Board Authority + Definitions
Not publishedof exam
Licensure, Renewal + CE
Not publishedof exam
Scope + Delegation
Not publishedof exam
Supervision + Health Access
Not publishedof exam
Anesthesia + Prescribing
Not publishedof exam
Records, Ads + Discipline
Not publishedof exam
Quick Facts
- Exam
- FDLR
- Vendor
- ADEX
- Items
- Up to 67
- Field-test
- Up to 5 unscored
- Time
- 90 minutes
- Pass
- 75% final score
- Fee
- $135
- Retake wait
- 10 days
- Weights
- Not published
- References
- Ch. 456, 466, 64B5
Supervision Ladder
Direct > Indirect > General > None
Direct: approves before dismissalIndirect: on premisesGeneral: authorized onlyNone: fluoride and education
Direct vs Indirect
Direct
- Dentist diagnoses
- Remains on premises
- Approves before dismissal
Indirect
- Dentist authorizes
- On premises
- No exit approval
Approval before dismissal
Exam Format
- FDLR items
- Up to 67Dentist
- FHLR items
- Up to 64Hygiene
- Field-test items
- Up to 5 unscored
- Time
- 90 minutes
- Pass
- 75% final score
- Retake wait
- 10 days after failure
- Results
- Pass/fail, 2-3 business days
- Registration validity
- 2 years from payment
Indirect vs General
Indirect
- Dentist on premises
- Procedure authorized
General
- Dentist may be absent
- Off-site work allowed
- 24-month authorization
Presence vs authorization only
Statutory Definitions
- Direct supervision
- Present, approves before dismissal466.003(9)
- Indirect supervision
- Authorizes, stays on premises466.003(10)
- General supervision
- Authorizes only, may leave466.003(11)
- Irremediable task
- Irreversible; anesthesia beyond topical466.003(12)
- Remediable task
- Reversible, no unalterable change466.003(13)
- Health access setting
- Listed public, nonprofit sites466.003(15)
- Digital scanning
- Computer-generated oral replica466.003(8)
- Patient of record
- History, exam, findings, plan
Remediable vs Irremediable
Remediable
- Reversible
- No unalterable change
- Delegable
Irremediable
- Irreversible
- Anesthesia beyond topical
- Not delegable
Reversible means delegable
Board of Dentistry
- Members
- 11 appointed by Governor
- Dentist seats
- 7 clinical practitioners
- Hygienist seats
- 2 licensed hygienists
- Lay seats
- 2 laypersons
- Terms
- 4 years, 10 maximum
- Council on Dental Hygiene
- 5 members, 3 meetings
- Probable cause panel
- 3 members, 2 dentists
- Headquarters
- Tallahassee
CE Stack
30 dentist | 24 hygienist | 2+2+2
Medical errors: every bienniumPrescribing: dentists onlyDomestic violence: third renewalHIV/AIDS: first renewal
Inactive vs Delinquent
Inactive
- Elected voluntarily
- Renewed biennially
- Reactivation fee owed
Delinquent
- Failed to renew
- Practice is felony
- Becomes null and void
Chosen vs lapsed
Licensure Pathways
- Required exams
- Laws and rules plus ADEX
- Minimum age
- 18 years
- Application fee cap
- $100, nonrefundable
- Three clinical failures
- Board education before retest
- Endorsement route
- MOBILE Act, s. 456.0145
- Endorsement practice
- 2 of last 4 years
- Health access license
- Health access settings only
- Expert witness certificate
- $50, valid 2 years
Renewal + License Status
- Renewal cycle
- Biennial
- Renewal fee cap
- $300
- Inactive
- No practice, still renewed
- Delinquent
- Not renewed at expiration
- Null and void
- Cannot be reactivated
- Retired over 5 years
- Board appearance required
- License display
- Conspicuous at each office
- Address change
- Written notice to Department
Continuing Education
- Dentist hours
- 30 per biennium
- Hygienist hours
- 24 per biennium36 maximum
- Medical errors
- 2 hours every biennium
- Controlled substance prescribing
- 2 hours, dentists only
- Domestic violence
- 2 hours, third renewal
- HIV/AIDS
- 2 hours by first renewal
- CPR
- Required, hours never count
- Practice management cap
- 3 hours per biennium
Hygienist vs Assistant
Hygienist
- Scaling and root planing
- Gingival curettage
- Anesthesia if certified
Assistant
- No scaling
- No curettage
- Restorative after training
Periodontal work is hygienist
Can This Be Delegated?
- Root planing→Hygienist only
- Gingival curettage→Hygienist only
- Removing sulcus calculus→Hygienist only
- Diagnosis or treatment planning→Dentist only
- Writing a prescription→Dentist only
- Placing rubber dam→Trained assistant
- Packing amalgam restoration→Trained assistant(Direct supervision)
- Cementing stainless crown→Dentist only(Permanent cementation)
Hygienist Scope
- Hygienist-only tasks
- Calculus, root planing, curettage
- Unsupervised anywhere
- Fluorides, education, hygiene instruction
- Dentist prescription validity
- 2 years maximum
- Local anesthesia
- CRDH under direct supervision
- CRDH patient limits
- 18 or older, nonsedated
- CRDH course
- 30 didactic, 30 clinical
- Dental charting
- Unsupervised at listed locations
- Charting disclosure form
- Patient must acknowledge first
Dental Assistant Duties
- Statutory remediable list
- 12 tasks in 466.024(1)
- Never delegable
- Diagnosis, planning, prescriptions
- Intraoral procedures
- Training required first
- Restorative functions
- Direct supervision after training
- Restorative course
- 105 clock hours
- Restorative experience
- 2,400 hours in 24 months
- Stainless steel crowns
- Fit and contour only
- Radiographer certification
- 3 months training plus course
Health Access Chain
Clearance -> scale -> exam in 13 months
Medical clearance firstScaling allowed unsupervisedDentist exam 13 monthsNo root planing
Health Access vs Private Office
Health access
- Listed public sites
- Unsupervised scaling allowed
- Reports violations
Private office
- For-profit practice
- No unsupervised scaling
- Not a setting
Setting unlocks unsupervised tasks
Which Supervision Level?
- Gingival curettage→Direct supervision(By licensure)
- Prophylaxis or root planing→General supervision(No training added)
- Exposing radiographs→General supervision
- Removing bonding adhesive→Indirect supervision
- Nitrous oxide, ASA I-III→Indirect supervision
- Nitrous oxide, special needs→Direct supervision
- CRDH local anesthesia→Direct supervision(Adult, nonsedated)
- Applying fluoride→No supervision(Any location)
Tasks By Supervision Level
- Gingival curettage
- Direct supervision
- Prophylaxis
- General supervision
- Root planing
- General supervision
- Radiographic film and sensors
- General supervision
- Excess bonding adhesive
- Indirect supervision
- Nitrous oxide, ASA I-III
- Indirect supervision
- Nitrous oxide, special needs
- Direct supervision
- General supervision authorization
- Valid 24 months
Health Access Settings
- Unsupervised tasks
- Charting, vitals, fluoride, sealants
- Calculus removal
- Prior medical clearance required
- Follow-up exam
- Dentist within 13 months
- Excluded tasks
- Root planing, gingival curettage
- Malpractice limits
- $100,000 / $300,000
- Referral duty
- Refer, encourage dental home
- Setting condition
- Immediately reports all violations
- Not a setting
- Private for-profit office
Permit Ladder
Minimal none | Moderate | Pediatric | General
Minimal: single doseModerate: titration or IVPediatric: under 18General: propofol, ketamine
Minimal vs Moderate Sedation
Minimal
- Single enteral dose
- No permit
- Consciousness kept
Moderate
- Titration or parenteral
- Permit required
- Three-person team
Single dose vs titration
Which Anesthesia Permit?
- Single enteral sedative dose→No permit(Minimal sedation)
- Titrating oral sedatives→Moderate sedation permit
- Intravenous moderate sedation→Moderate sedation permit
- Sedating a minor→Pediatric moderate permit
- Propofol or ketamine→General anesthesia permit
- Deep sedation→General anesthesia permit
- Hospital or surgery center→No permit needed(Chapter 395)
- Nitrous oxide analgesia→Course training(No permit)
Anesthesia Permits
- No permit needed
- Minimal sedation only
- Permit required
- Moderate, deep, general anesthesia
- Pediatric patient
- Under 18 or special needs
- Permit exception
- Hospital or surgery center
- Moderate sedation training
- 60 didactic hours, 20 patients
- General anesthesia training
- Two-year anesthesiology or OMFS residency
- Team size
- Three trained individuals
- Inspections
- Initial, then every 3 years
- PALS
- Patients 7 or under
Prescribing + Adverse Incidents
- Acute pain default
- 3-day Schedule II supply
- 7-day exception
- Write ACUTE PAIN EXCEPTION
- PDMP check
- Patients 16 and older
- PDMP unavailable
- Document reason, 3-day limit
- Dispensing exemption
- Fluorides and chlorhexidine only
- Adverse incident notice
- 48 hours, certified mail
- Adverse incident report
- Complete within 30 days
- Anesthesia CPR
- Recertify every 2 years
Deadline Clock
48 hours -> 30 days -> 90 days
48 hours: adverse notice30 days: full report90 days: records after death4 years: record retention
Felony vs Misdemeanor
Third-degree felony
- Unlicensed practice
- Suspended license use
- Nondentist ownership
First-degree misdemeanor
- Using title illegally
- Concealing violations
- Assisting outside office
Practicing vs pretending
Which Deadline Applies?
- Adverse incident occurs→48-hour written notice
- Adverse incident full report→30 days
- Discipline in another state→30 days
- Patient requests records→Under 30 days
- Dentist dies→90 days(Transfer records)
- Holding patient records→4 years
- General supervision authorization→24 months
- Unsupervised scaling done→13 months(Dentist exam)
Records + Retention
- Record retention
- 4 years, last appointment
- Appointment book entries
- 4 years per entry
- Corrections
- Strike through, date, initial
- Copy release
- Less than 30 days
- Unpaid fees
- Cannot withhold records
- Electronic backup
- Within 72 hours
- Dentist of record
- Primarily responsible for treatment
- Death of dentist
- Transfer within 90 days
- Death notice
- Weekly for four weeks
Advertising + Office Standards
- Fee advertising
- Minimum fee disclaimer required
- Advertised fee window
- Available 90 days after
- Sleep dentistry
- General anesthesia permit only
- Ad identification
- License number or name
- Solicitation
- In-person and phone prohibited
- AED
- Required at every office
- Steam and chemical vapor
- Spore test 40 hours
- Dry heat and ethylene oxide
- Spore test 120 hours
Penalties + Dental Labs
- Unlicensed practice
- Third-degree felony
- Suspended license use
- Third-degree felony
- Employing beyond scope
- Third-degree felony
- Nondentist ownership
- Third-degree felony
- Title or letters misuse
- First-degree misdemeanor
- Concealing violations
- First-degree misdemeanor
- Lab registration
- Biennial, fee under $300
- Lab delinquency fee
- $40 after 3 months
- Unregistered laboratory
- Second-degree misdemeanor
Common Traps
Curettage vs prophylaxis
Curettage needs direct supervision ≠ Prophylaxis needs general supervision
67 vs 64 items
Dentist exam has 67 ≠ Hygiene exam has 64
Scaling vs root planing
Scaling unsupervised in setting ≠ Root planing always supervised
Fluoride vs sealants
Fluoride unsupervised anywhere ≠ Sealants need health access
Hygienist vs assistant
Hygienist may root plane ≠ Assistant may never scale
Felony vs misdemeanor
Unlicensed practice is felony ≠ Title misuse is misdemeanor
CPR vs CE hours
CPR required each biennium ≠ CPR hours never count
3-day vs 7-day opioid
Default is 3 days ≠ 7 days needs written exception
Repealed rule 64B5-16.007
Repealed in December 2018 ≠ Use 466.003 and 64B5-16.001
Last Minute
- 1.67 items, 90 minutes, 75%
- 2.Retake wait = 10 days
- 3.Direct = approves before dismissal
- 4.General = authorized, dentist absent
- 5.Curettage direct; prophylaxis general
- 6.Dentist CE 30; hygienist 24
- 7.CPR required, hours never count
- 8.Records kept 4 years
- 9.Adverse incident: 48 hours, 30 days
- 10.Health access scaling: exam 13 months
- 11.Hygienist malpractice: $100,000 / $300,000
- 12.Minimal sedation needs no permit
- 13.Fee ads need minimum disclaimer
- 14.Only dentists may own practices
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