                                 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.