DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

DIRECTOR’S OFFICE

DENTISTRY - GENERAL RULES

Filed with the secretary of state on April 26, 2021

These rules take effect immediately upon filing with the secretary of state unless adopted

under section 33, 44, or 45a(6) of the administrative procedures act of 1969, 1969 PA

306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become

effective 7 days after filing with the secretary of state.

(By authority conferred on the director of the department of licensing and regulatory

affairs by sections 16145, 16148, 16174, 16178, 16182, 16186, 16201, 16204, 16205,

16215, 16608, 16611, 16625, 11626, 16631, 16644, 16651, 16652, 16653, 16654, 16655,

16656, 16657, and 16658 of the public health code, 1978 PA 368, MCL 333.16145,

333.16148, 333.16174, 333.16178, 333.16182, 333.16186, 333.16201, 333.16204,

333.16205, 333.16215, 333.16608, 333.16611, 333.16625, 333.16626, 333.16631,

333.16644, 333.16651, 333.16652, 333.16653, 333.16654, 333.16655, 333.16656,

333.16657, and 333.16658, and Executive Reorganization Order Nos. 1991-9, 1996-2,

2003-1, and 2011-4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)

R 338.11101, R 338.11103, R 338.11120, R 338.11121, R 338.11201, R 338.11202,

R 338.11203, R 338.11221, R 338.11223, R 338.11233, R 338.11235, R 338.11239,

R 338.11247, R 338.11253, R 338.11255, R 338.11259, R 338.11261, R 338.11267,

R 338.11301, R 338.11303, R 338.11307, R 338.11401, R 338.11501, R 338.11512,

R 338.11513, R 338.11515, R 338.11517, R 338.11519, R 338.11521, R 338.11523,

R 338.11525, R 338.11527, R 338.11601, R 338.11602, R 338.11603, R 338.11605,

R 338.11701, R 338.11703, R 338.11704, R 338.11704a, R 338.11705, R 338.11801,

R 338.11811, R 338.11813, R 338.11815, R 338.11817, R 338.11819, and R 338.11821

of the Michigan Administrative Code are amended, R 338.11209, R 338.11213,

R 338.11218, R 338.11257, R 338.11263, R 338.11265, R 338.11269, R 338.11271,

R 338.11302, R 338.11302a, R 338.11411, R 338.11415, R 338.11417, and R 338.11419

are added, and R 338.11107, R 338.11117, R 338.11123, R 338.11222, R 338.11241,

R 338.11245, R 338.11402, R 338.11403, R 338.11404, R 338.11404a, R 338.11405,

R 338.11405a, R 338.11405b, R 338.11405c, R 338.11406, R 338.11408, R 338.11409,

R 338.11410, R 338.11505, R 338.11604, R 338.11704b, and R 338.11704c are

rescinded, as follows:

PART 1. GENERAL PROVISIONS

R 338.11101 Definitions.

Rule 1101. (1) As used in these rules:

November 24, 2020

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(a) “Allied dental personnel” means the supporting team who receives appropriate

delegation from a dentist or dental therapist to participate in dental treatment.

(b) “Analgesia” means the diminution or elimination of pain in the conscious patient as

a result of the administration of an agent including, but not limited to, local anesthetic,

nitrous oxide, and pharmacological and non-pharmacological methods.

(c) “Approved course” means a course offered by either a dental, dental therapy, dental

hygiene, or dental assistant program accredited by the Commission on Dental

Accreditation (CODA) of the American Dental Association (ADA) that meets the

requirements in section 16611 of the code, MCL 333.16611.

(d) “Assistant” means a nonlicensed person who may perform basic supportive

procedures under the supervision of a dentist as provided in these rules.

(e) “Board” means the Michigan board of dentistry.

(f) “Conscious sedation” means a minimally depressed level of consciousness that

retains a patient’s ability to independently and continuously maintain an airway and

respond appropriately to physical stimulation or verbal command and that is produced by

a pharmacological or a non-pharmacological method or a combination of both.

(g) “Code” means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(h) “Dental therapist” means a person licensed under part 166 of the code, MCL

333.16601 to 333.16659, to provide the care and services and perform any of the duties

described in section 16656 of the code, MCL 333.16656.

(i) “Dentist” means, except as otherwise provided in R 338.11801, a person licensed by

the board under the code and these rules to engage in the practice of dentistry.

(j) “Department” means the department of licensing and regulatory affairs.

(k) “Enteral” means any technique of administration in which the agent is absorbed

through the gastrointestinal or oral mucosa.

(l) “General anesthesia” means the elimination of all sensations accompanied by a state

of unconsciousness and loss of reflexes necessary to maintain a patent airway.

(m) “Licensed” means the possession of a full license to practice, unless otherwise

stated by the code or these rules.

(n) “Local anesthesia” means the elimination of sensation, especially pain, in 1 part of

the body by the topical application or regional injection of a drug.

(o) “Office” means the building or suite in which dental treatment is performed.

(p) “Parenteral” means a technique of administration in which the drug bypasses the

gastrointestinal (gi) tract, including intramuscular (im), intravenous (iv), intranasal (in),

submucosal (sm), subcutaneous (sc), and intraocular (io).

(q) “Registered dental assistant” (RDA) means a person licensed as a registered dental

assistant by the board under the code and these rules. A dental hygienist may perform the

functions of a registered dental assistant if he or she is licensed by the board as a

registered dental assistant.

(r) “Registered dental hygienist” (RDH) means a person licensed as such a registered

dental hygienist by the board under the code and these rules.

(s) “Second pair of hands” means acts, tasks, functions, and procedures performed by a

dental assistant, registered dental assistant, or registered dental hygienist at the direction

of a dentist, dental therapist, or registered dental hygienist who is in the process of

rendering dental services and treatment to a patient. The acts, tasks, functions, and

procedures performed by a dental assistant, registered dental assistant, or registered

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dental hygienist are ancillary to the procedures performed by the dentist, dental therapist,

or registered dental hygienist and intended to provide help and assistance at the time the

procedures are performed. This definition does not expand the duties of the dental

assistant, registered dental assistant, or registered dental hygienist as provided by the

code and rules promulgated by the board.

(t) “Sedation” means the calming of a nervous, apprehensive individual, without

inducing loss of consciousness, through the use of systemic drugs. Agents may be given

orally, parenterally, or by inhalation.

(2) Unless otherwise defined in these rules, the terms defined in the code have the same

meaning when used in these rules.

R 338.11103 Identification, written consent.

Rule 1103. At the inception of care for a patient, both of the following must occur:

(a) Each dentist, dental therapist, dental assistant, registered dental assistant, and

registered dental hygienist shall identify himself or herself to the patient as a dentist,

dental therapist, dental assistant, registered dental assistant, or registered dental hygienist.

(b) The patient shall be provided with a written consent for treatment.

R 338.11107 Rescinded.

R 338.11117 Rescinded.

R 338.11120 Dental treatment records; requirements.

Rule 1120. (1) A dentist or dental therapist shall make and maintain a dental treatment

record on each patient.

(2) A dental treatment record must include all of the following information:

(a) Medical and dental history.

(b) The patient’s existing oral health care status and the results of any diagnostic aids

used.

(c) Diagnosis and treatment plan.

(d) Dental procedures performed upon the patient, including both of the following:

(i) The date the procedure was performed.

(ii) Identity of the dentist, dental therapist, or allied dental personnel performing each

procedure.

(e) Progress notes that include a chronology of the patient’s progress throughout the

course of all treatment.

(f) The date, dosage, and amount of any drug prescribed, dispensed, or administered to

the patient.

(g) Radiographic images taken in the course of treatment. If radiographic images are

transferred to another dentist, the name and address of that dentist must be entered in the

treatment record.

(3) All dental treatment records must be maintained for not less than 10 years from the

date of the last treatment.

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R 338.11121 Scheduled controlled substances; inventory record requirements.

Rule 1121. (1) When a controlled substance, as described in article 7 of the code, MCL

333.7101 to 333.7545, is stocked in a dental office for dispensing or administering to a

patient, the dentist shall maintain an accurate inventory record of the drug that includes

all of the following information:

(a) The date and quantity of the drug purchased.

(b) The amount of the drug, dosage of the drug, and the date the drug was dispensed or

administered.

(c) The name of the patient to whom it the drug was dispensed or administered.

(2) The inventory record must be available for inspection for not less than 10 years.

(3) The dentist shall keep an inventory record in addition to the dental treatment records

required by R 338.11120.

R 338.11123 Rescinded.

PART 2. LICENSURE

R 338.11201 Licensure by examination to practice dentistry; graduates of programs in

compliance with board standards.

Rule 1201. In addition to meeting the requirements of section 16174 of the code, MCL

333.16174, an applicant for dentist licensure by examination shall submit a completed

application, on a form provided by the department, together with the requisite fee and

shall meet all of the following requirements:

(a) Graduate from a dental educational program that complies with the standards in R

338.11301, in which he or she has obtained a doctor of dental surgery (DDS) degree or

doctor of dental medicine (DMD) degree.

(b) Pass all parts of the national board examination that is conducted and scored by the

Joint Commission on National Dental Examinations (JCNDE), to qualify for the licensing

examination in subdivision (c) or (d) of this rule.

(c) Subject to subdivision (d) of this rule, pass a dental simulated clinical written

examination that is conducted the Commission on Dental Competency Assessments

(CDCA), previously known as North East Regional Board (NERB), or a successor

organization, and 1 of the following:

(i) Pass all parts of a clinical examination that is conducted and scored by the CDCA

or a successor organization, or pass all parts of a clinical examination that is conducted

by a regional testing agency if the examination is substantially equivalent, as provided in

R 338.11255(5) and (6), to the dental simulated clinical written examination conducted

by the CDCA, or a successor organization.

(ii) Pass all parts of a clinical examination developed and scored by a state or other

entity that is substantially equivalent, as provided in R 338.11255(5) and (6), to the

clinical examination of the CDCA or a successor organization.

(d) Pass all parts, written and clinical, of the American Board of Dental Examiners, Inc

(ADEX) clinical examination that is conducted by the CDCA, a successor organization,

or by another regional testing agency. Beginning 1 year after the effective date of this

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subdivision, an applicant shall meet the requirements of this subdivision instead of the

requirements under subdivision (c) of this rule.

(e) Beginning January 6, 2022, complete a 1-time training identifying victims of human

trafficking as required in R 338.11271 and section 16148 of the code, MCL 333.16148.

(f) Complete a 1-time training in opioids and other controlled substances awareness as

required in R 338.3135.

R 338.11202 Licensure to practice dentistry; graduates of programs not meeting board

standards; requirements.

Rule 1202. An applicant for dentist licensure by examination who graduated from a

dental educational program that does not comply with the standards provided in R

338.11301 shall submit a completed application, on a form provided by the department,

together with the requisite fee and meet all of the following requirements:

(a) Comply with section 16174 of the code, MCL 333.16174.

(b) Submit to the department a final, official transcript establishing graduation from a

program in which he or she has obtained a dental degree. If the transcript is issued in a

language other than English, an original, official translation must also be submitted.

(c) Meet 1 of the following requirements:

(i) Graduate from a program in dentistry that complies with the standards in R

338.11301, in which he or she has obtained a DDS degree or DMD degree. The

completion of the program must be confirmed by official transcripts from the school.

(ii) Graduate from a minimum 2-year master's degree or certificate program in

dentistry that complies with the standards in R 338.11301, in which he or she has

obtained a degree or certificate in a specialty branch of dentistry recognized in R

338.11501, with proof as required in part 5 of these rules.

(d) Pass all parts of the national board examination that is conducted and scored by the

JCNDE.

(e) Subject to subdivision (f) of this subrule, pass the dental clinical written examination

and a clinical examination, as described in R 338.11201(c).

(f) Pass all parts, written and clinical, of the ADEX clinical examination that is

conducted by the CDCA, a successor organization, or by another regional testing agency.

Beginning 1 year after the effective date of this subdivision, an applicant shall meet the

requirements of this subdivision instead of the requirements under subdivision (e).

(g) Beginning January 6, 2022, complete a 1-time training identifying victims of human

trafficking as required in R 338.11271 and section 16148 of the code, MCL 333.16148.

(h) Complete a 1-time training in opioids and other controlled substances awareness as

required in R 338.3135.

R 338.11203 Dental examinations; required passing scores.

Rule 1203. (1) The board approves and adopts the examinations developed and scored

by the JCNDE. An applicant shall provide evidence to the department of passing each

component of the examination with a converted score of not less than 75.

(2) The board approves and adopts all parts of the ADEX clinical examination. A

passing score on the clinical examination is the score recommended by the CDCA or its

successor organization. An applicant shall provide evidence to the department of a

converted score of 75 or higher on each component of the examination.

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R 338.11209 Licensure by examination to practice dental therapy.

Rule 1209. In addition to meeting the requirements of section 16174 of the code, MCL

333.16174, an applicant for dental therapist licensure by examination shall submit a

completed application, on a form provided by the department, together with the requisite

fee and shall meet all of the following requirements:

(a) Graduate from a dental therapy educational program that meets the standards in R

338.11302.

(b) Pass the comprehensive, competency-based clinical examination developed and

scored by the CDCA with a passing converted score of not less than 75 on each

component of the examination.

(c) Complete at least 500 hours of clinical practice as required under R 338.11218.

(d) Beginning January 6, 2022, complete a 1-time training identifying victims of human

trafficking as required in R 338.11271 and section 16148 of the code, MCL 333.16148.

(e) Complete a 1-time training in opioids and other controlled substances awareness as

required in R 338.3135.

R 338.11213 Dental therapy examinations; required passing scores.

Rule 1213. The board approves and adopts the comprehensive, competency-based

dental therapy clinical examination developed and scored by the CDCA. An applicant

shall provide evidence to the department of passing each component of the examination

with a converted score of not less than 75.

R 338.11218 Dental therapy clinical practice in board approved program; requirements.

Rule 1218. (1) The dental therapy clinical practice required for licensure must comply

with all of the following:

(a) The clinical practice must be included in a dental therapy education program that

meets the standards in R 338.11302.

(b) A dental therapy student shall complete at least 500 clinical practice hours within

the educational program, including practice hours in extractions and restorations as

determined by the educational program.

(c) A dental therapy student shall be under the direct supervision of a dentist who is

currently licensed in this state and is in good standing.

(d) A dentist under disciplinary review or action shall not provide direct supervision of

a dental therapy student in a clinical practice. If a dentist is notified by the department

that he or she is under disciplinary review or action by any state, within 7 days of

notification, he or she shall notify the dental therapist program and discontinue directly

supervising the dental therapy student in his or her clinical practice.

(2) As used in this rule, “direct supervision” means that the supervising dentist complies

with all of the following:

(a) Designates a patient of record upon whom the procedures are to be performed by

the dental therapy student.

(b) Describes the procedures to be performed to the dental therapy student.

(c) Examines the patient before prescribing the procedures to be performed by the

dental therapy student.

(d) Examines the patient upon completion of the procedures that were performed by

the dental therapy student.

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(e) Is physically present in the office at the time the procedures are being performed by

the dental therapy student.

R 338.11221 Licensure by examination to practice dental hygiene.

Rule 1221. In addition to meeting the requirements of section 16174 of the code, MCL

333.16174, an applicant for dental hygienist licensure by examination shall submit a

completed application, on a form provided by the department, together with the requisite

fee shall meet all of the following requirements:

(a) Graduate from a dental hygiene educational program in compliance with the

standards in R 338.11303.

(b) Pass all parts of the dental hygiene national board examination that is conducted and

scored by the JCNDE to qualify for the licensing examination provided for in subdivision

(c) or (d) of this rule. The requirement does not apply to an applicant who graduated

from a dental hygiene program before 1962.

(c) Subject to subdivision (d) of this rule, pass a dental hygiene simulated clinical

written examination conducted by the CDCA or a successor organization, and 1 of the

following:

(i) Pass all parts of a clinical examination that is conducted and scored by the CDCA

or a successor organization or pass all parts of a clinical examination that is conducted by

a regional testing agency if the examination is substantially equivalent, as provided in R

338.11255(5) and (6), to the dental hygiene simulated clinical written examination

conducted by CDCA or a successor organization.

(ii) Pass all parts of a clinical examination developed and scored by a state or other

entity that is substantially equivalent as provided in R 338.11255(5) and (6), to the

clinical examination of the CDCA or a successor organization.

(d) Pass all parts written and clinical, of the ADEX clinical examination that is

conducted and scored by the CDCA, a successor organization, or by another regional

testing agency. Beginning 1 year after the effective date of this subdivision, an applicant

shall meet the requirements of this subdivision instead of the requirements under

subdivision (c) of this rule.

(e) Beginning January 6, 2022, complete a 1-time training identifying victims of human

trafficking as required in R 338.11271 and section 16148 of the code, MCL 333.16148.

R 338.11222 Rescinded.

R 338.11223 Registered dental hygienist examinations; passing scores.

Rule 1223. (1) The board approves and adopts the dental hygiene examination

developed and scored by the JCNDE. An applicant shall provide evidence to the

department of passing each component of the examination with a converted score of not

less than 75.

(2) The board approves and adopts all parts of the ADEX clinical examination. A

passing score on the clinical examination is the score recommended by the CDCA or its

successor organization. An applicant shall provide evidence to the department of a

converted score of 75 or greater on each component of the examination.

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R 338.11233 Registered dental hygienist; use of letters "R.D.H."; registered dental

assistant; use of letters "R.D.A."

Rule 1233. (1) Pursuant to section 16264 of the code, MCL 333.16264, the registered

dental hygienist who has received a bona fide degree or certificate of dental hygiene from

a duly recognized and accredited program of dental hygiene and who has completed all

requirements for licensure may use the letters "R.D.H." after his or her name in

connection with the practice of dental hygiene.

(2) Pursuant to section 16264 of the code, MCL 333.16264, a registered dental assistant

who has received a bona fide degree or certificate of dental assisting from a duly

recognized and accredited program of dental assisting and who has completed all

requirements for licensure may use the letters "R.D.A." after his or her name in

connection with the practice of dental assisting.

R 338.11235 Licensure to practice as a registered dental assistant; requirements.

Rule 1235. In addition to meeting the requirements of section 16174 of the code, MCL

333.16174, an applicant for registered dental assistant licensure by examination shall

submit a completed application, on a form provided by the department, together with the

requisite fee and shall meet both of the following requirements:

(a) Graduate or receive a certificate from an educational program that meets the

standards in R 338.11307.

(b) Provide evidence to the department of passing both a board-approved written

examination and board-approved clinical examination that meets the requirements in R

338.11239, with a score of not less than 75, on all sections of both examinations.

(c) Beginning January 6, 2022, complete a 1-time training identifying victims of human

trafficking as required in R 338.11271 and section 16148 of the code, MCL 333.16148.

R 338.11239 Registered dental assistant examination; content; time; place; passing

score.

Rule 1239. (1) Upon a written request, the board shall review a written and clinical

examination for compliance with the criteria in subrule (2) of this rule.

(2) An examination for licensure as a registered dental assistant must be both written

and clinical and include all of the following:

(a) Oral anatomy.

(b) Law and rules governing allied dental personnel.

(c) Instrumentation and use of dental materials.

(d) Mouth mirror inspection.

(e) Dental dam application.

(f) Application of anticariogenics, which includes sealants, fluoride varnish, and

fluoride applications.

(g) Placement and removal of temporary crowns and bands.

(h) Radiography.

(i) Application and removal of post extraction and periodontal dressings.

(j) Removal of sutures.

(k) Fabrication of temporary crowns.

(l) Placing, condensing, and carving amalgam restorations.

(m) Taking final impressions for indirect restorations.

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(n) Assisting and monitoring the administration of nitrous oxide analgesia.

(o) Placing, condensing, and carving intracoronal temporaries.

(p) Infection control, safety, and occupational safety and health administration.

(q) Orthodontic procedures.

(r) Placing resin bonded restorations, occlusal adjustment, and finishing and polishing

with a non-tissue cutting slow-speed handpiece.

(s) Selective coronal polishing before orthodontic or restorative procedures only.

(t) Charting the oral cavity.

(u) Classifying occlusion.

(v) Nutritional counseling.

(w) Medical emergency procedures.

(x) Pulp vitality testing.

(y) Placement and removal of gingival retraction materials or agents.

(z) Drying endodontic canals.

(aa) Taking impressions for study and opposing models.

(bb) Instructing in the use and care of dental appliances.

(cc) Applying topical anesthetic solution.

(dd) Etching, placing, contouring, and polishing of sealants with a slow-speed rotary

handpiece for occlusal adjustment.

(ee) Placing and removing matrices and wedges.

(ff) Applying cavity liners and bases.

(gg) Applying and dispensing in-office bleaching products.

(hh) Adjusting and polishing contacts and occlusion of indirect restorations.

(3) The passing score for an examination is a converted score of 75 on each section.

R 338.11241 Rescinded.

R 338.11245 Rescinded.

R 338.11247 Limited licenses; issuance; requirements.

Rule 1247. (1) The board may issue a an educational limited license for postgraduate

education, under section 16182(2)(a) of the code, MCL 333.16182, to an applicant who is

a graduate of a dental, dental therapy, dental hygiene, or dental assistant program, and

who is engaged in CODA accredited postgraduate dental education. An educational

limited license is renewable only 7 times. A 1-time extension may be granted by the

board. All of the following apply to an educational limited license:

(a) An applicant for an educational limited license shall comply with all of the

following:

(i) Submit the required fee and a completed application on a form provided by the

department.

(ii) Meet the requirements of section 16174 of the code, MCL 333.16174.

(iii) Submit proof of graduation from a dental, dental therapy, dental hygiene, or

dental assistant program in the form of a certified copy of a diploma and transcript. If the

transcript is issued in a language other than English, an applicant shall submit an original,

official translation.

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(iv) Submit documentation verifying that he or she has been accepted into a CODA

accredited postgraduate dental education program.

(b) An educational limited license holder shall not hold himself or herself out to the

public as being engaged in the practice of dentistry, dental therapy, dental hygiene, or as

a dental assistant, or provide dental services outside his or her postgraduate dental

education program.

(c) An educational limited licensed dentist, dental therapist, or dental hygienist may

perform dental procedures upon patients as directed by his or her postgraduate dental

education program if the procedures are performed under the general supervision, as

defined in R 338.11401(d), of a fully licensed dentist.

(d) An educational limited licensed dental assistant may perform dental procedures

upon patients as directed by his or her postgraduate dental education program if he or she

complies with all of the following:

(i) The procedures are performed under the direct supervision, as defined in R

338.11401(c), of a fully licensed dentist.

(ii) The limited licensed dental assistant has satisfied the 35 hours of additional

education in an approved course as required under sections 16611(7) and (11) to (13) of

the code, MCL 333.16611.

(iii) The limited licensed dental assistant has successfully completed a course in

dental radiography that is substantially equivalent to a course taught in a program

approved by the board under R 338.11302, R 338.11303, or R 338.11307.

(2) The board may issue a limited license, under section 16182(2)(b) of the code, MCL

333.16182, for nonclinical services, to an applicant of a dental, dental therapy, dental

hygiene, or dental assistant program who functions only in a nonclinical academic

research or administrative setting. All of the following apply to a nonclinical limited

license:

(a) An applicant for a nonclinical limited license shall comply with all of the

following:

(i) Submit the required fee and a completed application on a form provided by the

department.

(ii) Meet the requirements of section 16174 of the code, MCL 333.16174.

(iii) Submit proof of graduation from a dental, dental therapy, dental hygiene, or

dental assistant program in the form of a certified copy of a diploma and transcript. If the

transcript is issued in a language other than English, the applicant shall submit an

original, official translation.

(iv) Submit documentation verifying that the applicant has been placed in a

nonclinical academic, research, or administrative setting.

(b) A nonclinical license holder shall not hold himself or herself out to the public as

being engaged in the practice of dentistry, dental therapy, dental hygiene, or as a dental

assistant other than in their nonclinical academic, research, or administrative setting, or

provide dental services outside of his or her nonclinical academic, research, or

administrative setting.

(3) The board may issue a limited license, under section 16182(2)(c) of the code, MCL

333.16182, for clinical academic services, to an applicant who is a graduate of a dental,

dental therapy, dental hygiene, or dental assistant program, who practices the health

profession only in connection with his or her employment or other contractual

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relationship with that academic institution. All of the following apply to a clinical limited

license:

(a) An applicant for a clinical limited license shall comply with all of the following:

(i) Submit the required fee and a completed application on a form provided by the

department.

(ii) Meet the requirements of section 16174 of the code, MCL 333.16174.

(iii) Submit proof of graduation from a dental, dental therapy, dental hygiene, or

dental assistant program in the form of a certified copy of a diploma and transcript. If the

transcript is issued in a language other than English, the applicant shall submit an

original, official translation.

(iv) Submit documentation verifying that the applicant has been offered and accepted

employment in an academic institution.

(b) A clinical limited license holder shall not hold himself or herself out to the public

as being engaged in the practice of dentistry, dental therapy, dental hygiene, or as a dental

assistant other than in connection with his or her employment or other contractual

relationship with an academic institution, or provide dental services outside his or her

employment or other contractual relationship with an academic institution.

(c) A clinical academic limited licensed dentist, dental therapist, or dental hygienist

may perform dental procedures upon patients in connection with his or her employment

or contractual relationship with an academic institution if the procedures are performed

under the general supervision, as defined in R 338.11401(d), of a fully licensed dentist.

(d) A clinical academic limited licensed dental assistant may perform dental

procedures upon patients in connection with his or her employment or contractual

relationship with an academic institution if he or she complies with all of the following:

(i) The procedures are performed under the direct supervision, as defined in R

338.11401(c), of a fully licensed dentist.

(ii) The limited licensed dental assistant has satisfied the 35 hours of additional

education in an approved course as required under section 16611(7), and (11) to (13) of

the code, MCL 333.16611.

(iii) The limited licensed dental assistant has successfully completed a course in

dental radiography that is substantially equivalent to a course taught in a program

approved by the board pursuant to R 338.11303 or R 338.11307.

(4) Limited licenses must be renewed annually and are issued at the discretion of the

department.

R 338.11253 Certification of renewal; display.

Rule 1253. A licensee shall display a current certificate of licensure in his or her

principal place of practice. A licensee whose practice involves more than 1 office shall

have a copy of his or her current certificate of licensure on display at all additional

locations.

R 338.11255 Licensure by endorsement of dentist; requirements.

Rule 1255. (1) An applicant who has never held a dental license in this state and who is

not applying for licensure by examination may apply for licensure by endorsement by

submitting a completed application on a form provided by the department, together with

the requisite fee.

12

(2) An applicant who is licensed in another state as a dentist is presumed to have met the

requirements of section 16186 of the code, MCL 333.16186, if he or she meets all of the

following requirements in subdivisions (a) to (e), subject to subdivisions (f) and (g):

(a) Has graduated from a dental educational program that meets the standards in R

338.11301 and provides the department with the original, official transcripts of

professional education and documentation of graduation.

(b) Has passed all phases of the national board examination for dentists, in sequence.

(c) Verifies his or her license, on a form supplied by the department, by the licensing

agency of any state in which the applicant holds a current license or ever held a license as

a dentist, including the record of any disciplinary action taken or pending against the

applicant.

(d) Has held a license as a dentist in good standing in another state for 30 days before

filing an application in this state.

(e) Submits proof of successful completion of 1 of the regional examinations described

in subrule (4) of this rule. This requirement is waived for individuals who were licensed

initially in another state before 2002 and who were not required to complete a regional

examination as part of the initial licensing process as confirmed by the state in which the

initial license was awarded.

(f) If an applicant was licensed as a dentist in another state that required the successful

completion of a regional examination and the applicant has been practicing for a

minimum of 5 years in the United States immediately preceding the application for

licensure in this state, it is presumed that the applicant meets the requirements of

subdivisions (a), (b), and (d) of this subrule.

(g) If an applicant is licensed as a dentist in another state that does not require the

successful completion of a regional examination and the applicant has been practicing for

a minimum of 5 years in the United States immediately preceding the application for

licensure in this state, it is presumed that the applicant meets the requirements of

subdivisions (a) and (b) of this subrule.

(3) The board may deny an application for licensure by endorsement upon finding the

existence of a board action in any other state for a violation related to applicable

provisions of section 16221 of the code, MCL 333.16221, or upon determining that the

applicant does not fulfill the requirements of section 16186 of the code, MCL 333.16186.

(4) For purposes of this rule, subject to subrules (5) and (6) of this rule, the board

approves and adopts the clinical examinations of other regional testing agencies or state

boards if the examinations are substantially equivalent to all parts, written and clinical, of

the ADEX clinical examination that is conducted and scored by the CDCA, a successor

organization, or another regional testing agency. A passing score on the clinical

examination is the score recommended by the sponsoring organization. An applicant shall

present evidence to the department of a converted score of 75 or higher on each

component of the examination.

(5) To determine substantial equivalency as specified in subrule (4) of this rule, the

board shall consider at least the following factors:

(a) Subject areas included.

(b) Detail of material.

(c) Comprehensiveness.

(d) Length of an examination.

13

(e) Degree of difficulty.

(6) To demonstrate substantial equivalency as specified in subrule (4) of this rule, an

applicant may be required to submit materials, including the following:

(a) A copy of the examination booklet or description of the examination content and

examination scores issued by the testing agency.

(b) An affidavit from the appropriate state licensing agency that describes the

examination and sets forth the legal standards that were in effect at the time of the

examination.

(c) An affidavit from a state licensing board or examination agency that describes the

examination.

R 338.11257 Licensure by endorsement of dentist therapist; requirements.

Rule 1257. (1) An applicant who has never held a dental therapy license in this state and

who is not applying by examination may apply for licensure by endorsement by

submitting a completed application on a form provided by the department, together with

the requisite fee.

(2) An applicant who is licensed as a dental therapist in another state is presumed to

have met the requirements of section 16186 of the code, MCL 333.16186, if he or she

meets all of the following requirements:

(a) Has graduated from a dental therapy educational program that meets the standards

in R 338.11302 and provides the department with the original, official transcripts of

professional education and documentation of graduation for board evaluation.

(b) Has passed the comprehensive, competency-based clinical examination developed

and scored by the CDCA with a converted passing score of not less than 75 on each

component of the examination.

(c) Verifies completion of at least 500 hours of clinical practice in dental therapy, that

substantially meets the requirements of R 338.11218, in a dental therapy educational

program that meets the standards in R 338.11302.

(d) Verifies his or her license, on a form supplied by the department, by the licensing

agency of any state in which the applicant holds a current license or ever held a license as

a dental therapist, including the record of any disciplinary action taken or pending against

the applicant.

(e) Has held a license as a dental therapist in good standing in another state 30 days

before filing an application in this state.

(3) The board may deny an application for licensure by endorsement upon finding the

existence of a board action in any other state for a violation related to applicable

provisions of section 16221 of the code, MCL 333.16221, or upon determining that the

applicant does not fulfill the requirements of section 16186 of the code, MCL 333.16186.

(4) For purposes of this rule, subject to subrules (5) and (6) of this rule, the board may

approve a dental therapist clinical examination of another state board if the examination

is substantially equivalent to all parts of the comprehensive, competency-based clinical

examination developed and scored by the CDCA or a successor organization. A passing

score on a substantially equivalent examination is the score recommended by the

sponsoring organization. An applicant shall present evidence to the department of a

converted score of 75 or higher on each component of the examination.

14

(5) To determine substantial equivalency as specified in subrule (4) of this rule, the

board shall consider at least the following factors:

(a) Subject areas included.

(b) Detail of material.

(c) Comprehensiveness.

(d) Length of an examination.

(e) Degree of difficulty.

(6) To demonstrate substantial equivalency as specified in subrules (4) and (5) of this

rule, an applicant may be required to submit materials, including the following:

(a) A copy of the examination booklet or description of the examination content and

examination scores issued by the testing agency.

(b) An affidavit from the appropriate state licensing agency that describes the

examination and sets forth the legal standards that were in effect at the time of the

examination.

(c) An affidavit from a state licensing board or examination agency that describes the

examination.

R 338.11259 Licensure by endorsement of dental hygienists; requirements.

Rule 1259. (1) An applicant who has never held a registered dental hygienist license in

this state and who is not applying by examination may apply for licensure by

endorsement by submitting a completed application, on a form provided by the

department, together with the requisite fee.

(2) An applicant who is licensed in another state as a dental hygienist is presumed to

have met the requirements of section 16186 of the code, MCL 333.16186, if he or she

meets all of the following requirements in subdivisions (a) to (e), subject to subdivisions

(f) and (g):

(a) Has graduated from a dental hygiene educational program that meets the standards

provided in R 338.11303 and provides the department with the original, official

transcripts of professional education and documentation of graduation for board

evaluation.

(b) Has passed all phases of the national board examination for dental hygienists. This

requirement is waived for persons who graduated from an accredited school before 1962.

(c) Verifies his or her license, on a form supplied by the department, by the licensing

agency of any state of the United States in which the applicant holds a current license or

ever held a dental hygienist license including the record of any disciplinary action taken

or pending against the applicant.

(d) Submits proof of successful completion of a written and clinical examination that is

substantially equivalent to the examinations required in R 338.11223. This requirement is

waived for individuals who were licensed initially in another state of the United States

before 2002 and who were not required to complete a regional examination as part of the

initial licensing process as confirmed by the state of the United States in which the initial

license was awarded.

(e) Has held a license as a dental hygienist in good standing in another state 30 days

before filing an application in this state.

(f) If an applicant was licensed as a dental hygienist in another state that requires the

successful completion of a regional examination and the applicant has been practicing in

15

the United States for a minimum of 3 years immediately preceding the application for

licensure in this state, it is presumed that the applicant meets the requirements of

subdivisions (a), (b), and (d) of this subrule.

(g) If an applicant is licensed as a dental hygienist in another state that does not require

the successful completion of a regional examination and the applicant has been practicing

in the United States for a minimum of 3 years immediately preceding the application for

licensure in this state, it is presumed that the applicant meets the requirement of

subdivisions (a) and (b) of this subrule.

(3) The board may deny an application for licensure by endorsement upon finding the

existence of a board action in any other state of the United States for a violation related to

applicable provisions of section 16221 of the code, MCL 333.16221, or upon determining

that the applicant does not fulfill the requirements of section 16186 of the code, MCL

333.16186.

(4) For purposes of this rule, subject to subrules (5) and (6) of this rule, the board

approves and adopts the clinical examinations of other regional testing agencies or state

boards if the examinations are considered to be substantially equivalent to all parts,

written and clinical, of the ADEX clinical examination that is conducted and scored by

the CDCA, a successor organization, or another regional testing agency. A passing score

on the clinical examination is the score recommended by the sponsoring organization. An

applicant shall present evidence to the department of a converted score of 75 or higher on

each component of the examination.

(5) To determine substantial equivalency as specified in subrule (4) of this rule, the

board shall consider at least the following factors:

(a) Subject areas included.

(b) Detail of material.

(c) Comprehensiveness.

(d) Length of an examination.

(e) Degree of difficulty.

(6) To demonstrate substantial equivalency as specified in subrule (4) of this rule, an

applicant may be required to submit materials, including the following:

(a) A copy of the examination booklet or description of the examination content and

examination scores issued by the testing agency.

(b) An affidavit from the appropriate state licensing agency that describes the

examination and sets forth the legal standards that were in effect at the time of the

examination.

(c) An affidavit from a state licensing board or examination agency that describes the

examination.

R 338.11261 Licensure by endorsement of registered dental assistants; requirements.

Rule 1261. (1) An applicant who has never held a registered dental assistant license in

this state and who is not applying for licensure by examination may apply for licensure

by endorsement by submitting a completed application, on a form provided by the

department, together with the requisite fee.

(2) An applicant who is licensed or registered in another state is presumed to have met

the requirements of section 16186 of the code, MCL 333.16186, if he or she meets all of

the following requirements:

16

(a) Has graduated from a dental assistant educational program that meets the standards

in R 338.11307 and provides the department with the original, official transcripts of

professional education and documentation of graduation for board evaluation.

(b) Submits proof of successful completion of both a written and clinical examination,

approved by the board under R 338.11239, with a score of not less than 75, on each

section of both the written and clinical examinations.

(c) Verifies his or her license, on a form supplied by the department, by the licensing

agency of any state in which the applicant holds a current license or ever held a license

including the record of any disciplinary action taken or pending against the applicant.

(d) Has held a license as a dental assistant in good standing in another state 30 days

before filing an application in this state.

(3) A dental assistant who does not fulfill the requirements of subrule (2) of this rule is

not eligible for licensure by endorsement in this state and shall comply with the

provisions of R 338.11235.

(4) The board may deny an application for licensure by endorsement upon finding the

existence of a board action in any other state of the United States for a violation related to

applicable provisions of section 16221 of the code, MCL 333.16221, or upon determining

that the applicant does not fulfill the requirements of section 16186 of the code, MCL

333.16186.

R 338.11263 Relicensure requirements; dentists.

Rule 1263. An applicant whose dentist license in this state has lapsed, under the

provisions of section 16201(3) or (4) of the code, MCL 333.16201, as applicable, may be

relicensed by complying with the following requirements:

For a dentist who has let his or her license in this

state lapse:

Lapsed

0-3 years than 3 years,

but less than

Lapsed more

Lapsed

5 or more

years

5 years

(a) Submits a completed application, on a form

provided by the department, together with the

requisite fee.

(b) Establishes that he or she is of good moral

character as defined under sections 1 to 7 of 1974

PA 381, MCL 338.41 to 338.47.

√

(c) Submits fingerprints as required under section

16174(3) of the code, MCL 333.16174.

(d) Submits proof of current certification in basic or

advanced cardiac life support for health care

providers with a hands-on component from an

agency or organization that grants certification

pursuant to standards equivalent to those established

by the American Heart Association (AHA), earned

within the 2-year period before receiving the

license.

√

17

(e) Submits proof of having completed 60 hours of

continuing education in courses and programs

approved by the board as required under R

338.11701, all of which were earned within the 3-

year period immediately preceding the application

for licensure. If the continuing education hours

submitted with the application are deficient, the

applicant has 2 years from the date of the

application to complete the deficient hours. The

department shall hold the application and shall not

issue the license until the applicant has completed

the continuing education requirements. The 60

hours of continuing education must include all of

the following:

√

(i) At least 3 hours in pain and symptom

management.

(ii) One hour in dental ethics and jurisprudence

with inclusion of delegation of duties to allied

dental personnel.

(iii) One hour in infection control, which must

include sterilization of hand pieces, personal

protective equipment, and the Centers for

Disease Control and Prevention’s infection

control guidelines.

(f) Completed a 1-time training in identifying

victims of human trafficking that meets the

standards in R 338.11271.

(g) Completed a 1-time training in opioids and other

controlled substances awareness as required in R

338.3135.

(h) A dentist who is subject to part 8 of these rules,

R 338.11801 to R 338.11821, shall verify with his

or her application for relicensure, that he or she

complies with part 8 of these rules, R 338.11801 to

R 338.11821, and specify the make of the amalgam

separator in his or her office and the year that each

separator was installed.

√

(i) An applicant’s license must be verified by the

licensing agency of all other states of the United

States in which he or she ever held a license as a

dentist. Verification must include the record of any

disciplinary action taken or pending against the

applicant.

√

(j) If an applicant’s license is lapsed for more than 3

years but less than 5 years, he or she shall meet

either of the following:

√

18

(i) Within the 2-year period immediately

preceding the application for relicensure, retakes

and passes the ADEX simulated clinical written

examination for dentists developed and scored by

the CDCA or another testing agency with a

passing score of not less than 75.

(ii) Provides the department documentation that

he or she holds or held a valid and unrestricted

dentist’s license in another state in the United

States within 3 years immediately preceding the

application for relicensure.

(k) If an applicant’s license is lapsed 5 or more

years, he or she shall provide the department with

documentation that proves he or she holds or held a

valid and unrestricted dentist license in another state

in the United States within 3 years immediately

preceding the application for relicensure and meets

all of the requirements in subrules (a) to (i) of this

rule or complies with all of the following:

(i) Meets the requirements of section 16174 of the

code, MCL 333.16174, and the administrative

rules.

√

(ii) Provides proof of graduation from a dental

educational program that meets the standards in R

338.11301 in which he or she obtained a DDS or

DMD degree.

(iii) Provides proof of having passed all parts of

the national board examination conducted and

scored by the JCNDE to qualify for the dental

simulated clinical written examination.

(iv) Provides proof of having passed the ADEX

dental simulated clinical written examination

conducted and scored by the CDCA or another

regional agency within the 2-year period

immediately preceding the application for

relicensure.

(v) Provides proof of having passed the ADEX

dental clinical examination conducted and scored

by the CDCA or another regional testing agency.

R 338.11265 Relicensure requirements; dental therapists.

Rule 1265. An applicant whose dental therapist license in this state has lapsed, under the

provisions of section 16201(3) or (4) of the code, MCL 333.16201, as applicable, may be

relicensed by complying with the following requirements:

19

For a dental therapist who has let his or her

license in this state lapse:

Lapsed

0-3

years

Lapsed more

than 3 years,

but less than

5 years

Lapsed

5 or more

years

(a) Submits a completed application, on a form

provided by the department, together with the

requisite fee.

(b) Establishes that he or she is of good moral

character as defined under sections 1 to 7 of 1974

PA 381, MCL 338.41 to 338.47.

√

(c) Submits fingerprints as required under section

16174(3) of the code, MCL 333.16174.

(d) Submits proof of current certification in basic or

advanced cardiac life support for health care

providers with a hands-on component from an

agency or organization that grants certification

pursuant to standards equivalent to those

established by the AHA, earned within the 2-year

period before receiving the license.

(e) Submits proof of having completed 35 hours of

continuing education in courses and programs

approved by the board as required under R

338.11701, all of which were earned within the 2-

year period immediately preceding the application

for licensure. If the continuing education hours

submitted with the application are deficient, an

applicant has 2 years from the date of the application

to complete the deficient hours. The department shall

hold the application and shall not issue the license

until the applicant has completed the continuing

education requirements. The 35 hours of continuing

education must include all of the following:

(i) At least 2 hours in pain and symptom

management.

√

(ii) One hour in dental ethics and

jurisprudence.

(iii) One hour in infection control, which must

include sterilization of hand pieces, personal

protective equipment, and the Centers for Disease

Control and Prevention’s infection control

guidelines.

20

(f) Submits proof of having completed a 1-time

training in identifying victims of human trafficking

that meets the standards in R 338.11271.

√

(g) Submits proof of having completed a 1-time

training in opioids and other controlled substances

awareness as required in R 338.3135.

√

(h) An applicant’s license must be verified by the

licensing agency of all other states of the United

States in which he or she ever held a license as a

dental therapist. Verification must include the

record of any disciplinary action taken or pending

against the applicant.

√

(i) If an applicant’s license is lapsed for more than

3 years but less than 5 years, he or she shall meet

either of the following:

√

(i) Within the 2-year period immediately

preceding the application for relicensure, retakes

and passes a comprehensive, competency-based

clinical examination approved by the department

with a converted passing score of not less than

75.

(ii) Provides the department documentation that

he or she holds or held a valid and unrestricted

dental therapist’s license in another state in the

United States within 3 years immediately

preceding the application for relicensure.

(j) If an applicant’s license is lapsed for 5 years or

more, he or she shall provide the department with

documentation that proves he or she holds or held a

valid and unrestricted dental therapist license in

another state in the United States within 3 years

immediately preceding the application for

relicensure and meets all of the requirements in

subrules (a) to (h) of this rule or complies with all

of the following:

√

(i) Meets the requirements of section 16174 of

the code, MCL 333.16174, and the

administrative rules.

(ii) Provides proof of graduation from a dental

therapy program that meets the standards in R

338.11302.

21

(iii) Provides proof of having passed a

comprehensive, competency-based dental

therapy clinical examination as required in R

338.11213, within the 2-year period

immediately preceding the application for

relicensure.

R 338.11267 Relicensure requirements; registered dental hygienists.

Rule 1267. An applicant whose registered dental hygienist license in this state has

lapsed, under the provisions of section 16201(3) or (4) of the code, MCL 333.16201, as

applicable, may be relicensed by complying with the following requirements:

For a registered dental hygienist who has let his or

her license in this state lapse:

Lapsed

0-3 years than 3 years,

but less than

Lapsed more

Lapsed

5 or more

years

5 years

(a) Submits a completed application, on a form

provided by the department, together with the

requisite fee.

(b) Establishes that he or she is of good moral

character as defined under sections 1 to 7 of 1974

PA 381, MCL 338.41 to 338.47.

√

(c) Submits fingerprints as required under section

16174(3) of the code, MCL 333.16174.

(d) Submits proof of current certification in basic

or advanced cardiac life support for health care

providers with a hands-on component from an

agency or organization that grants certification

pursuant to standards equivalent to those

√

established by the AHA, earned within the 2-year

period before receiving the license.

(e) Submits proof of having completed 36 hours of

continuing education in courses and programs

approved by the board as required under R

338.11704, all of which were earned within the 3-

year period preceding the date of application for

relicensure. If the continuing education hours

submitted with the application are deficient, the

applicant has 2 years from the date of the

application to complete the deficient hours. The

department shall hold the application and shall not

issue the license until the applicant has completed

the continuing education requirements. The 36

hours of continuing education must include all of

the following:

22

(i) At least 2 hours in pain and symptom

management.

(ii) One hour in dental ethics and jurisprudence

with inclusion of delegation of duties to allied

dental personnel.

(iii) One hour in infection control, which must

include sterilization of hand pieces, personal

protective equipment, and the Centers for

Disease Control and Prevention’s infection

control guidelines.

(f) Submits proof of having completed a 1-time

training in identifying victims of human trafficking

that meets the standards in R 338.11271.

(g) An applicant’s license must be verified by the

licensing agency of all other states of the United

States in which he or she ever held a license as a

dental hygienist. Verification must include the

record of any disciplinary action taken or pending

against the applicant.

√

(h) If an applicant’s license is lapsed for more than

3 years but less than 5 years, he or she shall meet 1

of the following:

√

(i) Provide proof of having passed the ADEX

hygiene simulated clinical written examination

conducted and scored by the CDCA or another

regional agency, within the 2-year period

immediately preceding the application for

relicensure.

(ii) Provide the department documentation that

the applicant holds or has held a valid and

unrestricted license in another state within 3

years immediately preceding the application for

licensure.

(i) If an applicant’s license is lapsed for 5 years or

more, he or she shall provide the department with

documentation that proves he or she holds or held a

valid and unrestricted license in another state

within 3 years immediately preceding the

application for relicensure and meets all of the

requirements in subrules (a) through (g) of this rule

or complies with all of the following:

√

(i) Meets the requirements of section 16174 of

the code, MCL 333.16174, and the

administrative rules.

(ii) Provides proof of graduation from a dental

hygiene educational program that meets the

23

standards in R 338.11303.

(iii) Provides proof of having passed all parts of

the dental hygiene national board examination

conducted and scored by the JCNDE to qualify

for the dental hygiene simulated clinical written

examination. This paragraph does not apply to

an applicant who graduated from a dental

hygiene program before 1962.

(iv) Provides proof of having passed the ADEX

hygiene simulated clinical written examination

conducted and scored by the CDCA or another

regional testing agency, within the 2-year

period immediately preceding the application

for relicensure.

(v) Provides proof of having passed the ADEX

hygiene clinical examination conducted and

scored by the CDCA or another regional testing

agency.

R 338.11269 Relicensure requirements; registered dental assistants.

Rule 1269. An applicant whose registered dental assistant license in this state has

lapsed, under the provisions of section 16201(3) or (4) of the code, MCL 333.16201, as

applicable, may be relicensed by complying with the following requirements:

For a registered dental assistant who has let his or

her license in this state lapse:

Lapsed

0-3 years than 3 years,

but less than

Lapsed more

Lapsed

5 or more

years

5 years

(a) Submits a completed application, on a form

provided by the department, together with the

requisite fee.

(b) Establishes that he or she is of good moral

character as defined under sections 1 to section 7 of

1974 PA 381, MCL 338.41 to 338.47.

(c) Submits fingerprints as required under section

16174(3) of the code, MCL 333.16174.

√

(d) Submits proof of current certification in basic

or advanced cardiac life support for health care

providers with a hands-on component from an

agency or organization that grants certification

pursuant to standards equivalent to those

√

established by the AHA, earned within the 2-year

period before receiving the license.

(e) Submits proof of having completed 36 hours of

24

continuing education in courses and programs

approved by the board as required under R

338.11704, all of which were earned within the 3-

year period immediately preceding the date of the

application for relicensure. If the continuing

education hours submitted with the application are

deficient, the applicant has 2 years from the date of

the application to complete the deficient hours. The

department shall hold the application and shall not

issue the license until the applicant has completed

the continuing education requirements. The 36

hours of continuing education must include all of

the following:

√

(i) At least 2 hours in pain and symptom

management.

(ii) One hour in dental ethics and jurisprudence

with inclusion of delegation of duties to allied

dental personnel.

(iii) One hour in infection control, which must

include sterilization of hand pieces, personal

protective equipment, and the Centers for

Disease Control and Prevention’s infection

control guidelines.

(f) Completed a 1-time training in identifying

victims of human trafficking that meets the

standards in R 338.11271.

(g) An applicant’s license must be verified by the

licensing agency of all other states of the United

States in which he or she ever held a license as a

dental assistant. Verification must include the

record of any disciplinary action taken or pending

against the applicant.

√

(h) If an applicant’s license is lapsed more than 3

years but less than 5 years, he or she shall meet

either of the following:

√

(i) Pass a board-approved written and clinical

examination that meets the requirements of R

338.11239, within the 2-year period

immediately preceding the application for

relicensure.

(ii) Provide the department documentation that

he or she holds or held a valid and unrestricted

license in another state within 3 years

immediately preceding the application for

relicensure.

(i) If an applicant’s license is lapsed 5 years or

25

more, he or she shall provide the department with

documentation that proves he or she holds or held a

valid and unrestricted license in another state

within 3 years immediately preceding the

application for relicensure and meets all of the

requirements in subrules (a) through (g) of this rule

or complies with all of the following:

(i) Meets the requirements of section 16174 of

the code, MCL 333.16174, and the

√

administrative rules.

(ii) Provides proof of graduation or certification

from an educational program that meets the

standards in R 338.11307.

(iii) Provides proof of having passed a board-

approved clinical examination that meets the

requirements of R 338.11239.

(iv) Provides proof of having passed a board-

approved written examination that meets the

requirements of R 338.11239, within the 2-year

period immediately preceding the application

for relicensure.

R 338.11271 Training standards for identifying victims of human trafficking;

requirements.

Rule 1271. (1) Pursuant to section 16148 of the code, MCL 333.16148, an individual

seeking licensure, registration, or who is licensed or registered shall complete training in

identifying victims of human trafficking that meets the following standards:

(a) Training content covers all of the following:

(i) Understanding the types and venues of human trafficking in this state or the United

States.

(ii) Identifying victims of human trafficking in health care settings.

(iii) Identifying the warning signs of human trafficking in health care settings for

adults and minors.

(iv) Specifying resources for reporting the suspected victims of human trafficking.

(b) Acceptable providers or methods of training include any of the following:

(i) Training offered by a nationally recognized or state-recognized health-related

organization.

(ii) Training offered by, or in conjunction with, a state or federal agency.

(iii) Training obtained in an educational program that has been approved by the board

for initial licensure, or by a college or university.

(iv) Reading an article related to the identification of victims of human trafficking

that meets the requirements of subdivision (a) of this subrule and is published in a peer

review journal, health care journal, or professional or scientific journal.

(c) Acceptable modalities of training include any of the following:

(i) Teleconference or webinar.

(ii) Online presentation.

26

(iii) Live presentation.

(iv) Printed or electronic media.

(2) The department may select and audit a sample of individuals and request

documentation of proof of completion of training. If audited by the department, an

individual shall provide an acceptable proof of completion of training, including either of

the following:

(a) Proof of completion certificate issued by the training provider that includes the

date, provider name, name of training, and individual’s name.

(b) A self-certification statement by an individual. The certification statement must

include the individual’s name and either of the following:

(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,

training provider name, and name of training.

(ii) For training completed pursuant to subrule (1)(b)(iv) of this rule, the title of

article, author, publication name of peer review journal, health care journal, or

professional or scientific journal, and date, volume, and issue of publication, as

applicable.

(3) Pursuant to section 16148 of the code, MCL 333.16148, the requirements specified

in subrule (1) of this rule apply for license or registration renewals beginning with the

first renewal cycle after January 6, 2017, and for initial licenses or registrations issued

after January 6, 2022.

PART 3. EDUCATION

R 338.11301 Approval of dental educational programs; accreditation standards; adoption

by reference.

Rule 1301. (1) The board adopts by reference in these rules the standards of CODA of

the ADA, as set forth in the following publications:

(b) “Accreditation Standards for Advanced Dental Education Programs in Oral and

(c) “Accreditation Standards for Advanced Dental Education Programs in

(d) “Accreditation Standards for Advanced Dental Education Programs in

(e) “Accreditation Standards for Advanced Dental Education Programs in

(f) “Accreditation Standards for Advanced Dental Education Programs in

(g) “Accreditation Standards for Advanced Dental Education Programs in Pediatric

(h) “Accreditation Standards for Advanced Dental Education Programs in Oral and

(2) A dental educational program accredited by CODA, or a successor organization, is

considered board approved. CODA is the only accreditation accepted by the board.

27

(3) These standards may be obtained at no cost from CODA of the ADA, 211 East

Chicago Avenue, Chicago, Illinois, 60611-2678 or at no cost from the association's

website at http://www.ada.org. Copies of these standards are available at 10 cents per

page for inspection and distribution, from the Michigan Board of Dentistry, Department

of Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611 West

Ottawa, P. O. Box 30670, Lansing, Michigan, 48909.

R 338.11302 Approval of dental therapy educational programs; accreditation standards;

adoption by reference.

Rule 1302. (1) The board adopts by reference in these rules the standards of CODA of

the ADA, as set forth in the publication titled “Accreditation Standards for Dental

(2) A dental therapy educational program that is accredited by CODA or a successor

organization is considered board approved.

(3) For an applicant applying for a dental therapy license, upon application for licensure

on a department form, the board shall review and may approve an applicant’s dental

therapy education program if the program substantially conforms to the dental therapy

education program CODA standards at the time of graduation of the dental therapy

applicant.

(4) A dental therapy educational program must be taught at a postsecondary education

institution that meets the standards in R 338.11302a.

(5) CODA standards may be obtained at no cost from CODA of the ADA, 211 East

Chicago Avenue, Chicago, Illinois, 60611-2678 or at no cost from the association's

website at http://www.ada.org. Copies of these standards are available for inspection and

distribution at 10 cents per page from the Michigan Board of Dentistry, Department of

Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611 West Ottawa,

P. O. Box 30670, Lansing, Michigan, 48909.

R 338.11302a Higher education institutions; accreditation standards; adoption by

reference.

Rule 1302a. (1) A higher education institution meets the requirements of R

338.11302(4) if it is accredited by the accrediting body of the region in which the

institution is located and the accrediting body meets either the recognition policy and

procedures of the Council for Higher Education Accreditation (CHEA) or the recognition

procedures and criteria of the United States Department of Education.

(2) The board adopts by reference the procedures and criteria for recognizing

accrediting agencies of the United States Department of Education, 34 CFR part 602

(2009), and the CHEA Recognition of Accrediting Organizations Policy and Procedures,

September 24, 2018. Copies of the procedures and criteria of the United States

Department of Education and the policy and procedures of CHEA are available for

inspection and distribution at no cost from the website for the United States Department

of Education at the Office of Postsecondary Education,

http://www.ed.gov/about/offices/list/OPE/index.html and the CHEA website at

www.chea.org/revised-chea-recognition-policy-and-procedures-0 . Copies are also

available for inspection and distribution at 10 cents per page from the Michigan Board of

28

Dentistry, Bureau of Professional Licensing, Department of Licensing and Regulatory

Affairs, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

R 338.11303 Approval of dental hygiene educational programs; accreditation standards;

adoption by reference.

Rule 1303. (1) The board adopts by reference the standards of CODA of the ADA, as

set forth in the publication titled "Accreditation Standards for Dental Hygiene Education

program accredited by CODA is considered board approved. CODA is the only

accreditation accepted by the board.

(2) These standards may be obtained at no cost from CODA of the ADA, 211 East

Chicago Avenue, Chicago, Illinois, 60611-2678 or at no cost from the association's

website at http://www.ada.org. Copies of these standards are available for inspection and

distribution, at 10 cents per page from the Michigan Board of Dentistry, Department of

Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611 West Ottawa,

P.O. Box 30670, Lansing, Michigan, 48909.

R 338.11307 Approval of dental assisting schools educational programs; standards;

adoption by reference.

Rule 1307. (1) The board adopts by reference the standards of CODA of the ADA, as

set forth in the publication titled "Accreditation Standards for Dental Assisting Education

approved by the board. CODA is the only accreditation accepted by the board.

(2) These standards may be obtained at no cost from CODA of the ADA, 211 East

Chicago Avenue, Chicago, Illinois, 60611-2678 or at no cost from the association's

website at http://www.ada.org. Copies of these standards are available for inspection and

distribution, at 10 cents per page from the Board of Dentistry, Bureau of Professional

Licensing, Michigan Department of Licensing and Regulatory Affairs, 611 West Ottawa,

P.O. Box 30670, Lansing, Michigan, 48909.

PART 4A. DELEGATION, SUPERVISION, ASSIGNMENT OF

DENTAL ASSISTANTS, REGISTERED DENTAL ASSISTANTS, AND

REGISTERED DENTAL HYGIENISTS

R 338.11401 Definitions.

Rule 1401. As used in this part:

(a) “Assignment” means a dentist designates a patient of record upon whom services are

to be performed and describes the procedures to be performed. Unless assignment is

designated in these rules under general or direct supervision, the dentist need not be

physically present in the office at the time the procedures are being performed.

(b) “Delegation” means an authorization granted by a licensee to a licensed or

unlicensed individual to perform selected acts, tasks, or functions that fall within the

scope of practice of the delegator and that are not within the scope of practice of the

delegatee and that, in the absence of the authorization, would constitute illegal practice of

a licensed profession.

29

(c) “Direct supervision” means that a dentist complies with all of the following:

(i) Designates a patient of record upon whom the procedures are to be performed and

describes the procedures to be performed.

(ii) Examines the patient before prescribing the procedures to be performed and upon

completion of the procedures.

(iii) Is physically present in the office at the time the procedures are being performed.

(d) “General supervision” means that a dentist complies with both of the following:

(i) Designates a patient of record upon whom services are to be performed.

(ii) Is physically present in the office at the time the procedures are being performed.

(e) “Patient of record” means a patient who has been examined and diagnosed by a

dentist and whose treatment has been planned by a dentist or a patient who has been

examined, evaluated, assessed, and treatment planned by a dental therapist to the extent

authorized by the supervising dentist. A patient of record includes a patient getting

radiographic images by allied dental personnel with training pursuant to R 338.11411(a)

after receiving approval from the assigning dentist or dental therapist.

R 338.11402 Rescinded.

R 338.11403 Rescinded.

R 338.11404 Rescinded.

R 338.11404a Rescinded.

R 338.11405 Rescinded.

R 338.11405a Rescinded.

R 338.11405b Rescinded.

R 338.11405c Rescinded.

R 338.11406 Rescinded.

R 338.11408 Rescinded.

R 338.11409 Rescinded.

R 338.11410 Rescinded.

R 338.11411 Delegated and assigned dental procedures for allied dental personnel.

Rule. 1411. A dentist may assign or delegate procedures to an unlicensed dental

assistant, registered dental assistant, or registered dental hygienist under the provisions of

section 16611 of the code, MCL 333.16611, as provided in Table 1:

30

Table 1 - Delegated and Assigned Dental Procedures for Allied Dental Personnel

DA RDA RDH

Procedure

Operating of dental radiographic equipment. A DA shall have successfully completed a course in

dental radiography that is substantially equivalent to a course taught in a program approved by the

board pursuant to R 338.11302, R 338.11303, or R 338.11307. A dentist may delegate necessary

radiographs for a new patient to an RDA or RDH.

(a)

G

A

(b)

(c)

(d)

(e)

(f)

G

D

A

Instructing in the use and care of dental appliances.

Taking impressions for study and opposing models.

Applying nonprescription topical anesthetic solution.

Trial sizing of orthodontic bands.

Placing, removing, and replacing orthodontic elastic or wire separators, arch wires, elastics, and

ligatures.

(g)

(h)

(i)

D

A

D

A

Dispensing orthodontic aligners.

Removing orthodontic bands, brackets, and adhesives with non-tissue cutting instruments.

Polishing specific teeth with a slow-speed rotary hand piece immediately before a procedure that

requires acid etching before placement of sealants, resin-bonded orthodontic appliances, and direct

restorations.

(j)

(k)

(l)

G*

D

G*

D

Etching and placing adhesives before placement of orthodontic brackets and attachment for

aligners.

Cementing orthodontic bands or initial placement of orthodontic brackets and attachments for

aligners.

Removing excess cement from supragingival surfaces of a tooth with a non-tissue cutting

instrument.

A

(m)

(n)

(o)

(p)

(q)

(r)

A

Providing nutritional counseling for oral health and maintenance.

Applying commonly accepted medical emergency procedures.

Inspecting and charting the oral cavity using a mouth mirror and radiographs.

Preliminary examination including classifying occlusion.

Placing and removing dental dam.

A

Applying anticariogenic agents including, but not limited to, sealants, fluoride varnish, and

fluoride applications.

31

(s)

A

Polishing and contouring of sealants with a slow-speed rotary hand piece immediately following a

procedure for occlusal adjustment.

Fabricating temporary restorations and temporary crowns and temporary bridges.

Placing and removing a nonmetallic temporary or sedative restoration with non-tissue cutting

instruments.

(t)

(u)

A

(v)

(w)

(x)

(y)

(z)

A

G*

A

Sizing of temporary crowns and bands.

Temporarily cementing and removing temporary crowns and bands.

Preliminary examination including performing pulp vitality testing.

Applying desensitizing agents.

Taking impressions for intraoral appliances including bite registrations.

(aa)

(bb)

(cc)

(dd)

(ee)

(ff)

G*

A

D

G

Placing and removing matrices and wedges.

Applying cavity liners and bases.

Drying endodontic canals with absorbent points.

Placing and removing nonepinephrine retraction cords or materials.

Placing and removing post extraction and periodontal dressings.

Removing sutures.

A

G

(gg)

(hh)

Applying and dispensing in-office bleaching products.

Prior to cementation by the dentist, adjusting and polishing contacts and occlusion of indirect

restorations. After cementation, removing excess cement from around restorations.

Placing, condensing, and carving amalgam restorations.

Placing Class I resin bonded restorations, occlusal adjustment, finishing and polishing with non-

tissue cutting slow-speed rotary hand pieces.

(ii)

(jj)

D**

(kk)

(ll)

D**

D

Taking final impressions for direct and indirect restorations and prosthesis including bite

registration.

D

Assisting and monitoring the administration of nitrous oxide analgesia by a dentist or the RDH. A

dentist shall assign these procedures only if the RDA or RDH has successfully completed an

approved course that meets the requirements of section 16611(7) of the code, MCL 333.16611,

with a minimum of 5 hours of didactic instruction. The levels must be preset by the dentist or

RDH and must not be adjusted by the RDA except in case of an emergency, in which case the

RDA may turn off the nitrous oxide and administer 100% oxygen. As used in this subdivision,

“assisting” means setting up equipment and placing the face mask. Assisting does not include

32

titrating and turning the equipment on or off, except in the case of an emergency in which

circumstances the RDA may turn off the nitrous oxide and administer 100% oxygen.

Removing accretions and stains from the surfaces of the teeth and applying topical agents essential

to complete prophylaxis.

(mm)

A

(nn)

(oo)

(pp)

A

Root planing, debridement, deep scaling, and removal of calcareous deposits.

Polishing and contouring restorations.

Charting of the oral cavity, including all the following: periodontal charting, intra oral and extra

oral examining of the soft tissue, charting of radiolucencies or radiopacities, existing restorations,

and missing teeth.

(qq)

(rr)

(ss)

A

D

G

Applying topical anesthetic agents by prescription of the dentist.

Placing and removing surgical temporary sedative dressings.

Removing excess cement from tooth surfaces.

A

(tt)

Placing subgingival medicaments.

(uu)

(vv)

(ww)

(xx)

Micro abrasion of tooth surfaces to remove defects, pitting, or deep staining.

Performing soft tissue curettage with or without a dental laser.

Taking digital scans for final restorations or intra-oral appliances.

D

G

D*** Administering intra oral block and infiltration anesthesia, or no more than 50% nitrous oxide

analgesia, or both, to a patient who is 18 years of age or older if the RDH has met all of the

following requirements:

(i) Successfully completed an approved course that meets the requirements in section 16611(4) of

the code, MCL 333.16611, in the administration of local anesthesia, with a minimum of 15 hours

didactic instruction and 14 hours clinical experience.

(ii) Successfully completed a state or regional board administered written examination in local

anesthesia within 18 months of completion of the approved course in paragraph (i) of this

subdivision.

(iii) Successfully completed an approved course that meets the requirements in section 16611(4)

of the code, MCL 333.16611, in the administration of nitrous oxide analgesia, with a minimum of

4 hours didactic instruction and 4 hours clinical experience.

(iv) Successfully completed a state or regional board administered written examination in nitrous

oxide analgesia, within 18 months of completion of the approved course in paragraph (iii) of this

subdivision.

(v) Maintains and provides evidence of current certification in basic or advanced cardiac life

33

support that meets the standards contained in R 338.11705.

A = Assignment as defined in R 338.11401.

G = General supervision as defined in R 338.11401.

D = Direct supervision as defined in R 338.11401.

DA = Dental assistant.

RDA = Registered dental assistant as defined in R 338.11101.

* A dentist shall assign these procedures to an RDA and RDH only if the RDA has successfully completed an approved course that

meets the requirements in section 16611(12) and (13) of the code, MCL 333.16611, and contains a minimum of 10 hours of didactic

and clinical instruction.

** A dentist shall assign these procedures to an RDA only if the RDA has successfully completed an approved course that meets the

requirements in section 16611(11) of the code, MCL 333.16611, and contains a minimum of 20 hours of didactic instruction followed

by a comprehensive clinical experience of sufficient duration that validates clinical competence through a criterion based assessment

instrument.

RDH = Registered dental hygienist as defined in R 338.11101.

*** The department fee for certification of completion of the requirements is $10.

34

PART 4B. SUPERVISION OF DENTAL THERAPISTS

R 338.11415 Definitions

R 1415. As used in this part, “supervise” or "supervision” means overseeing or

participating in the work of another individual by a health professional licensed under

article 15 of the code, MCL 333.16101 to 333.18838, in circumstances where at least all

of the following conditions exist:

(a) Continuous availability of direct communication in person or by radio, telephone, or

telecommunication between the supervised individual and a health professional licensed

in this state.

(b) Availability of a health professional licensed in this state on a regularly scheduled

basis to review the practice of the supervised individual, to provide consultation to the

supervised individual, to review records, and to further educate the supervised individual

in the performance of his or her functions.

(c) The provision by the supervising health professional licensed in this state of

predetermined procedures and drug protocol.

R 338.11417 Practice agreement; care or services.

Rule 1417. (1) A dental therapist may practice only under the supervision of a dentist

licensed and practicing in this state through a written practice agreement that is signed by

the dental therapist and dentist licensed and practicing in this state and that meets all the

requirements in section 16655 of the code, MCL 333.16655.

(2) A dentist may supervise no more than 4 dental therapists pursuant to section

16655(5) of the code, MCL 333.16655.

(3) A dental therapist may supervise no more than 3 dental assistants or registered

dental assistants and 2 registered dental hygienists in any 1 health setting as allowed in a

written practice agreement. The practice agreement must define the type of supervision

required by the dental therapist.

(4) A dentist may not authorize a dental therapist to do either of the following:

(a) Prescribe controlled substances.

(b) Administer phentolamine mesylate.

(5) A dentist may authorize a dental therapist to provide care or services described in

sections 16656(1)(a) to (w) of the code, MCL 333.16656.

(6) A dental therapist may perform other services and functions agreed to by the

supervising dentist for which the dental therapist is trained that are ancillary to those care

and services described in sections 16656(1)(a) to (w) of the code, MCL 333.16656.

(7) Subject to section 16657 of the code, MCL 333.16657, and the dental therapist’s

written practice agreement, if the patient requires treatment that exceeds the dental

therapist’s capabilities or the scope of practice as a dental therapist, the dentist or dental

therapist shall refer the patient to an appropriate provider within a reasonable distance.

(8) Subject to section 16655 and 16656(2) of the code, MCL 333.16655 and 333.16656,

and the dental therapist’s written practice agreement, a dental therapist’s authority to

delegate to allied dental personnel may not exceed a dentist’s authority to delegate to

allied dental personnel under R 338.11411.

35

R 338.11419 Health settings.

Rule 1419. (1) A dental therapist may provide care and services in any health setting

included in section 16654 of the code, MCL 333.16654.

(2) The health setting in section 16654(f) of the code, MCL 333.16654, includes a

geographic area that is designated as a dental shortage area by the United States

Department of Health and Human Services in geographic health professional shortage

areas based on geographic area and population groups.

(3) The computation to determine 50% of the annual total patient base of the dental

therapist in section 16654(i) of the code, MCL 333.16654, includes any patient who has

been seen at least once by the dental therapist.

PART 5. SPECIALTIES

R 338.11501 Specialties; recognition by the board.

Rule 1501. (1) The department on behalf of the board may issue a health profession

specialty license in all of the following branches of dentistry as specialties:

(a) Oral and maxillofacial surgery.

(b) Orthodontics and dentofacial orthopedics.

(c) Prosthodontics.

(d) Periodontics.

(e) Pediatric dentistry.

(f) Endodontics.

(g) Oral pathology or oral and maxillofacial pathology.

(2) Each branch of a dental specialty that is licensed by the board is defined in these

rules, and by the standards set forth by CODA under R 338.11301.

R 338.11505 Rescinded.

R 338.11512 Oral and maxillofacial pathology explained; licensure requirements.

Rule 1512. (1) The practice of oral and maxillofacial pathology deals with the nature,

identification, and management of diseases affecting the oral and maxillofacial regions.

It is a science that investigates the causes, processes, and effects of these diseases. The

term "oral and maxillofacial pathology" means the same as the term "oral pathology."

(2) The specialty of oral and maxillofacial pathology includes, but is not limited to, the

research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical,

or other examinations.

(3) An applicant for licensure as an oral and maxillofacial pathologist shall meet all of

the following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of oral and maxillofacial pathology approved by

the board under R 338.11301.

(c) Provide verification of a passing score on the specialty certification examination

that is conducted and scored by the American Board of Oral and Maxillofacial Pathology.

36

R 338.11513 Oral and maxillofacial surgery explained; licensure requirements;

examination content.

Rule 1513. (1) The practice of oral and maxillofacial surgery includes the diagnosis,

surgical, and adjunctive treatment of diseases, injuries, and defects involving both the

functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial

region.

(2) The specialty of oral and maxillofacial surgery includes, but is not limited to, the

care, treatment, and procedures associated with an office and hospital-based practice

under R 338.11301.

(3) A dentist who applies for licensure as an oral and maxillofacial surgeon shall comply

with all of the following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have completed a residency in oral and maxillofacial surgery approved by the

board under R 338.11301.

(c) Satisfy either of the following:

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with the American Board of Oral and

Maxillofacial Surgery (ABOMS) through completion of the ABOMS specialty

examinations.

R 338.11515 Orthodontics and dentofacial orthopedics explained; licensure

requirements; examination content.

Rule 1515. (1) The practice of orthodontics includes the diagnosis, prevention,

interception, and correction of malocclusion, as well as the neuromuscular and skeletal

abnormalities of the developing or mature orofacial structures. The term "orthodontics

and dentofacial orthopedics" means the same as the term "orthodontics."

(2) The specialty of orthodontics includes, but is not limited to, all of the following:

(a) The diagnosis, prevention, interception, and comprehensive treatment of all forms

of malocclusion of the teeth and associated alterations in their surrounding structures.

(b) The design, application, and control of functional and corrective appliances.

(c) The growth guidance of the dentition and its supporting structures to attain and

maintain optimum occlusal relations in physiologic and esthetic harmony among facial

and cranial structures.

(3) A dentist who desires licensure as an orthodontist shall comply with all of the

following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of orthodontics approved by the board under R

338.11301.

(c) Provide the department with evidence of the successful passing of the American

Board of Orthodontics (ABO) written exam. The passing score accepted for licensure is

the passing score established by the ABO.

(d) Satisfy either of the following:

37

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with the ABO through completion of the

ABO specialty examinations.

R 338.11517 Prosthodontics explained; licensure requirements; examination content.

Rule 1517. (1) The practice of prosthodontics includes the diagnosis, treatment

planning, rehabilitation, and maintenance of the oral function, comfort, appearance, and

health of patients with clinical conditions associated with missing or deficient teeth or

oral and maxillofacial tissues, or both, using biocompatible substitutes.

(2) The specialty of prosthodontics includes, but is not limited to, the restoration and

maintenance of oral function, comfort, appearance, and health of the patient by the

restoration of natural teeth and the replacement of missing teeth and contiguous oral and

maxillofacial tissues with artificial substitutes.

(3) A dentist who applies for licensure as a prosthodontist shall comply with all of the

following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of prosthodontics approved by the board under R

338.11301.

(c) Provide verification of a passing score on the written portion of the specialty

certification examination that is conducted and scored by the American Board of

Prosthodontics (ABP).

(d) Satisfy either of the following:

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with the ABP through completion of the

ABP specialty examinations.

R 338.11519 Periodontics explained; licensure requirements; examination content.

Rule 1519. (1) The practice of periodontics includes the prevention, diagnosis, and

treatment of disease of the supporting and surrounding tissues of the teeth or their

substitutes and the maintenance of the health, function, and esthetics of these structures

and tissues.

(2) A dentist who desires licensure as a periodontist shall comply with both of the

following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of periodontics approved by the board under R

338.11301.

(c) Satisfy either of the following:

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

38

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with the American Board of Periodontology

through completion of the American Board of Periodontology specialty examinations.

R 338.11521 Pediatric dentistry explained; licensure requirements; examination content.

Rule 1521. (1) The practice of pediatric dentistry is an age-defined specialty that

provides both primary and comprehensive preventive and therapeutic oral health care for

infants and children through adolescence, including those with special health care needs.

(2) A dentist who desires licensure as a pediatric dentist shall comply with all of the

following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of pediatric dentistry approved by the board under

R 338.11301.

(c) Provide verification of a passing score on the written examination used for

specialty certification that is conducted and scored by the American Board of Pediatric

Dentistry (ABPD) or provide documentation of diplomate status with the ABPD.

(d) Satisfy either of the following:

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with ABPD through completion of the

ABPD specialty examinations.

R 338.11523 Endodontics explained; licensure requirements; examination content.

Rule 1523. (1) The practice of endodontics includes the morphology, physiology, and

pathology of the human dental pulp and periradicular tissues. Its study encompasses

related basic and clinical sciences, including the biology of the normal pulp and the

etiology, diagnosis, prevention, and treatment of diseases and injuries of the pulp and

associated periradicular conditions.

(2) A dentist who applies for licensure as an endodontist shall comply with all of the

following requirements:

(a) Hold a current license to practice dentistry in this state.

(b) Have graduated from a program of endodontics approved by the board under R

338.11301.

(c) Provide documentation to the department evidencing the successful passing of the

American Board of Endodontists (ABE) written examination. The passing score accepted

for licensure is the passing score established by the ABE.

(d) Satisfy either of the following:

(i) Submit a final official transcript of dental postgraduate training from a graduate

program of dentistry approved by the board under R 338.11301 or, in the case of a

hospital program that does not issue transcripts, certification by the hospital administrator

or other official of the satisfactory completion of the program.

(ii) Provide evidence of diplomate status with the ABE through completion of the

ABE specialty examinations.

39

R 338.11525 Specialists; holding self out to public.

Rule 1525. (1) A dentist who is not licensed as a specialist by the board shall not

announce or hold himself or herself out to the public as limiting his or her practice to, as

being specially qualified in, or as giving special attention to, a branch of dentistry that is

listed as a specialty in R 338.11501. A dentist is considered to be holding himself or

herself out as a specialist in a branch of dentistry that is listed as a specialty in R

338.11501 in either of the following situations:

(a) When, in any way, he or she gives public emphasis to the practice of a specialty of

dentistry listed in R 338.11501 without disclosing that he or she is a dentist who is not

licensed in this state as a specialist under R 338.11501.

(b) When he or she identifies himself or herself with a specialty of dentistry in R

338.11501, whether or not he or she claims special attention to or a practice limited to the

specialty, or if he or she employs the use of signs, professional cards, letterheads, other

listings, or letters to the public or the profession that, in any way, implies special

knowledge or ability in a specialty of dentistry in R 338.11501. This subdivision does

not apply to specialists who are advertising in the specialty for which they are licensed in

this state under R 338.11501.

(2) A dentist who is licensed as a specialist in this state under R 338.11501 shall include

his or her license number in all public advertisements for that specialty, including, but not

limited to, telephone books, solicitations, print media, newspapers, and internet

advertising.

(3) Identification as an employer, employee, or partner, with an individual who is duly

licensed as a specialist in this state under R 338.11501 constitutes announcement to the

public of qualifications for specialization, unless the individual so associating himself

or herself publicly states, by signs, cards, or announcements, that he or she is not

licensed in this state as a specialist under R 338.11501 or is engaged in the practice of

some other specialty of dentistry in which he or she is duly licensed in this state under R

338.11501.

R 338.11527 Dental license suspension or revocation; automatic suspension or

revocation of specialty licensure.

Rule 1527. The suspension or revocation of the dental license of a dentist automatically

causes the suspension or revocation of a specialty license issued to that dentist under the

code and these rules.

PART 6. GENERAL ANESTHESIA AND INTRAVENOUS CONSCIOUS

SEDATION AND ENTERAL SEDATION

R 338.11601 General anesthesia; conditions; violation.

Rule 1601. (1) A dentist shall not administer general anesthesia to a dental patient or

delegate and supervise the performance of any act, task, or function involved in the

administration of general anesthesia to a dental patient, unless all of the following

conditions are satisfied:

40

(a) The dentist has completed a minimum of 1 year of advanced training in general

anesthesia and pain control in a program that meets the standards adopted in R

338.11603(l). A program that is accredited by CODA as meeting the accreditation

standards for advanced dental education programs in anesthesiology meets the

requirements of this subdivision.

(b) The dentist and the delegatee, if any, maintain current certification in basic and

advanced cardiac life support for health care providers with a hands-on component from

an agency or organization that grants certification pursuant to standards substantially

equivalent to the standards adopted in R 338.11603(2). A certification in basic and

advanced cardiac life for health care providers with a hands-on component from AHA

meets the requirements of this subdivision.

(c) The facility in which the anesthesia is administered meets the equipment standards

adopted in R 338.11603(3).

(d) The dentist shall be physically present with the patient who is given any general

anesthesia until he or she regains consciousness and the dentist shall remain on the

premises until the patient is capable of being discharged.

(2) A dentist who does not meet the requirements of subrule (1) of this rule shall not

offer general anesthesia services for dental patients unless all of the following conditions

are met:

(a) General anesthesia services are directly provided through association with, and by,

either of the following individuals:

(i) A physician who is licensed under the provisions of part 170 or 175 of the code,

MCL 333.17001 to 333.17097, and 333.17501 to 333.17556, and who is a member in

good standing on the anesthesiology staff of a hospital accredited by the Joint

Commission.

(ii) A dentist who meets the requirements of subrule (1)(a) and (b) of this rule.

(b) A person who administers anesthesia, under the provisions of subdivision (a) of this

subrule, shall be physically present with the patient who is given any general anesthesia

until he or she regains consciousness and the dentist shall remain on the premises where

the general anesthesia is administered until the patient anesthetized is capable of being

discharged.

(c) The provisions of subrule (1)(b) and (c) of this rule must be complied with.

(3) A dentist is in violation of section 16221(l)(h) of the code, MCL 333.16221, if he or

she fails to comply with subrules (1) and (2) of this rule.

R 338.11602 Intravenous conscious sedation; conditions; violations.

Rule 1602. (1) A dentist shall not administer intravenous conscious sedation to a dental

patient or delegate and supervise the performance of any act or function involved in the

administration of intravenous conscious sedation to a dental patient unless 1 of the

following is satisfied:

(a) The dentist complies with R 338.11601(1) or (2).

(b) The dentist complies with all of the following provisions:

(i) The dentist has completed a minimum of 60 hours of training in intravenous

conscious sedation and related academic subjects, including a minimum of 40 hours of

supervised clinical instruction in which the dentist has sedated not less than 20 cases in a

course that complies with the standards adopted in R 338.11603(1). A program that is

41

accredited by CODA as meeting the accreditation standards for advanced dental

education programs meets the standards in R 338.11603(1).

(ii) The dentist and the delegatee, if any, maintains current certification in basic or

and advanced cardiac life support for health care providers with a hands-on component

from an agency or organization that grants certification under standards substantially

equivalent to the standards adopted in R 338.11603(2). A certification in basic and

advanced cardiac life support for health care providers with a hands-on component from

AHA meets the requirements of this paragraph.

(iii) The facility in which the anesthesia is administered complies with the equipment

standards adopted in R 338.11603(3).

(2) A dentist is in violation of section 16221(1)(h) of the code, MCL 333.16221, if he or

she fails to comply with subrule (1) of this rule.

R 338.11603 Adoption of standards; effect of certification of programs.

Rule 1603. (1) The board adopts by reference the CODA standards for anesthesiology

educational programs in the publication titled “Accreditation Standards for Advanced

advanced training in anesthesia and pain control and training in intravenous conscious

sedation and related subjects set forth by the ADA’s publication titled "Guidelines for

Teaching Pain Control and Sedation to Dentists and Dental Students," October 2016

edition. The guidelines may be obtained at no cost from the American Dental

Association, 211 E. Chicago Avenue, Chicago, Illinois, 60611, or at no cost on the

association's website at http://www.ada.org. A copy of the standards is available for

inspection and distribution, at 10 cents per page from the Michigan Board of Dentistry,

Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611

West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(2) The board adopts by reference the standards for credentialing in basic and advanced

life support for health care providers with a hands-on component set forth by the AHA in

the standards and guidelines for cardiopulmonary resuscitation and emergency cardiac

care for professional providers, published in "2015 American Heart Association

Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care”

(Volume 132, Issue 18 Supplement 2, November 3, 2015) and updates in 2017 and 2018.

A copy of the Guidelines for Cardiopulmonary Resuscitation and Emergency

Cardiovascular Care may be obtained at an approximate cost of $28.00 from the

American Heart Association, 7272 Greenville Avenue, Dallas, Texas, 75231 or at no cost

from the AHA’s website at https://cpr.heart.org/. A copy of this document is available for

inspection and distribution, at the same cost as purchasing a copy from AHA, from the

Michigan Board of Dentistry, Department of Licensing and Regulatory Affairs, Bureau

of Professional Licensing, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(3) The board adopts by reference the standards regarding the equipment within a

facility where anesthesia is administered set forth by the American Association of Oral

and Maxillofacial Surgeons in the publication titled "Office Anesthesia Evaluation

Manual," ninth edition. A copy of this manual may be obtained at a cost of approximately

$345.00 from the American Association of Oral and Maxillofacial Surgeons, 9700 West

Bryn Mawr Avenue, Rosemont, Illinois, 60018, or at the association's website at

http://www.aaoms.org at a cost of approximately $345.00. A copy of this document is

42

available for inspection and distribution, at the same cost as purchasing a copy from the

American Association of Oral and Maxillofacial Surgeons, from the Michigan Board of

Dentistry, Department of Licensing and Regulatory Affairs, Bureau of Professional

Licensing, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

R 338.11604 Rescinded.

R 338.11605 Enteral sedation; guidelines; adoption by reference; requirements for

approval of course and instructor.

Rule 1605. (1) Before being offered to licensees, a course and its instructors in enteral

sedation must be approved by the board and, at a minimum, the course objectives,

content, duration, evaluation, documentation, and faculty must be consistent with the

enteral sedation course standards in the ADA’s “Guidelines for Teaching Pain Control

and Sedation to Dentists and Dental Students,” October 2016, whose guidelines are

adopted by reference by the board. The guidelines may be obtained at no cost from the

American Dental Association, 211 E. Chicago Avenue, Chicago, Illinois, 60611 or at no

cost on the association's website at http://www.ada.org. A copy of the guidelines is

available for inspection and distribution, at 10 cents per page, from the Michigan Board

of Dentistry, Department of Licensing and Regulatory Affairs, Bureau of Professional

Licensing, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(2) A program or course that is certified by CODA as meeting the ADA’s standards for

advanced training in anesthesia and pain control and training in intravenous conscious

sedation in the publication titled "Guidelines for Teaching Pain Control and Sedation to

Dentists and Dental Students," October 2016 edition, is approved by the board.

PART 7. CONTINUING EDUCATION

R 338.11701 License renewal for a dentist, dental specialist, and special-retired

volunteer dentist; requirements; applicability.

Rule 1701. (1) This rule applies to an application for the renewal of a dentist license,

dental specialist license, and special retired volunteer dentist license under sections 16201

and 16184 of the code, MCL 333.16201 and 333.16184.

(2) Subject to subrule (8) of this rule, an applicant for a dentist license renewal who has

been licensed for the 3-year period immediately preceding the expiration date of the

license shall comply with both of the following during the 3-year period before the end of

the license cycle:

(a) Possess current certification in basic or advanced cardiac life support from an

agency or organization that grants certification pursuant to standards substantially

equivalent to the standards adopted in R 338.11705(4).

(b) Complete at least 3 continuing education credits in pain and symptom

management. Continuing education credits in pain and symptom management may

include, but are not limited to, courses in behavior management, psychology of pain,

pharmacology, behavior modification, stress management, clinical applications, and drug

interactions.

43

(3) Subject to subrule (8) of this rule, in addition to the requirements of subrule (2) of

this rule, an applicant for a dentist license renewal, who has been licensed for the 3-year

period immediately preceding the expiration date of the license, shall comply with all of

the following during the 3-year period before the end of the license cycle:

(a) Complete not less than 60 hours of continuing education approved by the board

under R 338.11704a.

(b) Complete a minimum of 20 hours of the required continuing education hours in

programs directly related to clinical issues including delivery of care, materials used in

delivery of care, and pharmacology.

(c) Complete a minimum of 20 hours of the required continuing education hours by

attending synchronous, live courses or programs that provide for direct interaction

between faculty and participants, including, but not limited to, lectures, symposia, live

teleconferences, workshops, and participation in volunteer patient or supportive dental

services provided for in R 338.11704a(1)(m). These courses, with the exception of the

volunteer services, may be counted toward the required courses in clinical issues such as

delivery of care, materials used in delivery of care, and pharmacology.

(4) Subject to subrule (8) of this rule, in addition to the requirements of subrules (2) and

(3) of this rule, a dental specialist shall complete 20 hours of the required continuing

education hours in the dental specialty field in which he or she is certified during the 3-

year period before the end of the license cycle.

(5) Subject to subrule (8) of this rule, in addition to the requirements of subrule (2) of

this rule, an applicant for a special retired dentist license shall comply with the following

during the 3-year period before the end of the license cycle:

(a) Complete not less than 40 hours of continuing education acceptable to the board in

R 338.11704a.

(b) Complete a minimum of 14 hours of the required hours of continuing education in

programs directly related to clinical issues such as delivery of care, materials used in

delivery of care, and pharmacology.

(c) Complete a minimum of 14 hours of the required hours of continuing education by

attending synchronous, live courses or programs that provide for direct interaction

between faculty and participants, including but not limited to, lectures, symposia, live

teleconferences, workshops, and providing volunteer clinical services provided for in R

338.11704a(1)(m) . These courses, with the exception of the volunteer clinical services,

may be counted toward the required courses in clinical issues such as delivery of care,

materials used in delivery of care, and pharmacology.

(d) Comply with the conditions for renewal in section 16184(2) of the code, MCL

333.16184.

(6) The submission of the application for renewal constitutes the applicant's

certification of compliance with the requirements of this rule. The board may require an

applicant or a licensee to submit evidence to demonstrate compliance with this rule. The

applicant or licensee shall maintain evidence of complying with the requirements of this

rule for a period of 5 years from the date of the submission for renewal. Failure to

comply with this rule is a violation of section 16221(h) of the code, MCL 333.16221.

(7) A request for a waiver under section 16205 of the code, MCL 333.16205, must be

received by the department before the expiration date of the license.

44

(8) Effective for an application for renewal that is filed for the renewal cycle that begins

1 year or more after the effective date of this subrule, an applicant shall meet the

requirements of this subrule and subrules (1), (7), and (9) to (14) of this rule. An

applicant for a dentist license renewal who has been licensed for the 3-year period

immediately preceding the expiration date of the license shall complete not less than 60

hours of continuing education approved by the board under R 338.11704a during the 3-

year period before the end of the license cycle.

(9) An applicant for a dental specialist license renewal who has been licensed for the 3-

year period immediately preceding the expiration date of the license shall complete 60

hours of continuing education approved by the board under R 338.11704a with not less

than 20 hours of the required 60 hours in board-approved continuing education in the

dental specialty field in which he or she is licensed within the 3-year period before the

end of the license cycle.

(10) In addition to meeting the requirements of section 16184 of the code, MCL

333.16184, an applicant for a special retired volunteer dentist license renewal who has

been licensed for the 3-year period immediately preceding the expiration date of the

license shall complete not less than 60 hours of continuing education approved by the

board under R 338.11704a during the 3-year period before the end of the license cycle.

(11) An applicant shall possess current certification in basic or advanced cardiac life

support for health care providers with a hands-on component from an agency or

organization that grants certification pursuant to standards substantially equivalent to the

standards adopted in R 338.11705(4).

(12) In complying with the requirements of subrules (8) to (10) of this rule, an applicant

for a dentist license, dental specialist license, and special retired volunteer dentist license

renewal who has been licensed for the 3-year period immediately preceding the

expiration date of the license shall comply with all of the following before the end of the

license cycle:

(a) Complete at least 3 hours of the required continuing education hours in pain and

symptom management. Continuing education hours in pain and symptom management

may include, but are not limited to, courses in behavior management, psychology of pain,

pharmacology, behavior modification, stress management, clinical applications, and drug

interactions. Hours earned through volunteer patient or supportive dental services

provided for in R 338.11704a(1)(m) do not count toward the required hours for pain and

symptom management.

(b) Complete at least 1 hour of the required continuing education hours in dental ethics

and jurisprudence with inclusion of delegation of duties to allied dental personnel. Hours

earned through volunteer patient or supportive dental services provided for in R

338.11704a(1)(m) do not count toward the required hours for dental ethics and

jurisprudence with inclusion of delegation of duties to allied dental personnel.

(c) Complete a minimum of 20 hours of the required continuing education hours in

programs directly related to clinical issues including delivery of care, materials used in

delivery of care, and pharmacology. Hours earned through volunteer patient or supportive

dental services provided for in R 338.11704a(1)(m) do not count toward the required

hours for clinical issues.

(d) Complete at least 1 hour of the required continuing education hours in infection

control, which must include sterilization of hand pieces, personal protective equipment,

45

and the Centers for Disease Control and Prevention’s infection control guidelines. Hours

earned through volunteer patient or supportive dental services provided for in R

338.11704a(1)(m) do not count toward the required hours for infection control.

(e) Complete a minimum of 20 hours of the required continuing education hours by

attending synchronous, live courses or programs that provide for direct interaction

between faculty and participants including, but not limited to, lectures, symposia, live

teleconferences, workshops, and participation in volunteer patient or supportive dental

services provided for in R 338.11704a(1)(m). These courses, with the exception of the

volunteer services in R 338.11704a(1)(m), may be counted toward the required courses in

clinical issues such as delivery of care, materials used in delivery of care, and

pharmacology.

(f) Complete no more than 30 hours of the required continuing education hours

asynchronously, noninteractive.

(13) Except for the 1-time training in human trafficking and 1-time training in opioid

and controlled substances awareness, which may be used to comply with the requirement

for the 1-time training and a continuing education requirement, an applicant may not earn

credit for a continuing education program or activity that is identical to a program or

activity an applicant has already earned credit for during that renewal period.

(14) The submission of the application for renewal constitutes the applicant's

certification of compliance with the requirements of this rule. The board may require an

applicant or a licensee to submit evidence to demonstrate compliance with this rule. An

applicant or licensee shall maintain evidence of complying with the requirements of this

rule for a period of 5 years from the date of the submission for renewal. Failure to

comply with this rule is a violation of section 16221(h) of the code, MCL 333.16221.

R 338.11703 License renewal for a dental therapist and special-retired volunteer dental

therapist; requirements; applicability.

Rule 1703. (1) This rule applies to an application for the renewal of a dental therapist

license and special-retired volunteer dental therapist license under sections 16184, 16201,

and 16653 of the code, MCL 333.16184, 333.16201, and 333.16653.

(2) An applicant for a dental therapist license renewal who has been licensed for the 2-

year period immediately preceding the expiration date of the license shall complete not

less than 35 hours of continuing education approved by the board under R 338.11704a

during the 2-year period before renewal.

(3) In addition to meeting the requirements of section 16184 of the code, MCL

333.16184, an applicant for a special-retired volunteer dental therapist license renewal

who has been licensed for the 2-year period immediately preceding the expiration date of

the license shall complete not less than 35 hours of continuing education approved by the

board under R 338.11704a during the 2-year period before renewal.

(4) An applicant shall possess current certification in basic or advanced cardiac life

support for health care providers with a hands-on component froman agency or

organization that grants certification pursuant to standards substantially equivalent to the

standards adopted in R 338.11705(4).

(5) In complying with the requirements of subrules (2) and (3) of this rule, an applicant

for a dental therapist license or special-retired volunteer dental therapist license renewal

46

who has been licensed for the 2-year period immediately preceding the expiration date of

the license shall comply with allof the following before the end of the license cycle:

(a) Complete at least 2 hours of the required continuing education hours in pain and

symptom management. Continuing education hours in pain and symptom management

may include, but are not limited to, courses in behavior management, psychology of pain,

pharmacology, behavior modification, stress management, clinical applications, and drug

interactions. Hours earned through volunteer patient or supportive dental services

provided for in R 338.11704a(1)(m) do not count toward the required hours for pain and

symptom management.

(b) Complete at least 1 hour of the required continuing education hours in dental

ethics and jurisprudence. Hours earned through volunteer patient or supportive dental

services provided for in R 338.11704a(1)(m) do not count toward the required hours for

dental ethics and jurisprudence.

(c) Complete at least 1 hour of the required continuing education hours in infection

control, which must include sterilization of hand pieces, personal protective equipment,

and the Centers for Disease Control and Prevention’s infection control guidelines. Hours

earned through volunteer patient or supportive dental services provided for in R

338.11704a(1)(m) do not count toward the required hours for infection control.

(d) Complete a minimum of 12 hours of the required continuing education hours in

programs directly related to clinical issues including delivery of care, materials used in

delivery of care, and pharmacology. Hours earned through volunteer patient or

supportive dental services provided for in R 338.11704a(1)(m) do not count toward the

required hours for clinical issues.

(e) Complete a minimum of 12 hours of the required continuing education hours by

attending synchronous, live courses or programs that provide for direct interaction

between faculty and participants including, but not limited to, lectures, symposia, live

teleconferences, workshops, and participation in volunteer patient or supportive dental

services provided for in R 338.11704a(1)(m). These courses, with the exception of the

volunteer services in R 338.11704a(1)(m), may be counted toward the required courses

in clinical issues including delivery of care, materials used in delivery of care, and

pharmacology.

(f) Complete no more than 18 hours of the required continuing education hours

asynchronously, noninteractive.

(6) Except for the 1-time training in human trafficking and 1-time training in opioid and

controlled substances awareness, which may be used to comply with the requirement for

the 1-time training and a continuing education requirement, an applicant may not earn

credit for a continuing education program or activity that is identical to a program or

activity the applicant has already earned credit for during that renewal period.

(7) The submission of the application for renewal constitutes the applicant's

certification of compliance with the requirements of this rule. The board may require an

applicant or a licensee to submit evidence to demonstrate compliance with this rule. An

applicant or licensee shall maintain evidence of complying with the requirements of this

rule for a period of 5 years from the date of the submission for renewal. Failure to

comply with this rule is a violation of section 16221(h) of the code, MCL 333.16221.

(8) A request for a waiver under section 16205 of the code, MCL 333.16205, must be

received by the department before the expiration date of the license.

47

R 338.11704 License renewal for a registered dental hygienist, registered dental

hygienist special volunteer, registered dental assistant, and registered dental assistant

special volunteer; requirements; applicability.

Rule 1704. (1) This rule applies to an application for the renewal of a registered dental

hygienist license, and a registered dental assistant license under section 16201 of the

code, MCL 333.16201, and a registered dental hygienist special-retired volunteer license

and a registered dental assistant special-retired volunteer license under section 16184 of

the code, MCL 333.16184.

(2) An applicant for a registered dental hygienist license renewal or a registered dental

assistant license renewal who has been licensed for the 3-year period immediately

preceding the expiration date of the license, shall complete not less than 36 hours of

continuing education approved by the board under R 338.11704a during the 3 years

before the end of the license cycle.

(3) An applicant holding both a registered dental hygienist license and a registered

dental assistants license shall complete not less than 36 hours of continuing education

acceptable to the board under R 338.11704a during the 3 years before the end of the

license cycle. The 36 hours must include not less than 12 hours devoted to registered

dental hygienist functions, and not less than 12 hours devoted to registered dental

assistant functions.

(4) In addition to meeting the requirements of section 16184 of the code, MCL

333.16184, an applicant for a special-retired volunteer registered dental assistant license

renewal or a special-retired volunteer registered dental hygienist license renewal who has

been licensed for the 3-year period immediately preceding the expiration date of the

license shall complete not less than 36 hours of continuing education approved by the

board under R 338.11704a during the 3-year period before the end of the license cycle.

(5) An applicant shall possess current certification in basic or advanced cardiac life

support for health care providers with a hands-on component from an agency or

organization that grants certification pursuant to standards substantially equivalent to the

standards adopted in R 338.11705(4).

(6) A request for a waiver under section 16205 of the code, MCL 333.16205, must be

received by the department before the expiration date of the license.

(7) In complying with the requirements of subrules (2) to (4) of this rule, an applicant

for a registered dental assistant license, registered dental hygienist license, special-retired

volunteer registered dental assistant license, or special-retired volunteer registered dental

hygienist license renewal who has been licensed for the 3-year period immediately

preceding the expiration date of the license shall also comply with all of the following

before the end of the license cycle:

(a) Complete a minimum of 12 hours of the required continuing education hours in

programs directly related to clinical issues including delivery of care, materials used in

the delivery of care, and pharmacology. Hours earned through volunteer patient or

supportive dental services provided for in R 338.11704a(1)(m) do not count toward the

required hours for clinical issues.

(b) Complete a minimum of 12 hours of the required continuing education hours by

attending synchronous, live courses or programs that provide for direct interaction

between faculty and participants including, but not limited to, lectures, symposia, live

teleconferences, workshops, and provision of volunteer patient or supportive dental

48

services provided for in R 338.11704a(1)(m). These courses, with the exception of the

volunteer services in R 338.11704a(1)(m), may be counted toward the required courses in

clinical issues including delivery of care, materials used in delivery of care, and

pharmacology.

(c) Complete at least 2 hours of the required continuing education hours in pain and

symptom management. Continuing education credits in pain and symptom management

may include, but are not limited to, courses in behavior management, psychology of pain,

pharmacology, behavior modification, stress management, clinical applications, and drug

interactions. Hours earned through volunteer patient or supportive dental services

provided for in R 338.11704a(1)(m) do not count toward the required hours for pain and

symptom management.

(d) Earn no more than 18 of the 36 hours of the required continuing education hours

asynchronously, noninteractive.

(e) Effective for an application for renewal that is filed for the renewal cycle that

begins 1 year or more after the effective date of this subrule, complete at least 1 hour of

the required continuing education hours in dental ethics and jurisprudence with inclusion

of delegation of duties to allied dental personnel. Hours earned through volunteer patient

or supportive dental services provided for in R 338.11704a(1)(m) do not count toward the

required hours for ethics and jurisprudence with inclusion of delegation of duties to allied

dental personnel.

(f) Effective for applications for renewal that are filed for the renewal cycle that begins

1 year or more after the effective date of this subrule, complete at least 1 hour of the

required continuing education hours in infection control, which must include sterilization

of hand pieces, personal protective equipment, and the Centers for Disease Control and

Prevention’s infection control guidelines. Hours earned through volunteer patient or

supportive dental services provided for in R 338.11704a(1)(m) do not count toward the

required hours for infection control.

(8) Effective for an application for renewal that is filed for the renewal cycle that begins

1 year or more after the effective date of this subrule, an applicant may not earn credit for

a continuing education program or activity that is identical to a program or activity the

applicant has already earned credit for during that renewal period, except for the 1-time

training in human trafficking and 1-time training in opioid and controlled substances

awareness, which may be used to comply with the requirement for the 1-time training and

a continuing education requirement.

(9) The submission of the application for renewal constitutes the applicant's certification

of compliance required by this rule. The board may require an applicant or licensee to

submit evidence to demonstrate compliance with this rule. The applicant or licensee shall

maintain evidence of complying with the requirements of this rule for a period of 5 years

from the date of the submission for renewal. Failure to comply with this rule is a

violation of section 16221(h) of the code, MCL 333.16221.

R 338.11704a Acceptable continuing education for licensees, limitations.

Rule 1704a. (1) The board shall consider any of the following as acceptable continuing

education for dentists, dental therapists, dental specialists, special-retired volunteer

dentists, special-retired volunteer dental therapists, registered dental hygienists, special-

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retired volunteer registered dental hygienists, registered dental assistants, and special-

retired volunteer registered dental assistants, unless otherwise noted:

ACCEPTABLE CONTINUING EDUCATION ACTIVITIES

(a) Completion of an approved continuing

education program or activity related to the

practice of dentistry. A continuing education

program or activity is approved, regardless of

the format in which it is offered, if it is

approved or offered for continuing education

credit by any of the following:

The number of hours earned are

the number of hours approved by

the sponsor or the approving

organization.

If the activity was not approved

for a set number of hours, then 1

credit hour for each 50 minutes of

participation may be earned.

 A dental, dental therapy, dental hygiene,

dental assistant, or a hospital-based

dental specialty educational program

approved by CODA.

 A continuing education sponsoring

organization, institution, or individual

approved by the Academy of General

Dentistry (AGD).

No limitation on the number of

hours earned.

 A continuing education national

sponsoring organization, institution, or

individual approved by the American

Academy of Dental Hygiene (AADH),

the American Dental Hygienists’

Association (ADHA), the American

Dental Assistants Association (ADAA),

and the Commission on Continuing

Education Provider Recognition ADA

Continuing Education Recognition

Program (ADA CERP) or its successor

organization.

 A continuing education sponsoring

organization, institution, or individual

approved by the Michigan Dental

Association (MDA), Michigan Dental

Hygienists Association (MDHA), and

Michigan Dental Assistants Association

(MDAA).

 Another state board of dentistry.

If audited, an applicant shall submit a copy of a

letter or certificate of completion showing the

applicant’s name, number of hours earned,

sponsor name or the name of the organization

that approved the program or activity for

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continuing education credit, and the date on

which the program was held or activity

completed.

(b) Completion of courses offered for credit in a

dental, dental therapy, dental hygiene, dental

assistant, or a hospital-based dental specialty

educational program approved by CODA.

Ten hours of continuing education

may be earned for each quarter

credit earned and 15 hours may be

earned for each semester credit

earned.

If audited, an applicant shall submit an official

transcript that reflects completion of the course No limitation on the number of

and number of semester or quarter credit hours

earned.

hours earned.

(c) Attendance at a program or activity related to

topics approved in R 338.2443(2) and R

338.143(2) for category 1 continuing education

by the board of medicine or board of

osteopathic medicine.

One hour may be earned for each

50 minutes of program attendance.

A maximum of 30 hours for a

dentist, and 18 hours for a dental

therapist, registered dental

If audited, an applicant shall submit a copy of a hygienist, and registered dental

letter or certificate of completion showing the

applicant’s name, number of hours earned,

sponsor name or the name of the organization

that approved the program or activity for

continuing education credit, and the date on

which the program was held or activity

completed.

assistant may be earned in each

renewal period.

(d) For dentists, satisfactory participation for a

minimum of 7 months in a hospital or

Twenty hours may be earned in

each calendar year for 7 months of

institution through a postgraduate dental clinical participation in the calendar year.

training program approved by CODA.

A maximum of 20 hours per

If audited, an applicant shall submit a copy of a calendar year may be earned.

letter or certificate of completion showing the

applicant’s name, number of hours attended, the

name of the hospital or institution, the name of

the clinical training program, the date of

participation, and the activities completed.

(e) For dentists, successful completion of an

American-board specialty examination.

Ten hours may be earned in the

year in which the applicant

achieves a passing score on a

specialty examination.

If audited, an applicant shall submit proof of a

passing score on the examination.

A maximum of 20 hours may be

earned in each renewal period.

Credit is not given for repeating

the same examination in a renewal

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period.

(f) Renewal of a dentist, dental therapist, registered For a dentist, 60 hours may be

dental hygienist, or registered dental assistant

license held in another state that requires

earned. For a dental therapist, 35

hours may be earned. For a

continuing education for license renewal that is registered dental hygienist or

substantially equivalent in subject matter and registered dental assistant, 36

total amount of required hours required in these hours may be earned.

rules if the applicant resides and practices in

another state.

A maximum of 60 hours for a

dentist, 35 hours for a dental

therapist, and 36 hours for a

registered dental hygienist or

If audited, an applicant shall submit proof of

current licensure in another state and a copy of

a letter or certificate of completion showing the registered dental assistant may be

applicant’s name, number of hours earned,

sponsor name or the name of the organization

that approved the program or activity for

continuing education credit, type of program or

activity, and the date on which the program was

held or activity completed.

earned in each renewal period.

(g) For a registered dental assistant, meeting the

requirements for recertification in R

Thirty-six hours may be earned.

338.11705(3).

A maximum of 36 hours may be

earned in each renewal period.

If audited, an applicant shall submit proof of

current certification, other than emeritus

certification, by the Dental Assisting National

Board (DANB).

(h) Initial publication of an article or text related to Twenty-five hours may be earned

the practice of dentistry, dental therapy, dental

hygiene, or dental assisting in either of the

following:

per publication.

A maximum of 25 hours may be

earned in each renewal period.

 A textbook.

 A journal of a national association of

dentists, dental therapists, dental

specialists, dental hygienists, or dental

assistants.

If audited, an applicant shall submit a copy of

the publication that identifies the applicant as

the author or a publication acceptance letter.

(i) Initial publication of an article related to the

practice of dentistry, dental therapy, dental

hygiene, or dental assisting in either of the

following:

Twelve hours may be earned per

publication.

A maximum of 12 hours may be

earned in each renewal period.

 A journal of an accredited dentistry,

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dental therapy, dental hygiene, or dental

assisting school.

 A state or state-component association

of dentists, dental therapists, dental

specialists, dental hygienists, or dental

assistants.

If audited, an applicant shall submit a copy of

the publication that identifies the applicant as

the author or a publication acceptance letter.

(j) Independent reading of articles or viewing or

listening to media, other than online programs,

One hour for each 50 minutes of

participation may be earned per

related to dental, dental therapy, dental hygiene, activity.

or dental assisting education.

A maximum of 10 hours may be

If audited, an applicant shall submit an affidavit earned in each renewal period.

attesting to the number of hours the applicant

spent participating in these activities that

includes a description of the activity.

(k) Development and presentation of a table

One hour for each 50 minutes

clinical demonstration or a continuing education devoted to the development and

lecture offered in conjunction with the

presentation of continuing education programs

approved by the board pursuant to subrule (3)

of this rule that is not a part of the licensee’s

regular job description.

initial presentation.

A maximum of 10 hours may be

earned in each renewal period.

If audited, an applicant shall submit a copy of

the curriculum and a letter from the program

sponsor verifying the length and date of the

presentation.

(l) Attendance at a dental-related program that is

approved by the board pursuant to subrule (3)

of this rule and that is relevant to health care

and advancement of the licensee's dental

education.

Ten hours of continuing education

may be credited per year.

A maximum of 10 hours may be

earned in each renewal period.

If audited, an applicant shall submit a copy of a

letter or certificate of completion showing the

applicant’s name, number of hours earned,

sponsor name or the name of the organization

that approved the program or activity for

continuing education credit, and the date on

which the program was held or activity

completed.

(m) Providing volunteer patient or supportive dental One hour for each 120 minutes of

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services in this state at a board-approved

providing patient or supportive

program pursuant to subrule (4) of this rule that dental services.

is not a part of the licensee’s regular job

description nor required under a board order or

agreement and that complies with the

following:

A dentist or special-retired

volunteer dentist may earn a

maximum of 20 hours per renewal

period.

 The program is a public or nonprofit

entity, program, or event, or a school or

nursing home.

A dental therapist, registered

dental hygienist, registered dental

assistant, special-retired volunteer

dental therapist, special-retired

volunteer registered dental

hygienist, and special-retired

volunteer registered dental

assistant may earn a maximum of

12 hours per renewal period.

 The program provides patient or

supportive dental services to the

indigent or dentally underserved

populations.

 The licensee does not receive direct or

indirect remuneration of any kind

including, but not limited to,

remuneration for materials purchased or

used.

 The licensee shall sign in and sign out

daily upon commencement and

termination of the provision of services.

 A dentist with a specialty license issued

from this state shall limit volunteer

clinical dental services to the specialty

area in which the dentist is licensed.

If audited, an applicant shall submit proof from

the sponsor of the assignments and the hours of

service provided.

(2) If an organized continuing education course or program is offered in segments of 50

to 60 minutes each, 1 hour of credit is given for each segment.

(3) The following requirements are established for board approval of continuing

education, which includes, but is not limited to, any continuing education not otherwise

approved by subrule (1) of this rule:

(a) The continuing education applicant shall submit a complete application, on forms

provided by the department. A licensee shall submit a “Patient Protection” form provided

by the department to the department for each continuing education course or program

involving treatment of live patients.

(b) A completed application form must be submitted to the department at least 70 days

before the date the course or program is conducted and 70 days before the next regularly

scheduled board meeting for the proposed continuing education to be considered for

approval by the board. Continuing education conducted before board consideration and

approval will be denied approval.

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(c) A course or program must substantially meet the standards and criteria for an

acceptable category of continuing education under this rule and must be relevant to health

care and advancement of the licensee’s dental education.

(d) Board approval is for a term of 3 years from the date of approval.

(e) Approved continuing education must be reevaluated by the board before any

changes during the 3-year approval term including, but not limited to, changes in the

following:

(i) Instructors and speakers.

(ii) Content, title, and number of continuing education hours to be awarded to

participants.

(f) Subject to subdivision (g) of this subrule, all changes to previously approved

continuing education courses or programs must be submitted on required department

forms at least 70 days before the date the continuing education course or program is

offered to participants and 70 days before the next regularly scheduled board meeting to

be considered for approval by the board. Any changes to the submitted and previously

approved courses or programs conducted before board reconsideration and approval will

be denied approval.

(g) Emergency changes to instructors and speakers that are unable to be submitted to

the board at least 70 days before the date of the continuing education may be reviewed by

the department in consultation with the board chair when proof acceptable to the

department is submitted with the change supporting the nature of the emergency.

(h) The specific dates of the continuing education course or program does not require

further board approval and may be changed without review by the board if the

presentation dates are within the board’s original 3-year term of approval.

(i) All of the following information must be recorded on a continuing education course

or program certificate of completion or other proof prepared by the sponsor conducting

the continuing education:

(i) The name of the applicant.

(ii) Continuing education approval number issued by the board.

(iii) Course title.

(iv) Speaker or instructor.

(v) Date the approved continuing education course was conducted.

(vi) Number of continuing education hours awarded.

(vii) Approved sponsor’s signature.

(viii) Dates of the current approval term.

(ix) Name of participant.

(j) The board may revoke the approval status of any approved continuing education

course or program any time the course or program fails to comply with these rules.

(4) The following requirements are established for board approval of a sponsor offering

volunteer continuing education opportunities under subrule (1)(m) of this rule:

(a) A sponsor shall apply to the department to obtain approval as a sponsoring entity

on the volunteer dental application form.

(b) A sponsor shall retain patient records.

(c) A sponsor shall retain documentation of all volunteer assignments and the hours of

service provided.

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(d) Upon request, a sponsor shall provide the board with the records, copy of the

assignments, hours of service, and evidence of compliance with the requirements of

subrule (1)(m) of this rule.

(e) A sponsor shall provide each licensee with verification of all volunteer hours of

dental care provided by the licensee upon completion of the licensee’s service.

(f) Upon request, a sponsor shall submit documentation to the department, evidencing

compliance with the requirements of subrules (1)(m) and (5) of this rule.

(g) Board approval is for a term of 4 years from the date of approval.

(h) The board may revoke the approval status of any volunteer continuing education

opportunity any time an approved continuing education program fails to comply with

these rules.

(i) All of the following information must be recorded on a continuing education

certificate of completion or other proof prepared by the sponsor conducting the volunteer

continuing education course or program:

(i) The name of the sponsoring organization.

(ii) Continuing education approval number issued by the board.

(iii) Dates and times of volunteer services.

(iv) Number of continuing education hours earned.

(v) Signature of individual responsible for attendance.

(vi) Dates of the current approval term.

(vii) Name of participant.

(5) A continuing education sponsor shall maintain evidence of participation in

continuing education, including signed continuing education certificates of completion

issued to participants, for a period of 5 years from the date of the continuing education

program or course.

R 338.11704b Rescinded.

R 338.11704c Rescinded.

R 338.11705 Standards and requirements; adoption by reference.

Rule 1705. (1) The board adopts by reference the standards and criteria of the AGD’s

Program Approval for Continuing Education (PACE) which are set forth in the

publication titled "PACE Academy of General Dentistry Program Approval for

Continuing Education Program Guidelines, Revised April 2019.” Information on the

PACE standards and criteria is available at no cost from the Academy of General

Dentistry, 560 W. Lake St., Sixth Floor, Chicago, Illinois, 60661-6600 or at no cost from

the academy's internet website at www.agd.org. A copy of the guidebook is available for

inspection and distribution at 10 cents per page from the Michigan Board of Dentistry,

Michigan Department of Licensing and Regulatory Affairs, Bureau of Professional

Licensing, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(2) The board adopts by reference the standards and criteria of the ADA CERP for

approval of continuing education sponsoring organizations, which are set forth in the

publication titled "ADA CERP Recognition Standards, and Procedures April 2019.” A

copy of this publication may be obtained at no cost from the association at ADA CERP,

211 E. Chicago Avenue, Chicago, Illinois, 60611-2678 or at no cost from the

56

association's internet website at www.ada.org. A copy of the publication is available for

inspection and distribution at 10 cents per page from the Michigan Board of Dentistry,

Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611

West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(3) The board adopts by reference the requirements for recertification established by

DANB as set forth in the publication titled "Dental Assisting National Board, Inc.

Recertification Requirements 2019." A copy of the publication may be obtained at no

cost from the Dental Assisting National Board, Inc., 444 N. Michigan Avenue, Suite 900,

Chicago, Illinois, 60611 or at no cost from the national board's internet website at

www.danb.org. A copy of the guidelines and requirements are available for inspection

and distribution at 10 cents per page from the Michigan Board of Dentistry, Department

of Licensing and Regulatory Affairs, Bureau of Professional Licensing, 611 West

Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

(4) The board adopts by reference the standards for certification in basic and advanced

cardiac life support for health care providers with a hands-on component set forth by the

AHA in the standards and guidelines for cardiopulmonary resuscitation and emergency

cardiac care for professional providers, published in "2015 American Heart Association

Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care,”

Volume 132, Issue 18, Supplement 2, November 3, 2015, with updates in 2017 and 2018.

A copy of the guidelines for cardiopulmonary resuscitation and emergency

cardiovascular care may be obtained at a cost of approximately $28.00 from the AHA’s

website at www.cpr.heart.org. A copy of this document is available for inspection and

distribution, at the same cost as purchasing a copy from the AHA, from the Michigan

Board of Dentistry, Department of Licensing and Regulatory Affairs, Bureau of

Professional Licensing, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan, 48909.

PART 8. DENTAL AMALGAM

R 338.11801 Definitions.

Rule 1801. (1) As used in this part:

(a) “Amalgam separator” means a device designed to remove dental amalgam waste

particles from dental office wastewater.

(b) “Dental amalgam” means a mixture of mercury and other metals used as a dental

restorative material.

(c) “Dental amalgam waste” means waste from a dental office containing any of the

following:

(i) Contact amalgam waste, which means dental amalgam that has been in contact

with the patient including, but not limited to, extracted teeth with dental amalgam

restorations; carving scrap collected at chair-side; and dental amalgam captured by chair-

side traps, vacuum pump filters, amalgam separators, or other dental amalgam capture

devices.

(ii) Non-contact amalgam scrap, which means dental amalgam that has not been in

contact with the patient including, but not limited to, excess dental amalgam mix

remaining at the end of a dental procedure.

57

(iii) Empty amalgam capsules, which means individually dosed containers left over

after mixing precapsulated dental amalgam.

(iv) Dental amalgam that may have accumulated in the plumbing system or that is

found in other areas of a dental office.

(d) “Dentist,” means an individual licensed under article 15 of the code, MCL

333.16101 to 333.18838, and these rules, to engage in the practice of dentistry, who uses

or removes dental amalgam or who owns or operates a dental office that generates dental

amalgam waste.

(e) “Discharge” means the release of any dental amalgam waste into the environment.

This includes any releases to land, ground or surface waters, septic systems, or

wastewater treatment systems.

(f) “Holding tank” means a closed, watertight, sealed structure designed and used to

receive and store wastewater. Holding tanks are designed and constructed for ultimate

disposal of collected wastewater at another site.

(g) “Recycle” or “recycling” means sending mercury or dental amalgam waste to either

the contracted separator company or a facility in the United States that reclaims or distills

the mercury for reuse. “Recycle” or “recycling” does not include any of the following:

(i) The on-site processing of mercury or dental amalgam waste.

(ii) The sale, donation, or exchange of mercury or dental amalgam waste through

internet lists.

(iii) The sale or donation of mercury or dental amalgam waste to any individual or

company for any other reuse purpose.

(2) Unless otherwise defined in these rules, the terms defined in the code have the same

meanings when used in this part.

R 338.11811 Amalgam separator; installation and operation; requirements.

Rule 1811. (1) On or before December 31, 2013, a dentist shall install, or have installed,

an amalgam separator on each wastewater drain in his or her dental office that is used to

discharge dental amalgam waste. In addition to meeting the requirements of the code and

these rules, a dentist who is required to install an amalgam separator, pursuant to section

16631 of the code, MCL 333.16631, shall comply with all of the following:

(a) Install an amalgam separator that meets the requirements of R 338.11813.

(b) Install, operate, and maintain the amalgam separator according to the

manufacturer’s instructions.

(c) Ensure the installed amalgam separator is properly sized to accommodate

maximum dental amalgam wastewater flow rates at the dental office. The maximum

allowable flow rate through an amalgam separator at a dental office must not exceed the

maximum flow rate capacity at which the amalgam separator was tested under R

338.11813(1)(a).

(d) Ensure that all wastewater from the dental office containing dental amalgam waste

passes through an installed and properly functioning and maintained amalgam separator

before being discharged.

(2) Subrule (1) of this rule does not apply to any of the following:

(a) Oral and maxillofacial surgeons.

(b) Oral and maxillofacial radiologists.

(c) Oral pathologists.

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(d) Orthodontists.

(e) Periodontists.

(f) Dentists while providing services in a dental school educational program, in a

hospital, or through a local health department.

(g) Dentists who install and use a holding tank and do not discharge amalgam waste.

R 338.11813 Amalgam separator; requirements.

Rule 1813. (1) An amalgam separator that is installed in a dental office under R

338.11811 must meet all of the following requirements:

(a) Be certified as passing the international organization for standardization (ISO)

11143 standard, 2008, for evaluating amalgam separators.

(b) Have a removal efficiency of not less than 95% as determined by the testing

required under subdivision (a) of this subrule, based on the overall average of the 3 empty

and the 3 simulated full test results.

(c) Be tested and certified by 1 of the following:

(i) SP technical research institute of Sweden.

(ii) Tuv nord, Germany.

(iii) NSF international.

(iv) Both of the following:

(A) A testing laboratory accredited by an accreditation body that is a signatory to the

international laboratory accreditation cooperation’s mutual recognition arrangement and

has a scope of accreditation that includes ISO 11143 standard, 2008.

(B) A certification body accredited by an accreditation body that is a signatory to the

international accreditation forum’s multilateral recognition arrangement and has a scope

of accreditation that includes ISO 11143 standard, 2008.

(2) Any amalgam separator that meets the requirements of subrule (1) of this rule

qualifies as an amalgam separator approved by the board.

R 338.11815 Collection, disposal, and recycling of dental amalgam waste; requirements.

Rule 1815. (1) A dentist shall comply with all of the following:

(a) Use amalgam only in a precapsulated form.

(b) Salvage, store, and recycle non-contact and contact dental amalgam materials,

including empty amalgam capsules.

(c) Collect and recycle extracted teeth or portions of teeth that contain dental amalgam

materials.

(d) Store all dental amalgam waste in enclosed and structurally sound containers until a

sufficient amount has been collected for shipment to a reclamation facility or recycler or

at a minimum, recycle annually.

(e) Label all containers holding dental amalgam waste. The label must include at a

minimum, the title “dental amalgam waste for recycling” and the date the waste was

initially placed in the container.

(f) Use chair-side traps to retain amalgam and recycle the content.

(g) Recycle all amalgam materials collected in amalgam separators, vacuum pump

filters, chair-side traps, or other wastewater processing devices.

59

(h) Ensure that the separators operate properly and do not become full and bypass. This

may include inspecting the separators annually, halfway through the operating life, or as

required by the manufacturer.

(i) Follow the steps for the cleanup of mercury spills as recommended by the Michigan

department of health and human services at www.michigan.gov/mercury .

(2) A dentist shall not do any of the following:

(a) Store bulk elemental mercury that is not in capsule form.

(b) Put dental amalgam waste down a toilet or drain.

(c) Put dental amalgam waste or empty amalgam capsules into trash containers, or

biohazard or infectious waste bags.

(d) Disinfect teeth or any item containing dental amalgam by autoclaving or using heat.

(e) Use cleaners containing bleach or chlorine to flush drains or wastewater lines.

(3) A dentist shall train and have written procedures for training dental office staff who

manage or dispose of dental amalgam waste to ensure compliance with this rule.

(4) This rule does not apply to a dentist listed in R 338.11811(2)(a) to (f). A dentist who

installs and uses a holding tank and does not discharge amalgam waste shall comply with

the requirements of subrules (1), (2), and (3) of this rule, as applicable.

R 338.11817 Record keeping.

Rule 1817. (1) A dentist who is subject to the provisions of R 338.11811 shall maintain

records at his or her dental office that include all of the following:

(a) Type of amalgam separator installed, including the manufacturer and model.

(b) Date the amalgam separator became operational.

(c) Documentation verifying that the amalgam separator meets the requirements of R

338.11813.

(d) Documentation of the manufacturer’s instructions for the operation and

maintenance of the amalgam separator.

(e) Service records for each amalgam separator in use at the dental office that includes

all of the following:

(i) Dates of maintenance.

(ii) Dates separator contents were recycled.

(iii) Name of the staff or contractor performing the service.

(f) Documentation verifying that the dentist disposed of and recycled any dental

amalgam waste that was generated from the individual’s dental office consistent with the

requirements of R 338.11815. The documentation must include all of the following:

(i) Name and address of the collection service or recycler.

(ii) Amount by weight of dental amalgam waste that was collected and the date it was

collected or shipped from the dental office for recycling.

(iii) Name and address of the facility where the dental amalgam waste is recycled.

(iv) Shipping or manifest papers documenting transfer of the dental amalgam waste to

the recycler.

(2) Upon request by an authorized state official, local public health department staff, or

local municipality’s representative, a dentist subject to this rule shall provide the records

required under subrule (1) of this rule.

(3) A dentist subject to this rule shall retain the records required under subrule (1) of this

rule for a minimum of 3 years.

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R 338.11819 Verification.

Rule 1819. With each license renewal, a dentist who is subject to the provisions of R

338.11811 shall verify on a form provided by the department that he or she is in

compliance with these rules and provide the amalgam separator make and year that each

separator was installed.

R 338.11821 Compliance and enforcement.

Rule 1821. Failure to comply with the requirements of these rules is a violation of

section 16221(h) of the code, MCL 333.16221, and may result in sanctions as provided

for in the code, or under state or federal law.