                                 CODE OF VIRGINIA

LICENSE; APPLICATION; QUALIFICATIONS; PRACTICE OF DENTAL HYGIENE; REPORT (§
54.1-2722)

A. No person shall practice dental hygiene unless he possesses a current,
active, and valid license from the Board of Dentistry. The licensee shall have
the right to practice dental hygiene in the Commonwealth for the period of his
license as set by the Board, under the direction of any licensed dentist.

B. An application for such license shall be made to the Board in writing and
shall be accompanied by satisfactory proof that the applicant (i) is of good
moral character, (ii) is a graduate of a dental hygiene program accredited by
the Commission on Dental Accreditation and offered by an accredited institution
of higher education, (iii) has passed the dental hygiene examination given by
the Joint Commission on National Dental Examinations, and (iv) has successfully
completed a clinical examination acceptable to the Board.

C. The Board may grant a license to practice dental hygiene to an applicant
licensed to practice in another jurisdiction if he (i) meets the requirements of
subsection B; (ii) holds a current, unrestricted license to practice dental
hygiene in another jurisdiction in the United States; (iii) has not committed
any act that would constitute grounds for denial as set forth in &#xA7;
54.1-2706; and (iv) meets other qualifications as determined in regulations
promulgated by the Board.

D. A licensed dental hygienist may, under the direction or general supervision
of a licensed dentist and subject to the regulations of the Board, perform
services that are educational, diagnostic, therapeutic, or preventive. These
services shall not include the establishment of a final diagnosis or treatment
plan for a dental patient. Pursuant to subsection W of &#xA7; 54.1-3408, a
licensed dental hygienist may administer topical oral fluorides under an oral or
written order or a standing protocol issued by a dentist or a doctor of medicine
or osteopathic medicine.
			A dentist may also authorize a dental hygienist under his direction to
administer Schedule VI nitrous oxide and oxygen inhalation analgesia and, to
persons 18 years of age or older, Schedule VI local anesthesia. In its
regulations, the Board of Dentistry shall establish the education and training
requirements for dental hygienists to administer such controlled substances
under a dentist&#8217;s direction.
			For the purposes of this section, &#8220;general supervision&#8221; means
that a dentist has evaluated the patient and prescribed authorized services to
be provided by a dental hygienist; however, the dentist need not be present in
the facility while the authorized services are being provided.
			The Board shall provide for an inactive license for those dental hygienists
who hold a current, unrestricted license to practice in the Commonwealth at the
time of application for an inactive license and who do not wish to practice in
Virginia. The Board shall promulgate such regulations as may be necessary to
carry out the provisions of this section, including requirements for remedial
education to activate a license.

E. For the purposes of this subsection, &#8220;remote supervision&#8221; means
that a public health dentist has regular, periodic communications with a public
health dental hygienist regarding patient treatment, but such dentist may not
have conducted an initial examination of the patients who are to be seen and
treated by the dental hygienist and may not be present with the dental hygienist
when dental hygiene services are being provided.
			Notwithstanding any provision of law, a dental hygienist employed by the
Virginia Department of Health or the Department of Behavioral Health and
Developmental Services who holds a license issued by the Board of Dentistry may
provide educational and preventative dental care in the Commonwealth under the
remote supervision of a dentist employed by the Department of Health or the
Department of Behavioral Health and Developmental Services. A dental hygienist
providing such services shall practice pursuant to protocols developed jointly
by the Department of Health and the Department of Behavioral Health and
Developmental Services for each agency, in consultation with the Virginia Dental
Association and the Virginia Dental Hygienists&#8217; Association. Such
protocols shall be adopted by the Board as regulations.
			A report of services provided by dental hygienists employed by the Virginia
Department of Health pursuant to such protocol, including their impact upon the
oral health of the citizens of the Commonwealth, shall be prepared and submitted
annually to the Secretary of Health and Human Resources by the Department of
Health, and a report of services provided by dental hygienists employed by the
Department of Behavioral Health and Developmental Services shall be prepared and
submitted annually to the Secretary of Health and Human Resources by the
Department of Behavioral Health and Developmental Services. Nothing in this
section shall be construed to authorize or establish the independent practice of
dental hygiene.

F. For the purposes of this subsection, &#8220;remote supervision&#8221; means
that a supervising dentist is accessible and available for communication and
consultation with a dental hygienist during the delivery of dental hygiene
services, but such dentist may not have conducted an initial examination of the
patients who are to be seen and treated by the dental hygienist and may not be
present with the dental hygienist when dental hygiene services are being
provided.
			Notwithstanding any other provision of law, a dental hygienist may practice
dental hygiene under the remote supervision of a dentist who holds an active
license by the Board and who has a dental practice physically located in the
Commonwealth. No dental hygienist shall practice under remote supervision unless
he has (i) completed a continuing education course designed to develop the
competencies needed to provide care under remote supervision offered by an
accredited dental education program or from a continuing education provider
approved by the Board and (ii) at least two years of clinical experience,
consisting of at least 2,500 hours of clinical experience. A dental hygienist
practicing under remote supervision shall have professional liability insurance
with policy limits acceptable to the supervising dentist. A dental hygienist
shall only practice under remote supervision at a federally qualified health
center; charitable safety net facility; free clinic; long-term care facility;
elementary or secondary school; Head Start program; mobile dentistry program for
adults with developmental disabilities operated by the Department of Behavioral
Health and Developmental Services&#8217; Office of Integrated Health; or women,
infants, and children (WIC) program.
			A dental hygienist practicing under remote supervision may (a) obtain a
patient&#8217;s treatment history and consent, (b) perform an oral assessment,
(c) perform scaling and polishing, (d) perform all educational and preventative
services, (e) take X-rays as ordered by the supervising dentist or consistent
with a standing order, (f) maintain appropriate documentation in the
patient&#8217;s chart, (g) administer topical oral fluorides, topical oral
anesthetics, topical and directly applied antimicrobial agents for treatment of
periodontal pocket lesions, and any other Schedule VI topical drug approved by
the Board of Dentistry under an oral or written order or a standing protocol
issued by a dentist or a doctor of medicine or osteopathic medicine pursuant to
subsection W of &#xA7; 54.1-3408, and (h) perform any other service ordered by
the supervising dentist or required by statute or Board regulation. No dental
hygienist practicing under remote supervision shall administer local anesthetic
or nitrous oxide.
			Prior to providing a patient dental hygiene services, a dental hygienist
practicing under remote supervision shall obtain (1) the patient&#8217;s or the
patient&#8217;s legal representative&#8217;s signature on a statement disclosing
that the delivery of dental hygiene services under remote supervision is not a
substitute for the need for regular dental examinations by a dentist and (2)
verbal confirmation from the patient that he does not have a dentist of record
whom he is seeing regularly.
			After conducting an initial oral assessment of a patient, a dental hygienist
practicing under remote supervision may provide further dental hygiene services
following a written practice protocol developed and provided by the supervising
dentist. Such written practice protocol shall consider, at a minimum, the
medical complexity of the patient and the presenting signs and symptoms of oral
disease.
			A dental hygienist practicing under remote supervision shall inform the
supervising dentist of all findings for a patient. A dental hygienist practicing
under remote supervision may continue to treat a patient for 180 days. After
such 180-day period, the supervising dentist, absent emergent circumstances,
shall either conduct an examination of the patient or refer the patient to
another dentist to conduct an examination. The supervising dentist shall develop
a diagnosis and treatment plan for the patient, and either the supervising
dentist or the dental hygienist shall provide the treatment plan to the patient.
The supervising dentist shall review a patient&#8217;s records at least once
every 10 months.
			Nothing in this subsection shall prevent a dental hygienist from practicing
dental hygiene under general supervision whether as an employee or as a
volunteer.

HISTORY: 1950, pp. 983-985, §§ 54-200.2, 54-200.4, 54-200.7 through 54-200.9,
54-200.11; 1968, c. 604; 1970, c. 639; 1972, cc. 805, 824; 1973, c. 391; 1975,
c. 479; 1976, c. 327; 1986, c. 178; 1988, c. 765; 1990, c. 441; 1997, c. 855;
2002, c. 170; 2005, cc. 505, 587; 2006, c. 858; 2007, c. 702; 2009, cc. 99, 506,
561; 2011, c. 289; 2012, c. 102; 2013, c. 240; 2016, c. 497; 2017, c. 410; 2019,
cc. 86, 431; 2024, c. 295; 2025, c. 277.