Regulatory Compliance - Q&A: Dental Scope of Practice

CDA Practice Support

Dentists may attend courses that instruct on performing certain procedures. However, attending a course does not necessarily mean that a California dentist may perform that procedure. A dentist may perform procedures permitted by their state’s laws. Each state has its own scope of practice. California’s dental scope of practice is found in Business & Professions Code section 1625, which states:

Dentistry is the diagnosis or treatment, by surgery or other method, of diseases and lesions and the correction of malposition of the human teeth, alveolar process, gums, jaws or associated structures; and such diagnosis or treatment may include all necessary related procedures as well as the use of drugs, anesthetic agents and physical evaluation. Without limiting the foregoing, a person practices dentistry within the meaning of this chapter who does any one or more of the following:

a) By card, circular, pamphlet, newspaper, internet website, social media or in any other way advertises themselves or represents themselves to be a dentist.

b) Performs, or offers to perform, an operation or diagnosis of any kind, or treats diseases or lesions of the human teeth, alveolar process, gums, jaws or associated structures or corrects malposed positions thereof.

c) In any way indicates that the person will perform by themselves or their agents or servants any operation upon the human teeth, alveolar process, gums, jaws or associated structures or in any way indicates that the person will construct, alter, repair or sell any bridge, crown, denture or other prosthetic appliance or orthodontic appliance.

d) Makes or offers to make an examination of, with the intent to perform or cause to be performed any operation on the human teeth, alveolar process, gums, jaws or associated structures.

e) Manages or conducts as manager, proprietor, conductor, lessor or otherwise a place where dental operations are performed.

May a dentist perform a cosmetic procedure?

The Dental Board of California has advised that cosmetic procedures, and the use of appropriate products for those procedures, that are performed for the treatment of diseases and lesions and the correction of malposition of the human teeth, alveolar process, gums, jaws or associated structures and are part of a dental plan fall into the definition of the practice of dentistry. A dentist who does not hold an elective facial cosmetic surgery permit may only provide Botox and dermal fillers for cosmetic purposes when administered as part of a comprehensive dental treatment plan. The documentation should be explicit, detailed and include photographs. An oral surgeon with an elective facial cosmetic surgery (EFCS) permit is the only dentist who may provide cosmetic services on a standalone basis. Enforcement actions have been pursued against general dentists who perform cosmetic procedures for the sole purpose of cosmetic improvements of facial tissues rather than for cosmetic improvements related to dental treatment.

What is a dentist permitted to do with a patient who may have sleep apnea?

It is appropriate for dentists to screen patients for signs and symptoms of sleep-disordered breathing and to work with physicians to diagnose and treat sleep-disordered breathing. However, the diagnosis of sleep apnea is solely within a physician’s scope of practice in California.

May a dentist perform venipuncture?

Venipuncture performed as part of dental treatment is considered to be within the dental scope of practice. After discussing the subject in 2019, the dental board chose not to consider additional regulation. The procedure may be performed in a dental practice by California active licensed dentists who have the knowledge and skill to perform it, registered nurses and certified phlebotomists.

May a dentist perform laser hair removal?

No. Laser hair removal is considered a medical procedure in California.

Regulatory Compliance appears monthly and features resources about laws that impact dental practices. Visit cda.org/ practicesupport for more than 600 practice support resources, including practice management, employment practices, dental benefit plans and regulatory compliance.