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Although the title of this Act implies that it is purely related to dentists, the Act pertains to dentists, dental hygienists, and dental assistants. The Dental Practice Act therefore consists of Chapter 43-28, Chapter 43-28.1 and Chapter 43-20. Although Chapter 43-28, relates more specifically to the dentist it also applies to dental hygienists and dental assistants with equal force when applicable. Chapter 43-20 relates to dental hygienists and dental assistants. Chapter 43-28.1 is specifically the Dentists’ Loan Repayment Program.
Statute - North Dakota Century Code 43-28-01 through 43-28-27 - Dentist
Statute - North Dakota Century Code 43-28.1 - Dentist
Statute - North Dakota Century Code 43-20-01 through 43-20-12 - Hygienist and Dental Assistant
How is a Rule different than the Law? Rules further clarify and define the laws contained in the Dental Practice Act. For example, the laws governing a dental hygienist in Chapter 43-20 describe the dental hygiene scope of permitted practice. The Administrative Rules specifically describe what is included and excluded from the practice of dental hygiene. Administrative rules have the force of law.
Chapter 20-01-01 ORGANIZATION OF THE BOARD
Chapter 20-02-01 DENTISTS - GENERAL REQUIREMENTS
Chapter 20-03-01 DENTAL ASSISTANTS - DUTIES
Chapter 20-04-01 DENTAL HYGIENISTS - DUTIES
ND Administrative Code 20-02-01-09 - Retention of records: A dentist shall retain a patient's dental record for a minimum of six years after the patient's last examination, prescription, or treatment. Records for minors shall be retained for a minimum of either one year after the patient reaches the age of eighteen or six years after the patient's last examination, prescription, or treatment, whichever is longer. Proper safeguards shall be maintained to ensure safety of records from destructive elements. The requirements of this rule apply to electronic records as well as to records kept by any other means.
The Code of Ethics as defined in the Administrative Rules means the April 2016 version of the American Dental Association's Principles of Ethics and Code of Professional Conduct. A violation of the Code of Ethics adopted by the Board by rule is grounds for disciplinary action. Two continuing education hours pertaining to Ethics and Jurisprudence is required for renewal of license and registration.
Pharmacy Laws | Pharmacy Guidelines | Medical Records | Professional Organizations |
Board of Pharmacy Administrative Code 61-12-01-02. Dispenser Reporting - North Dakota Administrative Code - Title 61, Article, 12 Chapter 1 (ndlegis.gov)
N.D.C.C. 43-15-31.3. Oral transmission of prescriptions - North Dakota Century Code t43c15 (ndlegis.gov)
Patient Records | Laser Technology | Mercury-free Dentistry | Record Keeping | Teeth Whitening Services
The purpose of this policy is to clarify the Board's position and laws regarding the ownership and release of patient records. The American Dental Association calls upon dentists to follow high ethical standards who have the benefit of the patient as their primary goal. Failure to release a copy of the patient record upon request of the patient or the patient's parent/legal guardian to do so is grounds for discipline pursuant to North Dakota Century Code § 43-28-18 and § 23-12-14.
Record definition: A patient record includes any document or combination of documents that pertains to a patient's medical/dental history, diagnosis, prognosis, or medical/dental condition, and that is generated and maintained in the process of the patient's dental treatment. Patient records include:
A patient record should not include:
Ownership: Patient records belong to the treating practitioner; however, the patient has an absolute right to a copy of his/her patient records.
Costs: This obligation to provide a copy of records exists whether or not the patient's account is paid in full. Since the patient has an absolute right to a copy of his/her records, a dentist may not ignore a request for records due to an unpaid balance for services rendered. Further, a dentist cannot demand payment for copies up front. The dentist may add the fee (provided the costs are provided for in NDCC 23-12-14) for copies to the unpaid balance, and include this in any claim for reimbursement, but records cannot be held hostage for payment of any kind.
Disclaimer: Nothing in this policy supersedes the confidentiality requirements outlined in the Health Insurance Portability and Accountability Act. Further these statements do not apply to records subpoenaed for the North Dakota State Board of Dental Examinations investigation/enforcement purposes as those requests are exempted from the protections under HIPPA.
It is the position of the Board that any services provided by a licensee, regardless of the devise used, must be within the scope of practice for each licensee. Whenever a new treatment modality is brought forward, it is the Board’s policy that the dentist must have equal or greater proficiency and training in the technology. Licensees utilizing the new technology must maintain documentation of the satisfactory completion of the formal continuing education or training. The particular technology utilized does not alter the fact that the dentist is ultimately responsible.
There are no rules or regulations in place that would prohibit a licensee from discussing the pros and cons of specific filling materials with a patient. The Board does not regulate the filling materials used as long as the treatment rendered conforms to the standard of care and is the appropriate treatment for the diagnosis. As is the approach of this Board regarding mercury-free dentistry and other professional practice related areas, the Board makes determinations within its disciplinary jurisdiction. This is consistent with the mandated mission of the Board, which is to assure that licensees practice in an ethical and competent manner that is appropriate to preserve the health, safety, and welfare of the public.
Review with the patient the current scientific data on the safety of dental amalgams – that there is no evidence that amalgams pose a significant health risk to non-allergic patients and that no known health benefits result from the removal of dental amalgams. Provide the same data for the alternative materials suggested for use.
Although the State Board of Dental Examiners recognizes the right of the patient to request removal of amalgam dental fillings by a licensed dentist, the dentist may not make a diagnosis of mercury toxicity nor make a claim that removal of amalgam dental fillings will result in a cure, alleviation, or improvement, of any systemic medical condition. If a dentist believes that amalgam dental materials may be detrimental to a patient's medical health, it is incumbent upon the dentist to make a referral to a licensed physician for examination and evaluation of the suspected medical condition.
Record Keeping/Transfer of Patient Record
Although no statute or rule is currently in place for record keeping, laws outlining transferring of records and retention of records do exist in the Administrative Rules (Chapters 20-02-01-08 and 20-02-01-09). Recent laws require transfer of the record within ten business days. A good record protects the patient and the provider. A dentist’s recollection of events is not likely to be adequate for a subsequent provider, review by the NDSBDE, insurance claims, or a jury. Common record keeping errors seen by the NDSBDE during its administrative processes with licensees include:
Pursuant to the North Dakota Century Code "Practice of dentistry" means examination, diagnosis, treatment, repair, administration of local or general anesthetics, prescriptions, or surgery of or for any disease, disorder, deficiency, deformity, discoloration, condition, lesion, injury, or pain of the human oral cavity, teeth, gingivae, and soft tissues, and the diagnosis, surgical, and adjunctive treatment of the diseases, injuries, and defects of the upper and lower human jaw and associated structures.” [See N.D.C.C. 43-28-01(7) https://www.legis.nd.gov/cencode/t43c28.pdf?20130906111204 ].
The Board (North Dakota Board of Dental Examiners) interprets the law as it pertains to the teeth whitening services to mean treatment or repair of the discoloration of teeth, as the practice of dentistry. The law is not broadly interpreted by the Board, therefore, an individual who purchases products for personal home use (e.g., Crest Whitestrips®) would not be in violation of the North Dakota Century Code. Likewise, the purchase of products such as hair coloring, etc. for personal home use is not prohibited.
Although teeth whitening services are similar to products available for purchase in drug stores or online, the Board, whose role is to protect the public, contends that it is reasonable to require a level of training for teeth whitening, which might include adverse reactions and for which infection control and sterilization procedures are imperative.
The Board of Dental Examiners jurisdiction lies specifically with the regulation of those who hold a dental license, dental hygiene license or dental assisting registration. Therefore, a complaint received by the Board against an individual who is not licensed by or regulated by the Board, who provides teeth whitening services to the public (or the unlawful practice of dentistry), is referred to the ND States Attorney’s Office.
Bloodborne Infectious Disease Resources including Post-Exposure Procedures - Occupational Health and Safety Administration (OSHA)
Bloodborne infectious Disease Resources including Post-Exposure Guidelines - Centers for Disease Control and Prevention (CDC)
Environmental Protection Agency (EPA) - Medical Waste
Sharps Waste and other Mailable Regulated Medical Waste - United States Postal Service
OSHA Safety and Health Topics for Healthcare Facilities - OSHA Safety - Healthcare Facilities
Healthcare Infection Control Practices Advisory Committee General Guidelines - HICPAC