1.2 Purpose of RSA 317-A, the License Requirement & What Counts as Practicing Dentistry
Key Takeaways
- RSA 317-A:1 bars anyone from practicing, offering to practice, or using the D.M.D. or D.D.S. designation in New Hampshire unless licensed under the chapter.
- RSA 317-A:20, I lists eight acts that constitute practicing dentistry, including owning or operating a dental business, administering anesthetics, and dispensing or applying teeth whitening agents.
- RSA 317-A:20, III exempts five groups, including CODA students and residents under supervision and out-of-state consultants who have no patient contact.
- Under RSA 317-A:33, practicing dentistry or dental hygiene without a license is a misdemeanor for a natural person and a felony for any other person.
- RSA 317-A:7-b permits Board licensees to provide services through telemedicine as defined in RSA 310:7.
The Dental Practice Act: Purpose and License Requirement
Purpose and the licensing gate
RSA 317-A:1 states the chapter's purpose: for the protection of the public health, safety, and welfare, anyone practicing or offering to practice dentistry in New Hampshire must show they are qualified and must be licensed. The same section bars using any title, sign, card, device, or the abbreviations D.M.D. or D.D.S., or any other designation indicating the practice of dentistry, without a license.
RSA 317-A:7 adds that no person shall begin the practice of dentistry or dental hygiene without first obtaining a license from the Office of Professional Licensure and Certification (OPLC). Hygienists have a parallel title rule in RSA 317-A:21, I. No one may provide dental hygiene services or use the abbreviation R.D.H. unless licensed. Under RSA 317-A:21-c, I, using the title "registered dental hygienist" is itself treated as practicing dental hygiene.
What counts as practicing dentistry — RSA 317-A:20, I
The statute sweeps in far more than drilling and filling. A person is practicing dentistry if he or she:
| Paragraph | Conduct that is "practicing dentistry" |
|---|---|
| (a) | Uses, or permits use of, "dentist," "dental surgeon," D.D.S., D.M.D., or any words implying the practice of dentistry |
| (b) | Owns, leases, maintains, or operates a dental business where dental operations are performed, or manages or conducts one |
| (c) | Tells the public, by any means, that he or she can perform dental operations |
| (d) | Diagnoses, treats, or prescribes for lesions, diseases, disorders, or deficiencies of the oral cavity, teeth, gums, maxilla, mandible, or adjacent structures, including by electronic media, paid or unpaid |
| (e) | Supervises a dentist within the scope of the practice of dentistry |
| (f) | Makes, supplies, repairs, or adjusts dentures, bridges, or appliances except on a licensed dentist's written prescription using that dentist's impressions or casts |
| (g) | Administers dental anesthetics, general or local |
| (h) | Dispenses teeth whitening agents or whitens or bleaches teeth, unless the product is sold over the counter for the person's own use or board rules authorize the activity |
Two consequences are frequently tested:
- Ownership is practice. Because paragraph (b) makes operating a dental business the practice of dentistry, an unlicensed investor who owns and runs a dental office is practicing without a license. The narrow exception for health care charitable trusts is covered in section 8.3.
- Laboratories need a prescription. A dental laboratory that fabricates a crown on a licensed dentist's written prescription and impressions is outside paragraph (f). One that takes impressions directly from the public is practicing dentistry.
Who is exempt — RSA 317-A:20, III and IV
Nothing in RSA 317-A:20 prevents:
- (a) Physicians and surgeons licensed under RSA 329 from practicing dentistry incidental to the practice of medicine.
- (b) Students of CODA-accredited schools from practicing in hospitals or other institutions under the supervision of a faculty member of a CODA-accredited school who is also licensed under RSA 317-A.
- (c) A health care charitable trust from owning or operating a dental clinic, subject to the conditions discussed in section 8.3.
- (d) Graduates of a CODA-accredited school from practicing in a CODA-accredited residency under the supervision of a dentist with an active New Hampshire license, for the length of the residency.
- (e) A consultant who is licensed as a physician or dentist in another state or Canada, has no contact with the patient, and gives an opinion to a New Hampshire dentist. The New Hampshire dentist remains responsible for diagnosis and treatment. Den 501.01(l) repeats this rule.
Under RSA 317-A:20, IV, anything the Board determines to be dental hygiene under RSA 317-A:12 or 317-A:21-c is not the practice of dentistry. That is why a hygienist performing an authorized prophylaxis is not an unlicensed dentist.
Telemedicine
RSA 317-A:7-b allows persons licensed by the Board to provide services through telemedicine as defined in RSA 310:7. This supports RSA 317-A:20, I(d)'s recognition that diagnosis "by use of electronic media" is still the practice of dentistry. A licensee practicing remotely remains fully subject to the chapter.
Criminal penalty and false papers
- RSA 317-A:33 — Except as otherwise provided, anyone who practices or attempts to practice dentistry or dental hygiene without a license, or who violates any provision of RSA 317-A, is guilty of a misdemeanor if a natural person or a felony if any other person (for example, a corporation).
- RSA 317-A:32 — Filing or attempting to file another person's diploma or license as one's own, or a forged affidavit of identification or qualification, is forgery.
- RSA 317-A:35 — Fines imposed and collected by a court under the chapter are paid to OPLC.
Criminal penalties are separate from professional discipline. A licensed dentist who lets an unlicensed person practice in the office also commits professional misconduct under RSA 317-A:17, II(i), covered in Chapter 8.
A day spa employee who is not licensed under RSA 317-A applies professional-strength whitening gel to clients' teeth for a fee. How does RSA 317-A:20 treat this activity?
A periodontist licensed in Vermont reviews radiographs sent by a New Hampshire dentist and gives an opinion. The Vermont periodontist never communicates with or examines the patient. Does the periodontist need a New Hampshire license?
A corporation with no licensed dentist owners opens a clinic in Nashua where it hires the clinicians and controls the operation. Under RSA 317-A:33, what is the criminal classification of practicing dentistry without a license by an entity that is not a natural person?