Has ever been or is currently named as a party in any malpractice or professional liability claim or lawsuit or has any pending;

 

g. Has had hospital privileges revoked, suspended, restricted, denied, not renewed or involuntarily relinquished; and

 

h.  Has ever had a DEA license revoked, suspended, denied, placed on probation, restricted or otherwise sanctioned by a state or federal licensing/regulatory board or agency, or which is currently involved in an investigation or disciplinary process;

 

(13)  Whether the applicant has a physical or mental illness or other condition, or addiction to alcohol, narcotics or other mind altering drugs which impairs the applicant’s ability to practice dentistry;

 

(14)  Whether the applicant uses general anesthesia, deep sedation or moderate sedation on an outpatient basis for dental patients in New Hampshire;

 

(15)  Whether the applicant, if he or she holds a moderate sedation permit, has documented 12 cases in the biennium or 4 hours of continuing education in sedation training;

 

(16)  Excluding an in-office ancillary services, whether the applicant has an ownership in any entity which provides diagnostic or therapeutic services, and if so, attach a list;

 

(17)  Whether the applicant has completed 40 hours of continuing education, at least 30 of which are clinical in nature, within the 2 years immediately preceding the application;

 

(18)  Whether the applicant’s BLS-HCP is current; and

 

(19)  Whether the applicant has registered with the New Hampshire Controlled Drug Prescription Health and Safety Program (PDMP), as required in RSA 318-B:33, II and Ph 1503.01 (a), if the applicant possesses a DEA number to prescribe schedules II-IV controlled substances. If the applicant possesses a DEA number, the applicant shall provide the number to the board.

 

(b)  Failure to register shall constitute professional misconduct within the meaning of RSA 317-A:17, II and shall be grounds for disciplinary action. A licensee shall not engage in the prescribing or dispensing of controlled substances in schedules II-IV without having registered with the New Hampshire PDMP.

 

(c)  The form shall be completed and attested to by the applicant and filed with the board. Deceptive or false statements, knowingly made by the applicant shall result in denial of license. By signing the form, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against the applicant's license to practice dentistry and consents to a criminal background check.

 

          (d)  If the answer to (a) (17) is ‘no’, then a 30-day extension period for late registration shall be available to complete the requirement.

 

          (e)  Pursuant to Den 301.08, there shall be a fee for late biennial registration.  The form used shall be the same as the regular renewal form.

 

          (f)  Applicants for renewal may complete their renewal applications online at https://nhlicenses.nh.gov.

 

          (g)  Pursuant to RSA 126-A:5, XVIII-a.(a) and RSA 317-A:12-a, dentists shall complete, as part of their renewal application, the New Hampshire division of public health service’s health professions survey issued by the state office of rural health and primary care, department of health and human services, pursuant to He-C 801.

 

          (h)  The board shall provide dentists with the opportunity to opt out of the survey.  Written notice of the opt-out opportunity shall be provided with the renewal application. The opt out form shall be available on the NH state office of rural health and primary care website at https://www.dhhs.nh.gov/dphs/bchs/rhpc/data-center.htm.

 

          (i)  Dentists choosing to opt-out of the survey shall complete and submit the “New Hampshire Health Professions Survey Opt-Out Form,”  revised June 2020, to the state office of rural health and primary care, department of health and human services, via one of the following:

 

(1)  Mail;

 

(2)  Email; or

 

(3)  Fax.

 

          (j)  Information contained in the opt-out forms shall be kept confidential in the same accord with the survey form results, pursuant to RSA 126-A:5 XVIII-a(c).

 

Source.  #10068, eff 1-10-12; ss by #10689, eff 10-7-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #13116, eff 20-9-20

 

          Den 301.05  Application for Temporary Licensure.

 

          (a)  A temporary dental or dental hygiene license shall be granted on an individual request basis for a professional education program using dental clinical procedures.

 

          (b)  A temporary license shall be granted on an individual request basis for research projects having a clinical dental component.

 

          (c)  Applicants shall meet the minimum requirements for licensure by examination or licensure by endorsement certification process in New Hampshire.

 

          (d)  If the applicant does not meet the minimum requirements, the board shall require the applicant to obtain a license through the process utilizing the CDCA or other regional board clinical performance test or the endorsement certification application process.

 

          (e)  A temporary license shall be valid for one year or the length of an educational program or research project, whichever occurs first.

 

Source.  Editorial Addition; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; rpld by #5755, eff 12-14-93

 

New.  #5755, eff 12-14-93 (from Den 301.06); amd by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; amd by #8260, eff 1-19-05; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; renumbered by #10068; ss by #10689, eff 10-7-14; ss by #10794, eff 3-7-15; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15

 

         Den 301.06  License Activation.  Pursuant to RSA 317-A:16, any dentist or dental hygienist holding an inactive license shall be restored to active status by the board upon:

 

         (a)  Filing a written request with the board;

 

         (b)  Furnishing evidence of continuing professional character and competence as follows:

 

(1)  Having a letter of good standing sent directly to the New Hampshire dental board from any dental board where the applicant has practiced; and

 

(2)  If the applicant has not been practicing for:

 

a.  Three years or less, submitting evidence of current continuing education equivalent to 20 hours per year for dentists and 10 hours per year for dental hygienists;

 

b.  More than 3 years but less than 5 years, submitting evidence of current continuing education and completion of a refresher course approved by the board; and

 

c.  Five years or more, the applicant shall pass the entire American Board of Dental Examiners (ADEX) examination, including a periodontal scaling exam, within 6 months prior to license activation; and

 

         (c)  Payment of the full registration fee adopted in Den 301.08.

 

         (d)  A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board.

 

Source.  #6909, eff 12-9-98; ss by #6975, eff 4-10-99; ss by #7270, eff 5-12-00; ss by #7929, eff 8-6-03; ss by #8260, eff 1-19-05; ss by #8838, eff 3-9-07; amd and renumbered by #10068, eff 1-10-12 (from Den 301.04); ss by #10689, eff 10-7-14; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300)

 

          Den 301.07  Application for Temporary Licensure to Provide Voluntary Services.

 

          (a)  A license shall be granted on an individual request basis for the provision of voluntary dental or dental hygiene services.

 

          (b) Pursuant to RSA 317-A:8 II, the applicant shall complete and submit an “Application for Registration and License Renewal – Volunteer” form, effective November 2017.

 

          (c)  Licensure to provide volunteer services shall be issued:

 

(1)  Only for the provision of voluntary services without pay or compensation for work or service performed; and

 

(2)  For specific programs and locations.

 

          (d)  A license to provide volunteer services shall be valid for not more than one year, and shall expire on May 1.

 

          (e)  Applicants for subsequent licenses to provide volunteer services shall comply with (b) above to the extent the information originally provided is no longer complete or accurate.

 

          (f)  There shall be no fees relative to licensure to provide voluntary services.

 

          (g)  There shall be no continuing education requirements, except that applicants shall maintain BLS-HCP certification and shall have taken 2 CEU’s in infection control each biennium.

 

(h)  Retired dentists and retired dental hygienists seeking a license to provide voluntary services shall have had all their dental licenses or dental hygiene licenses in good standing at the time they retired.

 

Source.  #7661, eff 3-13-02; ss by #8260, eff 1-19-05; ss by #8838, eff 3-9-07; amd by #9973, eff 8-9-11; renumbered by #10068 (from Den 301.05); EXPIRED 3-9-15 (paras. (a)-(c) & (e)-(h)); ss by #11053, eff 3-10-16; ss by #12428, eff 12-6-17

 

         Den 301.08  Board Fees.  The board of dental examiners shall establish the following fees cited in Table 3.1.1 below:

 

Table 3.1.1 Fees

 

Type of Fee

   Fee

 

 

Dentist

 

Application and examination fee for dental license

$200.00

Active dental registration fee

$365.00

Inactive dental registration fee

$145.00

Reinstatement fee for lapsed active dental license

$225.00

Reinstatement fee for lapsed inactive dental license

$   35.00

Application to administer general anesthesia and sedation,

per dentist and per location

$   35.00

 

 

Dental Hygienist

 

Application and examination fee for dental hygienist license

$100.00

Active dental hygienist registration fee

$165.00

Inactive dental hygienist registration fee

$  65.00

Reinstatement fee for lapsed active dental hygienist license

$100.00

Reinstatement fee for lapsed inactive dental hygienist license

$  35.00

Application for dental hygienist to administer local anesthesia

$  25.00

Application for dental hygienist to administer nitrous oxide

$  25.00

 

 

Certified Public Health Dental Hygienist (CPHDH)

 

Application for CPHDH certificate

$  25.00

Biennial certificate renewal fee for CPHDH

$  25.00

Reinstatement fee for lapsed CPHDH certification

$  25.00

 

 

Expanded Function Dental Auxiliary (EFDA)

 

Application and certificate for EFDA

$  25.00

 

Source. #7970, eff 10-10-03; ss and moved by #8260, eff 1-19-05 (from Den 301.04); amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; ss by #9069, eff 1-11-08; ss by #9408-B, eff 3-10-09; ss by #9633, eff 1-7-10; ss by #9973, eff 8-9-11; ss and renumbered by #10068, eff 1-10-12 (from Den 301.06); ss by #10437, eff 10-8-13; ss by #10689, eff 10-7-14; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300)

 

          Den 301.09  Change in Name or Address.

 

          (a)  All persons licensed to practice dentistry or dental hygiene in this state shall notify the board in writing within 30 days of a name change and provide the board a copy of the documentation that legally changed the name, if any.

 

          (b)  All persons licensed to practice dentistry or dental hygiene in this state shall notify the board in writing within 30 days of any change of business, residential, or email address.

 

          (c)  All persons licensed to practice dentistry or dental hygiene in this state who fail to notify the board in writing within 30 days of any change of business, residential, or email address shall be issued a letter of concern.

 

Source.  #8260, eff 1-19-05 (from Saf-C 301.05); ss by #8838, eff 3-9-07; renumbered by #10068 (from Den 301.07); ss by #10794, eff 3-7-15; ss by #12428, eff 12-6-17

 

          Den 301.10  Military Service Active License.  Active dental or dental hygiene licensure shall be granted to persons holding an inactive New Hampshire dental or dental hygiene license while on active military duty, upon request by the licensee.

 

Source.  #8260, eff 1-19-05 (from Saf-C 301.06); ss by #8838, eff 3-9-07; renumbered by #10068 (from Den 301.08); ss by #10794, eff 3-7-15

 

          Den 301.11  Use of Social Security Number.

 

          (a)  Applicants for licensure as a dental hygienist or a dentist shall provide their social security numbers as required by Den 301.01(a)(4) and Den 301.02(a)(4).

 

          (b)  Pursuant to RSA 161-B:11, VI-a and 42 U.S.C.A. 666(a)(13), the board shall provide a licensee’s social security number to the department of health and human services in conjunction with proceedings or actions to establish paternity or to establish or enforce child support.

 

          (c)  Pursuant to 45 CFR 60.8 and 45 CFR 61.7, the board shall provide a licensee’s or applicant’s social security number to their respective educational institutions, law enforcement and professional licensure agencies, the licensure testing examiners utilized by the board to assess applicant professional competence, the American Association of Dental Boards, the National Practitioner Data Bank, or their equivalents, in order to ensure accurate identification of the applicant’s or licensee’s identity for the protection of the public welfare.

 

          (d)  Licensees’ social security numbers shall not be provided to any other third party or be used for any other purpose.  Pursuant to RSA 161-B:11, VI-a, social security numbers shall be confidential and not subject to RSA 91-A, the right-to-know law.

 

Source.  #8584, eff 3-16-06; ss by #8838, eff 3-9-07; renumbered by #10068 (from Den 301.09); ss by #10689, eff 10-7-14

 

         Den 301.12  Reinstatement of Lapsed Licenses.

 

         (a)  When a license has lapsed as a result of failure of the applicant to submit a completed renewal application, the applicant shall, no later than November 1 of the year the license lapsed, print or type on the reinstatement the following:

 

(1)  For dental hygienist reinstatement, the ination required for initial dental hygienist licensure, pursuant to Den 301.01 (a)(1) - (7), (9) - (12), and (16), Den 301.01 (b), (c), (d), and documentation showing that the applicant has completed 20 CEUs for the biennium; and

 

(2)  For dentist reinstatement, the ination required by initial dentist licensure, pursuant to Den 301.02 (a)(1) - (7), (9) - (11), (15), Den 301.02 (b), (c), (d), and documentation showing that the applicant has completed 40 CEUs for the biennium.

 

         (b)  The applicant shall submit a registration fee and reinstatement fee with the reinstatement application, as set forth in Den 301.08.

 

         (c)  If reinstating to active status, the applicant shall retake the NH dental jurisprudence examination.

 

         (d)  A completed criminal history records check and fingerprint card, seeking both a New Hampshire and a federal records check, in accordance with the procedure and payment requirements specified by the NH department of safety at Saf-C 5700, and if the federal criminal history records check shows the existence of a criminal record in another state, the applicant shall obtain a detailed criminal record check directly from that state and provide it to the board.

 

Source.  #9408-B, eff 3-10-09; amd by #9973, eff 8-9-11; renumbered by #10068 (from Den 301.10); ss by #10991, eff 12-9-15; ss by #10689, eff 10-7-14; ss by #12428, eff 12-6-17; ss by #13367, eff 4-19-22 (see Revision Note at chapter heading for Den 300)

 

          Den 301.13  Restricted License.

 

          (a)  A restricted license shall limit a dentist or dental hygienist to performing those procedures specified by the board.

 

          (b)  Restricted licenses shall be issued:

 

(1)  To dentists and dental hygienists who are limited to performing some, but not all, procedures to acceptable professional standards thereby protecting the public; and

(2)  To dentists and dental hygienists who are in need of remedial training in specific areas to reach professional standards that protect the public welfare.

 

Source.  #9408-B, eff 3-10-09; renumbered by #10068 (from Den 301.11); ss by #10991, eff 12-9-15

 

PART Den 302  QUALIFICATIONS AND SUPERVISION

 

          Den 302.01  Purpose.  The purpose of this section is to establish the qualification requirements for dentists, dental hygienists and dental assistants pursuant to RSA 317-A:12, XII-b.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; ss by #6186, eff 2-17-96; ss by #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #10794, eff 3-7-15

 

          Den 302.02  Supervision.

 

          (a) “Direct supervision” means a dentist with an active license is in the dental office, authorizes the procedure, and remains in the dental office while the procedures are being performed, and evaluates the performance of the dental hygienist or dental assistant before dismissal of the patient.

 

          (b)  “Indirect supervision” means a dentist with an active license is in the dental office, authorizes the procedures, and remains in the dental office while the procedures are being performed by the dental hygienist or dental assistant, and evaluates the performance of the dental hygienist or dental assistant at a subsequent appointment.

 

          (c)  “General supervision” means a dentist with an active license has authorized the procedures, and the procedures are being carried out in accordance with the dentist’s diagnosis and treatment plan, and the procedures will be personally evaluated and reviewed by the dentist with the patient at least once in a 12 month period.

 

          (d)  “Public health supervision” means a dentist with an active license authorizes procedures which are to be carried out by:

 

(1)  A dental hygienist with an active license practicing in a school, hospital or other institution, or for a homebound person without the dentist having to be present, provided the dentist has reviewed the records once in a 12 month period; or

 

(2)  A dental assistant in a school, hospital or other institution, or for a homebound person who shall be supervised by a CPHDH as set forth in Den 401.01 (d).

 

          (e)  For purposes of (c) above, at the time the procedures performed under general supervision are evaluated, dentists shall use their professional judgment to determine whether a more extensive oral examination is appropriate.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91; ss by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; amd by #7929, eff 8-6-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13; EXPIRED: 3-9-15 (paras. (a)-(c) & (e)); ss by #10991, eff 12-9-15

 

          Den 302.03  Dental Hygienist Qualifications.  In addition to the qualifications included in RSA 317-A:21, an applicant for examination and registration as a dental hygienist in the state of New Hampshire shall have taken and passed the American Board of Dental Examiners (ADEX) dental hygiene examination, or other similar U.S. regional or state board examination for dental hygienists, including clinical procedure components.  The applicant shall complete the examination within the 3 year period prior to the completion of the licensing process in New Hampshire, unless the applicant seeks licensure by endorsement certification as provided in Den 301.01 (h) pursuant to RSA 317-A:12 III, in which circumstance the 3 year period shall not apply.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #4298, eff 7-28-87; ss by #5110, eff 4-4-91; amd by #5699, eff 9-14-93; amd by #6186, eff 2-17-96; ss by #6909, eff 12-9-98; ss by #7270, eff 5-12-00; ss by #8838, eff 3-9-07; ss by #9408-B, eff 3-10-09; ss by #10437, eff 10-8-13); ss by #10991, eff 12-9-15

 

          Den 302.04  Dentist Qualifications.

 

          (a)  In addition to the qualifications included in RSA 317-A:8, an applicant for dental licensure by examination in the state of New Hampshire shall have taken and passed the American Board of Dental Examiners (ADEX) examination, or other similar U.S. regional or state board clinical examination for dentist, including a clinical periodontal/scaling component.  The examination shall be completed within the 3 year period prior to the completion of the licensing process in New Hampshire, unless the applicant seeks licensure by endorsement certification as provided in Den 301.02 (h), pursuant to RSA 317-A:12 III, in which circumstance the 3 year period shall not apply.

 

          (b)  Dentists announcing specialization and limitation of practice shall adhere to section 5-H of the American Dental Association Principles of Ethics and Code of Professional Conduct, as amended 2016, and referenced in Appendix II, except as provided in (c) below.

 

          (c)  Dentists may announce diplomate status granted by a bona fide national organization which is not recognized as a certifying board by the American Dental Association but grants diplomate status based upon the dentist’s postgraduate education, experience and written and oral examinations based upon psychometric principles. The announcement, if made by a general dentist, shall indicate that he or she is a general dentist.

 

          (d) Dentists who wish to perform botulinum toxin or dermafiller procedures shall submit documentation to the board that demonstrates completion of at least 8 hours of hands-on training prior to performing such procedures.

 

Source.  #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7778, eff 10-10-02; amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; amd by #9973, eff 8-9-11; amd by #10068, eff 1-10-12; ss by #10437, eff 10-8-13; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #12549, eff 6-15-18

 

          Den 302.05  Dental Hygienist Qualification in Specific Area.

 

(a)  Any dental hygienist shall be considered qualified in a specific area if he or she has successfully completed an expanded duty course, or successfully challenged an examination in same, or both, as stated in Den 302.05 (a) through (q).  Course records, pursuant to Den 403.06, and a certificate of course completion shall be retained by the course participant and provided to the board upon request by the board. 

 

          (b)  Any dental hygienist may petition the board for approval of an expanded duty course or equivalent training course.  The petition shall include all information that the petitioner wishes the board to consider in evaluating the proposed course, such as the entity giving the course, an outline of the topics to be covered, the number of hours of lectures and hours of practical experience and the textbooks to be used.

 

          (c)  No dental hygienist shall be considered qualified prior to the date that he or she is officially informed by the course or examination provider that he or she has successfully completed an expanded duty course approved by the board.

 

          (d)  Any dental hygienist shall be considered qualified in provisional crown and bridge restorations after successfully completing an expanded duty course in provisional crown and bridge restorations which:

 

(1)  Is offered by a continuing education provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 hours;

 

(3)  Includes at least the following:

 

a.  Provisional restoration anatomy;

 

b.  Occlusal requirements; and

 

c.  Cementation; and

 

(4)  Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (e) If qualification in provisional crown and bridge restorations is determined, the duty shall be performed with the following conditions:

 

(1)  A dental hygienist qualified in provisional crown and bridge restorations shall perform this service only under the direct supervision of a licensed dentist;

 

(2)  The provisional restoration may be fabricated intraorally, however all occlusal adjustments and modifications shall be completed extraorally; and

 

(3)  The completed provisional restoration shall be examined by the dentist prior to cementation by a qualified dental hygienist.

 

          (f)  Any dental hygienist shall be considered qualified in orthodontic duties after successfully completing an expanded duty course in orthodontic duties which:

 

(1)  Is offered by a continuing education provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 hours;

 

(3)  Includes at least the following:

 

a.  Placement and removal of orthodontic separators;

 

b.  Preparation of teeth for bonding of brackets;

 

c.  Removal of orthodontic bands or brackets;

 

d.  Trial fitting of orthodontic bands;

 

e.  Using hand instruments to remove excess cement from bands on the coronal surfaces of the teeth;

 

f.  Trial fitting of head gear;

 

g.  Simple emergency adjustment of orthodontic appliances to relieve pain;

 

h.  Taking impressions for orthodontic appliances;

 

i.  Attachment or tying in and removal of orthodontic wires; and

 

j.  Bending arch wires; and

 

(4)  Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (g) If qualification in orthodontics is determined, the duty shall be performed with the following conditions:

 

(1)  A dental hygienist qualified in orthodontic duties shall perform this service only under the direct supervision of a licensed dentist.

 

          (h)  The duty of placing dental sealants shall be performed under the general supervision or public health supervision of a licensed dentist.

 

          (i)  Any dental hygienist shall be considered qualified in local anesthesia only after successfully completing an expanded duty course in local anesthesia which:

 

(1)  Is offered by an institution accredited by CODA;

 

(2)  Is a minimum of 20 didactic hours and 12 clinical hours;

 

(3)  Entails passing the local anesthesia examination given by the CDCA;

 

(4)  Includes at least the following topics:

 

a.  Neurophysiology of pain and pain control;

 

b.  Pharmacology of local anesthetic solutions and drug interactions;

 

c.  Potential local and systemic complications;

 

d.  Medical and dental indications and contraindications;

 

e.  Medical and dental history assessment;

 

f.  Safely assembling and handling a syringe;

 

g.  Locating anatomical landmarks associated with local anesthesia;

 

h.  Injection techniques;

 

i.  Hands-on experience with maxillary and mandibular injections by administering at least 6 infiltration and 6 block injections; and

 

j.  Legal issues associated with local anesthesia administration by a dental hygienist; and

 

(5) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (j)  If qualification in local anesthesia is determined, the duty shall be performed with the following conditions:

 

(1)  A dental hygienist qualified in local anesthesia shall:

 

a.  Administer local anesthesia only under the direct supervision of a dentist; and

 

b.  Display at his or her place of practice proof of anesthesia qualification approved by the board;

 

(2)  Any hygienist graduating from a CODA accredited school of dental hygiene shall comply with (i) above if a local anesthesia course meeting the foregoing requirements was not part of the school curriculum;

 

(3)  A dental hygienist who has qualified to administer local anesthesia in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (i) above and a letter from a supervising dentist attesting to the hygienist's experience administering local anesthesia within the previous 2 years; and

 

(4)  Students enrolled in a CODA accredited school of dental hygiene, who have passed a local anesthesia course as part of the school curriculum, shall not be in violation of this rule if they administer local anesthesia as part of a dental hygiene examination.

 

(k)  To obtain a local anesthesia permit, a dental hygienist qualified to administer local anesthesia shall provide to the board:

 

(1)  A written request and a certified check or money order made payable to the "Treasurer, State of New Hampshire" for the local anesthesia fee specified in Den 301.08, or if presented in person, the payment may be in cash;

 

(2)  Proof of course completion.  Applicants whose course was taken out of state shall also provide a copy of the course syllabus; and

 

(3)  His or her CDCA score.

 

          (l)  Any dental hygienist shall be considered qualified to monitor the administration of nitrous oxide (N2O) to patients after successfully completing an expanded duty course in monitoring the administration of nitrous oxide which:

 

(1)  Is offered by a course provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 6 hours;

 

(3)  Includes at least the following:

 

a.  Aspects of pain and anxiety;

 

b.  Anatomy and physiology of respiration;

 

c.  Stages of drug induced central nervous system depression;

 

d.  Pharmacology and physiological effects of nitrous oxide;

 

e.  Advantages and disadvantages of inhalation sedation using nitrous oxide;

 

f.  Medical assessment of patient prior to using nitrous oxide; and

 

g.  Proper administration of nitrous oxide to include:

 

1.  Description and use of inhalation equipment;

 

2.  Patient monitoring;

 

3.  Possible reactions of patients under nitrous oxide;

 

4.  Hazards of nitrous oxide for patients and operator; and

 

5.  Management of complications;

 

(4)  Requires the passing of a written test administered by the course provider; and

 

(5)  Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

(m)  If qualification in monitoring the administration of nitrous oxide (N2O) is determined, the duty shall be performed with the following conditions:

 

(1) A dental hygienist qualified in the monitoring of nitrous oxide shall monitor nitrous oxide only under the direct supervision of a dentist;

 

(2)  A dental hygienist qualified to monitor the administration of nitrous oxide shall monitor only after a dentist has initiated the administration and brought the patient to the intended level of nitrous oxide inhalation sedation;

 

(3)  A dental hygienist qualified to monitor the administration of nitrous oxide shall be currently certified in BLS-HCP; and

 

(4) A dental hygienist who has qualified to monitor nitrous oxide in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (l) above and a letter from a supervising dentist attesting to the hygienist's experience monitoring nitrous oxide within the previous 2 years.

 

          (n)  Any dental hygienist shall be considered qualified to administer nitrous oxide (N2O) for minimal sedation of patients after successfully completing an expanded duty course in the monitoring and administration of nitrous oxide which:

 

(1)  Is offered by an institution accredited by CODA;

 

(2)  Is a minimum of 8 didactic hours and 6 clinical hours;

 

(3)  Includes at least the following:

 

a.  Physiological and psychological aspects of pain and anxiety;

 

b.  Stages of drug induced central nervous system depression;

 

c.  Anatomy and physiology as they relate to inhalation sedation;

 

d.  Indications and contraindications of inhalation sedation;

 

e.  Pharmacology and physiological effects of nitrous oxide, including drug interactions;

 

f.  Medical assessment of patient prior to using nitrous oxide;

 

g.  Description and use of inhalation sedation equipment;

 

h.  Monitoring of patient’s vital functions;

 

i.  Preventing, recognizing and managing possible complications of inhalation sedation;

 

j.  Health hazards and techniques to limit occupational exposure;

 

k.  Abuse potential of nitrous oxide; and

 

l.  Maintenance of proper records;

 

(4)  Requires the passing of a written test administered by the course provider;

 

(5)  Requires successfully completing a clinical evaluation by the course provider; and

 

(6) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (o) If qualification in the administration of nitrous oxide (N2O) is determined, the duty shall be performed with the following conditions:

 

(1)  A dental hygienist qualified in the administration of nitrous oxide shall:

 

a.  Administer nitrous oxide only under the direct supervision of a dentist; and

 

b. Display at his or her place of practice proof of a nitrous oxide qualification course approved by the board;

 

(2)  Any hygienist graduating from CODA accredited school of dental hygiene shall comply with (l) above if a nitrous oxide course meeting the foregoing requirements was not part of the school curriculum;

 

(3)  A dental hygienist who has qualified to administer nitrous oxide in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (l) above and a letter from a supervising dentist attesting to the hygienist's experience administering nitrous oxide within the previous 2 years; and

 

(4)  Students enrolled in a CODA accredited school of dental hygiene, who have passed a nitrous oxide course as part of the school curriculum, shall not be in violation of this rule if they administer nitrous oxide as part of a dental hygiene examination.

 

          (p) Those individuals who qualify in the administration of nitrous oxide on or after January 1, 2018 shall be issued a permit upon submission of the following:

 

(1)  Proof of course completion and, if the course was taken out of state, a copy of the course syllabus;

 

(2)  A written request; and

 

(3)  A check or money order made payable to the "Treasurer, State of New Hampshire" for the application fee specified in Den 301.08, or if presented in person, the payment may be in cash.

 

          (q)  In-office tooth whitening shall be performed under general supervision.

 

Source.  #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7778, eff 10-10-02; amd by #7818, eff 1-9-03; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8100, eff 6-11-04; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; ss by 9408-B, eff 3-10-09; amd by #9778, eff 9-3-10; amd by #9973, eff 8-9-11; amd by #10328-B, eff 5-7-13; amd by #10437, eff 10-8-13; ss by #10689, eff 10-7-14; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17

 

          Den 302.06  Dental Assistant Qualification in Specific Area.

 

          (a)  Any dental assistant who is 18 years of age or older shall be considered qualified in a specific area if he or she has successfully completed an expanded duty course, or successfully challenged an examination in same, or both, as stated in Den 302.06 (a) through (ac). A course or exam given by an entity other than the board itself shall include the passing grade or other standard for successful completion of said course or exam set by the entity giving said course or exam. Course records, pursuant to Den 403.06, and a certificate of course completion shall be retained by the course participant and provided to the board upon request by the board. Traditional dental assistants, before qualifying in any other area addressed in Den 302.06, shall have taken and passed an introduction to dental assisting course and qualify for infection control in the dental office as stated in Den 302.06(b)(1)c.

 

          (b)  Traditional dental assistants shall qualify in infection control in the dental office after successfully completing a course in the topic, as follows:

 

(1)  The expanded duty course shall:

 

a.  Be offered by a course provider as defined in Den 403.07(a)(1);

 

b.  Be a minimum of 4 hours;

 

c.  Pursuant to RSA 317-A:17, II (g), follow the current Centers for Disease Control “Infection Control Recommendations for the Dental Office and the Dental Laboratory”; and

 

d. Require the passing of a written exam administered by the continuing education provider; and

 

(2)  Written evidence certifying that the infection control course has been successfully completed shall be signed by the course provider and given to the dental assistant.

 

          (c)  Any dental assistant may petition the board for approval of an expanded duty course or equivalent training course.  The petition shall include all information that the petitioner wishes the board to consider in evaluating the proposed course, such as the entity giving the course, an outline of the topics to be covered, the number of hours of lectures and hours of practical experience and the textbooks to be used. The board shall, within 60 days of receipt of such petition, send written notice of approval or a written request for further information from the petitioner.

 

          (d)  No dental assistant shall be considered qualified prior to the date that he or she is officially informed by the course or examination provider that he or she has successfully completed an expanded duty course approved by the board.

 

          (e)  A traditional dental assistant shall have 200 hours of experience in clinical dental assisting in order to qualify to take a course in introduction to dental assisting, which course shall be a prerequisite to any other expanded duty course described in this section.

 

          (f)  Any introduction to dental assisting course shall:

 

(1)  Be offered by a course provider as defined in Den 403.07(a)(1);

 

(2)  Be a minimum of 6 hours;

 

(3)  Contain at least the following subjects:

 

a.  The taking of medical and dental histories;

 

b.  Obtaining and reading vital signs;

 

c.  Oral and dental anatomy;

 

d.  Charting existing restorations and teeth;

 

e.  Inspection of the oral cavity; and

 

f.  The Health Insurance Portability and Accountability Act of 1996 (HIPAA);

 

(4)  Require the passing of a written examination administered by the continuing education provider; and

 

(5) Provide to the dental assistant written evidence certifying that the course has been successfully completed, which is signed by the course provider.

 

          (g)  Any dental assistant who successfully completes the introduction to dental assisting course shall be qualified to perform those duties set forth in Den 401.01 and Den 401.02.

 

          (h)  Any traditional dental assistant shall have 200 hours of experience in clinical dental assisting in order to qualify to take a radiology course.

 

          (i)  Any dental assistant shall be considered qualified in dental radiology after successfully completing an expanded duty course in dental radiology which:

 

(1) Is offered by a continuing education provider as specified in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 lecture hours, which may be taken online, and 8 laboratory hours;

 

(3)  Includes at least the following:

 

a.  Asepsis, radiation safety;

 

b.  Parallel and bi-secting techniques;

 

c.  Full mouth projections, panoramic projections, projections, and extra-oral projections;

 

d.  Dark room procedures;

 

e.  Radiographic landmarks, interpretation, and mounting;

 

f. Passing the radiology written examination of the Dental Assisting National Board, provided that dental assistants who have been practicing since before December 9, 1998 shall be exempt from taking and passing the DANB exam; and

 

g.  Passing of a written exam administered by the continuing education provider; and

 

(4) Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (j)  The duty of dental radiology shall be performed only under the direct supervision of a licensed dentist.

 

          (k)  Any traditional dental assistant shall have 200 hours of experience in clinical dental assisting in order to qualify to take a course in provision crown and bridge restorations.

 

          (l)  Any dental assistant shall be considered qualified in provisional crown and bridge restorations after successfully completing an expanded duty course in provisional crown and bridge restorations which:

 

(1)  Is offered by a continuing education provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 hours;

 

(3)  Includes at least the following:

 

a.  Provisional restoration anatomy;

 

b.  Occlusal requirements;

 

c.  Cementation; and

 

d.  Passing of a written exam administered by the continuing education provider; and

 

(4) Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (m)  The duty of provisional crown and bridge restorations shall be performed with the following conditions:

 

(1)  A dental assistant qualified in provisional crown and bridge restorations shall perform this service only under the direct supervision of a licensed dentist;

 

(2)  The provisional restoration may be fabricated intraorally, however all occlusal adjustments and modifications shall be completed extraorally; and

 

(3)  The completed provisional restoration shall be examined by the dentist prior to cementation by a qualified dental assistant.

 

          (n)  Any traditional dental assistant shall have at least 200 hours of experience in clinical dental assisting in order to qualify to take a course in orthodontics.

 

          (o)  Any traditional dental assistant shall be considered qualified in orthodontic duties after successfully completing an expanded duty course in orthodontic duties which:

 

(1)  Is offered by a continuing education provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 hours;

 

(3)  Includes at least the following:

 

a.  Placement and removal of orthodontic separators;

 

b.  Preparation of teeth for bonding of brackets;

 

c.  Removal of orthodontic bands or brackets;

 

d.  Trial fitting of orthodontic bands;

 

e.  Using hand instruments to remove excess cement from bands on the coronal surfaces of the teeth;

 

f.  Trial fitting of head gear;

 

g.  Simple emergency adjustment of orthodontic appliances to relieve pain;

 

h.  Taking impressions for orthodontic appliances;

 

i.  Attachment or tying in and removal of orthodontic wires;

 

j.  Bending arch wires; and

 

k. Passing of a written exam administered by the continuing education provider; and

 

(4)  Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (p)  The duty of orthodontics shall only be performed under the direct supervision of a licensed dentist.

 

          (q)  Any traditional dental assistant shall have at 400 hours of experience in clinical dental assisting in order to qualify to take a sealants course.

 

          (r)  Any traditional dental assistant shall be considered qualified in dental sealants after successfully completing an expanded duty course in dental sealants which:

 

(1)  Is offered by a continuing education provider as specified in Den 403.07(a)(1);

 

(2)  Is a minimum of 8 hours;

 

(3)  Includes at least the following:

 

a.  Use of chemical and light cured sealants;

 

b.  Proper techniques of applying sealants;

 

c.  Isolation techniques;

 

d.  Practice in applying sealants in a laboratory setting;

 

e.  Application of sealants on an actual patient in a clinical setting; and

 

f.  Passing an exam administered by the continuing education provider; and

 

(4)  Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (s)  The duty of dental sealants shall only be performed under the direct supervision of a licensed dentist.

 

          (t)  Traditional dental assistants shall have experience consisting of at least 400 hours in clinical dental assisting in order to qualify to take a course in coronal polishing.

 

          (u)  Any dental assistant other than a graduate dental assistant shall be considered qualified in coronal polishing after meeting the eligibility requirements and successfully completing an expanded duty course in coronal polishing which:

 

(1)  Is offered by a continuing education provider as set forth in Den 403.07 (a);

 

(2)  Is a minimum of 8 hours; and

 

(3)  Includes at least the following subjects:

 

a.  Handpiece maintenance and sterilization;

 

b.  Polishing agents;

 

c.  Polishing techniques;

 

d.  Infection control;

 

e.  Medical and dental history indications and contraindications;

 

f.  Hands-on polishing in a clinical setting; and

 

g.  Passing of a written examination administered by the continuing education provider; and

 

(4) Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (v)  The duty of coronal polishing shall be performed with the following conditions:

 

(1)  Coronal polishing by dental assistants shall be accomplished by a combination of slow speed handpiece, not to exceed 10,000 rpm, and appropriate polishing agents with a rubber cup or bristle brush;

 

(2) Coronal polishing shall be accomplished by dental assistants only after a dentist or dental hygienist has determined that the teeth are free of calculus;

 

(3) A dental assistant qualified in coronal polishing shall perform this service only under the direct supervision of a licensed dentist or dental hygienist; and

 

(4)  Coronal polishing shall in no way be represented as a prophylaxis unless a dentist or dental hygienist has determined the teeth are free of calculus immediately prior to the polishing.

 

          (w)  Any traditional dental assistant shall have 400 hours of experience in clinical dental assisting prior to taking an expanded duty course in monitoring the administration of nitrous oxide anesthesia.

 

          (x)  Any traditional dental assistant shall be considered qualified to monitor the administration of nitrous oxide (N2O) to patients after successfully completing an expanded duty course in monitoring the administration of nitrous oxide which:

 

(1)  Is offered by a course provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 6 hours;

 

(3)  Includes at least the following:

 

a.  Aspects of pain and anxiety;

 

b.  Anatomy and physiology of respiration;

 

c.  Stages of drug induced central nervous system depression;

 

d.  Pharmacology and physiological effects of nitrous oxide;

 

e.  Advantages and disadvantages of inhalation sedation using nitrous oxide;

 

f.  Medical assessment of patient prior to using nitrous oxide; and

 

g.  Proper administration of nitrous oxide to include:

 

1.  Description and use of inhalation equipment;

 

2.  Patient monitoring;

 

3.  Possible reactions of patients under nitrous oxide;

 

4.  Hazards of nitrous oxide for patients and operator; and

 

5.  Management of complications;

 

(4)  Requires the passing of a written examination administered by the continuing education provider; and

 

(5) Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (y)  If qualification in monitoring the administration of nitrous oxide is determined, the duty shall be performed with the following conditions:

 

(1)  A dental assistant qualified in the monitoring of nitrous oxide shall monitor nitrous oxide only under the direct supervision of a dentist;

 

(2)  A dental assistant qualified to monitor the administration of nitrous oxide shall monitor only after a dentist has initiated the administration and brought the patient to the intended level of nitrous oxide inhalation sedation; and

 

(3)  A dental assistant qualified to monitor the administration of nitrous oxide shall be currently certified in BHLS-HCP; and

 

(4)  A dental assistant who has qualified to monitor nitrous oxide in another jurisdiction shall qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (x) above and a letter from a supervising dentist attesting to the assistant's experience monitoring nitrous oxide within the previous 2 years.

 

          (z)  Any traditional dental assistant shall have at least 400 hours in clinical dental assisting in order to qualify to take a course in office whitening.

 

          (aa)  A dental assistant shall be qualified to perform in-office tooth whitening after successfully completing an expanded duty course in in-office tooth whitening which:

 

(1)  Is offered by a course provider as defined in Den 403.07(a)(1);

 

(2)  Is a minimum of 4 hours;

 

(3)  Includes at least the following;

 

a.  An overview of prescription and non-prescription whitening systems;

 

b.  Mechanisms of action;

 

c.  Treatment methods;

 

d.  Safety considerations, including:

 

1.  Contraindications; and

 

2.  Side effects; and

 

e.  Passing of a written examination administered by the continuing education provider; and

 

(4)  Provides to the dental assistant written evidence certifying that the course has been successfully completed and which is signed by the course provider.

 

          (ab)  The duty of in-office tooth whitening shall only be performed under the direct supervision of a licensed dentist.

 

Source.  #12428, eff 12-6-17

 

          Den 302.07  Expanded Function Dental Auxiliary (EFDA).

 

          (a)  Any dental hygienist, or certified or graduate dental assistant as defined in Den 401.02, shall be considered qualified to place, contour and adjust direct restorative materials within the oral cavity after successfully completing an expanded function dental auxiliary (EFDA) course in dental restorations, as follows:

 

(1)  The direct dental restorations course shall have the following prerequisites:

 

a.  Course candidates shall be a registered dental hygienist, or a dental assistant who is certified by the Dental Assistant National Board or is a graduate of a CODA accredited school of dental assisting;

 

b.  All candidates shall have a minimum of 4,500 hours of dental clinical experience;

 

c.  All candidates shall be recommended for the course by a dentist with an active NH dental license;

 

d.  Dental assistants, other than graduate dental assistants, shall be qualified to perform a preliminary inspection of the oral cavity, pursuant to Den 302.05 (d); and

 

e.  All candidates shall be currently certified in BLS-HCP; and

 

(2)  The EFDA course in direct dental restorations shall:

 

a.  Be offered by an institution accredited by CODA;

 

b.  Be a minimum of 50 didactic hours and 100 hours of pre-clinical training in a curriculum approved by the board;

 

c.  Include at least the following subjects:

 

1.  Dental materials;

 

2.  Use of the low speed hand piece and high speed hand piece;

 

3.  Placement and finishing of amalgams, and composite resins;

 

4.  Dental occlusion; and

 

5.  Dental jurisprudence;

 

d.  Include assessment certifying successful course completion and provide written evidence signed by the course provider and given to the hygienist or dental assistant; and

 

e.  Be followed by 6 weeks, minimum of 120 hours, of training in a dental office under the direct supervision and monitoring by the faculty of a school accredited by CODA or its designate.

 

          (b)  The following shall apply to all EFDA's:

 

(1)  The EFDA shall register with the board and submit proof of the required EFDA training and experience, as well as a fee to obtain an EFDA permit from the board;

 

(2)  The EFDA shall renew the EFDA permit in odd numbered years before May 1st, if EFDA employment is continued;

 

(3)  The EFDA shall prominently display the permit where the EFDA works;

 

(4)  A maximum of 2 EFDA’s shall be employed in a dental practice regardless of the number of dentists;

 

(5)  Dentists shall inform the board of EFDA’s employed within 10 days of employment;

 

(6)  EFDA’s shall complete 10 CEU’s each biennium in restorative dentistry;

 

(7)  A dental auxiliary who has qualified in the placement, contouring and adjustment of direct dental restorations in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (a) above and a letter from a supervising dentist attesting to the auxiliary’s experience with direct restorations within the previous 2 years; and

 

(8)  EFDA’s shall practice under the direct supervision of a New Hampshire licensed dentist.

 

Source.  #10991, eff 12-9-15; ss by #12428 (formerly Den 302.06)

 

          Den 302.08  Certified Public Health Dental Hygienist (CPHDH).

 

          (a)  Any dental hygienist shall be considered qualified as a CPHDH after:

 

(1)  Obtaining a bachelor’s degree in dental hygiene with a minimum of 6 semester hours in community dental health;

 

(2)  Obtaining a master’s degree in public health; or

 

(3)  Successfully completing the following courses which are offered by a continuing education provider as defined in Den 403.07(a)(1) and by successful completion of an examination by the course provider:

 

a.  Caries stabilization in the public health setting which:

 

1.  Is a minimum of 6 hours; and

 

2.  Includes at least the following:

 

(i)  Indications for interim therapeutic restorations (ITRs);

 

(ii)  Appropriate technique for placing ITRs;

 

(iii)  Variables that influence the success of ITRs;

 

(iv)  Selection of intermediary materials for specific restoration; and

 

(v)  Characteristics and handling of intermediary materials and follow-up coding;

 

b.  Evidence based dentistry which:

 

1.  Is a minimum of 4 hours; and

 

2.  Includes at least the following:

 

(i)  Evidence based approach to dental treatment;

 

(ii)  Applying evidence based theory to public health practice; and

 

(iii)  Hands-on computer experience relevant to practice;

 

c.  Infection control in public health settings which:

 

1.  Is a minimum of 4 hours; and

 

2.  Includes at least the following:

 

(i)  Lecture and hands on experience;

 

(ii)  Review of latest infection control procedures in dentistry; and

 

(iii)  Proper asepsis techniques while working in non-traditional settings;

 

d.  Medical management in public health dental settings which:

 

1.  Is a minimum of 6 hours; and

 

2.  Includes at least the following:

 

(i)  Both lecture and hands-on learning;

 

(ii)  Systemic conditions and diseases with emphasis on dental hygiene treatment planning;

 

(iii) Management of dental and medical emergencies in alternative dental settings; and

 

(iv)  Pharmacology review of current therapy for the most common disease states with an emphasis on high-risk patients; and

 

e.  Management of medical records which:

 

1.  Is a minimum of 4 hours; and

 

2.  Includes at least the following:

 

(i)  Legal requirements for medical records;

 

(ii)  Family Educational Rights and Privacy Act (FERPA);

 

(iii)  Guidance in drafting a Privacy Impact Assessment (PIA); and

 

(iv)  New Hampshire law for reporting patient abuse.

 

          (b)  The following shall apply to qualification as a CPHDH:

 

(1)  All CPHDHs shall have:

 

a.  Practiced as a dental hygienist for 3200 hours, 1600 hours of which shall be within the 2 years prior to certification;

 

b.  Completed a course in caries stabilization that is a minimum of 6 hours as outlined in (a)(3)a; and

 

c.  Qualified in dental sealants pursuant to Den 302.05(h), if similar training was not received as part of the dental hygiene school curriculum;

 

(2)  Hygienists qualifying as a CPHDH by completing the courses specified in (a)(3) above shall complete the courses within the 4 years prior to certification, or if they are already working in a public health setting, within 4 years of this rule becoming effective;

 

(3)  Documented proof of the completion of all requirements shall be retained by both the collaborating dentist and hygienist, and submitted to the board for certification;

 

(4)  Hygienists who have qualified as a CPHDH, prior to practicing as such, shall have a written collaborative agreement with a dentist with an active New Hampshire dental license to practice under the dentist’s supervision;

 

(5)  Hygienists who have qualified as a CPHDH, prior to practicing as such, shall register with the board and submit proof of the required training and experience, as well as a fee to obtain certification from the board;

 

(6)  CPHDHs shall comply with duties listed in RSA 317-A:21-e;

 

(7)  CPHDHs shall display at his or her place of practice proof of certification approved by the board;

 

(8)  Hygienists who have been granted certification as a CPHDH shall renew certification in odd-numbered years before May 1st;

 

(9) CPHDHs who fail to renew their certification before May 1st of odd-numbered years, pursuant to RSA 317-A:13, shall be subject to a late fee pursuant to Den 301.08;  and

 

(10) CPHDHs who fail to renew their certification before May 1st of odd-numbered years, pursuant to RSA 317-A:13, shall be subject to a reinstatement fee for lapsed certification pursuant to Den 301.08.

 

          (c)  Each applicant for certification to practice as a CPHDH in the state of New Hampshire shall provide the following on the "Application for CPHDH Certification" form:

 

(1)  Applicant's name;

 

(2)  Applicant's date of birth;

 

(3)  Applicant's place of birth;

 

(4)  Applicant's social security number, pursuant to RSA 161-B:11, VI-a;

 

(5)  Any other name by which the applicant has been known;

 

(6)  Applicant's current business and residential addresses, telephone numbers, and primary email address, either business or personal;

 

(7)  Name of supervising dentist;

 

(8)  Whether the applicant's BLS-HCP certification is current, and if so, provide proof;

 

(9)  Applicant's level of education including:

 

a.  Original transcripts of master's degree in public health, and certificates of completion showing compliance with course requirements set forth in Den   302.08 (a);

 

b.  Original transcripts of bachelor's degree in dental hygiene, with a minimum of 6 hours in community dental health, and certificates of completion showing compliance with course requirements set forth in Den 302.08 (a); or

 

c.  Registered dental hygienist, without either a master's degree in public health or bachelor's degree in dental hygiene, shall submit certificates of completion for those courses required by Den 302.08 (a) and (b);

 

(10)  Applicant's educational background, including proof that the applicant has:

 

a.  Practiced as a dental hygienist for 3200 hours, 1600 hours of which shall be within the 2 years prior to certification;

 

b.  Completed a course in caries stabilization that is a minimum of 6 hours as outlined in Den 302.08(a)(3)(a);

 

c. Qualified in dental sealants pursuant to Den 302.05(h), if similar training was not received as part of the dental hygiene school curriculum; and

 

d.  Completed an approved course in infection control in public health settings as outlined in Den 302.08(a)(3)c.; and

 

(11)  An unmounted passport-type photograph of the applicant shall be:

 

a.  Attached to the form;

 

b.  Taken not more than 6 months before the date on the application; and

 

c.  No smaller than 2 and 1/2 inches square.

 

          (d)  The form shall be signed by the applicant, notarized, and filed with the board.  Deceptive or false statements, knowingly made by the applicant, shall result in denial of a CPHDH certificate.  By signing the form, the applicant shall waive any confidentiality regarding disclosure to the board from any other jurisdiction about any pending complaints or action being taken against the applicant's license to practice as a CPHDH.

 

          (e)  The form shall be accompanied by the following documents:

 

(1)  A check or money order made payable to the "Treasurer, State of New Hampshire" for the application fee specified in Den 301.08, or if presented in person, the payment may be in cash; and

 

(2)  A letter confirming whether the applicant has a written collaborative agreement with a dentist with an active New Hampshire dental license to practice under the dentist's supervision.

 

Source.  #10991, eff 12-9-15; renumbered by #12428 (formerly Den 302.07)

 

PART Den 303  EXAMINATION

 

          Den 303.01  Dental Examination.  Each applicant for a license to practice dentistry in the state of New Hampshire shall be examined by the board on the contents of RSA 317-A and its accompanying rules.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #10794, eff 3-7-15

 

          Den 303.02  Dental Hygienist Examination.  Each applicant for a license to practice as a dental hygienist in the state of New Hampshire shall be examined by the board on the contents of RSA 317-A and its accompanying rules.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #10794, eff 3-7-15

 

          Den 303.03  Jurisprudence Exam.

 

          (a)  Each applicant for initial licensure to practice as a dentist or registered dental hygienist shall be examined by the board of dental examiners on the contents of RSA 317-A Dental Practice Act, administrative rules Den 100 through 500, and the American Dental Association’s Principles of Ethics and Code of Professional Conduct.

 

          (b)  The examination shall be:

 

(1)  Taken at home using pen and paper or if available electronically taken on a secure website provided to the applicant by the board; and

 

(2)  Open book.

 

Source.  #4037, eff 4-9-86; amd by #4105, eff 8-1-86; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #9408-B, eff 3-10-09; ss by #10689, eff 10-7-14

 

PART Den 304  USE OF GENERAL ANESTHESIA AND SEDATION BY DENTISTS

 

          Den 304.01  Definitions.

 

          (a)  "General anesthesia" means a controlled state of unconsciousness, accompanied by a partial or complete loss of protective reflexes, including inability to maintain an airway independently and respond purposefully to physical stimulation or verbal command, produced by a pharmacologic or nonpharmacologic method, or combination thereof.

 

          (b)  Deep sedation" means an induced state of depressed consciousness, accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently and/or to respond purposefully to verbal command, and is produced by a pharmacologic or nonpharmacologic method, or combination thereof.

 

          (c) " Moderate sedation”, formerly known as conscious sedation, means a minimally depressed level of consciousness that retains the patient's ability to independently and continuously maintain an airway and respond appropriately to physical stimulation or verbal command, produced by a pharmacologic or nonpharmacologic method, or combination thereof.

 

          (d)  “Minimal sedation”, formerly known as anxiolysis, means a drug induced state during which patients respond normally to verbal commands. Although cognitive function and coordination might be impaired, ventilatory and cardiovascular functions are unaffected.

 

Source.  #4298, eff 7-28-87; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98; ss by #7304, eff 6-9-00; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; ss by #9256, eff 9-10-08; ss by #10991, eff 12-9-15

 

          Den 304.02  Administration of General Anesthesia or Sedation Exclusively by a New Hampshire Licensed Anesthesiologist or Certified Registered Nurse Anesthetist. Dentists shall not be obligated to obtain a permit pursuant to this part if general anesthesia or sedation is being administered exclusively by a New Hampshire licensed anesthesiologist or certified registered nurse anesthetist, so long as:

 

      (a)  The dentist first provides to the board:

 

(1)  The name of the licensed anesthesiologist or certified registered nurse anesthetist that the licensee intends will be administering anesthesia or sedation; and

 

(2)  The level of sedation being administered; and

 

          (b)  The dentist intending to use an anesthesiologist or certified registered nurse anesthetist for administration under this section passes an initial facility inspection of the facility or office as described in Den 304.05(c)(1) plus subsequent evaluations every 5 years thereafter, provided that anesthesiologists or certified registered nurse anesthetists who pass an initial facility inspection at one facility or office shall not be required to pass additional inspections at other facilities.

 

Source.  #12428, eff 12-6-17

 

          Den 304.03  Permits for Use of General Anesthesia, Deep Sedation and Moderate Sedation.

 

          (a)  No dentist shall use general anesthesia, deep sedation, or moderate sedation on an outpatient basis for dental patients except pursuant to Den 304.02 or as follows:

 

(1)  Such dentist shall possess a permit of authorization issued by the board;

 

(2)  Such permit shall be subject to review and shall be renewed every 2 years at the same time as biennial registration for the practice of dentistry;

 

(3)  Such dentist shall be certified in BLS-HCP; and

 

(4)  Such dentist shall be currently certified in American Heart Association (AHA) approved advanced cardiac life support (ACLS) if treating post-pubertal patients. Such dentists shall be currently certified in American Heart Association (AHA) approved pediatric advanced life support (PALS) if treating pre-pubertal patients. These requirements shall supersede any requirements for current ACLS or PALS certification stated in the American Academy of Pediatric Dentistry 2016 “Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures” as referenced in Den 304.04(b)(1).

 

          (b)  In order to receive a permit to use general anesthesia, deep sedation and moderate sedation the dentist shall:

 

(1)  Apply on an “Initial Application to Administer General Anesthesia and/or Sedation” form, effective October 2018, to the board, as specified in Den 304.05;

 

(2)  Submit the application fee specified in Den 301.08; and

 

(3)  Provide evidence showing that he or she:

 

a.  Complies with one of the following:

 

1.  Has completed advanced training in anesthesiology and related academic subjects beyond the undergraduate dental school level in a training program as described in Part III C. of the American Dental Association 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”, as specified in Appendix II; or

 

2.  Has completed advanced training in anesthesiology and related academic subjects as described in the CODA requirements for each advanced program; and

 

b.  Has a properly staffed and equipped facility as set forth in:

 

1.  The 8th edition of the “Office Anesthesia Evaluation Manual” of the American Association of Oral and Maxillofacial Surgeons, 2012, as specified in Appendix II; or

 

2.  Part IV C. of the American Dental Association 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”, as specified in Appendix II.

 

Source.  #4738; eff 1-16-90; ss by #5110, eff 4-4-91; rpld and moved to Part Den 403 by #5332, eff 4-1-92; ss by #6909, eff 12-9-98; ss by #7304, eff 6-9-00; amd by #8260, eff 1-19-05; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; ss by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #9778, eff 9-3-10; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13; amd by #10437, eff 10-8-13; ss by #10689, eff 10-7-14; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17 (from Den 304.02)

 

          Den 304.04  Permits for Moderate Sedation Only.

 

          (a)  In order to receive an unrestricted permit or a restricted permit to use moderate sedation only, the dentist shall:

 

(1)  Apply on a prescribed application form to the board, as specified in Den 304.05 below;

 

(2)  Submit the application fee specified in Den 301.08; and

 

(3)  Provide evidence that he or she:

 

a.  Has met the requirements of Part V of the American Dental Association 2016 “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students”, as specified in Appendix II; and

 

b.  Has a properly staffed and equipped facility as set forth in:

 

1.  The 8th edition of the “Office Anesthesia Evaluation Manual” of the American Association of Oral and Maxillofacial Surgeons, 2012, as specified in Appendix II; or

 

2.  Part IV B. of the American Dental Association 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”, as specified in Appendix II;

 

          (b)  The following shall apply to an unrestricted moderate sedation permit:

 

(1)  Patients shall be of any age, however for pre-pubertal patients treatment shall follow the American Academy of Pediatric Dentistry 2016 “Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures”, as specified in Appendix II;

 

(2)  Routes of administration shall be enteral, parenteral or any combination with inhalation sedation;

 

(3)  With or without inhalation sedation, agents shall be limited to a single dose of one or more drugs, or a multi-dose of a single drug using manufacturer guidelines;

 

(4)  To renew their permit, dentists shall document 6 cases per year or 4 hours of continuing education in sedation training per biennium; and

 

(5)  Case documentation shall include:

 

a.  Age and sex of patient;

 

b.  ASA classification;

 

c.  Procedures;

 

d.  Drugs and dosage; and

 

e.  Level of sedation.

 

          (c)  The following shall apply to a restricted moderate sedation permit:

 

(1)  Patients shall be post-pubertal;

 

(2) Routes of administration shall be enteral or combination enteral-inhalation. Parenteral administration shall not be used;

 

(3)  With or without inhalation sedation, agents shall be limited to a single dose of one or more drugs, or a multi-dose of a single drug using manufacturer guidelines;

 

(4) To renew their permit, dentists shall document 6 cases per year or 4 hours continuing education in sedation training per biennium; and

 

(5)  Case documentation shall include:

 

a.  Age and sex of patient;

 

b.  ASA classification;

 

c.  Procedures;

 

d.  Drugs and dosage; and

 

e.  Level of sedation.

 

Source.  #12428, eff 12-6-17; amd by #12549, eff 6-15-18

 

          Den 304.05  General Anesthesia, Deep Sedation and Moderate Sedation, and Moderate Sedation Only Permit Application Procedures and Evaluations.

 

          (a)  Each applicant for a permit to use general anesthesia, deep sedation and moderate sedation, or moderate sedation only shall supply the board with the following on the “Initial Application to Administer General Anesthesia and/or Sedation” form, effective October 2018:

 

(1)  Applicant’s name;

 

(2)  Applicant’s home address;

 

(3)  Applicant’s primary email address,

 

(4)  Applicant’s New Hampshire dental license number;

 

(5)  Professional addresses and telephone numbers where permits are to be used;

 

(6)  Proof of the basis in Den 304.03 above upon which the permit is to be issued;

 

(7)  A list of all staff members who assist in general anesthesia or sedation; and

 

(8)  Current cardiac life support training status of the applicant and each of the foregoing staff members.

 

(b)  The form shall be signed and dated.

 

          (c)  To determine if the requirements of this section have been met by dentists to administer general anesthesia, deep sedation and moderate sedation, or moderate sedation only:

 

(1)  The board shall require passage of an initial facility inspection, equipment and drugs as they relate to general anesthesia and sedation prior to the issuance of the initial permit;

 

(2)  The board shall require, within 8 months of the issuance of the initial permit, passage of a comprehensive evaluation including personnel, records and patient treatment as they relate to general anesthesia and sedation.  A comprehensive evaluation shall not be required for a second location;

 

(3)  The comprehensive evaluation shall be carried out by a team of dental consultants acting as agents of the board, as follows:

 

a.  Dentists with permits to administer general anesthesia, deep sedation and moderate sedation shall be evaluated by dental consultants who satisfy Den 304.03 (b)(3) b. 1. or 2.; and

 

b.  Dentists with permits to administer moderate sedation only shall be evaluated by dental consultants who satisfy Den 304.03(b)(3) b. 1. or 2. above or (c)(3) a.;

 

(4)  If more than one office location is used by the dentist, then each office shall have facility inspection;

 

(5)  If the applicant fails the facility inspection or comprehensive evaluation, upon written request of the applicant, a second facility inspection or comprehensive evaluation shall be conducted by a different team of consultants;

 

(6)  Upon satisfactory completion of the facility inspection and comprehensive evaluations, a comprehensive evaluation shall be held at least once every 5 years; and

 

(7)  Such evaluation shall be carried out in the same manner as the initial comprehensive evaluation.

 

          (d)  The evaluation of patient treatment shall include instances where the highest form of pain and anxiety control was used by the dentist being evaluated.

 

(e)  The board shall take action in any one or more of the following ways as necessary to protect the public welfare when the results of a facility inspection or comprehensive evaluation are unsatisfactory:

 

(1)  By permit revocation or suspension;

 

(2)  By limitation or restriction of a permit; and

 

(3) By requiring the licensee to participate in an educational program relevant to areas the licensee has been found to be professionally deficient.

 

          (f)  The following requirements for inspection or evaluation fees shall apply:

 

(1)  Fees for inspections and evaluations shall be borne by the dentist examined;

 

(2)  If the facility inspection or comprehensive evaluation cannot be completed because the dentist is unprepared, the full fee shall remain owed;

 

(3)  Third party fees shall be paid directly to the third party at the time of the facility inspection or comprehensive evaluation;

 

(4)  Payment of all required fees shall be noted on the inspection or evaluation report for the evaluation to be satisfactory;

 

(5)  Following an unsatisfactory facility inspection or comprehensive evaluation, a second inspection or evaluation shall require a second full fee; and

 

(6)  The board shall take action for failure to pay required inspection and evaluation fees, pursuant to Den 304.05(f).

 

          (g)  For those applicants who have not used general anesthesia, deep sedation or moderate sedation in New Hampshire, a permit shall be granted by the board based solely upon credentials contained in the application, after complete processing of the application and thorough investigation by an facility inspection as described in (a) and (c) above.

 

Source. #12428, eff 12-6-17; amd by #13251, EMERGENCY RULE, eff 8-11-21, EXPIRED:  8-7-22

 

          Den 304.06  Minimal Sedation.

 

          (a)  Dentists administering minimal sedation shall:

 

(1)  Not be required to have a permit;

 

(2)  Have met the requirements of Part IV of the American Dental Association 2016 “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students”, as specified in Appendix II; and

 

(3)  Follow the guidelines set forth in Part IV A. of the American Dental Association 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”, as specified in Appendix II including having a properly staffed and equipped facility.

 

          (b)  The following routes of administration shall apply to the use of minimal sedation:

 

(1)  For pre-pubertal patients the route shall be inhalation only, using nitrous oxide; and

 

(2)  For post-pubertal patients the route shall be by:

 

a.  Inhalation using nitrous oxide;

 

b. Enteral, using one or more doses of one drug within a 24-hour period using manufacturers guidelines; or

 

c.  A combination inhalation-enteral, as above in a. and b.

 

Source.  #12428, eff 12-6-17; amd by #12549, eff 6-15-18

 

          Den 304.07  Mortality Reports.

 

          (a)  Dentists shall inform the board in writing within 20 days of mortality related to their administration of general anesthesia or sedation in an outpatient facility.

 

          (b)  The report shall include a description of:

 

(1)  Dental procedure;

 

(2)  Pre-operative physical condition of the patient;

 

(3)  Drugs and dosages administered;

 

(4)  Techniques used in administering the drugs;

 

(5)  Any adverse occurrence, including:

 

a.  Patient’s signs and symptoms;

 

b.  Treatment instituted in response to adverse occurrences; and

 

c.  Patient’s response to the treatment; and

 

(6)  Patient’s condition on termination of any procedures undertaken.

 

Source.  #12428, eff 12-6-17

 


CHAPTER Den 400  DENTAL ASSISTANTS AND HYGIENISTS DUTIES

 

REVISION NOTE:

 

            The Governor declared a State of Emergency in Executive Order 2020-04, which was effective 3-13-20.  The declaration and subsequent Emergency Orders issued pursuant to Executive Order 2020-04, which may have affected various rules and statutes governing licensees under Chapter Den 400.  The State of Emergency terminated at midnight on 6-11-21, and rules or statutes which had been amended during the State of Emergency were restored.  To determine what rules in Den 400 were applicable during the State of Emergency, the user should check not only the source notes of the rules but also the Emergency Orders in effect at the time in question.

 

            Document #13341, effective 2-8-22, amended paragraph (f) in Den 403.07 titled “Categories of Credit as an emergency rule.  Document #13366, effective 4-19-22, subsequently readopted with amendment Den 403.07 as a regular rule before the emergency rule would have expired on 8-7-22 pursuant to RSA 541-A:18, V.

 

PART Den 401  ASSISTANTS

 

          Den 401.01  Assistants' Duties.

 

          (a)  A dental assistant shall perform the following duties under general supervision, as defined in Den 101.11 and arranged by degree of supervision in Den 302.02:

 

(1)  Sterilize instruments;

 

(2)  Organize and arrange instruments on bracket tables;

 

(3)  Seat patient, place protective materials or garments including the lubrication of such patient's lips;

 

(4)  Reorganize instruments and equipment after the patient has departed;

 

(5)  Process dental radiographs;

 

(6)  Function as a dental laboratory technician;

 

(7)  Perform tests on saliva;

 

(8)  Train or instruct groups or individual patients in techniques of oral hygiene and mouth care; and

 

(9)  Take the blood pressure of a patient.

 

          (b)  A dental assistant shall perform the following duties under direct supervision, as defined in Den 101.10 and arranged by degree of supervision in Den 302.02:

 

(1)  Retract a patient's cheek, tongue or other oral tissues during a dental operation;

 

(2)  Assist with the placement or removal of a rubber dam and accessories used for its placement and retention, as directed by an operating dentist during the course of a dental operation;

 

(3)  Remove such debris as is normally created or accumulated during the course of treatment being rendered by a licensed dentist by the use of vacuum devices, compressed air, mouth washes and water; and

 

(4)  Place cotton rolls and topical anesthesia prior to delivery of local anesthesia by a dentist or dental hygienist.

 

          (c)  Before qualifying to perform the duties delineated in Den 401.01 (d), any dental assistant, other than a certified dental assistant or graduate dental assistant, shall qualify in infection control in the dental office as stated in Den 302.06(b).

 

          (d)  A dental assistant shall perform the following duties pursuant to the definition of "Public Health Supervision" as set forth in Den 302.02 (d)(2) to assist a CPHDH:

 

(1)  Process and sterilize instruments and perform infection control;

 

(2)  Organize and arrange instruments on bracket tables;

 

(3)  Seat patient, place protective materials or garments including the lubrication of such patient's lips;

 

(4)  Reorganize instruments and equipment after the patient has departed the healthcare facility;

 

(5)  Process dental radiographs;

 

(6)  Train or instruct groups or individual patients in techniques of oral hygiene   and mouth care;

 

(7)  Retract a patient's cheek, tongue or other oral tissues during a dental hygiene and remove such debris as is normally created or accumulated during the course of treatment being rendered by a CPHDH by the use of vacuum devices, compressed air, mouthwashes and water; and

 

(8)  Assist with the placement or removal of a rubber dam and accessories used for its placement and retention, as directed by an operating CPHDH during the course of a dental hygiene operation.

 

          (e)  If qualified pursuant to Den 302.06, a dental assistant shall be eligible to:

 

(1)  Take dental and medical histories;

 

(2)  Apply topical fluoride after prophylaxis by a licensed professional;

 

(3)  Apply non-prescription topical anesthesia;

 

(4)  Apply non-prescription desensitizing agents to the cementum and dentin;

 

(5)  Take and record blood pressure;

 

(6)  Select impression trays, seat, hold, remove, and pour impressions for study models, single arch athletic mouthguards, and custom fluoride trays;

 

(7)  Insert athletic mouthguards;

 

(8)  Perform dental radiography;

 

(9)  Pit and fissure sealants;

 

(10)  Perform coronal polishing; and

 

(11)  Conduct preliminary oral inspection.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; amd by #4298, eff 7-28-87; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98; amd by #7970, eff 10-10-03; amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; ss by #10794, eff 3-7-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17

 

          Den 401.02  Certified Dental Assistants' and Graduate Dental Assistants' Duties.  Certified dental assistants as defined in Den 101.05 and graduate dental assistants as defined in Den 101.13 may, in addition to the duties of assistants, perform the following duties under direct supervision as defined in Den 101.11 and arranged by degree of supervision in Den 302.02:

 

          (a)  Take dental and medical histories;

 

          (b)  Place and remove rubber dams;

 

          (c)  Place and remove matrices;

 

          (d)  Apply topical fluoride after prophylaxis by a licensed professional;

 

          (e)  Apply non-prescription topical anesthesia;

 

          (f)  Apply non-prescription desensitizing agents to the cementum and dentin;

 

          (g)  Take and record blood pressure;

 

          (h)  Select impression trays, seat, hold, remove and pour impressions for study models, single arch athletic mouth guards, custom fluoride trays and whitening trays;

 

          (i)  Insert athletic mouthguards;

 

          (j)  Perform pulpal vitality testing procedures;

 

          (k)  Remove sutures and dressings; and

 

          (l)  After at least 400 hours of work experience in clinical dental assisting:

 

(1)  Make final impressions;

 

(2)  Place periodontal dressings;

 

(3)  Place amalgam prior to condensing by a dentist;

 

(4)  Place cavity liners and bases;

 

(5)  Place and remove gingival retraction cord;

 

(6)  Place and remove temporary restorations, not to include temporary crowns and bridges unless qualified pursuant to Den 302.06, and not to include the use of intraoral rotary instruments;

 

(7)  Cement bands and bond brackets, not to include the use of rotary instruments to remove excess cement or bonding material;

 

(8)  Make bite registrations when maximum intercuspation can be achieved; and

 

(9)  Place and remove dry socket medications.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #4298, eff 7-28-87; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98; amd by #8100, eff 6-11-04; amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #9778, eff 9-3-10; ss by #10689, eff 10-7-14; ss by #12428, eff 12-6-17

 

          Den 401.03  Qualified Dental Assistants’ Duties.  Any dental assistant, who has qualified pursuant to Den 302.06, shall perform the following duties under direct supervision as defined in Den 101.11:

 

            (a)  Dental radiography;

 

            (b)  Pit and fissure sealants;

 

            (c)  Orthodontic duties;

 

            (d)  Fabrication of provisional crown and bridge restorations;

 

            (e)  Coronal polishing;

 

          (f)  Preliminary oral inspection;

 

          (g)  Monitor nitrous oxide administration; and

 

(h)  In-office tooth whitening.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #4105, eff 8-1-86; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6909, eff 12-9-98; amd by #7818, eff 1-9-03; amd by #8100, eff 6-11-04; ss by #8838, eff 3-9-07; ss by #9973, eff 8-9-11; ss by #13021, eff 4-9-20

 

PART Den 402  HYGIENISTS

 

          Den 402.01  Hygienists' Duties:  A dental hygienist shall perform the following duties:

 

          (a)  Under general supervision, as defined in Den 101.12:

 

(1)  Perform all the duties a dental assistant may perform under Den 401.01 and all the duties a certified dental assistant and graduate dental assistant may perform under Den 401.02;

 

(2)  Perform complete oral prophylaxis as appropriate, including the removal of subgingival biofilm, its by-products, and biofilm retentive calculus deposits by debridement, scaling, and root planing;

 

(3)  Collect and assess medical and dental histories, including documentation of existing and relevant systemic conditions;

 

(4)  Perform extraoral or intraoral assessment, including oral cancer screening, and document all findings;

 

(5)  Assess the hard tissue and document all findings of existing conditions and deviations from normal;

 

(6)  Assess periodontal structures and conditions and document all findings;

 

(7)  Assess occlusion and document all findings;

 

(8)  Make a complete and accurate recording of all assessment findings regarding dental hygiene services relevant to patient care;

 

(9)  Perform dental radiography;

 

(10)  Perform comprehensive collection of patient data to identify the physical and oral health status;

 

(11)  Assess and analyze data collected and determine the patient’s dental hygiene treatment needs that a dental hygienist is qualified and licensed to treat;

 

(12)  Establish a dental hygiene care plan that reflects the realistic goals and treatment strategies to facilitate optimal oral health;

 

(13) Implement a dental hygiene care plan and evaluate dental hygiene treatment for effectiveness;

 

(14)  Place prescribed periodontal antimicrobial agents;

 

(15)  Apply topical preventive and anesthetic agents, including silver diamine fluoride; and

 

(16) The administration, prescription, and dispensing of a fluoride supplement, topically applied fluoride, and chlorhexidine gluconate oral rinse;

 

          (b)  Under indirect supervision as defined in Den 101.14, in-office tooth whitening;

 

          (c)  Under direct supervision as defined in Den 101.11:

 

(1)  Remove excess restorative material extending beyond the margins of the preparation, to include the use of a low speed hand piece, if necessary;

 

(2)  Place retraction cord;

 

(3)  Place and remove periodontal dressings;

 

(4)  Place temporary restorations, not to include temporary crowns and bridges, unless qualified pursuant to Den 302.05;

 

(5)  Make cytological smears;

 

(6)  Perform brush biopsies;

 

(7)  Make final impressions;

 

(8)  Place amalgam prior to condensing by a dentist;

 

(9)  Place cavity liners and bases;

 

(10)  Remove temporary restorations, not to include the use of rotary instruments;

 

(11)  Cement bands and bond brackets;

 

(12)  Perform orthodontic duties, if qualified pursuant to Den 302.05;

 

(13)  Fabricate provisional crown and bridge restorations, if qualified pursuant to Den 302.05;

 

(14)  Administer local anesthesia, if qualified pursuant to Den 302.05;

 

(15)  Monitor nitrous oxide inhalation administration, if qualified pursuant to Den 302.05; and

 

(16)  Administer nitrous oxide if qualified pursuant to Den 302.05; and

 

          (d)  Under public health supervision as defined in Den 101.24:

 

(1)  Collect and assess medical and dental histories, including preliminary inspection of the oral cavity and surrounding structures, and periodontal probing and charting;

 

(2) Perform complete oral prophylaxis as appropriate, including the removal of calciferous deposits and the removal of subgingival accretions and stains by scaling and root planing;

 

(3)  Apply topical fluoride, including fluoride varnish;

 

(4)  Instruct in oral hygiene techniques;

 

(5)  Administer fluoride rinse programs as follows:

 

a.  Obtain consent from a legally responsible adult;

 

b.  Train personnel in storage, dosage, safety, administration, and rinsing procedures; and

 

c. Have a legally authorized physician, dentist, advanced practice registered nurse, or physician assistant pursuant to RSA 318:42, II dilute concentrated fluoride solutions prior to dispensing;

 

(6)  Place sealants when authorized by a dentist with an active license provided that:

 

a.  Written informed consent shall be obtained from the patients’ legal guardian; and

 

b. The supervising dentist and the hygienist shall be responsible for the sealants being indicated and correctly placed; and

 

(7)  Make impressions, fabricate and deliver athletic mouthguards.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #4298, eff 7-28-87; ss by #5110, eff 4-4-91; amd by #5722, eff 10-15-93; ss by #6909, eff 12-9-98; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8100, eff 6-11-04; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #9633, eff 1-7-10; amd by #9778, eff 9-3-10; amd by #9973, eff 8-9-11; amd by #10437, eff 10-8-13; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; ss by #13021, eff 4-9-20

 

          Den 402.02  Public Health Supervision Status.

 

          (a)  In order to obtain public health supervision status, a dental hygienist shall complete a dental hygienist application for public health supervision status, to include the following:

 

(1)  Applicant's name and license number;

 

(2)  Applicant's current business and residential addresses, telephone numbers and primary email address either business or personal;

 

(3)  The name of the public health supervision program where the applicant is employed;

 

(4)  That the applicant agrees to limit any duties to those outlined in Den 402;

 

(5)  That the applicant agrees to follow appropriate infection control guidelines as recommended by the Center for Disease Control and Prevention; and

 

(6)  That the applicant agrees to advise participants in the program that the services provided do not replace regular examination by a dentist;

 

(b)  The hygienist or supervising dentist shall send a summary of program results to the board at the one-year anniversary of the program's inception and each and every year after or, if the program lasts less than a year, at the end of the program; and

 

(c)  The form shall be signed and dated by the applicant and the supervising dentist of the program.

 

Source.  #10991, eff 12-9-15

 

          Den 402.03  Program Application for Public Health Supervision.

 

          (a)  Each applicant for approval of a program under public health supervision shall provide the following on the "Application for Dental Program Approval under Public Health Supervision" form:

 

(1)  Supervising dentist's name and license number;

 

(2)  Supervising dentist's primary business address, business telephone number and primary email address either business or personal;

 

(3)  Name of the program;

 

(4)  Agency sponsoring the program;

 

(5)  Date(s) of activity, as well as sites and population served;

 

(6)  A description of the dental hygiene services to be provided; and

 

(7)  The names and license numbers of hygientists working in the program, to be updated whenever changes occur.

 

          (b)  The form shall be signed and dated by the applicant and the supervising dentist of the program.

 

          (c)  The hygienist or supervising dentist shall send a summary of program results to the board at the one-year anniversary of the program's inception and each and every year after or, if the program lasts less than a year, at the end of the program.

 

Source.  #10991, eff 12-9-15

 

PART Den 403  CONTINUING EDUCATION

 

          Den 403.01  Purpose.  The purpose of this section is to establish the minimum continuing education requirements as provided by RSA 317-A:12, XI.

 

Source.  #5332, eff 4-1-92 (from Den 304.02), EXPIRED: 4-1-98

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #10794, eff 3-7-15

 

          Den 403.02  Definitions of Terms.  The following definitions of terms shall apply to this part:

 

          (a)  "Certificate of CEU credit" means a document issued to a particular licensee by a provider certifying that the licensee has satisfactorily completed a program of continuing education;

 

          (b)  "Clinical dental care or dental hygiene care subjects" means those areas of study that deal with the performance of dental or dental hygiene services for patients;

 

          (c)  "Continuing education" means dental education designed to maintain professional competence in the practice of dental hygiene and/or dentistry, improve professional skills, and preserve dental standards for the purpose of protecting the public health and welfare;

 

          (d)  "Continuing education unit" (CEU) means one hour of attendance at lectures, seminars and meetings, 30 minutes of attendance at clinical or laboratory participatory courses, or 20 minutes as a presenter of an original paper, essay, or formal lecture to a group of professionals, not including certification in a specialty;

 

          (e)  "Licensee" means any active or inactive licensed dental hygienist or dentist in the State of New Hampshire; and

 

          (f)  "Non-clinical subjects" means those areas of study related to personal development or practice management as related to dentistry or dental hygiene.

 

Source.  #5332, eff 4-1-92 (from Den 304.02), EXPIRED: 4-1-98

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; ss by #10794, eff 3-7-15; ss by #12428, eff 12-6-17

 

          Den 403.03  Continuing Education Requirement.

 

          (a)  Dental hygienists with an active New Hampshire license shall complete a minimum of 20 CEUs of continuing education per biennium. At least 15 CEUs shall be earned in clinical dental care subjects, including successful completion of a BLS-HCP course as specified in Den 403.07(b).  At least 2 CEUs shall be earned in infection control in a live or online course which includes the center for disease control infection prevention and control guidelines and recommendations in its syllabus.  Starting April 1, 2020, at least 2 CEUs shall be earned in Medical Emergency Training.

 

          (b)  Dentists with an active New Hampshire license shall complete a minimum of 40 CEUs of continuing education per biennium. At least 30 CEUs shall be earned in clinical dental care subjects, including successful completion of a BLS-HCP course as specified in Den 403.07(b).  At least 2 CEUs shall be earned in infection control in a live or online course which includes the center for disease control infection prevention and control guidelines and recommendations in its syllabus.  Starting April 1, 2020, at least 2 CEUs shall be earned in Medical Emergency Training.

 

          (c)  Licensees required to register with the prescription drug monitoring program and who possess a valid drug enforcement administration number shall provide evidence of having completed, as a condition for renewal:

 

(1)  Three CEUs in the area of pain management, addiction disorder, or a combination of both pain management and addiction disorder; or

 

(2)  An online examination in the area of pain management, addiction disorder, or a combination of pain management and addiction disorders.

 

          (d)  The CEUs completed during the 2 years preceding April 1st in the year of renewal shall conform to the criteria identified throughout these rules.

 

          (e)  One CEU shall be given for each hour of attendance at lectures, seminars, and meetings. For each hour of attendance at clinical or laboratory participatory courses, 2 CEUs shall be given. Successful completion of an entire course or segment of a course shall be required to receive continuing education credit for that course.

 

          (f) Each licensee shall retain all certificates and/or documents as evidence of participation, as described in Den 403.06(d), in a continuing education program or course for a period of 3 years from the date of the program course. It shall be the responsibility of each course participant to assure that verification of course participation is attained. Upon request of the board, such documentation shall be made available to the board or its representative for random audit and/or verification purposes.

 

          (g)  Excess CEUs earned in one biennial registration period shall not be carried forward into the next biennial registration period for the purpose of fulfilling that biennium’s continuing education requirement for licensure renewal.

 

          (h)  Dental board members and hygiene committee members shall be given 3 CEUs per full year of membership on the board or the committee.

 

          (i)  Anesthesia and sedation committee members shall be given 1 CEU per evaluation, with a maximum of 3 CEUs per year.

 

          (j)  Up to 3 CEUs shall be given for courses taken when initially obtaining a specialty.

 

Source.  #5332, eff 4-1-92 (from Den 304.02); amd by #6186, eff 2-17-96; paragraphs (a)-(c), (g) & (h) EXPIRED: 4-1-98; ss by #6909, eff 12-9-98; amd by #7364, eff 9-19-00; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #10328-B, eff 5-7-13; ss by #10689, eff 10-7-14; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; ss by #13021, eff 4-9-20

 

          Den 403.04  Renewal and Monitoring.

 

          (a)  Biennially, each active licensee shall submit to the board before April 1 a summary of continuing education indicating that the required number of CEUs were completed.

 

          (b) Active licensees who require an extension to complete the biennial continuing education requirement shall have until April 30th to meet the requirement and, pursuant to RSA 317-A:15, submit to the board:

 

(1)  A completed registration and license renewal form;

 

(2)  A biennial registration fee; and

 

(3)  A late biennial registration fee.

 

          (c)  During the biennium, at least 3 percent of active licensees shall be randomly audited by the board for compliance with Den 403. Documentation demonstrating completion of continuing education shall be submitted to the board within 30 days after the licensee is notified of the audit. Academy of General Dentistry, specialty, NH Dental Society, and Dental Hygienists’ Association printouts shall be acceptable.  If

the submitted documentation does not fulfill the requirements of Den 403, the licensee shall be notified and called for a hearing before the board to determine if the licensee has obtained the minimum requirement to maintain an active license.

 

Source.  #5332, eff 4-1-92 (from Den 304.02); amd by #6186, eff 2-17-96; paragraph (b) EXPIRED: 4-1-98; ss by #6909, eff 12-9-98; amd by #7970, eff 10-10-03; ss by #8838, eff 3-9-07; ss by #9256, eff 9-10-08; amd by #9633, eff 1-7-10; amd by #9973, eff 8-9-11; ss by #11053, eff 3-10-16

 

          Den 403.05  Waivers.

 

          (a)  A licensee seeking a waiver because of severe illness, incapacity, or other hardship of any requirement of this part shall submit a written petition to the board outlining the reasons the licensee was unable to satisfy the biennial continuing education requirement.  Waivers shall be granted if the board finds that severe illness, incapacity or other hardship prevented the licensee from satisfying the biennial continuing education requirement.

 

(b)  Dental hygienists and dentists submitting applications for the first biennial licensure renewal after initial New Hampshire licensure shall be exempt from the continuing education requirement for that initial license period only.

 

Source.  #5332, eff 4-1-92 (from Den 304.02), EXPIRED: 4-1-98

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; amd by #9256, eff 9-10-08; EXPIRED: 3-9-15 (para. (b)); ss by #10991, eff 12-9-15

 

          Den 403.06  Criteria of Acceptance.

 

          (a)  The board shall not pre-approve courses.

 

          (b)  Each licensee shall select courses dealing with matters directly related to the practice of dentistry or dental hygiene.

 

          (c)  The licensee shall maintain records provided by the program sponsor.

 

          (d)  The records shall contain the:

 

(1)  Name of the licensee;

 

(2)  Full name of the course;

 

(3)  Date of the course;

 

(4)  Location where the course was given;

 

(5)  Duration of the course in days and hours;

 

(6)  Name and mailing address of the provider; and

 

(7)  Number of CEUs.

 

Source.  #5332, eff 4-1-92 (from Den 304.02), EXPIRED: 4-1-98

 

New.  #6909, eff 12-9-98, EXPIRED: 12-9-06

 

New.  #8838, eff 3-9-07; amd by #9973, eff 8-9-11; EXPIRED: 3-9-15 (paras. (b)-(d)); ss by #11053, eff 3-10-16

 

          Den 403.07  Categories of Credit.

 

          (a)  A licensee shall be entitled to obtain up to 100% of the required continuing education units CEUs in any or all of the following categories:

 

(1)  Education and scientific courses sponsored or approved by the following:

 

a.  American Dental Association, component societies and constituent societies;

 

b.  Academy of General Dentistry;

 

c. American Dental Hygienists Association, component societies, and constituent societies;

 

d.  State or local dental or dental hygiene professional associations or societies;

 

e.  Dental schools, medical schools, and dental hygiene schools;

 

f.  Hospital sponsored courses and conferences;

 

g.  Governmental health agencies and health institutions; and

 

h.  Postgraduate dental schools or postgraduate dental hygiene schools; and

 

(2)  Courses required to maintain certification in any nationally recognized professional specialty board; and

 

          (b)  A licensee shall receive credit for 100% of required CEUs for passing the written portion of the American Board of Dental Examiners (ADEX), or other similar U.S. regional or state board clinical examination for dentists or dental hygienists.

 

          (c)  A licensee shall receive credit for 3 CEUs per biennium for successful completion of BLS-HCP course(s) given by an American Heart Association, Red Cross, National Safety Council, American Safety and Health Institute, American College of Emergency Physician, or Military Training Network qualified instructor, or sponsored or approved by organizations referenced in Den 403.07 (a)(1).  BLS-HCP shall be considered a clinical care subject.  All BLS-HCP, ACLS, and PALS courses shall include a hands-on component.

 

          (d)  A licensee shall receive credit for up to 15% of the required CEUs in the following categories:

 

(1)  An original, dental-related scientific paper written by the licensee and published in a peer reviewed scientific or professional journal; or

 

(2)  An original presentation of a paper, essay, or formal lecture to a group of fellow professionals.

 

          (e)  A licensee who holds a faculty or research appointment at an accredited dental school, dental hygiene school, or medical school shall receive credit for up to 20% of the required CEUs by teaching or performing research at least one full day per week per academic year.

 

          (f)  A licensee shall receive credit for up to 20% of the required CEUs for a licensee's original presentation at a table clinic or exhibit at a regional or national meeting.  Such activity shall be credited as 2 CEUs per original presentation.

 

          (g)  A licensee shall receive credit for up to 20% of the required CEUs by participating in correspondence courses which require the successful completion of a written examination by the licensee to be scored by the provider of such programs.

 

          (h)  A licensee shall receive credit for up to 50% of the required CEUs by participating in audio-visual or online programs or live webinars which require the successful completion of a written examination by the licensee to be scored by the provider of such programs.

 

          (i)  A licensee shall receive credit for up to 10% of the required CEUs by attending regional or national meetings of the American Dental Association and its components, the Academy of General Dentistry, the American Dental Hygienists’ Association, and the national and regional specialty organizations.

 

          (j)  A licensee who serves as expert consultant for the administrative prosecutions unit of the consumer protection bureau of the NH department of justice shall:

 

(1)  Be credited with one clinical CEU for every 3 hours engaged as a consultant, up to 10 CEU’s per biennium; 

 

(2)  Have an active New Hampshire dental or dental hygiene license; and

 

(3)  Not be a member of the board.

 

          (k)  A licensee shall receive credit for up to 20% of the required CEUs by participating in the Commission on Dental Competency Assessments (CDCA).

 

Source.  #5332, eff 4-1-92 (from Den 304.02), EXPIRED: 4-1-98

 

New.  #6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by #7661, eff 3-13-02; amd by #7929, eff 8-6-03; amd by #8100, eff 6-11-04; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #9973, eff 8-9-11; amd by #10328-B, eff 5-7-13; ss by #10689, eff 10-7-14; ss by #12428, eff 12-6-17; ss by #13021, eff 4-9-20; amd by #13341, EMERGENCY RULE, eff 2-8-22; ss by #13366, eff 4-19-22 (see Revision Note at chapter heading for Den 400)

 

 


CHAPTER Den 500  ETHICAL AND PROFESSIONAL DUTIES

 

PART Den 501  ETHICAL DUTIES

 

          Den 501.01  Ethical Duties.

 

          (a)  In addition to those obligations of dentists under the American Dental Association Principles of Ethics and Code of Professional Conduct (as amendment [April 2012] 2016), as specified in Appendix II, and the obligations of dental hygienists under the Code of Ethics of the American Dental Hygienists’ Association (as amended 2016), as specified in Appendix II, pursuant to RSA 317-A:17, II(j), the provisions of this section shall apply.

 

          (b)  Dentists shall protect the health of their patients by only assigning to hygienists and assistants those duties specified in Den 400 that the hygienist and assistants are trained to perform correctly.

 

          (c)  Dentists shall be further obliged to prescribe and supervise the patient care provided by all dental hygienists and dental assistants working under their direction.

 

          (d)  A dentist shall neither aid nor encourage a dentist, a dental hygienist or a dental assistant in their employ to make use of lists of patients from an office of former employment, nor shall a dentist, a dental hygienist or a dental assistant use such lists or information gathered therefrom unless prior written consent allowing use of the lists has been obtained from the previous employer.

 

          (e)  Upon request of a patient, dentists shall provide a copy of the patient’s records within 20 days for a nominal fee not to exceed $15 for up to 30 pages and $0.50 per page thereafter, pursuant to RSA 332-I. Radiographs and models shall be provided at a reasonable cost. This obligation shall exist whether or not the patient’s account is paid in full or whether the patient has paid for his or her records.

 

          (f)  A dentist shall inform the board in writing within 20 days of patient mortality associated with dental treatment. The mortality report shall meet the requirements of Den 304.07(b).

 

          (g)  Dentists who are about to close a dental practice in New Hampshire shall inform their patients of record of the impending closure to allow 3 months, when possible, for patients to obtain copies of their records or have their records sent to another dentist.  Such dentist shall notify the board in writing of his or her intent to close a dental practice and shall provide the board with the name, address, and telephone number of the licensee to whom the dentist’s patient records will be transferred.

 

          (h)  Pursuant to RSA 317-A:27-a, dentists shall have an ongoing obligation to afford their prior patients access to those records not previously provided to the patient or new dentist.

 

          (i)  Dentists and dental hygienists shall have an ongoing obligation to repay loans provided to them for their dental education.

 

          (j)  Dentists and dental hygienists shall inform the board within 30 days in writing of any sanction pursuant to Den 301.01 (a)(10), Den 301.02 (a)(10), Den 301.03 (a)(10), and Den 301.04 (a) (12) imposed by any jurisdiction.

 

          (k)  When discontinuing a course of treatment, dentists shall be available to provide emergency care for up to 30 days or until the patient obtains the services of another dentist, whichever occurs first.

 

          (l)  A consultant shall not be required to have a New Hampshire dental license to provide a consultation/expert opinion to a New Hampshire dentist regarding a patient, if the consultant has no contact with the patient.

 

          (m)  When dental records are being discarded, dentists shall destroy them by shredding or some other method that maintains confidentiality.

 

          (n)  Either directly or through a third party creditor, dentists shall not make patients financially responsible for the entire cost of a treatment plan before the patient gives informed consent to the treatment plan, including all financial responsibilities clearly explained.

 

          (o)  Licensees shall submit only truthful and correct information in any application or other documents filed with or statement made to the board.

 

          (p)  Pursuant to RSA 317-A:17, II (g), licensees shall adhere to   the American Dental Association’s current guidelines for infection control and radiographic practices, as published 2016 and available as noted in Appendix II.

 

Source.  #287.2, eff 1-17-74; ss by #2981, eff 2-28-85; ss by #5110, eff 4-4-91, EXPIRED: 4-4-97

 

New.  #6540, eff 7-18-97; ss by #6909, eff 12-9-98; amd by #7364, eff 9-19-00; amd by #7778, eff 10-10-02; amd by #7929, eff 8-6-03; amd by #7970, eff 10-10-03; amd by #8260, eff 1-19-05; amd by #8584, eff 3-16-06; amd by #8694, eff 7-27-06; ss by #8838, eff 3-9-07; amd by #8963, eff 8-16-07; amd by #9256, eff 9-10-08; amd by #9408-B, eff 3-10-09; amd by #9633, eff 1-7-10; amd by #9778, eff 9-3-10; amd by #9973, eff 8-9-11; amd by #10068, eff 1-10-12; amd by #10328-B, eff 5-7-13; amd by #10437, eff 10-8-13; ss by #10689, eff 10-17-14; ss by #10824, eff 5-6-15; ss by #10991, eff 12-9-15; ss by #12428, eff 12-6-17; amd by #12549, eff 6-15-18

 

PART Den 502  PROFESSIONAL DUTIES

 

          Den 502.01  Professional Misconduct.

 

(a)  Dentists shall, pursuant to RSA 317-A:17, II (j), be under a professional duty to comply with the requirements of the Controlled Drug Prescription Health and Safety Program (PDMP), RSA 318-A:31-38, and all administrative rules of the board of pharmacy adopted thereunder.

 

          (b)  Pursuant to RSA 318-B:36, the following actions shall result in a disciplinary proceeding and the imposition of sanctions by the board in accordance with its rules:

 

(1)  Prescribing or dispensing of controlled substances in schedules II-IV after June 30, 2015 without having registered with the program; 

 

(2)  The knowing disclosure of program information by a person authorized to receive it in a manner that violates RSA 318-B or administrative rules of the board of pharmacy;

 

(3)  The use of program information by a person authorized to receive it for a purpose that violates RSA 318-B or administrative rules of the board of pharmacy; and

 

(4)  Permitting the use or disclosure of program information under control of the dentist by a person not authorized to receive it in violation of RSA 318-B or administrative rules of the board of pharmacy.

 

Source.  #10824, eff 5-6-15; amd in para (c) by #11013, EMERGENCY RULE, eff 1-5-16, EXPIRES: 7-3-16; amd in para. (c) by #11129, REPEAL OF EMERGENCY RULE, eff 6-29-16

 

PART Den 503  OPIOID PRESCRIBING

 

          Den 503.01  Applicability.  This part shall apply to the prescribing of opioids for the management or treatment of non-cancer and non-terminal pain, and shall not apply to the supervised administration of opioids in a health care setting.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17

 

          Den 503.02  Obligation to Obey.  The ethical standards set forth in this part shall bind all licensees, and noncompliance with these standards shall constitute unprofessional conduct as used in NH RSA 326-B:37, II(h).  The board shall investigate violations of these standards and impose disciplinary sanctions for such violations by following the disciplinary procedures set forth in Den 200.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17

 

          Den 503.03  Definitions.  Except where the context makes another meaning manifest, the following words shall have the meanings indicated when used in this part:

 

          (a)  “Acute pain” means the normal, predicted physiological response to a noxious chemical, thermal, or mechanical stimulus and typically is associated with invasive procedures, trauma, and disease.  It can be time-limited, often less than 30 days in duration;

 

          (b)  “Administer” means an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a person for immediate consumption or use;

 

          (c) “Addiction” means a primary, chronic, neurobiologic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations.  It is characterized by behaviors that include impaired control over drug use, craving, compulsive use, or continued use despite harm.  The term does not include physical dependence and tolerance, which are normal physiological consequences of extended opioid therapy for pain;

 

          (d)  “Chronic pain” means a state in which non-cancer pain persists beyond the usual course of an acute disease or healing of an injury, or that might or might not be associated with an acute or chronic pathologic process that causes continuous or intermittent pain over months or years.  It also includes intermittent episodic pain that might require periodic treatment. For the purposes of these rules, chronic pain does not include pain from cancer or terminal disease;

 

          (e)  “Clinical coverage” means specified and prearranged coverage that is available 24 hours a day, 7 days a week, to assist in the management of patients with chronic pain;

 

          (f)  “Dose unit” means one pill, one capsule, one patch, or one liquid dose;

 

          (g)  “Medication-assisted treatment” means any treatment of opioid addiction that includes a medication, such as methadone, buprenorphine, or naltrexone, that is approved by the FDA for opioid detoxification or maintenance treatment; 

 

          (h)  “Morphine equivalent dose (MED)” means a conversion of various opioids to a morphine equivalent dose by the use of board-approved conversion tables;

 

          (i)  “Prescription” means a verbal, written, facsimile, or electronically transmitted order for medications for self-administration by an individual patient;

 

          (j)  “Risk assessment” means a process for predicting a patient’s likelihood of misusing or abusing opioids in order to develop and document a level of monitoring for that patient;

 

          (k)  “Treatment agreement” means a written agreement that outlines the joint responsibilities of dentist and patient; and

 

          (l)  “Treatment plan” means a written plan that reflects the particular benefits and risks of opioid use for each individual patient and establishes goals, expectations, methods and time course for treatment.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17 (from Den 503.02)

 

          Den 503.04  Acute Pain.  If opioids are indicated and clinically appropriate for prescription for acute pain, prescribing licensees shall:

 

          (a)  Conduct and document an examination of the oral cavity and associated structures and a medical history;

 

          (b)  Consider the patient’s risk for opioid misuse, abuse, or diversion and prescribe for the lowest effective dose for less than 30 days;

 

          (c)  Document the prescription and rationale for all opioids;

 

          (d)  Ensure that the patient has been provided information that contains the following:

 

(1)  Risk of side effects, including addiction and overdose resulting in death;

 

(2)  Risks of keeping unused medication;

 

(3)  Options for safely securing and disposing of unused medication; and

 

(4)  Danger in operating motor vehicle or heavy machinery;

 

          (e)  Comply with all federal and state controlled substances laws, rules, and regulations;

 

          (f)  Complete a board-approved risk assessment tool, such as the evidence based screening tool Screener and Opioid Assessment for Patients with Pain (SOAPP);

 

          (g)  Document the consideration of non-pharmacological modalities and non-opioid therapy, and an appropriate pain treatment plan which includes the type of drug, the dosage, and the duration of the prescription;

 

          (h)  Utilize a written informed consent that explains the following risks associated with opioids:

 

(1)  Addiction;

 

(2)  Overdose and death;

 

(3)  Physical dependence;

 

(4)  Physical side effects;

 

(5)  Hyperalgesia;

 

(6)  Tolerance; and

 

(7)  Crime victimization;

 

          (i)  In an emergency department, urgent care setting, or walk-in clinic:

 

(1)  Not prescribe more than the minimum amount of opioids dentally necessary to treat the patient’s dental condition. In most cases, an opioid prescription of 3 or fewer days is sufficient, but a licensee shall not prescribe for more than 7 days; and

 

(2)  If prescribing an opioid for acute pain that exceeds a board-approved limit, document the dental condition and appropriate clinical rationale in the patient’s medical record; and

 

          (j)  Not be obligated to prescribe opioids for more than 30 days, but if opioids are indicated and appropriate for persistent, unresolved acute pain that extends beyond a period of 30 days, the licensee shall work in concert with the patient’s primary care physician or a licensed pain management program, and shall continue to adhere to the terms of Den 503.05 for establishing a pain management program.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17 (from Den 503.03)

 

          Den 503.05  Chronic Pain.  If opioids are indicated and clinically appropriate for prescription for chronic pain, prescribing licensees shall:

 

          (a)  Conduct and document an examination of the oral cavity and associated structures and a medical history;

 

          (b)  Conduct and document a risk assessment, including, but not limited to, the use of an evidence-based screening tool such as the Screener and Opioid Assessment for Patients with Pain (SOAPP);

 

          (c)  Document the prescription and rationale for all opioids;

 

          (d)  Prescribe for the lowest effective dose for a limited duration;

 

          (e)  Comply with all federal and state controlled substances laws, rules, and regulations;

 

          (f)  Utilize a written informed consent that explains the following risks associated with opioids:

 

(1)  Addiction;

 

(2)  Overdose and death;

 

(3)  Physical dependence;

 

(4)  Physical side effects;

 

(5)  Hyperalgesia;

 

(6)  Tolerance; and

 

(7)  Crime victimization;

 

          (g)  Create and discuss a treatment plan with the patient.  This shall include, but not be limited to the goals of treatment, in terms of pain management, restoration of function, safety, time course for treatment, and consideration of non-pharmacological modalities and non-opioid therapy.  Informed consent documents and treatment agreements may be part of one document for the sake of convenience;

 

          (h)  Utilize a written treatment agreement that is included in the medical record, and specifies conduct that triggers the discontinuation or tapering of opioids;

 

          (i)  The agreement shall also address, at a minimum, the following:

 

(1)  The requirement of safe medication use and storage;

 

(2)  The requirement of obtaining opioids from only one prescriber or practice;

 

(3)  The consent to periodic and random drug testing; and

 

(4)  The prescriber’s responsibility to be available or to have clinical coverage available;

 

          (j)  Document the consideration of a consultation with an appropriate specialist in the following circumstances:

 

(1)  When the patient receives a 100 mg morphine equivalent dose daily for longer than 90 days;

 

(2)  When a patient is at high risk for abuse or addiction; or

 

(3)  When a patient has a co-morbid psychiatric disorder; 

 

          (k)  Reevaluate treatment plans and use of opioids at least twice a year;

 

          (l)  Require random and periodic urine drug testing at least annually for all patients using opioids for longer than 90 days.  Unanticipated findings shall be addressed in a manner that supports the health of the patient;

 

          (m)  Have clinical coverage available for 24 hours per day, 7 days per week, to assist in the management of patients; and

 

          (n)  The prescribing licensee may forego the requirements for a written treatment agreement and for periodic drug testing for patients:

 

(1)  Who are residents in a long-term, non-rehabilitative nursing home facility where medications are administered by licensed staff; or

 

(2)  Who are being treated for episodic intermittent pain and receiving no more than 50 dose units of opioids in a 3 month period.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17 (from Den 503.04)

 

          Den 503.06  Prescription Drug Monitoring Program.

 

          (a)  Prescribing licensees required to register with the program under RSA 318-B:31-40, or their delegate, shall query the prescription drug monitoring program to obtain a history of schedule II-IV controlled substances dispensed to a patient, prior to prescribing an initial schedule II, III, and IV opioids for the management or treatment of this patient’s pain and then periodically and at least twice per year, except when:

 

(1)  Controlled medications are to be administered to patients in a health care setting;

 

(2) The program is inaccessible or not functioning properly, due to an internal or external electronic issue; or

 

(3)  An emergency department is experiencing a higher than normal patient volume such that querying the program database would materially delay care.

 

          (b)  A licensee shall document the exceptions described in (a)(2) and (3) above in the patient’s medical record.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17

 

          Den 503.07  Medication Assisted Treatment.  Prescribing licensees who prescribe medication assisted treatment shall adhere to the principles outlined in the American Society of Addiction Medicine’s National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use (2015) found at http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline as cited in Appendix II.

 

Source.  #11130, eff 6-29-16; ss by #12061, eff 1-1-17

 


APPENDIX I

 

RULE

STATUTE

Den 101

RSA 541-A:7

Den 101.02

RSA 317-A:12, XIII

Den 101.03

RSA 317-A:2; 317-A:12, XIII

Den 101.05

RSA 317-A:12, XIII

Den 101.06

RSA 541-A:7; 317-A:12, XII-b and XII-c

Den 101.11

RSA 317-A:12, XII

Den 101.10

RSA 317-A:12, XIII

Den 101.14

RSA 541-A:7; 317-A:7-a

Den 101.15

RSA 317-A:7; 317-A:9; 317-A:12, IV

Den 101.16

RSA 317-A:12, XIII

Den 101.20

RSA 317-A:12, XIII; 317-A:21-e, IV

Den 101.24

RSA 317-A:12, XIII

Den 101.25

RSA 317-A:4; 317-A:12, XIII

Den 102.01

RSA 317-A:12, XIII

Den 102.01 (f)

RSA 317-A:12, X, XIII; 541-A:16, I (a)

Den 102.02

RSA 15-A; 317-A:12, XIII; 541-A:16, I (a)

 

 

Den 201.01 - 201.02

RSA 317-A:1; 317-A:12

Den 202.01

RSA 317-A:12

Den 203.01 - 203.02

RSA 317-A:12, IX and X; 317-A:18; 317-A:18-a

Den 204.01

RSA 317-A:12, IX; 317-A:18-a, III

Den 205.01 - 205.03

RSA 317-A:12, X; 317-A:18

Den 206.01 - 206.02

RSA 317-A:12, X; 317-A:18

Den 206.03

RSA 317-A:12, X

Den 207.01

RSA 317-A:12, X; 317-A:18

Den 207.02

RSA 317-A:12, X; 317-A:17; 541-A:16, I(a)

Den 207.02 (i)

RSA 317-A:12, XIII; 317-A:18

Den 207.03

RSA 317-A:12, X; 317-A:18

Den 207.04

RSA 317-A:12, X; 317-A:18-b

Den 207.05

RSA 317-A:12, X

Den 207.06

RSA 317-A:12, IX; 317-A:18-a

Den 208.01 - 208.02

RSA 317-A:12, IX and X; 317-A:18-a

Den 208.03 

RSA 317-A:12, X

Den 208.04 – 208.15

RSA 317-A:12, IX and X; 317-A:18-a

Den 208.15(c)

RSA 317-A:12, X; 317-A:18

Den 208.16

RSA 317-A:12, IX; RSA 317-A:18-a

Den 209.02

RSA 317-A:12, IX; 317-A:18-a

Den 209.02 (b), (c)

RSA 317-A:12, IX; 317-A:18-a

Den 209.03

RSA 317-A:12, IX; 317-A:18-a

Den 209.03 (b)

RSA 317-A:12, X; 317-A:18-a

Den 209.04 – 209.05

RSA 317-A:12, IX; 317-A:18-a

Den 210.01

RSA 317-A:12, IX; 317-A:18-a

Den 210.01 (a)

RSA 317-A:12, IX; 317-A:18-a

Den 210.02- 210.03

RSA 317-A:12, IX; 317-A:18-a

Den 210.04

RSA 317-A:12, X; 317-A:18-a

Den 211.01 - 211.02

RSA 317-A:12, IX; 317-A:18-a

Den 212.01 - 212.02

RSA 317-A:12, X; 317-A:18, VII

Den 212.03

RSA 317-A:4, I (d); RSA 317-A:12, X; RSA 317-A:18, VII

Den 212.04

RSA 317-A:12, X; RSA 317-A:18, VII

Den 212.05

RSA 317-A:12, X

Den 213.01 - 213.03

RSA 541-A:16, I(c); 317-A:12

Den 213.04

RSA 541-A:16, I(c); 317-A:12

Den 213.04 (b)

RSA 317-A:12, XIII; 541-A:16, I (c)

Den 214.01 - 214.02

RSA 541-A:16, I(d); 317-A:12

Den 214.01 (a)

RSA 317-A:12, XIII; 541-A:16, I (d)

Den 214.02 (a) intro

RSA 317-A:12, XIII; 541-A:16, I (d)

Den 215.01

RSA 541-A:16, II(a); 317-A:12, XIII

Den 215.01 (c)

RSA 317-A:12, XIII; 541-A:16, I (a)

Den 216.01 - 216.02

RSA 541-A:16, II (a); RSA 317-A:12, XIII

 

 

Den 301.01

(Specific provisions implementing specific

statutes are cited below)

RSA 317-A:12, I, and III; 317-A:8

Den 301.01

RSA 317-A:12, III; RSA 541-A:16, I(b) intro.

Den 301.01 (i)

RSA 317-A:12, III and IV

Den 301.01 (k)

RSA 317-A:12 III, and IV

 

 

Den 301.02

(Specific provisions implementing specific

statutes are cited below)

RSA 317-A:12, I, and III; 317-A:8

Den 301.02

RSA 317-A:12, III; RSA 541-A:16, I(b) intro.

Den 301.02 (h) (1)

RSA 317-A:12, III and IV

Den 301.02 (o)

RSA 318-B:33, II

Den 301.03

RSA 317-A:12, I and V; RSA 317-A:13

Den 301.03 (f)–(i)

RSA 317-A:12-a

Den 301.04

RSA 317-A:12, V; RSA 317-A:13; RSA 318-B:33

Den 301.04 (g)-(j)

RSA 317-A:12-a

Den 301.05

RSA 317-A:8; 317-A:12, I

Den 301.06

RSA 317-A:12, VIII; RSA317-A:12, XIV; RSA 317-A:16

Den 301.07

RSA 317-A:12, I

Den 301.08

RSA 317-A:12, VIII; RSA317-A:12, XIV; RSA 317-A:16

Den 301.09

RSA 317-A:12, I and II; RSA 317-A:13, III;

RSA 317-A:18, VI

Den 301.10

RSA 317-A:7-a, III; 317-A:12, III

Den 301.11

RSA 161-B:II, VI-a

Den 301.12

RSA 317-A:15-a;

Den 301.13

RSA 317-A:12, III

Den 302.01

RSA 317-A:12, III

Den 302.02

RSA 317-A:12, XIII

Den 302.03

RSA 317-A:12, III

Den 302.04

RSA 317-A:12, III

Den 302.05

RSA 317-A:12, III and XII-b

Den 302.06

RSA 317-A:12, III and XII-b

Den 302.07

RSA 317-A:12, III

Den 302.08

RSA 317-A:12, III

Den 303.01

RSA 317-A:9; 317-A:12, IV

Den 303.02

RSA 317-A:9; 317-A:12, IV; 317-A:21-a

Den 303.03

RSA 317-A:12, IV; 317-A:9

Den 304.01

RSA 317-A:20, II; 317-A:12, XII-a (e)

Den 304.02

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 304.03

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 304.04

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 304.05

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 304.06

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 304.07

RSA 317-A:12, XII-a; RSA 317-A:20, II

Den 401.01

RSA 317-A:12, XII-b

Den 401.02

RSA 317-A:12, XII-b

Den 401.03

RSA 317-A:12, XII-b 

Den 402.01

RSA 317-A:21-c; RSA 317-A:12, XII-b

Den 402.02

RSA 317-A:12, I

Den 402.03

RSA 317-A:12, I

Den 403.01

RSA 317-A:12, XI

Den 403.02

RSA 317-A:12, XI

Den 403.03

RSA 317-A:12, XI

Den 403.04

RSA 317-A:12, XI

Den 403.05

RSA 317-A:12, XI

Den 403.06

RSA 317-A:12, XI

Den 403.07

RSA 317-A:12, XI

 

 

Den 501.01

RSA 317-A:12, VI

Den 502.01

RSA 318-B:33

Den 503

RSA 317-A:12, VI, XIII; RSA 318-B:41, I(a)(2), II

 


 

APPENDIX II

 

 

Rule

Title

Obtain at:

Den 304.02 (b)(3)a.1.

and b.2.; (c)(3) b.2.;

and (m)(3)

 

ADA 2012 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”

 

(Amended 2012)

 

American Dental Association

 

Obtain online www.ada.org/~/media/ADA/Advocacy/Files/ anesthesia_use_guidelines.ashx

 

Cost:  none

 

Contact:  (800) 621-8099

Jane Josek, ext. 2694

 

Den 304.02 (b)(3)b.1.; and (c)(3)b.1.

 

8th edition of the “Office Anesthesia Evaluation Manual” of the American Association of Oral and Maxillofacial Surgeons, 2012

 

American Association of Oral and Maxillofacial Surgeons

 

Obtain online www.ada.org/~/media/ADA/Advocacy/Files/ anesthesia_use_guidelines.ashx

 

Cost:  $95 (member)

$285 (non-member)

 

Contact:  (800) 366-6725

 

Den 304.02 (c)(3)a.;

and (m)(2)

 

ADA 2012 “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students”

 

(Amended 2012)

 

American Dental Association

 

Obtain online

www.ada.org/~/media/ADA/Member%20 Center/FIles/teaching_paincontrol_guidelines.ashx

 

Cost:  none

 

Contact:  (800) 621-8099

Jane Josek, ext. 2694

 

Den 304.04 (a)(3)a.;

and Den 304.06(a)(2)

 

ADA October 2016 “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students”

 

(Amended Oct. 2016)

American Dental Association

 

Obtain online

www.ada.org/~/media/ADA/Member%20 Center/FIles/teaching_paincontrol_guidelines.ashx

 

Cost:  none

 

Contact:  (800) 621-8099

Jane Josek, ext. 2694

Den 304.06(a)(3)

 

ADA October 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”

American Dental Association

Obtain online www.ada.org/~/media/ADA/Advocacy/Files/ anesthesia_use_guidelines.ashx

Cost:  none

Contact:  (800) 621-8099

Jane Josek, ext. 2694

Den 304.02 (d)(1)

 

American Academy of Pediatric Dentistry 2006 “Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures”

 

(Adopted 2006)

 

(Reaffirmed 2011 by American Academy of Pediatric Dentistry and American Academy of Pediatrics)

 

American Academy of Pediatric Dentistry

 

Obtain online

www.aapd.org/media/Policies_Guidelines/ G_Sedation.pdf

 

Cost:  none

 

Contact:  (312) 337-2169

 

Den 304.03 (b)(3)a.1. and b.2.; (c)(3) b.2.; and Den 304.04(a)(3)b., 2.

 

ADA 2016 “Guidelines for the Use of Sedation and General Anesthesia by Dentists”

American Dental Association

Obtain online www.ada.org/~/media/ADA/Advocacy/Files/ anesthesia_use_guidelines.ashx

Cost:  none

Contact:  (800) 621-8099

Jane Josek, ext. 2694

 

 

Den 304.03(b)(3)b.1; and Den 304.04(a)(3)b.1

8th Edition of the “Office Anesthesia Evaluation Manual” of the American Association of Oral and Maxillofacial Surgeons, 2012

American Association of Oral and Maxillofacial Surgeons

 

Obtain online

https://www.aaomsstore.com/p-134-office-anesthesia-evaluation-manual-8th-edition.aspx

 

Cost: $95 (member)

$285 (non-member)

$190 (instutition)

 

Contact: (800) 366-6725

 

 

Den 304.04 (a)(3)a.;

and Den 304.06(a)(2)

 

ADA 2012 “Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students”

 

(Amended 2012)

 

American Dental Association

 

Obtain online

www.ada.org/~/media/ADA/Member%20 Center/FIles/teaching_paincontrol_guidelines.ashx

 

Cost:  none

 

Contact:  (800) 621-8099

Jane Josek, ext. 2694

 

Den 304.04(b)(1)

“Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures”

(Eff. 2006)

 

American Academy of Pediatric Dentistry

 

Obtain online

http://www.aapd.org/media/Policies_Guidelines/

G_Sedation1.pdf

 

Cost: none

Den 304.06(a)(3)

“Guidelines for the Use of Sedation and General Anesthesia by Dentists”

 

(Eff. 2012)

American Dental Association

 

Obtain online

http://www.ada.org/en/~/media/ADA/

Education%20and%20Careers/

Files/ADA_Sedation_Use_Guidelines

 

Cost: none

 

Den 501.01 (a); Den 302.04 (b)

 

Principles of Ethics and Code of Professional Conduct

 

(Amended April 2012)

 

American Dental Association

 

Obtain online www.ada.org/194.aspx

 

Cost:  none

 

Contact:  (312) 440-2500

American Dental Association

211 East Chicago Ave.

Chicago, IL 60611-2678

 

Den 501.01 (a)

Code of Ethics of the American Dental Hygienists Association

 

(Adopted June 20, 2011

Amended June 18, 2012)

American Dental Hygienists’ Association

 

Obtain online www.adha.org

Click on tab About ADHA,

then click on Bylaws and Ethics

 

Cost:  none

 

Any questions or information requests can be directed to membership. services@adha.net

or by calling (312) 440-890

 

Den 501.01(p)

Dental Radiographic Examinations: Recommendations for Patient Sedation and Limiting Radiation Exposure

(Revised 2016)

 

American Dental Association

Obtain online at no cost at:

http://www.ada.org/~/media/ADA/Member%20Center/

FIles/Dental_Radiographic_Examinations_2012.ashx

 

Den 501.01 (a); Den 302.04 (b)

 

Principles of Ethics and Code of Professional Conduct

 

(Amended Nov. 2016)

 

American Dental Association

 

Obtain online www.ada.org/194.aspx

 

Cost:  none

 

Contact:  (312) 440-2500

American Dental Association

211 East Chicago Ave.

Chicago, IL 60611-2678

Den 501.01 (a)

Code of Ethics of the American Dental Hygienists Association

 

(Adopted June 20, 2011

Amended June 13, 2016)

American Dental Hygienists’ Association

 

Obtain online www.adha.org

Click on tab About ADHA, then click on Bylaws and Ethics

 

Cost:  none

 

Any questions or information requests can be directed to membership. services@adha.net

or by calling (312) 440-890

Den 503.07

The American Society of Addiction Medicine’s “National Practice Guideline For the Use of Medications in the Treatment of Addiction Involving Opioid Use,” adopted on June 1, 2015.

No cost to download from:

http://www.asam.org/quality-practice/guidelines-and-consensus-documents/npg/complete-guideline