Utah Office of Administrative Rules

NOTICE OF SUBSTANTIVE CHANGE

TYPE OF FILING: Amendment

Filing ID: 57975

Rule or section number:

R156-69

1. Agency Information

Title catchline:

Commerce, Professional Licensing

Building:

Heber M. Wells Building

Street address:

160 E 300 S

City, state:

Salt Lake City, UT 84111

Mailing address:

PO Box 146741

City, state and zip:

Salt Lake City, UT 84114-6741

2. Contact Persons

Name:

Phone:

Email:

Lisa Martin

801-530-7632

lmartin@utah.gov

Please address questions regarding information on this notice to the persons listed above.

3. General Information

A. Rule or section catchline:

R156-69. Dentist and Dental Hygienist Practice Act Rule

B. Purpose of the new rule or reason for the change:

The Division of Professional Licensing (Division) in collaboration with the Dentist and Dental Hygienist Licensing Board is filing this amendment to changes in response to HB 372 passed in the 2025 General Session that included three new expanded function certifications for dental auxiliaries under the indirect supervision of a dentist:

1) the administration of botulinum toxin by a dental hygienist;

2) the placement of direct restorations by a dental hygienist or dental assistant; and

3) the removal of coronal adhesive by a dental hygienist or dental assistant.

The amendments create the qualifications for each expanded function certification along with the initial scope of licensure which may be expanded in the future.

The amendments also clarify the educational requirements and parameters for a dentist who administers dermal fillers or botulinum toxin injections.

Additional nonsubstantive formatting changes are also made throughout this rule to streamline and update this rule, clarify and update definitions, and comply with the Rulewriting Manual for Utah.

C. Summary of the new rule or change:

The amendments make the following changes:

In Section R156-69-102: updates definitions to clarify terms used in the rule and to remove terms no longer used.

In Section R156-69-301a: clarifies the education standards and parameters for the administration of dermal fillers and botulinum toxin.

In Section R156-69-301d: clarifies the education requirements required for an entity providing hygienist education and updates the names of the organizations administering qualifying exams.

In Sections R156-69-302b and R156-69-302c: updates the names of the organizations administering qualifying exams.

In Section R156-69-303: adds language defining the terms of an expanded function certification for dental auxiliaries.

In Section R156-69-304a: clarifies and updates the continuing professional education (CPE) requirements for licensees and defines the CPE requirements for expanded function certification holders.

In Section R156-69-502: adds new examples of unprofessional conduct including those applicable to the new expanded function certifications for dental auxiliaries.

Section R156-69-603 is renumbered to Section R156-69-803a. Additional revisions update the restrictions on dental assistants for those dental assistants who obtain an expanded function certification.

Section R156-69-604 is renumbered to Section R156-69-803b.

In Section R156-69-801: updates the requirements for a dental hygienist engaging in the practice of dental hygiene in a public health setting without supervision.

The amendment also adds the following new sections:

1) Section R156-69-808a defines the minimum entry requirements and standards for a dental hygienist to obtain a certification for the administration of botulinum toxin; includes the education requirements the dental hygienist shall complete that aligns with the requirements for a dentist; defines the initial scope of practice for this certification including the limit on administering botulinum toxin injections only within the oral and maxillofacial areas of a patient; and defines the continuing professional education requirements to maintain certification.

2) Section R156-69-808b defines the minimum entry requirements and standards for a dental auxiliary to obtain a certification for the placement of direct restorations; includes the educational training requirements of the program that the dental auxiliary shall complete; defines the initial scope of practice for this certification including the use of a dental or surgical magnification device and allowing the use of a slow-speed handpiece on direct restorations; and defines the continuing professional education requirements to maintain certification.

3) Section R156-69-808c defines the minimum entry requirements and standards for a dental auxiliary to obtain a certification for the removal of dental adhesive; includes the educational requirements of the program that the dental auxiliary shall complete; defines the initial scope of practice for this certification including the requirement to use a dental or surgical magnification device and allowing the use of a slow-speed handpiece while removing coronal adhesive; and defines the continuing professional education requirements to maintain certification.

4) Section R156-69-808d defines the consent requirements for a dental auxiliary while training to obtain an expanded function certification and a dental auxiliary who has an expanded function certification.

The remaining amendments also make nonsubstantive formatting changes for clarity, update the rule language for style and formatting consistent with the Rulewriting Manual for Utah, and update citation references.

4. Legislative Action Information

A. Are any changes in this filing because of state legislative action?

Changes are because of legislative action.

B. If yes, any bill number and session:

HB 372 (2025 General Session), SB 44 (2025 General Session)

5. Fiscal Information

Provide an estimate and written explanation of the aggregate anticipated cost or savings to:

A. State budget:

There is a one-time cost of $199.93 for the Division to purchase the newest edition of Parameters of Care: AAOMS Clinical Practice Guidelines for Oral and Maxillofacial Surgery, 7th edition, which is incorporated by reference in this rule.

The proposed amendments to Section R156-69-301a will not affect any state practices or procedures, so the Division does not anticipate any fiscal impact on the state budget.

The remaining proposed amendments are made in accordance with the requirements of SB 372 (2025), so the Division does not anticipate additional costs or savings to the state budget beyond that determined by the fiscal note for SB 372 (2025) at:

https://le.utah.gov/%7E2025/bills/static/HB0372.html.

B. Local governments:

The proposed amendments to Section R156-69-301a will not affect any local government's practices or procedures, so the Division does not anticipate any fiscal impact on any local government.

The remaining proposed amendments are made in accordance with the requirements of SB 372 (2025), so the Division does not anticipate additional costs or savings to any local government practices or procedures, the Division does not anticipate any fiscal impact to local governments.

C. Small businesses ("small business" means a business employing 1-49 persons):

The proposed amendments to Section R156-69-301a will not directly affect any small businesses' practices or procedures, so the Division does not anticipate any fiscal impact on any small businesses.

The remaining proposed amendments are made in accordance with the requirements of SB 372 (2025), so the Division does not anticipate additional costs or savings to small businesses beyond that determined by the fiscal note for SB 372 (2025) at:

https://le.utah.gov/%7E2025/bills/static/HB0372.html.

D. Non-small businesses ("non-small business" means a business employing 50 or more persons):

The proposed amendments to Section R156-69-301a will not directly affect any non-small businesses' practices or procedures, so the Division does not anticipate any fiscal impact on non-small businesses.

The remaining proposed amendments are made in accordance with the requirements of SB 372 (2025), so the Division does not anticipate additional costs or savings to non-small businesses beyond that determined by the fiscal note for SB 372 (2025) at:

https://le.utah.gov/%7E2025/bills/static/HB0372.html.

E. Persons other than small businesses, non-small businesses, state, or local government entities ("person" means any individual, partnership, corporation, association, governmental entity, or public or private organization of any character other than an agency):

The proposed amendments to Section R156-69-301a clarify and update the training requirements for a dentist who provides botulinum toxin injections to match the training requirements for a dental hygienist with a certification for the administration of botulinum toxin injections.

Rather than completing an 8-hour course on botulinum toxin and dermal fillers, a dentist who provides botulinum toxin injections is now required to complete a 10-hour training course specific to the administration of botulinum toxin injections.

The proposed amendments to Section R156-69-301a also clarify and update the training requirements for a dentist who provides dermal fillers. A dentist who provides dermal fillers is now required to complete a 10-hour training course specific to dermal fillers. There are approximately 3,888 licensed dentists in Utah.

The proposed amendments to Section R156-69-301a may result in a fiscal impact on dental licensees, but quantifying any impact is not possible as it will vary widely depending on licensee choices and individual circumstances.

The remaining proposed amendments are made in accordance with the requirements of SB 372 (2025), so the Division does not anticipate additional costs or savings to persons other than small businesses, non-small businesses, state, or local government entities beyond that determined by the fiscal note for SB 372 (2025) at:

https://le.utah.gov/%7E2025/bills/static/HB0372.html.

F. Compliance costs for affected persons:

As described in box 6E, quantifying any impact of proposed changes to Section R156-69-301a is not possible as it will vary widely depending on licensee choices and individual circumstances.

The remaining proposed amendments are made in accordance with the requirements of SB 372, so the Division does not anticipate additional compliance costs for affected persons beyond that determined by the fiscal note for SB 372 at https://le.utah.gov/%7E2025/bills/static/HB0372.html.

6. Regulatory Impact Summary Table

Enter the cost or savings in the relevant cell. If there is no cost or savings, enter, "$0." If a cost or savings is inestimable, enter, "inestimable."

Fiscal Cost

FY2027

FY2028

FY2029

FY2030

FY2031

State Budget

$199.93

Local Governments

Small Businesses

Non-Small Businesses

Other Persons

Total Fiscal Cost

$199.93

Fiscal Benefits

FY2027

FY2028

FY2029

FY2030

FY2031

State Budget

Local Governments

Small Businesses

Non-Small Businesses

Other Persons

Total Fiscal Benefits

Net Fiscal Benefits

($199.93)

7. Regulatory Impact Analysis Approval

The Commissioner of the Department of Commerce, Margaret W. Busse, has reviewed and approved this regulatory impact analysis.

8. Family Impact Information

A. The agency has considered this rule's impact on family health, stability, and formation:

☒

9. Citation Information

Provide citations to the statutory authority for the rule. If there is also a federal requirement for the rule, provide a citation to that requirement:

Section 58-69-101

Subsection 58-1-106(1)(a)

Subsection 58-1-202(1)(a)

10. Incorporation by Reference Information

Incorporation by Reference (if this rule incorporates more than two items by reference, please include additional tables):

A. This rule adds or updates the following title of material incorporated by reference (a copy of the material incorporated by reference must be submitted to the Office of Administrative Rules. If none, leave blank):

Official Title of Materials Incorporated (from title page)

Parameters of Care: AAOMS Clinical Practice Guidelines for Oral and Maxillofacial Surgery

Publisher

American Association of Oral and Maxillofacial Surgeons

Issue Date

2023

Issue or Version

7th edition

B. This rule adds or updates the following title of material incorporated by reference (a copy of the material incorporated by reference must be submitted to the Office of Administrative Rules. If none, leave blank):

Official Title of Materials Incorporated (from title page)

American Society of Anesthesiologists

Publisher

Standards for Postanesthesia Care

Issue Date

October 23, 2024

C. This rule adds or updates the following title of material incorporated by reference (a copy of the material incorporated by reference must be submitted to the Office of Administrative Rules. If none, leave blank):

Official Title of Materials Incorporated (from title page)

Principles of Ethics and Code of Conduct

Publisher

American Dental Association

Issue Date

October 2024

D. This rule adds or updates the following title of material incorporated by reference (a copy of the material incorporated by reference must be submitted to the Office of Administrative Rules. If none, leave blank):

Official Title of Materials Incorporated (from title page)

ADHA Code of Ethics

Publisher

American Dental Hygienists Association

Issue Date

October 2024

11. Public Notice Information

The public may submit written or oral comments to the agency identified in box 1.

A. Comments will be accepted until:

07/01/2026

B. A public hearing (optional) will be held (The public may request a hearing by submitting a written request to the agency, as outlined in Section 63G-3-302 and Rule R15-1.):

Date:

Time (hh:mm AM/PM):

Place (physical address or URL):

06/12/2026

1:00 PM

Anchor Meeting Location:

Heber M. Wells Building

Room 474

160 E 300 S

Salt Lake City, UT

Video call link:

https://meet.google.com/ffn-tgae-wym

Or dial: (US) +1 513-468-1160

PIN: 431 136 780#

More phone numbers: https://tel.meet/ffn-tgae-wym?pin=2887063598876

12. Effective Date Information

This rule change MAY become effective on:

(NOTE: This is the date the agency anticipates making the filing effective. It is NOT the effective date)

07/08/2026

13. Agency Authorization Information

Agency head or

designee and title:

Mark B. Steinagel, Division Director

Date:

04/27/2026

R156. Commerce, Professional Licensing.

R156-69. Dentist and Dental Hygienist Practice Act Rule.

R156-69-101. Title.

(1) This rule is known as the "Dentist and Dental Hygienist Practice Act Rule."

(2) This rule is adopted by the Division under Subsection 58-1-106(1)(a) to enable the Division to administer Title 58, Chapter 69, Dentist and Dental Hygienist Practice Act.

(3) The organization of this rule and its relationship to Rule R156-1 is as described in Section R156-1-10[7]1.

R156-69-102. Definitions.

Terms used in this rule are defined in Title 58, Chapter 1, Division of Professional Licensing Act, and Title 58, Chapter 69, Dentist and Dental Hygienist Practice Act. [ ]In addition:

(1) "AAOMS standards" as used in Subsections R156-69-301a(3)(d) and R156-69-301b(5)(d)(i) means the following American

Association of Oral and Maxillofacial Surgeons (AAOMS) standards, which are incorporated by reference:

(a) Office Anesthesia Evaluation Manual, 2018, 9th edition; and

(b) Parameters of Care[, 2017 6th edition.]: AAOMS Clinical Practice Guidelines for Oral and Maxillofacial Surgery, 2023, 7th

edition.

[(2) "AAPD" means the American Academy of Pediatric Dentistry.]

([3]2) "ACLS" means Advanced Cardiac Life Support.

([4]3) "ADA" means the American Dental Association.

[(5) "ADA CERP" means American Dental Association Continuing Education Recognition Program.]

([6]4) "ADA [Sedation and General Anesthesia]SGA Policy Statement" means the ADA Policy Statement: The Use of Sedation

and General Anesthesia by Dentists, 2007 edition, which is incorporated by reference.

([7]5) "ADA PCS Teaching Guidelines" as used in Section R156-69-301b and Subsection R156-69-301d(2)(b)(i)(A)(I) means the

Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students published by the American Dental Association[,] as

adopted by the ADA House of Delegates, October 2016, which is incorporated by reference.

([8]6) "ADA Use of SGA Guidelines" means the Guidelines for the Use of Sedation and General Anesthesia by Dentists published

by the American Dental Association[,] as adopted by the ADA House of Delegates, October 2016, which is incorporated by reference.

([9]7) "ADEX" means American Board of Dental Examiners.

(8) "ADEX predecessor organization" as used in Subsections R156-69-301d(2)(c)(i), R156-69-302b(2), and R156-69-302c(1)(b),

means:

(a) the Commission on Dental Competency Assessments (CDCA);

(b) the Council of Interstate Testing Agencies, Inc. (CITA); and

([10]9) "ADHA" as used in Subsections R156-69-304a(11)(a)(iii)(E) and R156-69-502(29) means the American Dental

Hygienists' Association.

([11]10) "Advertising or otherwise holding oneself out to the public as a dentist" as used in Subsection R156-69-502(2) means

representing or promoting oneself as a dentist through[ any of the following or similar methods]:

(a) a business name[s];

(b) a business sign[s];

(d) a business card[s];

(e) letterhead;

(f) a business announcement[s];

(g) a flyer[s];

(h) a mailer[s];

(i) a promotion[s];

(j) an advertisement[s];

(k) a radio or television commercial[s];

(l) a listing[s] in printed or an online telephone directory;[ies; or]

(m) a blog, podcast, social media, or other means of mass communication generally available; or

([m]n) [any ]another type of advertisement or promotional communication.

([12]11) "Analgesia"[ means the same as] is as defined in the ADA Use of SGA Guidelines.

([13]12) "Anesthesiology" means the science of administration of anesthetics and the condition of the patient while under

anesthesia.

([14]13) "ASA standards" means the following American Society of Anesthesiologists (ASA) standards, which are incorporated

by reference:

(a) Basic Standards for Preanesthesia Care, 2020 edition;

(b) Standards for Basic Anesthetic Monitoring, 2020 edition; and

([15]14) "BCLS" means Basic Cardiac Life Support.

([16]15) "BLS" means Basic Life Support.

[(17) "CDCA" means Commission on Dental Competency Assessments.]

([18]16) "CDEL" means the Council on Dental Education and Licensure.

[(19) "CITA" means Council of Interstate Testing Agencies, Inc.]

([20]17) "CODA" means the Commission on Dental Accreditation of the [American Dental Association (ADA)]ADA.

([21]18) "Competency" means displaying special skill or knowledge derived from training and experience.

([22]19) "CPR" means cardiopulmonary resuscitation.

([23]20) "CRDTS" means the Central Regional Dental Testing Service, Inc.

([24]21) "DANB" means the Dental Assisting National Board, Inc.

([25]22) "Deep sedation" as defined in Subsection 58-1-510(1)(b) is further defined in the [standards in Subsection R156-69-

301b(3).]ADA Use of SGA Guidelines.

([26]23) "Deep sedation and general anesthesia permit" means the dentist deep sedation and general anesthesia permit

classification and scope of practice established in Section R156-69-301[b]a and Subsection R156-69-304a(3)(c) under Subsection 58-69-

301(4).

(24)(a) "Dental hygiene assessment" as used in Subsection 58-69-102(10)(c) includes:

(i) assessing a patient's dental hygiene status to identify an existing or potential oral health issue that a dental hygienist is

educationally qualified and licensed to treat; and

(ii) formulating a dental hygiene treatment plan under Subsection 58-69-102(10)(d).

(b) "Dental hygiene assessment" does not include:

(i) providing a definitive treatment diagnosis; or

(ii) creating a treatment plan that includes:

(A) operative dentistry;

(B) botulinum toxin; or

([27]25) "Dental hygienist with local anesthesia and nitrous oxide analgesia permit" means the dental hygienist local anesthesia

permit classification and scope of practice established in Sections R156-69-301c and R156-69-301d under Subsection 58-69-301(4).

(26) "Dental auxiliaries" as used in Section 58-69-808 means a dental hygienist or dental assistant.

([28]27) "Discharge criteria" means the minimum requirements for a patient to be safely discharged from the care of a dentist.

([29]28) "General anesthesia" as defined in Subsection 58-1-510(1)(c) is further defined in the [standards in Subsection R156-69-

301b(3).]ADA Use of SGA Guidelines.

([30]29) "Local anesthesia" [means the same]is as defined in the [standards in Subsection R156-69-301b(3).]ADA Use of SGA

Guidelines.

([31]30) "Local anesthesia permit" means the dentist local sedation permit classification and scope of practice established in

Section R156-69-301[b]a under Subsection 58-69-301(4).

[(32) "Maximum recommended dose (MRD)" is the maximum FDA recommended dose of a drug, as printed in FDA approved

labeling for unmonitored home use.]

([33]31) "Minimal sedation" as defined in Subsection 58-1-[501]510(1)(e) is further defined in the [standards in Subsection R156-

69-301b(3).]ADA Use of SGA Guidelines.

([34]32) "Minimal sedation permit" means the dentist minimal sedation permit classification and scope of practice established in

[Section]Subsections R156-69-301[b]a(1)(b) and (2)(b) under Subsection 58-69-301(4).

([35]33) "Moderate sedation" as defined in Subsection 58-1-510(1)(f) is further defined in the [standards in Subsection R156-69-

301b(3).]ADA Use of SGA Guidelines.

([36]34) "Moderate sedation permit" means the dentist moderate sedation permit classification and scope of practice established in

[Section]Subsections R156-69-301[b]a(1)(c) and (2)(c) under Subsection 58-69-301(4).

([37]35) "PALS" means Pediatric Advanced Life Support.

([38]36) "Pediatric dentistry" means the [age-defined ]dental specialty area 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.

([39]37) "Pediatric Sedation Guidelines" means the guidelines established in [Cote CJ, Wilson S. American Academy of Pediatric

Dentistry, American Academy of Pediatrics ]Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After

Sedation for Diagnostic and Therapeutic Procedures, [Pediatric Dent 2019; 41(4):E-26-E-52,]published by the American Academy of

Pediatrics and the American Academy of Pediatric Dentistry, June 2019, which is incorporated by reference.

([40]38) "Practice of dental hygiene" [under]as defined in Subsection 58-69-102[(7)(a)(ix)](10) includes performing:

(a) laser bleaching; [and]or

(b) laser periodontal debridement.

([41]39) "Prominent disclaimer" as used in Subsection 58-69-502(2)(b) means a disclaimer that:

(a) is in the same size [of lettering ]as the largest lettering [contained ]in [the]an advertisement, publication, or other

communication in which the disclaimer appears; or

(b) is in the same volume and speed as the slowest speed and highest volume included in the advertisement, commercial, or other communication in which the disclaimer appears.

(40) "Qualified continuing professional education" or "CPE" means continuing professional education under Section 58-69-304

that meets the requirements of Section R156-69-304a.

([42]41) "Route of administration" means the technique of administering sedation agents, and includes the following, as defined in

the ADA Use of SGA Guidelines:

(a) enteral;

(b) parenteral;

(d) transmucosal; and

(e) inhalation.

([43]42) "Specialty area" [or "dental specialty"]as used in Subsections R156-69-102(36) and R156-69-502(2) means an area of

dentistry in which the dentist has successfully completed at least two full-time years in a specialty postdoctoral program accredited by CODA.

([44]43) "SRTA" means the Southern Regional Testing Agency, Inc. which merged with CRDTS.

(44) "TMD" as used in in Subsections R156-69-301a(5) and R156-69-808a(3)(f)(ii) means a temporomandibular disorder.

([45]45) "UDA" means the Utah Dental Association.

([46]46) "UDHA" means the Utah Dental Hygienists' Association.

([47]47) "Unprofessional conduct" is further defined[, in accordance with Subsection 58-1-203(1)(e),] in Section R156-69-502

under Subsection 58-1-203(1)(e).

[(48) "WREB" means the Western Regional Examining Board.]

R156-69-301a. Dentist Anesthesia and Analgesia - Permit Classifications and Scopes of Practice[.] -- Dermal Filler -- Botulinum

Toxin.

(1) Under Section 58-1-510 and Subsection 58-69-301(4)([b]a), the classification of dentist anesthesia and analgesia permits are as

follows:

(a) local anesthesia permit;

(b) minimal sedation permit;

(d) deep sedation and general anesthesia permit.

(2) Under [Subsections]Section 58-1-510[(2) through (4)] and Subsection 58-69-301(4)([a]b), the scope of practice for each dentist

anesthesia and analgesia permit is established as follows:

(a) a dentist with a local anesthesia permit may administer local anesthesia and nitrous oxide analgesia and supervise the

administration of local anesthesia and nitrous oxide analgesia in compliance with the standards in Subsection (3);

(b) a dentist with a minimal sedation permit may:

(i) exercise the privileges of a local anesthesia permit; and

(ii) administer and supervise the administration of minimal sedation via nitrous oxide[-oxygen,] analgesia and oxygen, with or

without the administration of enteral medications, in compliance with the standards in Subsection (3);

(i) exercise the privileges of a minimal sedation permit;

(ii) administer and supervise the administration of moderate sedation in compliance with the standards in Subsection (3); and

(iii) when engaging in the administration of moderate sedation shall:

(A) use pulse oximetry; and

(B) have at least one ACLS or PALS trained individual present in-operatory during sedation; and

(d) a dentist with a deep sedation and general anesthesia permit may:

(i) exercise the privileges of a moderate sedation permit;

(ii) administer or supervise the administration of deep sedation or general anesthesia in compliance with the standards in Subsection (3); and

(iii) when engaging in the administration of deep sedation or general anesthesia, shall:

(A) use pulse oximetry and end[ ]-tidal carbon dioxide (CO2) monitoring with capnography; and

(B) have at least one ACLS or PALS trained individual present in-operatory during sedation.

(3) Under [Subsections]Section 58-1-510[(3) and (4)] and Subsections 58-69-102([8]6) and 58-69-807(2) and (5),[Section 58-69-

802:

(a) ] a dentist shall possess the knowledge, skills, education, and training required by and shall comply with the following

standards, as applicable to the dentist's permitted scope of practice:

([i]a) the ADA Use of SGA Guidelines;

([ii]b) the Pediatric Sedation Guidelines;

([iii]c) the ADA [Sedation and General Anesthesia]SGA Policy Statement;

([iv]d) the AAOMS standards;

([v]e) the ASA standards; and

([vi]f) Section 58-1-510.[; and

(b) a dentist who practices facial cosmetic dentistry using the neurotoxin clostridium botulinum or an injectable dermal filler shall

demonstrate competency by having successfully completed a minimum of eight hours of training that:

(i) is taught by properly trained and licensed individuals teaching within their scope of practice;

(ii) includes a hands-on component; and

(iii) includes the following topics:

(A) treatment for temporomandibular joint dysfunction;

(B) infection control; and

(4)(a) A dentist who meets the requirements of Subsections (4)(b) and R156-69-304a(4) may administer a dermal filler:

(i) within the oral and maxillofacial areas of a patient for cosmetic purposes; and

(ii) in the dentist's regularly announced office location during standard business hours.

(b) A dentist who provides treatment to a patient under Subsection (4)(a) shall demonstrate competency by successfully

completing an approved ten-hour CPE course on dermal fillers that:

(i) is taught by an instructor who:

(A) has an active and current license;

(B) is qualified by education, training, and experience to provide instruction on dermal fillers;

(D) has successfully administered dermal fillers on at least 50 patients;

(E) is teaching within the scope of practice for the instructor's license; and

(F) meets the CPE requirements of Section R156-69-304a; and

(ii) includes:

(A) a hands-on component on a live patient;

(B) infection control; and

(5)(a) A dentist who meets the requirements of Subsections (5)(b) and R156-69-304a(5) may administer a botulinum toxin

injection:

(i) within the oral and maxillofacial areas of a patient:

(A) for cosmetic purposes; or

(B) as a therapeutic treatment to reduce the pain or discomfort of diagnosed TMD as defined in Subsection R156-69-102(44) and

other medical conditions of the oral and maxillofacial areas including bruxism and migraines; and

(ii) in the dentist's regularly announced office location during standard business hours.

(b) A dentist who provides treatment to a patient under Subsection (5)(a) shall demonstrate competency by successfully

completing an approved 20-hour CPE course on administering botulinum toxin injections that meets the following education requirements:

(i) includes:

(A) didactic instruction;

(B) hands-on training on a live patient;

(C) at least ten hours of training on administering botulinum toxin for treating TMD and other medical conditions of the oral and

maxillofacial areas including bruxism and migraines; and

(D) at least ten hours of training on administering botulinum toxin for cosmetic purposes;

(ii) covers the following topics:

(A) anatomy;

(B) neurophysiology;

(D) risk factors for administration of botulinum;

(E) infection control;

(F) injection techniques;

(G) dental facial asymmetry and aesthetics;

(H) lip hypermobility;

(I) treatment for TMD as defined in Subsection R156-69-102(44) and other medical conditions of the oral and maxillofacial areas

including bruxism and migraines;

(J) management of complications;

(K) indications and contraindications;

(L) long-term use of botulinum toxin; and

(M) risk factors for administering the neurotoxin botulinum toxin; and

(iii) except as provided in Subsection (5)(c), is taught by an instructor who:

(A) has an active and current license;

(B) is qualified by education, training, and experience to provide instruction on administering botulinum toxin injections;

(D) has successfully administered botulinum toxin injections on at least 50 patients;

(E) is teaching within the scope of practice for the instructor's license; and

(F) meets the CPE requirements of Section R156-69-304a.

R156-69-301b. Dentist Anesthesia and Analgesia - Permit Qualifications.

(1) Under Sections 58-1-510 and 58-69-802 and Subsections 58-69-301(4)([b]c) and 58-69-807(2) and (5), the qualifications and

training and safety standards for each classification of dentist anesthesia and analgesia permit are established in this section.

(2) A[n] dentist applicant for a local anesthesia permit shall:

(a) hold current CPR or BCLS-BLS certification; and

(b) document successful completion of:

(i) training in the administration of nitrous oxide analgesia that conforms to:[ the ADA Teaching Guidelines, and if engaging in

pediatric dentistry, the Pediatric Sedation Guidelines; or]

(A) the ADA PCS Teaching Guidelines; and

(B) if engaging in pediatric dentistry, the Pediatric Sedation Guidelines; or

(ii) continuing professional education training provided by an ADA accredited school that is the substantial equivalent of the

training in Subsection ([3]2)(b)(i).

(3) A[n] dentist applicant for a minimal sedation permit shall:

(a) hold current BCLS-BLD certification;

(b) hold a current Utah controlled substance license in good standing;

(d) document successful completion of:

(i) training in the administration of nitrous oxide analgesia that conforms to:[ the ADA Teaching Guidelines, and if engaging in

pediatric dentistry, the Pediatric Sedation Guidelines; or]

(A) the ADA PCS Teaching Guidelines; and

(B) if engaging in pediatric dentistry, the Pediatric Sedation Guidelines; or

(ii) continuing professional education training provided by an ADA accredited school that is the substantial equivalent of the

training in Subsection (3)(d)(i); and

(e) document successful completion of:

(i) training in pharmacological methods of minimal sedation that conforms to:[ the ADA Teaching Guidelines, and if engaging in

pediatric dentistry, the Pediatric Sedation Guidelines; or]

(A) the ADA PCS Teaching Guidelines; and

(B) if engaging in pediatric dentistry, the Pediatric Sedation Guidelines; or

(ii) continuing professional education training provided by an ADA accredited school that is the substantial equivalent of the

training in Subsection (3)(e)(i).

(4) A[n] dentist applicant for a moderate sedation permit shall:

(a) hold current ACLS or PALS certification, except if engaging in pediatric dentistry, the applicant shall hold current PALS certification;

(b) hold a current Utah controlled substance license in good standing;

(d) document successful completion, as evidenced by a letter from the course director, of:

(i) comprehensive predoctoral or postdoctoral training in the administration of moderate sedation that:

(A) conforms to the ADA PCS Teaching Guidelines[, and if engaging in pediatric dentistry, the Pediatric Sedation Guidelines];

(B) if engaging in pediatric dentistry, conforms to the Pediatric Sedation Guidelines;

([B]C) includes at least 60 hours of didactic education in sedation; and

([C]D) includes at least 20 sedation cases; or

(ii) continuing professional education training provided by an ADA accredited school that is substantial equivalent of the

education and training in Subsection (4)(d)(i).

(5) A[n] dentist applicant for a deep sedation and general anesthesia permit shall:

(a) hold current ACLS or PALS certification, except if engaging in pediatric dentistry, the applicant shall hold current PALS certification;

(b) hold a current Utah controlled substance license in good standing;

(d) document successful completion, as evidenced by a letter from the program director, of at least one full-time year in a program of advanced postdoctoral training in the administration of deep sedation and general anesthesia, that conforms to:

[(i) the ADA Teaching Guidelines, and if engaging in pediatric dentistry, the Pediatric Sedation Guidelines; and

(ii) the ASA standards or the AAOMS standards.]

(i) the ASA Standards or the AAOMS standards;

(ii) the ADA PCS Teaching Guidelines; and

(iii) if engaging in pediatric dentistry, the Pediatric Sedation Guidelines.

R156-69-301c. Dental Hygienist Anesthesia and Analgesia - Permit Classification.

Under Subsections 58-69-102[(7)(b)](10)(k) and 58-69-301(4)(a), the Division may issue a dental hygienist with local anesthesia

and analgesia permit to a dental hygienist [may be issued an anesthesia and analgesia permit ]in the classification of dental hygienist with

local anesthesia and nitrous oxide analgesia.

R156-69-[204]301d. Dental Hygienist Anesthesia and Analgesia -- Dental Hygienist With Local Anesthesia and Nitrous Oxide

Analgesia Permit Qualifications.

(1) Under Subsection 58-69-301(4)([b]c), the qualifications, training, and safety standards for the classification of [for a ]dental

hygienist with local anesthesia [permit]and nitrous oxide analgesia permit are [the following:]established in this section.

(2) An applicant for a dental hygienist with local anesthesia and nitrous oxide analgesia permit shall:

[(1)](a)(i) hold current Utah licensure as a dental hygienist; or

([b]ii) provide documentation [of]verifying that the applicant meets[ing] Utah requirements for licensure as a dental hygienist; and

[(2) completion of a program of training in the administration of local anesthesia, including nitrous oxide, that:

(a)(i) is accredited by the CODA; or

(ii) is the substantial equivalent of Subsection (2)(a)(i) provided in a continuing education format by an ADA accredited school;

and

(b) documentation of successful completion of the program by a letter from the program director, or equivalent; and]

(b)(i) complete one of the following:

(A) a training program on administering local anesthesia and nitrous oxide analgesia that is CODA accredited; or

(B) a training course that is the substantial equivalent to Subsection (2)(b)(i)(A) that is approved by, conducted by, or under

sponsorship of:

(I) county, state, or federal agency;

(II) an accredited institution of higher education;

(III) a professional association, society, or organization representing a licensed profession whose program objectives relate to the

practice of dental hygiene;

(IV) the ADA or an ADA subgroup;

(V) the ADHA or an ADHA subgroup; or

(VI) the UDA or UDHA; and

(ii) ensure that the training program director or the equivalent sends a letter directly to the Division verifying that the applicant

successfully completed the training program under Subsection (2)(b)(i)(A) or the CPE requirement under Subsection (2)(b)(i)(B);

[(3)(a) a passing score on the WREB, CDCA, or SRTA written anesthesia examination; or]

(c)(i) pass the written local anesthesia examination from:

(A) ADEX or an ADEX predecessor organization;

(B) CRDTS; or

([b]ii) provide proof of a current[,] and active license in good standing [license ]to administer local anesthesia and nitrous oxide

analgesia issued in another [state]jurisdiction in the United States; and

([4]d) current CPR certification or BCLS-BLS certification.

R156-69-302b. Qualifications for Licensure - Examination Requirements - Dentist.

Under Subsections 58-69-302(1)(e) and (f), an applicant for licensure as a dentist shall pass the periodontics, endodontics, operative, class 2 restoration, class 3 restoration, and prosthodontics sections of [any]one of the following regional dental clinical licensure

examinations:

[(1) the WREB examination, with a passing score as established by the WREB;

(2) the CDCA examination, with a passing score as established by the CDCA;]

([3]1) the SRTA examination, with a passing score as established by the SRTA;

([4]2) the CRDTS examination, with a passing score as established by the CRDTS; or

[(5) the CITA examination, with a passing score as established by the CITA.]

(3) the ADEX examination or an ADEX predecessor organization's examination, with a passing score established by the

organization.

R156-69-302c. Qualifications for Licensure - Examination and Certification Requirements - Dental Hygienist.

Under Subsections 58-69-302(3)(e) and (f), an applicant for licensure as a dental hygienist shall pass:[ the following examinations:]

(1) [any ]one of the following examinations:

[(a) the WREB examination, with a passing score as established by the WREB;

(b) the CDCA examination, with a passing score as established by the CDCA;]

([c]a) the SRTA examination, with a passing score as established by the SRTA;

([d]b) the CRDTS examination, with a passing score as established by the CRDTS; or

[(e) the CITA examination, with a passing score as established by the CITA: and]

(c) the ADEX examination or an ADEX predecessor organization, with a passing score as established by the organization; and

(2) the CPR-BLS examination or ACLS-PALS examination[,] as evidenced by current CPR-BLS certification or ACLS-PALS

certification.

R156-69-303. [Renewal Cycle - Procedures]Term of License, Permit, and Certification - Procedures.

(1)(a) Under Subsection 58-1-308(1) and Section 58-69-303, the renewal date for the two-year renewal cycle for [licensees]each

license or permit under Title 58, Chapter 69, Dentist and Dental Hygienist Practice Act is established in Section R156-1-308a.

([2]b) Renewal procedures shall be in accordance with Sections R156-1-308[b]a through R156-1-308l.

(2) An expanded function certification issued to a dental auxiliary under Section 58-69-808:

(a) is a one-time certificate; and

(b) does not expire unless the Division revokes, suspends, restricts, places on probation, or otherwise acts upon the certification for

a dental auxiliary who no longer meets the qualifications for certification or who has engaged in unlawful or unprofessional conduct,

including:

(i) failing to comply with CPE requirements;

(ii) failing to keep active and in good standing a license that qualifies the dental auxiliary to perform the expanded function under

the certification;

(iii) failing to confine practice to the parameters permitted by law and rule for performing the expanded function; or

(iv) failing to confine the dental auxiliary's practice to those acts permitted by law and rule and in which the dental auxiliary is

competent by education, training, or experience.

(3) A dental auxiliary whose expanded function certification has expired may apply to obtain a new certification by submitting:

(a) a new application for certification;

(b) payment of the application fee; and

(c) documentation showing completion of or compliance with the requirements provided by statute and rule for a new certification.

R156-69-304a. Continuing Professional Education (CPE) and Certification - Dentist and Dental Hygienist -- Expanded Function

Dental Auxiliaries Certification.

(1) Under Subsections 58-1-203(1)(g) and 58-1-308(3)(b) and Sections 58-69-304, 58-69-803, and 58-69-808, the CPE

requirements for a license, permit, or certification under this rule are established in this section.

([1]2) [Under Section 58-69-304, each]During each two-year renewal cycle, a licensed dentist [and]or a licensed dental hygienist

shall complete at least 30 hours of qualified [continuing professional education during each two-year licensure period, to include:]CPE that

meet the requirements of this section.

(3) A licensed dentist with a sedation permit shall complete the following:

(a) for a minimal sedation permit holder, at least two hours of CPE specific to the administration of enteral anesthesia-

pharmacology and minimal sedation;

(b) for a moderate sedation permit holder:

(i) at least four didactic hours of CPE specific to moderate sedation and anesthesia; and

(ii) attestation of successful completion of at least ten sedation cases; and

(i) at least eight didactic hours of CPE specific to general anesthesia; and

(ii) attestation of successful completion of at least 30 sedation cases.

(4) A dentist who administers dermal fillers under Subsection R156-69-301a(4) shall complete at least one hour of CPE that is

specific to dermal fillers.

(5) A dentist who administers botulinum toxin under Subsection R156-69-301a(5) shall complete at least one hour of CPE that is

specific to botulinum toxin.

(6) A dental hygienist with a certification for:

(a) the delegated maxillofacial administration of botulinum toxin under Section R156-69-808a shall complete at least one hour of

CPE that is specific to the maxillofacial administration of botulinum toxin; and

(b) the placement of direct restorations under Section R156-69-808b shall complete at least three hours of didactic CPE that is

specific to for the placement of direct restorations.

(7)(a) Every two years, a dental assistant with a certification for:

(i) the placement of direct restorations under Section R156-69-808b shall complete at least three hours of didactic CPE that is

specific to for the placement of direct restorations; and

(ii) the removal of coronal dental adhesive under Section R156-69-808c shall complete at least one hour of CPE that is related to

the removal of coronal dental adhesive.

(b) The two-year CPE cycle in Subsection (7)(a) for a dental assistant with a certification for an expanded function shall match the

two-year renewal cycle for a license or permit under Title 58, Chapter 69, Dentist and Dental Hygienist Practice Act as established in Section

R156-1-308a.

([2]8)(a) Under Subsections 58-1-203(1)(g) and 58-69-301(4), an applicant for renewal or reinstatement of dentist licensure or

dental hygienist licensure shall hold current CPR-BLS, ACLS, or PALS certification as required by the license and permit classification.[ to

qualify for reinstatement or renewal, but the applicant's recertification hours do not count toward the applicant's 30 required hours of

continuing professional education.]

(b) An applicant's recertification hours under Subsection (8)(a) may not count toward the applicant's 30 hours of CPE.

[(3) Qualified continuing professional education hours for licensees who have not been licensed for the entire two-year period shall

be prorated from the date of licensure.]

(9) If an individual first becomes licensed, permitted, or certified during the two-year renewal cycle, the individual's required

number of continuing professional education hours shall be increased or decreased proportionately according to the date of licensure.

([4]10) [Continuing education]A CPE course under this section shall meet the following requirements:

(a) have learning objectives that are clearly stated in the course material that are directly related to the licensee's professional

practice;

([a]b) be relevant to the licensee's professional practice;

([b]c) be prepared and presented by individuals who are qualified by education, training, and experience to provide dental and

dental hygiene continuing professional education;[ and]

(d) be presented in a competent, well-organized, and sequential manner consistent with the stated purpose and objective of the

program; and

([c]e) have [a method of verification]records of attendance and completion available for review.

([5]11) Credit for continuing professional education during each two-year renewal cycle shall be recognized as follows:

(a) unlimited hours for continuing professional education that:[ completed in blocks of time of not less than 50 minutes in formally

established classroom courses, seminars, lectures, conferences, or training sessions that comply with Subsection (4) and are approved by,

conducted by or under sponsorship of:]

(i) is completed in blocks of time of at least 50 minutes;

(ii)(A) completed in one of the following formats:

(I) college or university lecture and discussion;

(II) professional conference;

(III) seminar; or

(IV) training session; and

(B) complies with Subsection (10);

(iii) is approved by, conducted, by or under sponsorship of:

[(i) a government agency, including the Division of Professional Licensing;]

(A) county, state, or federal agency;

[(ii) recognized universities and colleges, or an accredited dental, dental hygiene, or dental postgraduate program;]

(B) an accredited institution of higher education;

([iii]C) a professional association[s], society[ies], [and]or organization[s] representing a licensed profession whose program

objectives relate to the practice of dentistry [and]or dental hygiene;[ or]

[(iv) the ADA or any subgroup, the ADHA or any subgroup, a recognized health care professional association or a peer study club;]

(D) the ADA or an ADA subgroup;

(E) the ADHA or an ADHA subgroup;

(F) the UDA or UDHA;

(G) a recognized health care professional association; or

(H) a peer study club; and

(iv) is verified by a certificate of course completion that includes:

(A) the name of the attendee;

(B) the name of course provider;

(D) the date of the course;

(E) the title of the course;

(F) the number of course hours; and

(G) the format of professional development under Subsection (11)(a)(ii)(A);

(b) up to 15 hours of continuing professional education may be recognized for a course that is taken online or through home study

that:

(i) includes an examination; and

(ii) meets the requirements of Subsections (11)(a)(i), (iii), and (iv);

([b]c) [a maximum of ten]up to ten hours [per two-year period ]may be recognized for teaching continuing professional education

relevant to dentistry [and]or dental hygiene; and

[(c) a maximum of 15 hours per two-year period may be recognized for continuing education that is provided online or through

home study with an examination and a completion certificate; and]

(d) [a maximum of]up to three hours [per two-year period ]may be recognized for continuing professional education [in]on

practice and office management.

([6]12) [A]Under Subsection 58-13-3(8), a licensee may fulfill up to 15% of the licensee's continuing professional education

requirement by providing direct patient care as a volunteer.[ services at a qualified location under Section 58-13-3. For every four

documented hours of volunteer services, the licensee may earn one hour of continuing education.]

([7]13) A licensee shall maintain documentation sufficient to prove compliance with this section for two years after the end of the

renewal cycle for which the continuing professional education is due.

([8]14) The Division may defer or waive continuing professional education requirements [for a licensee under]as provided in

Section R156-1-308d.

R156-69-502. Unprofessional Conduct.

Under Subsection 58-1-203(1)(e), "[U]unprofessional Conduct" includes the following:

(1) for a[ny] patient under any level of sedation[,] including nitrous oxide analgesia:

(a) failing to provide continuous in-operatory observation by a trained dental patient care staff member until the patient continuously and independently maintains their airway and may be safely discharged; or

(b) failing to record the discharge time and the person discharging the patient in the patient's records;

(2) under Subsections 58-69-502(1)(b) and (2), advertising or otherwise holding oneself out to the public as a dentist or dental group that practices in a specialty area, if:

(a) the dentist, or each dentist in the dental group, has not successfully completed an advanced educational program accredited by CODA; or

(b) as specified in Subsection 58-69-502(2)(b), the advertisement or other method of holding oneself out to the public as a dentist or dental group does not include a prominent disclaimer under Subsection R156-69-102([41]39) that the dentist or dentists performing

services are licensed as general dentists or that the specialty services:

(i) is or are licensed as general dentists or that the specialty services will be provided by a general dentist; or

(ii) is or are specialists, but not qualified as a specialist in the specialty area being advertised;

(3) advertising in a[ny] form that is misleading, deceptive, or false, including the display of a[ny] credential, education, or training

that is inaccurate, or making an[y] unsubstantiated claim of superiority in education, certification, training, skill, experience, or [any ]another

quantifiable aspect;

(4) prescribing treatments and medications outside the scope of dentistry;

(5) prescribing for oneself a[ny] Schedule II or III controlled substance;

(6) engaging in practice as a dentist or dental hygienist without prominently displaying a copy of the current Utah license;

(7)(a) failing to personally maintain current CPR, BCLS-BLS, ACLS, or PALS certification as required by the licensee's anesthesia permit; or

(b) employing patient care staff who fail to maintain current CPR or BCLS-BLS certification;

(8) providing consulting or other dental services under anonymity;

(9) engaging in unethical or illegal billing practices or fraud, including:

(a) reporting an incorrect treatment date for obtaining payment;

(b) reporting charges for services not provided;

(d) generally representing a charge to a third party that is different from that charged to the patient;

(10) failing to establish and maintain appropriate dental records;

(11) failing to maintain patient records for seven years;

(12) failing to provide copies of x-rays, reports, or records to a patient or the patient's designee upon written request and payment

of a nominal fee for copies, regardless of the payment status of the services in the record;

(13) failing to discuss the risks of using an opiate with a patient or the patient's guardian before issuing an initial opiate prescription [in accordance with]under Section 58-37-[19]306;

(14) violating Section R156-69-301a or R156-69-301b;

(15) violating Section R156-69-301d;

(16) administering a product that is not approved by the Food and Drug Administration (FDA);

(17) as a dentist, failing to properly administer:

(a) a dermal filler; or

(b) a botulinum toxin injection;

(18) as a dentist, administering a dermal filler or botulinum toxin injection outside of the dentist's:

(a) regularly announced office location; or

(b) standard business hours;

(19) as a dentist supervising a dental hygienist with a certification for delegated maxillofacial administration botulinum toxin,

failing to:

(a) adequately supervise the dental hygienist; or

(b) provide a final evaluation of the patient and the injection before the patient leaves;

(20) as a dental hygienist with a certification for delegated maxillofacial administration of botulinum toxin:

(a) failing to properly administer a botulinum toxin injection; or

(b) administering a botulinum toxin injection:

(i) without the supervision of a dentist who meets the requirements of Subsection R156-69-301a(5); or

(ii) outside of the supervising dentist's:

(A) regularly announced office location; or

(B) standard business hours;

(21) as a dentist, failing to adequately supervise a dental auxiliary in accordance with the requirements of statute or rule;

(22) violating Section R156-69-808a, R156-69-808b, or R156-69-808c;

([15]23) for a dental hygienist working in a public health setting, violating Subsection [58-69-801(4) or ]58-69-801([5]3) or

Section R156-69-801[.];

(24) failing to obtain consent under Subsection R156-69-808d(1);

(25) failing to obtain written informed consent under Subsection R156-69-808d(2);

(26) as a supervising dentist, failing to obtain or maintain professional liability insurance covering a dental auxiliary employee

performing an expanded function service under Section R156-69-808a, R156-69-808b, or R156-69-808c;

(27) as a dental auxiliary who has certification to perform an expanded function under Section R156-69-808a, R156-69-808b, or

R156-69-808c, performing an expanded function knowing that the supervising dentist has failed to obtain or maintain professional liability

insurance covering the dental auxiliary to perform the expanded function;

(28) failing as a dentist to follow the ADA's Principles of Ethics and Code of Professional Conduct, revised October 2024, which

is incorporated by reference; or

(29) failing as a dental hygienist to follow the ADHA Code of Ethics, adopted October 2024, which is incorporated by reference.

R156-69-801. Dental Hygienist Notification to Division of Practice in Public Health Setting.

(1)(a) Under Subsection 58-69-801(3), a dental hygienist who will engage in the practice of dental hygiene in a public health

setting without the general supervision of a dentist shall notify the Division on a one-time basis under Subsections 58-69-801(3)(b) and 58-1-

308(3) by submitting to the Division the Public Health Setting Practice Notification form that is available on the Division's website at

https://commerce.utah.gov/dopl/dentistry/.

(b) The dental hygienist shall submit a completed Dental Hygienist Notice to Division of Practice in a Public Health Setting form

to the Division:

(i) before the day the dental hygienist first engages in the practice of dental hygiene in a public health setting;

(ii) when the dental hygienist no longer engages in the practice of dental hygiene in a public health setting; and

(iii) when the dental hygienist applies to renew or reinstate the dental hygienist's license.

(2) A dental hygienist shall maintain a copy of each of the dental hygienist's submitted Public Health Setting Practice Notification

form:

(a) for two years after the end of the license cycle during which the dental hygienist submitted the form; and

(b) to make a copy of each form available for inspection by the Division upon request.

R156-69-[603]803a. Use of [Unlicensed Individuals as ]Dental Assistants.

(1) Under Section 58-69-803, the standards regulating the use of [unlicensed individuals as ]dental assistants as defined in

Subsection 58-69-102(3) are [that an unlicensed individual may not, under any circumstance:]established, defined, and clarified in this

section.

(2) Under Section 58-69-803, a dental assistant may not:

([1]a) provide a definitive treatment diagnosis;

([2]b) place, condense, carve, finish, or polish restorative materials[, or perform final cementation;] unless the dental assistant has

a certification for the placement of direct restorations under Section R156-69-808b;

([3]d) cut hard tissue or soft tissue[ or extract teeth];

(e) extract teeth;

([4]f) remove stains, deposits, or accretions, except as is incidental to polishing teeth coronally with a rubber cup;

([5]g) initially introduce nitrous oxide analgesia and oxygen to a patient for establishing and recording a safe plane of analgesia for

the patient, except under the direct supervision of a licensed dentist who:[after a baseline percentage and flow rate suitable for the patient is

established and documented by a licensed dentist holding the appropriate permit;]

(i) holds the appropriate sedation permit; and

(ii) has established and documented a baseline percentage and flow rate suitable for the patient;

([6]h) remove bonded materials from teeth with a rotary dental instrument or use [any]a rotary dental instrument within the oral

cavity[, except to polish teeth coronally with a rubber cup;]:

(i) except to polish teeth coronally with a rubber cup; or

(ii) unless the dental assistant has a certification for the removal of coronal adhesive under Section R156-69-808c;

([7]i) take jaw registrations or oral impressions for supplying artificial teeth as substitutes for natural teeth, including electronic

imaging, except for diagnostic or opposing models for the fabrication of temporary or provisional restorations or appliances;

([8]j) correct or attempt to correct the malposition or malocclusion of teeth, or make an adjustment that will result in the movement

of teeth upon an appliance that is worn in the mouth;

([9]k) perform sub-gingival instrumentation;

([10]l) provide decisions concerning the use of drugs, including their dosage or prescription;

([11]m) expose radiographs without meeting the following qualifications:

([a]i) completing a dental assisting course accredited by [the ADA Commission on Dental Accreditation]CODA; or

([b]ii) passing one of the following examinations:

([i]A) the DANB Radiation Health and Safety Examination (RHS); or

([ii]B) a radiology exam approved by the Board that covers the topics in Section R156-69-[604]803b;

([12]n) work without a current CPR or BCLS certification;

([13]o) provide injection of any substance;

([14]p) start an intravenous (IV) line or administer medication in an [IV]intravenous line;

([15]q) convert a denture into a fixed implant prosthesis, also known as performing a conversion; or

([16]r) adjust a permanent or final prosthetic, removable or fixed, that is worn by a patient or will be worn by a patient.

R156-69-[604]803b. Radiology Course for [Unlicensed Individuals as ]Dental Assistants.

Under Section 58-69-803 and Subsection 58-54-306(2), the radiology certification course in Subsection R156-69-

[603(11)]803a(2)(m) for a dental assistant shall include radiology theory consisting of the following:

(1) orientation to radiation technology;

(2) terminology;

(3) basic radiographic dental anatomy and pathology[ - cursory];

(4) basic radiation physics[ - basic];

(5) radiation protection to patient and operator;

(6) radiation biology including interaction of ionizing radiation on cells, tissues and matter;

(7) factors influencing biological response to cells and tissues to ionizing radiation and cumulative effects of x-radiation;

(8) intraoral and extraoral radiographic techniques;

(9) processing techniques including proper disposal of chemicals;

(10) infection control in dental radiology; and

(11) use of portable and handheld x-ray devices.

R156-69-807. Teledentistry Requirements and Parameters.

[Under Subsections 58-69-802(2) and 58-69-807(4), t]The requirements and parameters for teledentistry to ensure the safe use of

teledentistry are established in [Title 26, Chapter 60, Telehealth Act and ]Sections 58-69-807 and R156-1-602[ and R156-1-603].

[R156-69-801. Dental Hygienist Notification to Division of Practice in Public Health Setting.

(1)(a) Under Subsection 58-69-801(5), a dental hygienist who will engage in the practice of dental hygiene in a public health

setting without general supervision and without a collaborative practice agreement with a dentist, shall notify the Division on a one-time

basis under Subsections 58-69-801(5)(b) and 58-1-308(3) by submitting to the Division the Public Health Setting Practice Notification form

that is available on the Division's website at https://dopl.utah.gov/dentistry.

(b) The dental hygienist shall submit a completed Public Health Setting Practice Notification form:

(i) before the day the dental hygienist first engages in the practice of dental hygiene in a public health setting; and

(ii) thereafter, on each day that the dental hygienist applies to renew or reinstate the dental hygienist's license.

(2) If a dental hygienist will cease to engage in the practice of dental hygiene in a public health setting under Subsection 58-69-

801(5), the dental hygienist shall notify the Division by submitting to the Division the Public Health Setting Practice Notification form.

(3) A dental hygienist shall maintain a copy of the dental hygienist's submitted Public Health Setting Practice Notification form for

two years after the end of the license cycle during which the dental hygienist submitted the form, and make a copy available for inspection by

the Division upon request.

]

R156-69-808a. Expanded Functions of Dental Auxiliaries -- Dental Hygienist -- Certification for Delegated Maxillofacial

Administration of Botulinum Toxin -- Parameters -- CPE.

(1) Under Subsections 58-69-808(1)(a) and (2), the qualifications, training, and safety standards for a dental hygienist to obtain a

certification for the delegated maxillofacial administration of botulinum toxin are established in this section.

(2) Under Subsection 58-69-808(2)(a), a dental hygienist applying for the delegated maxillofacial administration of botulinum

toxin certification shall:

(a) hold the Utah dental hygienist with local anesthesia license for at least two years;

(b) have actively practiced as a dental hygienist with local anesthesia for at least 3,500 hours within the six years immediately

preceding the application for the certification;

(c) complete and pass an approved course on administering botulinum toxin injections that meets the educational requirements of

Subsection R156-69-301a(5)(b); and

(d) demonstrate clinical competency:

(i) by successfully performing at least eight botulinum toxin injections:

(A) under the direct supervision of a licensed dentist who:

(I) meets the requirements of Subsection R156-69-301a(5); and

(II) is approved by the Division;

(B) after obtaining written informed consent from each patient that meets the requirements of Subsection R156-69-808d(2);

(D) within a one-year period; and

(ii) that is confirmed by the supervising dentist under Subsection (2)(d)(i)(A) who submits a letter directly to the Division that:

(A) verifies the applicant competently completed the requirements of Subsection (2)(d)(i); and

(B) endorses the applicant's competence in administering botulinum toxin injections.

(3) Under Subsections 58-69-808(1)(a) and (2)(b), a dental hygienist with a certification under this section shall only provide

botulinum toxin injections to a patient under the following parameters:

(a) after obtaining consent from each patient that meets the requirements of Subsection R156-69-808d(1);

(b) as part of a dentist's comprehensive dental treatment plan;

(c) the supervising dentist obtains and maintains professional liability insurance for the dental hygienist for work performed while

engaging in the practice of injecting botulinum toxin;

(d) when a dentist who meets the requirements of Subsection R156-69-301a(5):

(i) delegates the procedure; and

(ii) supervises the procedure;

(e) in the regularly announced office location of the supervising dentist who meets the requirements of Subsection R156-69-

301a(5);

(f) within the oral and maxillofacial areas of a patient for one of the following purposes:

(i) for cosmetic purposes; or

(ii) as a therapeutic treatment to reduce the pain or discomfort for a diagnosis of TMD or other medical conditions of the oral and

maxillofacial areas including bruxism and migraines;

(g) the supervising dentist completes a final evaluation of the patient and the injection before the patient leaves; and

(h) the patient's record specifies that the dental hygienist completed the injection.

(4) Under Subsection 58-69-808(2)(b), a dental hygienist with certification for the delegated maxillofacial administration of

botulinum toxin shall complete the CPE requirements for the practice of injecting botulinum toxin under Subsection R156-69-304a(6)(a).

R156-69-808b. Expanded Functions of Dental Auxiliaries -- Certification for the Placement of Direct Restorations -- Parameters --

CPE.

(1) Under Subsections 58-69-808(1)(b) and (2), the qualifications, training, and safety standards for a dental hygienist or dental

assistant to obtain a certification for the placement of direct restorations are established in this section.

(2) Under Subsection 58-69-808(2)(a), an applicant for a certification under this section shall:

(a) meet one of the following requirements:

(i) currently hold a dental hygienist license; or

(ii) provide evidence that the applicant is a dental assistant:

(A) with at least 3,500 hours of dental assisting in the last six years; and

(B) who holds current CPR or BCLS-BLS certification;

(b) complete and pass an approved education program of at least 172 hours that:

(i) is:

(A) CODA accredited;

(B) recognized by DANB; or

https://commerce.utah.gov/dopl/dentistry/;

(ii) includes a hands-on component that requires obtaining written informed consent from each patient that meets the requirements

of Subsection R156-69-808d(2);

(iii) is taught by an instructor who:

(A) has an active and current license as a dentist;

(B) is qualified by education, training, and experience to provide instruction on the placement of direct restorations;

(D) is teaching within the scope of practice for the instructor's license;

(E) meets the CPE requirements of Section R156-69-304a; and

(F) may be assisted by a licensed hygienist who is certified in direct restorations, when:

(I) in a non-patient lab setting; and

(II) under the direct supervision of the instructor dentist; and

(iv) meets the requirements of Subsection (3); and

(i) includes:

(A) a written component; and

(B) a clinical component; and

(ii) is approved by the Division in collaboration with the Board as listed on the Division website at

https://commerce.utah.gov/dopl/dentistry/.

(3) Under Subsection 58-69-808(2)(a), a dental hygienist or dental assistant applying for a certification under this section shall

complete an education program on the placement of direct restorations with a curriculum that meets the following requirements:

TABLE 1

Curriculum for the Placement of Direct Restorations Certification

Topics

Subtopics

Minimum didactic

clock hours

Minimum clinical

patient care clock

hours

Foundational anatomy,

physiology, morphology, and

occlusion

Including:

morphology;

interproximal contact of primary teeth and permanent teeth;

occlusal concepts including malocclusion;

centric contacts, excursions, and how they relate to restorative

contours;

marginal ridge form;

embrasures;

anatomical principles supporting restorative outcomes; and

poor outcomes of restorations including incorrect restoration

occlusal adjustment, poor interproximal contour, and

improper placement or bonding techniques

6 hours

12 hours

Restorative materials and armamentarium including:

amalgam;

hybrid or nano-hybrid composite including filler types,

monomer composition, viscosity, and selection;

flowable composite;

packable composite;

resin-modified glass ionomer (RMGI);

conventional glass ionomers (GI);

intermediate restorative material (IRM);

bonding agents including etching and rinsing, self-etch

technique, and different bonding generations; and

selecting appropriate materials

Restorative materials,

armamentarium, and

instrumentation

Instrumentation including:

hand instruments;

handpiece ergonomics;

dental bur selection;

matrix systems including Tofflemire, sectional matrices,

wedges selection, and correct size for proper contour;

a slow-speed handpiece for restorative material; and

dental or surgical magnification devices such as dental loupes

or a microscope

8 hours

20 hours

Adhesive dentistry and tooth

isolation

Including:

adhesive systems;

bonding strategies;

curing protocols;

rubber dam placement including clamp selection, punch

patterns, and inversion techniques;

moisture control and contamination including saliva, sulcular

fluid management, and bonding inhibition;

management of oxygen-inhibited layer and smear layer; and

infection control

6 hours

16 hours

Direct restoration placement

and finishing for Class I

through VI

Including:

contacts;

occlusion;

10 hours

40 hours

occlusal adjustment including marking and adjusting an

occlusion post-placement;

occlusal adjustment including interpretation and functional

occlusal contact adjustments;

shade matching including hue, chroma, value, metamerism,

and layering;

matrix band placement including Tofflemire retainer setup,

band contouring, and wedge technique for proximal contact

and seal;

condensation technique for amalgam;

managing condensation timing with setting characteristics;

carving and finishing amalgam;

smoothing margins and removing flash without ditching;

amalgam safety and mercury hygiene;

composite placement techniques including bonding,

incremental fill, anatomical shaping, and light curing

strategies;

finishing and polishing including contouring, surface texture,

margins, polishing, and retention; and

identify potential restorative complications and mitigation of

complications including patient factors and procedures

Caries removal, liners, and

bases

Including:

selective caries removal;

liner placement;

bases;

interim therapeutic restorations (ITR) principles; and

temporizations

4 hours

10 hours

Law and rule

1 hour

N/A

Professional ethics

Including consent

1 hour

N/A

Clinical integration and

simulated patient care

Including:

comprehensive treatment sequencing;

full treatment sequencing, time management, and patient

positioning;

case management including recognizing when isolation fails

and managing complications;

provider and patient ergonomics;

one Class II posterior composite;

one Class III anterior composite; and

one Class II posterior amalgam

8 hours

30 hours

Comprehensive knowledge-

based written exam

N/A

Competency examinations

Summative evaluations on performance that is judged with

calibrated rubrics

N/A

(4)(a) Under Subsection 58-69-808(2)(b), a dental hygienist or dental assistant with a current certification under this section shall

perform direct restoration services as follows:

(i) provide one or more of the following services:

(A) place, condense, carve, or polish restorative materials on a direct restoration; and

(B) use a hand instrument or a slow-speed handpiece on the direct restoration under Subsection (4)(a)(i)(A); and

(ii) under the following parameters:

(A) after obtaining consent from the patient that meets the requirements of Subsection R156-69-808d(1);

(B) have magnification tools available and use when necessary;

(C) the supervising dentist obtains and maintains professional liability insurance covering the certification holder for work

performed while engaging in the expanded function;

(D) the supervising dentist completes a final evaluation of the direct restoration placement including fit, contact, finish, and

occlusion before the patient leaves; and

(E) the patient's record documents that the dental hygienist or dental assistant completed the direct restoration placement.

(b) A dental hygienist or dental assistant with a current certification under this section may not use pulp capping materials.

(5) Under Subsection 58-69-808(2)(b), a dental hygienist or dental assistant with certification under this section shall complete the

CPE requirements for the placement of direct restorations under Subsection R156-69-304a(6)(b) or (7)(a)(i).

R156-69-808c. Expanded Functions of Dental Auxiliaries -- Certification for the Removal of Coronal Dental Adhesive -- Parameters

-- CPE.

(1) Under Subsections 58-69-808(1)(c) and (2), the qualifications, training, and safety standards for a dental hygienist or dental

assistant to obtain certification for the removal of coronal dental adhesive are established in this section.

(2) Under Subsection 58-69-808(2)(a), an applicant for a certification under this section shall:

(a) meet one of the following requirements:

(i) currently hold a dental hygienist license; or

(ii) provide evidence that the applicant is a dental assistant:

(A) with at least 3,500 hours of dental assisting in the last six years; and

(B) who holds current CPR or BCLS-BLS certification; and

(b) complete and pass an approved education program of at least 22 hours that:

(i) is:

(A)(I) CODA accredited;

(II) recognized by DANB; or

(III) a course recognized by the Utah Association of Orthodontists (UAO); and

(B) approved by the Division in collaboration with the Board, as listed on the Division website at

https://commerce.utah.gov/dopl/dentistry/.

(ii) includes a hands-on component that requires obtaining written informed consent from each patient in accordance with

Subsection R156-69-808d(2);

(iii) is taught by an instructor who:

(A) has an active and current license as a dentist;

(B) is qualified by education, training, and experience to provide instruction on the removal of coronal adhesive;

(D) is teaching within the scope of practice for the instructor's license; and

(E) meets the CPE requirements of Section R156-69-304a; and

(iv) meets the requirements of Subsection (3).

(3) Under Subsection 58-69-808(2)(a), a dental hygienist or dental assistant applying for a certification under this section shall

complete an education program on the removal of coronal adhesive that meets the following requirements:

TABLE 2

Curriculum for the Removal of Coronal Adhesive Certification

Topics

Subtopics

Didactic Hours

Foundational

knowledge of

anatomy, physiology,

and morphology

Including:

dental anatomy including tooth structures, locations, classifications, and terminology

of primary and permanent teeth;

tooth morphology including the shape, size, surfaces, and features of primary teeth

and permanent teeth;

supportive tissues and structures including gingiva, periodontal ligament, alveolar

bone, cementum, frenums, mucosa, and tongue;

orthodontic terminology; and

enamel composition and properties, and abnormalities including attrition, abrasion,

erosion, discoloration, pitting, cracks, chips, and decalcifications

3 didactic hours

Appliances,

restorations, and

materials

Including:

orthodontic brackets;

bonding adhesives;

dental restorations including crowns, bridges, veneers, implants, composite, and

amalgam; and

use of dental radiographs in identification of dental restorations

2 didactic hours

Dental Instruments

Including:

hand instruments, band-removing pliers, and bracket removing pliers;

a slow-speed handpieces and configuration for safe coronal adhesive removal;

handpiece components including bur retention mechanism, size, shape, lighting, and

water;

dental bur selection;

dental or surgical magnification devices including dental loupes;

maintenance including sanitation, sterilization, and decontamination; and

demonstrate competency on typodont teeth

4 didactic hours

Techniques for

coronal adhesive

polishing

Including:

handpiece grip and ergonomics;

tooth isolation;

infection control

safety of enamel, tooth, and supportive structures; and

adhesive removal sequence including bracket removal, fine adhesive removal, enamel

polishing, and differentiation between adhesive and enamel and dental restoration

materials and enamel abnormalities;

3 didactic hours

Case management

Including:

identifying potential complications, and mitigating and managing complications

including patient factors and procedures;

prevention strategies; and

poor outcomes of improper techniques

1 didactic hour

Law and rule, and

Professional Ethics

Including:

scope limitations;

supervision requirements; and

record keeping

1 didactic hour

Clinical integration

and simulated patient

care

Including:

recognizing common errors and prevention;

comprehensive treatment sequencing, and time management;

case management including recognizing when isolation fails and managing

complications;

provider and patient ergonomics; and

removal and enamel polishing of a minimum of 55 tooth surfaces under direct

supervision

2 didactic hours and 6

clinical hours

Comprehensive

knowledge-based

written exam

Including:

law and rule including scope of practice;

professional ethics; and

all aspects of didactic and simulated training

N/A

Competency

examinations

Summative evaluations on performance of at least 24 teeth on a live patient and that is

judged with calibrated rubrics

N/A

(4) Under Subsection 58-69-808(2)(b), a dental hygienist or dental assistant certified under this section shall provide services to

remove coronal adhesive under the following parameters:

(a) after obtaining consent from each patient that meets the requirements of Subsection R156-69-808d(1);

(b) the supervising dentist obtains and maintains professional liability insurance covering the certification holder for work

performed while engaging in the expanded function;

(d) have magnification tools available and use the magnification tools when necessary;

(e) the supervising dentist completes a final evaluation of the removal of coronal dental adhesive after the removal of coronal

adhesive is completed; and

(f) record in the patient's file that the dental hygienist or dental assistant completed the removal of coronal dental adhesive.

(5) Under Subsection 58-69-808(2)(b), a dental assistant with certification under this section shall complete the CPE requirements

for the removal of coronal dental adhesive under Subsection R156-69-304a(7)(a)(ii).

R156-69-808d. Consent for Expanded Functions.

(1) Under Subsection 58-69-808(2), the supervising dentist and the dental auxiliary who has certification to perform an expanded

function under Section R156-69-808a, R156-69-808b, or R156-69-808c shall obtain consent from each patient that includes:

(a) a statement that the dental auxiliary:

(i) has Division certification to perform the expanded function service; and

(ii) shall perform the expanded function service under a dentist's indirect supervision under Subsection 58-69-808(1); and

(b) a description of each expanded function service the dental auxiliary will perform.

(2) Under Subsection 58-69-808(2), the supervising dentist and the dental auxiliary who is training to obtain certification to

perform an expanded function under Section R156-69-808a, R156-69-808b, or R156-69-808c shall obtain written informed consent from

each patient that includes:

(a) a statement that the dental auxiliary:

(i) is training to receive Division certification for the expanded function service; and

(ii) shall perform the expanded function service under a dentist's direct supervision; and

(b) a description of each expanded function service the dental auxiliary will perform.

KEY: licensing, dentists, dental hygienists, dental assistants, dental auxiliaries, permit, certification, expanded function

Date of Last Change: [November 24, 2025]2026

Notice of Continuation: October 22, 2025

Authorizing, and Implemented or Interpreted Law: 58-69-101; 58-1-106(1)(a); 58-1-202(1)(a)

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Rule 69: Dentist and Dental Hygienist Practice Act Rule