Title 201 | Chapter 008 | Regulation 533
SUPERSEDED
This document is no longer current.
GENERAL GOVERNMENT CABINET
Board of Dentistry
(New Administrative Regulation)
201 KAR 8:533.Licensure of dentists.
Section 1.
General Licensure Requirements. An applicant desiring dental licensure in the Commonwealth shall at a minimum:(1)
Understand, read, speak, and write the English language with a comprehension and performance level equal to at least the ninth grade of education, verified by testing as necessary;(2)
Submit a completed, signed, and notarized Application for Dental Licensure with an attached applicant photo taken within the past six (6) months;(3)
Pay the fee required by 201 KAR 8:520;(4)
Not be currently subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(5)
Complete and pass the board's jurisprudence exam;(6)
Provide proof of having current certification in cardiopulmonary resuscitation (CPR) which meets or exceeds the American Heart Association Guidelines for CPR and ECC;(7)
Submit to a nationwide state and federal criminal background check by fingerprint through the Department of Kentucky State Police;(8)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(9)
Provide proof that the applicant is a graduate of a Commission on Dental Accreditation (CODA) accredited dental school or college or dental department of a university;(10)
Provide proof that the applicant has successfully completed Part I and Part II of the National Board Dental Examination, which is written and theoretical, conducted by the Joint Commission on National Dental Examinations; and(11)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.Section 2.
Requirements for Licensure by Examination.(1)
Each individual desiring initial licensure as a dentist by examination shall complete all of the requirements listed in Section 1 of this administrative regulation.(2)
Each individual desiring initial licensure as a dentist by examination shall successfully complete a clinical examination within the five (5) years preceding the filing of the application. The board shall accept the following regional clinical examinations:(a)
The examination of the Council of Interstate Testing Agencies (CITA);(b)
The examination of the Central Regional Dental Testing Service (CRDTS);(c)
The examination of the Commission on Dental Competency Assessments (CDCA);(d)
The examination of the Southern Regional Testing Agency (SRTA); and(e)
The examination of the Western Regional Examining Board (WREB).(3)
An individual desiring initial licensure as a dentist by examination more than two (2) years after fulfilling all of the requirements of his CODA accredited dental education shall:(a)
Hold a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; or(b)
If the applicant does not hold a license to practice dentistry in good standing, complete a board approved refresher course prior to receiving a license to practice dentistry in the Commonwealth of Kentucky.(4)
An applicant who has taken a clinical examination three (3) times and failed to achieve a passing score shall not be allowed to sit for the examination again until the applicant has completed and passed a remediation plan approved by the board.Section 3.
Requirements for Licensure by Credentials. Each individual desiring initial licensure as a dentist by credentials shall:(1)
Complete all of the requirements listed in Section 1 of this administrative regulation;(2)
Provide proof of having passed a state, regional, or national clinical examination used to determine clinical competency in a state or territory of the United States or the District of Columbia; and(3)
Provide proof that, for five (5) of the six (6) years immediately preceding the filing of the application, the applicant has been engaged in the active practice of dentistry when he or she was legally authorized to practice dentistry in a state or territory of the United States or the District of Columbia if the qualifications for the authorization were equal to or higher than those of the Commonwealth of Kentucky.Section 4.
Requirements for Student Limited Licensure.(1)
Each individual desiring a student limited license shall:(a)
Complete all of the requirements listed in Section 1 of this administrative regulation with the exception of subsections (9) and (10);(b)
Provide a letter from the dean or program director of a postgraduate, residency, or fellowship program in the Commonwealth of Kentucky stating that the applicant has been accepted into the program and the expected date of completion;(c)
Submit a signed Statement Regarding Student Licensure Limitations; and(d)
Submit an official final transcript of the applicant's dental coursework with the degree posted.(2)
An individual licensed under this section shall only practice dentistry in conjunction with programs of the dental school where the individual is a student and shall only provide professional services to patients of these programs.(3)
Licenses issued under this section shall be renewed with all other dental licenses issued by the board and shall automatically expire upon the termination of the holder's status as a student.(4)
A program enrolling an individual holding a student limited license shall notify the board in writing of the date the student graduates from or exits the program.(5)
Nothing in this section shall prohibit:(a)
A student from performing a dental operation under the supervision of a competent instructor within the dental school, college, or department of a university or private practice facility approved by the board. The board may authorize a student of any dental college, school, or department of a university to practice dentistry in any state or municipal institution or public school, or under the board of health, or in a public clinic or a charitable institution. A fee shall not be accepted by the student beyond the expenses provided by the stipend;(b)
A student limited license holder from working under the general supervision of a licensed dentist within the confines of the postgraduate training program; and(c)
A volunteer health practitioner from providing services under KRS 39A.350-39A.366.Section 5.
Requirements for Faculty Limited Licensure.(1)
Each individual desiring a faculty limited license shall:(a)
Complete all of the requirements listed in Section 1 of this administrative regulation with the exception of subsections (9) and (10);(b)
Provide a letter from the dean or program director of the dental school showing a faculty appointment with one (1) of the Commonwealth's dental schools;(c)
Submit a signed Statement Regarding Faculty Licensure Limitations; and(d)
Submit an official final transcript of his or her dental coursework with the degree posted.(2)
An individual licensed under this section shall only practice dentistry in conjunction with programs of the dental school where the individual is a faculty member and shall only provide professional services to patients of these programs.(3)
Licenses issued under this section shall be renewed with all other dental licenses issued by the board and shall automatically expire upon the termination of the holder's status as a faculty member.(4)
A program employing an individual holding a faculty limited license shall notify the board in writing of the date the licensee exits the program.Section 6.
Requirements for Licensure of Foreign Trained Dentists.(1)
Each individual desiring licensure as a dentist who is a graduate of a non-CODA accredited dental program shall successfully complete two (2) years of postgraduate training in a CODA accredited general dentistry program and shall:(a)
Provide proof of having passed the Test of English as a Foreign Language (TOEFL) administered by the Educational Testing Service with a score of 650 on the paper-based test (PBT) or a score of 116 on the internet-based test (iBT), if English is not the applicant's native language;(b)
Submit a completed, signed, and notarized Application for Dental Licensure with an attached applicant photo taken within the past six (6) months;(c)
Pay the fee required by 201 KAR 8:520;(d)
Not be currently subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(e)
Complete and pass the board's jurisprudence exam;(f)
Provide proof of having current certification in cardiopulmonary resuscitation (CPR) that meets or exceeds the American Heart Association Guidelines for CPR and ECC;(g)
Submit to a state and federal criminal background check by fingerprint through the Department of Kentucky State Police;(h)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(i)
Provide proof of having successfully completed two (2) years postgraduate training in a CODA accredited general dentistry program;(j)
Submit one (1) letter of recommendation from the program director of each training site;(k)
Provide proof of successful completion of Part I and Part II of the National Board Dental Examination, which is written and theoretical, conducted by the Joint Commission on National Dental Examinations within the five (5) years preceding application for licensure;(l)
Provide proof of successfully completing within the five (5) years prior to application a clinical examination required by Section 2(2) of this administrative regulation; and(m)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
An individual desiring initial licensure as a dentist who is a graduate of a non-CODA accredited dental program and applies more than two (2) years after fulfilling all of the requirements of his or her postgraduate training in a CODA accredited general dentistry program shall:(a)
Hold a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; or(b)
If the applicant does not hold a license to practice dentistry in good standing, complete a board approved refresher course prior to receiving a license to practice dentistry in the Commonwealth of Kentucky.Section 7.
Requirements for Charitable Limited Licensure.(1)
Each individual desiring a charitable limited license shall:(a)
Understand, read, speak, and write the English language with a comprehension and performance level equal to at least the ninth grade of education, verified by testing as necessary;(b)
Submit a completed, signed, and notarized Application for Charitable Dental Licensure with an attached applicant photo taken within the past six (6) months;(c)
Pay the fee required by 201 KAR 520;(d)
Not be subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(e)
Have a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; and(f)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
An individual licensed under this section shall:(a)
Work only with charitable entities registered with the Cabinet for Health and Family Services that have met the requirements of KRS 313.254 and 201 KAR 8:581;(b)
Only perform procedures allowed by KRS 313.254(4) and (5) which shall be completed within the duration of the charitable event;(c)
Be eligible for the provisions of medical malpractice insurance procured under KRS 304.40-075;(d)
Perform these duties without expectation of compensation or charge to the individual, and without payment or reimbursement by any governmental agency or insurer;(e)
Have a charitable limited license that shall be valid for no more than two (2) years and shall expire during the regular dental renewal cycle; and(f)
Comply with reciprocity requirements if applicable.1.
A state that extends a reciprocal agreement shall comply with this section.2.
An individual shall notify the sponsor of a charitable clinic and the board of the intent to conduct or participate in the clinic.3.
An individual conducting or participating in a charitable clinic shall have a license to practice dentistry in the state in which the dentist practices.(3)
A dentist licensed under this section shall not be allowed to prescribe any medications while practicing in the Commonwealth.Section 8.
Requirements for Specialty Licensure. Each individual desiring initial licensure as a specialist as defined by KRS 313.010(9) shall:(1)
Submit a completed, signed, and notarized Application for Specialty Licensure with an attached applicant photo taken within the past six (6) months;(2)
Pay the fee required by 201 KAR 8:520;(3)
Hold an active Kentucky license to practice general dentistry prior to being issued a specialty license; and(4)
Submit satisfactory evidence of completing a CODA accredited graduate or postgraduate specialty program after graduation from a dental school.Section 9.
Minimum Continuing Education Requirements.(1)
Each individual desiring renewal of an active dental license shall complete thirty (30) hours of continuing education that relates to or advances the practice of dentistry and would be useful to the licensee's practice.(2)
Acceptable continuing education hours shall include course content designed to increase:(a)
Competency in treating patients who are medically compromised or who experience medical emergencies during the course of dental treatment;(b)
Knowledge of pharmaceutical products and the protocol of the proper use of medications;(c)
Competence to diagnose oral pathology;(d)
Awareness of currently accepted methods of infection control;(e)
Knowledge of basic medical and scientific subjects including biology, physiology, pathology, biochemistry, pharmacology, epidemiology, and public health;(f)
Knowledge of clinical and technological subjects;(g)
Knowledge of subjects pertinent to patient management, safety, and oral healthcare;(h)
Competency in assisting in mass casualty or mass immunization situations;(i)
Clinical skills through the volunteer of clinical charitable dentistry that meets the requirements of KRS 313.254;(j)
Knowledge of office business operations and best practices; or(k)
Participation in dental association or society business meetings.(3)
A minimum of ten (10) hours shall be taken in a live interactive presentation format.(4)
A maximum of ten (10) hours total may be taken that meet the requirements of subsection (2)(i) - (k) of this section.(5)
A minimum of three (3) hours of continuing education must be taken in the use of the Kentucky All Schedule Prescription Electronic Reporting System (KASPER), pain management, or addiction disorders.(6)
Dentists who hold a board-issued sedation permit shall also meet the continuing education requirements of 201 KAR 8:550, Section 8. All continuing education hours shall be verified by the receipt of a certificate of completion or certificate of attendance bearing:(a)
The signature of or verification by the provider;(b)
The name of the licensee in attendance;(c)
The title of the course or meeting attended or completed;(d)
The date of attendance or completion;(e)
The number of hours earned; and(f)
Evidence of the method of delivery if the course was taken in a live interactive presentation format.(7)
It shall be the sole responsibility of the individual licensee to obtain documentation from the provider or sponsoring organization verifying participation as established in subsection (5) of this section and to retain the documentation for a minimum of five (5) years.(8)
At license renewal, each licensee shall attest to the fact that he or she has complied with the requirements of this section.(9)
Each licensee shall be subject to audit of proof of continuing education compliance by the board.Section 10.
Requirements for Renewal of a Dental License.(1)
Each individual desiring renewal of an active dental license shall:(a)
Submit a signed, completed Application for Renewal of Dental Licensure;(b)
Pay the fee required by 201 KAR 8:520;(c)
Maintain, with no more than a thirty (30) day lapse, CPR certification that meets or exceeds the American Heart Association Guidelines for CPR and ECC unless a hardship waiver is approved by the board; and(d)
Meet the continuing education requirements as provided for in Section 9 of this administrative regulation except in the following cases:1.
If a hardship waiver has been submitted to and is subsequently approved by the board;2.
If the licensee graduated in the first year of the biennial license period, the licensee shall complete one-half (1/2) of the hours as outlined in Section 9 of this administrative regulation; and3.
If the licensee graduated in the second year of the biennial license period, the licensee shall not be required to complete the continuing education requirements outlined in Section 9 of this administrative regulation.(2)
If a licensee has not actively practiced dentistry in the two (2) consecutive years preceding the filing of the renewal application, he or she shall complete and pass a board approved refresher course prior to resuming the active practice of dentistry.Section 11.
Retirement of a License.(1)
Each individual desiring retirement of a dental license shall submit a completed and signed Retirement of License Form.(2)
Upon receipt of this form, the board shall send written confirmation of retirement to the address provided by the licensee on the Retirement of License form.(3)
A licensee shall not retire a license that has a pending disciplinary action against it.(4)
Each retirement shall be effective upon the processing of the completed and signed Retirement of License Form by the board.Section 12.
Reinstatement of a License.(1)
Each individual desiring reinstatement of a properly retired dental license shall:(a)
Submit a completed, signed, and notarized Application to Reinstate a Dental License with an attached applicant photo taken within the past six (6) months;(b)
Pay the fee required by 201 KAR 8:520;(c)
Show proof of having current certification in CPR that meets or exceeds the American Heart Association Guidelines for CPR and ECC;(d)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(e)
Submit to a nationwide state and federal criminal background check by fingerprint through the Department of Kentucky State Police; and(f)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
If an individual applies to reinstate a license within two (2) years of when the license was last active, the individual shall provide proof of having met the continuing education requirements as outlined in Section 9 of this administrative regulation within those two (2) years.(3)
If the applicant has not actively practiced dentistry in the two (2) consecutive years immediately preceding the filing of the reinstatement application, the applicant shall complete and pass a refresher course approved by the board.(4)
If a license is reinstated in the first year of the biennial license period, the licensee shall complete all of the continuing education requirements as outlined in Section 9 of this administrative regulation prior to the renewal of the license.(5)
If a license is reinstated in the second year of the biennial license period, the licensee shall complete one-half (1/2) of the hours as outlined in Section 9 of this administrative regulation prior to the renewal of the license.Section 13.
Requirements for Verification of Licensure. Each individual desiring verification of a dental license shall:(1)
Submit a signed and completed Verification of Licensure or Registration Form; and(2)
Pay the fee required by 201 KAR 8:520.Section 14.
Requesting a Duplicate License. Each individual desiring a duplicate dental license shall:(1)
Submit a signed and completed Duplicate License or Registration Request Form; and(2)
Pay the fee required by 201 KAR 8:520.Section 15.
Issuance of Initial Licensure. If an applicant has completed all of the requirements for licensure within six (6) months of the date the application was received at the office of the board, the board shall:(1)
Issue a license in sequential numerical order; or(2)
Deny licensure due to a violation of KRS Chapter 313 or 201 KAR Chapter 8.Section 16.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Application for Charitable Dental Licensure", February 2023;(b)
"Application for Dental Licensure", February 2023;(c)
"Application for Renewal of Dental Licensure", February 2023;(d)
"Application for Specialty Licensure", February 2023;(e)
"Application to Reinstate a Dental License", February 2023;(f)
"Duplicate License or Registration Request Form", February 2023;(g)
"Retirement of License Form", February 2023;(h)
"Statement Regarding Faculty Licensure Limitations", February 2023;(i)
"Statement Regarding Student Licensure Limitations", February 2023;(j)
"Verification of Licensure or Registration Form", February 2023; and(k)
"2020 American Heart Association Guidelines for CPR and ECC", 2020.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222, Monday through Friday, 8 a.m. through 4:30 p.m. This material is also available on the board's Web site at http://dentistry.ky.gov.JEFF ALLEN, Executive Director
APPROVED BY AGENCY: February 13, 2023
FILED WITH LRC: February 14, 2023 at 8:55 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on April 27, 2023 at 3:00 p.m., Eastern Time at the Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be cancelled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through April 30, 2023. Send written notification of intent to be heard at the public hearing, or written comments on the proposed administrative regulation to the contact person below.
CONTACT PERSON: Jeff Allen, Executive Director, Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222, phone (502) 429-7280, fax (502) 429-7282, email jeffrey.allen@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Jeff Allen
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes requirements to practice dentistry in Kentucky.
(b) The necessity of this administrative regulation:
KRS 313.021(1)(a) requires the board to exercise the administrative functions of the Commonwealth in the regulation of dentists.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation establishes the rules for obtaining a license to practice as a dentist in Kentucky.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation establishes requirements for being licensed to practice dentistry in conformity with its authorizing statute.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
(b) The necessity of the amendment to this administrative regulation:
(c) How the amendment conforms to the content of the authorizing statutes:
(d) How the amendment will assist in the effective administration of the statutes:
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This administrative regulation will primarily affect the approximately 3,200 licensed dentists in Kentucky as well as any new applicants for licensure and the patients of licensed dentists. (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it an amendment, including: (a) List the actions that each of the related entities identified in question (3) will have to take to comply with this administrative regulation or amendment: Each individual impacted will be required to apply for or renew their licensure in accordance with applicable law and administrative regulations. (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question. This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Each individual impacted will be required to apply for or renew their licensure in accordance with applicable law and adminis-trative regulations.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
The administrative regulation will result in a healthier patient population and the avoidance of potentially costly violations of applicable law and administrative regulations by licensed dentists.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
No additional cost.
(b) On a continuing basis:
No additional cost.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
? Licensure fees are used to fund the implementation of this administrative regulation.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
Fee amounts are already established in a separate administrative regulation (201 KAR 8:520) and no increase is needed.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(9) TIERING: Is tiering applied?
No; this administrative regulation impacts all similarly situated entities equally.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
None.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 313.021.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This administrative regulation is not expected to impact the existing revenue generated by dental licensure, which is approximately $1,100,000 every fiscal biennium to the Board of Dentistry.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
This administrative regulation is not expected to impact the existing revenue generated by dental licensure, which is approximately $1,100,000 every fiscal biennium to the Board of Dentistry.
(c) How much will it cost to administer this program for the first year?
There will be no additional cost as a result of this administrative regulation.
(d) How much will it cost to administer this program for subsequent years?
There will be no additional cost as a result of this administrative regulation. Note: If specific dollar amounts cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
This administrative regulation does not establish specific fees, which are contained in a separate administrative regulation; however, the revenue generated from dentist licensure is approximately $1,100,000 every fiscal biennium.
Expenditures (+/-):
Expenditures specifically related to this administrative regulation are difficult to determine due to indirect personnel and overhead costs; however, total agency expenditures are approximately $1,400,000 every fiscal biennium.
Other Explanation:
Not applicable.
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None
(c) How much will it cost the regulated entities for the first year?
No additional cost as a result of this administrative regulation. This administrative regulation does not contain specific fees, which are provided for in a separate administrative regulation.
(d) How much will it cost the regulated entities for subsequent years?
There will be no additional cost as a result of this administrative regulation. This administrative regulation does not contain specific fees, which are provided for in a separate administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. This administrative regulation does not directly have a major economic impact as it does not contain specific fee amounts. When administered in conjunction with the current fees established elsewhere, it impacts the dental health community by just over $500,000 per year, primarily from licensure fees.
GENERAL GOVERNMENT CABINET
Board of Dentistry
(New Administrative Regulation)
201 KAR 8:533.Licensure of dentists.
Section 1.
General Licensure Requirements. An applicant desiring dental licensure in the Commonwealth shall at a minimum:(1)
Understand, read, speak, and write the English language with a comprehension and performance level equal to at least the ninth grade of education, verified by testing as necessary;(2)
Submit a completed, signed, and notarized Application for Dental Licensure with an attached applicant photo taken within the past six (6) months;(3)
Pay the fee required by 201 KAR 8:520;(4)
Not be currently subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(5)
Complete and pass the board's jurisprudence exam;(6)
Provide proof of having current certification in cardiopulmonary resuscitation (CPR) which meets or exceeds the American Heart Association Guidelines for CPR and ECC;(7)
Submit to a nationwide state and federal criminal background check by fingerprint through the Department of Kentucky State Police;(8)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(9)
Provide proof that the applicant is a graduate of a Commission on Dental Accreditation (CODA) accredited dental school or college or dental department of a university;(10)
Provide proof that the applicant has successfully completed Part I and Part II of the National Board Dental Examination, which is written and theoretical, conducted by the Joint Commission on National Dental Examinations; and(11)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.Section 2.
Requirements for Licensure by Examination.(1)
Each individual desiring initial licensure as a dentist by examination shall complete all of the requirements listed in Section 1 of this administrative regulation.(2)
Each individual desiring initial licensure as a dentist by examination shall successfully complete a clinical examination within the five (5) years preceding the filing of the application. The board shall accept the following regional clinical examinations:(a)
The examination of the Council of Interstate Testing Agencies (CITA);(b)
The examination of the Central Regional Dental Testing Service (CRDTS);(c)
The examination of the Commission on Dental Competency Assessments (CDCA);(d)
The examination of the Southern Regional Testing Agency (SRTA); and(e)
The examination of the Western Regional Examining Board (WREB).(3)
An individual desiring initial licensure as a dentist by examination more than two (2) years after fulfilling all of the requirements of his CODA accredited dental education shall:(a)
Hold a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; or(b)
If the applicant does not hold a license to practice dentistry in good standing, complete a board approved refresher course prior to receiving a license to practice dentistry in the Commonwealth of Kentucky.(4)
An applicant who has taken a clinical examination three (3) times and failed to achieve a passing score shall not be allowed to sit for the examination again until the applicant has completed and passed a remediation plan approved by the board.Section 3.
Requirements for Licensure by Credentials. Each individual desiring initial licensure as a dentist by credentials shall:(1)
Complete all of the requirements listed in Section 1 of this administrative regulation;(2)
Provide proof of having passed a state, regional, or national clinical examination used to determine clinical competency in a state or territory of the United States or the District of Columbia; and(3)
Provide proof that, for five (5) of the six (6) years immediately preceding the filing of the application, the applicant has been engaged in the active practice of dentistry when he or she was legally authorized to practice dentistry in a state or territory of the United States or the District of Columbia if the qualifications for the authorization were equal to or higher than those of the Commonwealth of Kentucky.Section 4.
Requirements for Student Limited Licensure.(1)
Each individual desiring a student limited license shall:(a)
Complete all of the requirements listed in Section 1 of this administrative regulation with the exception of subsections (9) and (10);(b)
Provide a letter from the dean or program director of a postgraduate, residency, or fellowship program in the Commonwealth of Kentucky stating that the applicant has been accepted into the program and the expected date of completion;(c)
Submit a signed Statement Regarding Student Licensure Limitations; and(d)
Submit an official final transcript of the applicant's dental coursework with the degree posted.(2)
An individual licensed under this section shall only practice dentistry in conjunction with programs of the dental school where the individual is a student and shall only provide professional services to patients of these programs.(3)
Licenses issued under this section shall be renewed with all other dental licenses issued by the board and shall automatically expire upon the termination of the holder's status as a student.(4)
A program enrolling an individual holding a student limited license shall notify the board in writing of the date the student graduates from or exits the program.(5)
Nothing in this section shall prohibit:(a)
A student from performing a dental operation under the supervision of a competent instructor within the dental school, college, or department of a university or private practice facility approved by the board. The board may authorize a student of any dental college, school, or department of a university to practice dentistry in any state or municipal institution or public school, or under the board of health, or in a public clinic or a charitable institution. A fee shall not be accepted by the student beyond the expenses provided by the stipend;(b)
A student limited license holder from working under the general supervision of a licensed dentist within the confines of the postgraduate training program; and(c)
A volunteer health practitioner from providing services under KRS 39A.350-39A.366.Section 5.
Requirements for Faculty Limited Licensure.(1)
Each individual desiring a faculty limited license shall:(a)
Complete all of the requirements listed in Section 1 of this administrative regulation with the exception of subsections (9) and (10);(b)
Provide a letter from the dean or program director of the dental school showing a faculty appointment with one (1) of the Commonwealth's dental schools;(c)
Submit a signed Statement Regarding Faculty Licensure Limitations; and(d)
Submit an official final transcript of his or her dental coursework with the degree posted.(2)
An individual licensed under this section shall only practice dentistry in conjunction with programs of the dental school where the individual is a faculty member and shall only provide professional services to patients of these programs.(3)
Licenses issued under this section shall be renewed with all other dental licenses issued by the board and shall automatically expire upon the termination of the holder's status as a faculty member.(4)
A program employing an individual holding a faculty limited license shall notify the board in writing of the date the licensee exits the program.Section 6.
Requirements for Licensure of Foreign Trained Dentists.(1)
Each individual desiring licensure as a dentist who is a graduate of a non-CODA accredited dental program shall successfully complete two (2) years of postgraduate training in a CODA accredited general dentistry program and shall:(a)
Provide proof of having passed the Test of English as a Foreign Language (TOEFL) administered by the Educational Testing Service with a score of 650 on the paper-based test (PBT) or a score of 116 on the internet-based test (iBT), if English is not the applicant's native language;(b)
Submit a completed, signed, and notarized Application for Dental Licensure with an attached applicant photo taken within the past six (6) months;(c)
Pay the fee required by 201 KAR 8:520;(d)
Not be currently subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(e)
Complete and pass the board's jurisprudence exam;(f)
Provide proof of having current certification in cardiopulmonary resuscitation (CPR) that meets or exceeds the American Heart Association Guidelines for CPR and ECC;(g)
Submit to a state and federal criminal background check by fingerprint through the Department of Kentucky State Police;(h)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(i)
Provide proof of having successfully completed two (2) years postgraduate training in a CODA accredited general dentistry program;(j)
Submit one (1) letter of recommendation from the program director of each training site;(k)
Provide proof of successful completion of Part I and Part II of the National Board Dental Examination, which is written and theoretical, conducted by the Joint Commission on National Dental Examinations within the five (5) years preceding application for licensure;(l)
Provide proof of successfully completing within the five (5) years prior to application a clinical examination required by Section 2(2) of this administrative regulation; and(m)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
An individual desiring initial licensure as a dentist who is a graduate of a non-CODA accredited dental program and applies more than two (2) years after fulfilling all of the requirements of his or her postgraduate training in a CODA accredited general dentistry program shall:(a)
Hold a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; or(b)
If the applicant does not hold a license to practice dentistry in good standing, complete a board approved refresher course prior to receiving a license to practice dentistry in the Commonwealth of Kentucky.Section 7.
Requirements for Charitable Limited Licensure.(1)
Each individual desiring a charitable limited license shall:(a)
Understand, read, speak, and write the English language with a comprehension and performance level equal to at least the ninth grade of education, verified by testing as necessary;(b)
Submit a completed, signed, and notarized Application for Charitable Dental Licensure with an attached applicant photo taken within the past six (6) months;(c)
Pay the fee required by 201 KAR 520;(d)
Not be subject to disciplinary action pursuant to KRS Chapter 313 that would prevent licensure;(e)
Have a license to practice dentistry in good standing in another state or territory of the United States or the District of Columbia; and(f)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
An individual licensed under this section shall:(a)
Work only with charitable entities registered with the Cabinet for Health and Family Services that have met the requirements of KRS 313.254 and 201 KAR 8:581;(b)
Only perform procedures allowed by KRS 313.254(4) and (5) which shall be completed within the duration of the charitable event;(c)
Be eligible for the provisions of medical malpractice insurance procured under KRS 304.40-075;(d)
Perform these duties without expectation of compensation or charge to the individual, and without payment or reimbursement by any governmental agency or insurer;(e)
Have a charitable limited license that shall be valid for no more than two (2) years and shall expire during the regular dental renewal cycle; and(f)
Comply with reciprocity requirements if applicable.1.
A state that extends a reciprocal agreement shall comply with this section.2.
An individual shall notify the sponsor of a charitable clinic and the board of the intent to conduct or participate in the clinic.3.
An individual conducting or participating in a charitable clinic shall have a license to practice dentistry in the state in which the dentist practices.(3)
A dentist licensed under this section shall not be allowed to prescribe any medications while practicing in the Commonwealth.Section 8.
Requirements for Specialty Licensure. Each individual desiring initial licensure as a specialist as defined by KRS 313.010(9) shall:(1)
Submit a completed, signed, and notarized Application for Specialty Licensure with an attached applicant photo taken within the past six (6) months;(2)
Pay the fee required by 201 KAR 8:520;(3)
Hold an active Kentucky license to practice general dentistry prior to being issued a specialty license; and(4)
Submit satisfactory evidence of completing a CODA accredited graduate or postgraduate specialty program after graduation from a dental school.Section 9.
Minimum Continuing Education Requirements.(1)
Each individual desiring renewal of an active dental license shall complete thirty (30) hours of continuing education that relates to or advances the practice of dentistry and would be useful to the licensee's practice.(2)
Acceptable continuing education hours shall include course content designed to increase:(a)
Competency in treating patients who are medically compromised or who experience medical emergencies during the course of dental treatment;(b)
Knowledge of pharmaceutical products and the protocol of the proper use of medications;(c)
Competence to diagnose oral pathology;(d)
Awareness of currently accepted methods of infection control;(e)
Knowledge of basic medical and scientific subjects including biology, physiology, pathology, biochemistry, pharmacology, epidemiology, and public health;(f)
Knowledge of clinical and technological subjects;(g)
Knowledge of subjects pertinent to patient management, safety, and oral healthcare;(h)
Competency in assisting in mass casualty or mass immunization situations;(i)
Clinical skills through the volunteer of clinical charitable dentistry that meets the requirements of KRS 313.254;(j)
Knowledge of office business operations and best practices; or(k)
Participation in dental association or society business meetings.(3)
A minimum of ten (10) hours shall be taken in a live interactive presentation format.(4)
A maximum of ten (10) hours total may be taken that meet the requirements of subsection (2)(i) - (k) of this section.(5)
A minimum of three (3) hours of continuing education must be taken in the use of the Kentucky All Schedule Prescription Electronic Reporting System (KASPER), pain management, or addiction disorders.(6)
Dentists who hold a board-issued sedation permit shall also meet the continuing education requirements of 201 KAR 8:550, Section 8. All continuing education hours shall be verified by the receipt of a certificate of completion or certificate of attendance bearing:(a)
The signature of or verification by the provider;(b)
The name of the licensee in attendance;(c)
The title of the course or meeting attended or completed;(d)
The date of attendance or completion;(e)
The number of hours earned; and(f)
Evidence of the method of delivery if the course was taken in a live interactive presentation format.(7)
It shall be the sole responsibility of the individual licensee to obtain documentation from the provider or sponsoring organization verifying participation as established in subsection (5) of this section and to retain the documentation for a minimum of five (5) years.(8)
At license renewal, each licensee shall attest to the fact that he or she has complied with the requirements of this section.(9)
Each licensee shall be subject to audit of proof of continuing education compliance by the board.Section 10.
Requirements for Renewal of a Dental License.(1)
Each individual desiring renewal of an active dental license shall:(a)
Submit a signed, completed Application for Renewal of Dental Licensure;(b)
Pay the fee required by 201 KAR 8:520;(c)
Maintain, with no more than a thirty (30) day lapse, CPR certification that meets or exceeds the American Heart Association Guidelines for CPR and ECC unless a hardship waiver is approved by the board; and(d)
Meet the continuing education requirements as provided for in Section 9 of this administrative regulation except in the following cases:1.
If a hardship waiver has been submitted to and is subsequently approved by the board;2.
If the licensee graduated in the first year of the biennial license period, the licensee shall complete one-half (1/2) of the hours as outlined in Section 9 of this administrative regulation; and3.
If the licensee graduated in the second year of the biennial license period, the licensee shall not be required to complete the continuing education requirements outlined in Section 9 of this administrative regulation.(2)
If a licensee has not actively practiced dentistry in the two (2) consecutive years preceding the filing of the renewal application, he or she shall complete and pass a board approved refresher course prior to resuming the active practice of dentistry.Section 11.
Retirement of a License.(1)
Each individual desiring retirement of a dental license shall submit a completed and signed Retirement of License Form.(2)
Upon receipt of this form, the board shall send written confirmation of retirement to the address provided by the licensee on the Retirement of License form.(3)
A licensee shall not retire a license that has a pending disciplinary action against it.(4)
Each retirement shall be effective upon the processing of the completed and signed Retirement of License Form by the board.Section 12.
Reinstatement of a License.(1)
Each individual desiring reinstatement of a properly retired dental license shall:(a)
Submit a completed, signed, and notarized Application to Reinstate a Dental License with an attached applicant photo taken within the past six (6) months;(b)
Pay the fee required by 201 KAR 8:520;(c)
Show proof of having current certification in CPR that meets or exceeds the American Heart Association Guidelines for CPR and ECC;(d)
Provide verification within three (3) months of the date the application is received at the office of the board of any license to practice dentistry held previously or currently in any state or jurisdiction;(e)
Submit to a nationwide state and federal criminal background check by fingerprint through the Department of Kentucky State Police; and(f)
Provide a written explanation for any positive returns on a query of the National Practitioner Data Bank.(2)
If an individual applies to reinstate a license within two (2) years of when the license was last active, the individual shall provide proof of having met the continuing education requirements as outlined in Section 9 of this administrative regulation within those two (2) years.(3)
If the applicant has not actively practiced dentistry in the two (2) consecutive years immediately preceding the filing of the reinstatement application, the applicant shall complete and pass a refresher course approved by the board.(4)
If a license is reinstated in the first year of the biennial license period, the licensee shall complete all of the continuing education requirements as outlined in Section 9 of this administrative regulation prior to the renewal of the license.(5)
If a license is reinstated in the second year of the biennial license period, the licensee shall complete one-half (1/2) of the hours as outlined in Section 9 of this administrative regulation prior to the renewal of the license.Section 13.
Requirements for Verification of Licensure. Each individual desiring verification of a dental license shall:(1)
Submit a signed and completed Verification of Licensure or Registration Form; and(2)
Pay the fee required by 201 KAR 8:520.Section 14.
Requesting a Duplicate License. Each individual desiring a duplicate dental license shall:(1)
Submit a signed and completed Duplicate License or Registration Request Form; and(2)
Pay the fee required by 201 KAR 8:520.Section 15.
Issuance of Initial Licensure. If an applicant has completed all of the requirements for licensure within six (6) months of the date the application was received at the office of the board, the board shall:(1)
Issue a license in sequential numerical order; or(2)
Deny licensure due to a violation of KRS Chapter 313 or 201 KAR Chapter 8.Section 16.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"Application for Charitable Dental Licensure", February 2023;(b)
"Application for Dental Licensure", February 2023;(c)
"Application for Renewal of Dental Licensure", February 2023;(d)
"Application for Specialty Licensure", February 2023;(e)
"Application to Reinstate a Dental License", February 2023;(f)
"Duplicate License or Registration Request Form", February 2023;(g)
"Retirement of License Form", February 2023;(h)
"Statement Regarding Faculty Licensure Limitations", February 2023;(i)
"Statement Regarding Student Licensure Limitations", February 2023;(j)
"Verification of Licensure or Registration Form", February 2023; and(k)
"2020 American Heart Association Guidelines for CPR and ECC", 2020.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222, Monday through Friday, 8 a.m. through 4:30 p.m. This material is also available on the board's Web site at http://dentistry.ky.gov.JEFF ALLEN, Executive Director
APPROVED BY AGENCY: February 13, 2023
FILED WITH LRC: February 14, 2023 at 8:55 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on April 27, 2023 at 3:00 p.m., Eastern Time at the Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222. Individuals interested in being heard at this hearing shall notify this agency in writing by five workdays prior to the hearing of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be cancelled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through April 30, 2023. Send written notification of intent to be heard at the public hearing, or written comments on the proposed administrative regulation to the contact person below.
CONTACT PERSON: Jeff Allen, Executive Director, Kentucky Board of Dentistry, 312 Whittington Parkway, Suite 101, Louisville, Kentucky 40222, phone (502) 429-7280, fax (502) 429-7282, email jeffrey.allen@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Jeff Allen
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes requirements to practice dentistry in Kentucky.
(b) The necessity of this administrative regulation:
KRS 313.021(1)(a) requires the board to exercise the administrative functions of the Commonwealth in the regulation of dentists.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation establishes the rules for obtaining a license to practice as a dentist in Kentucky.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation establishes requirements for being licensed to practice dentistry in conformity with its authorizing statute.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
(b) The necessity of the amendment to this administrative regulation:
(c) How the amendment conforms to the content of the authorizing statutes:
(d) How the amendment will assist in the effective administration of the statutes:
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This administrative regulation will primarily affect the approximately 3,200 licensed dentists in Kentucky as well as any new applicants for licensure and the patients of licensed dentists. (4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it an amendment, including: (a) List the actions that each of the related entities identified in question (3) will have to take to comply with this administrative regulation or amendment: Each individual impacted will be required to apply for or renew their licensure in accordance with applicable law and administrative regulations. (b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question. This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Each individual impacted will be required to apply for or renew their licensure in accordance with applicable law and adminis-trative regulations.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
The administrative regulation will result in a healthier patient population and the avoidance of potentially costly violations of applicable law and administrative regulations by licensed dentists.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
No additional cost.
(b) On a continuing basis:
No additional cost.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
? Licensure fees are used to fund the implementation of this administrative regulation.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
Fee amounts are already established in a separate administrative regulation (201 KAR 8:520) and no increase is needed.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation maintains existing fees which are already established in 201 KAR 8:520.
(9) TIERING: Is tiering applied?
No; this administrative regulation impacts all similarly situated entities equally.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
None.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 313.021.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
This administrative regulation is not expected to impact the existing revenue generated by dental licensure, which is approximately $1,100,000 every fiscal biennium to the Board of Dentistry.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
This administrative regulation is not expected to impact the existing revenue generated by dental licensure, which is approximately $1,100,000 every fiscal biennium to the Board of Dentistry.
(c) How much will it cost to administer this program for the first year?
There will be no additional cost as a result of this administrative regulation.
(d) How much will it cost to administer this program for subsequent years?
There will be no additional cost as a result of this administrative regulation. Note: If specific dollar amounts cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
This administrative regulation does not establish specific fees, which are contained in a separate administrative regulation; however, the revenue generated from dentist licensure is approximately $1,100,000 every fiscal biennium.
Expenditures (+/-):
Expenditures specifically related to this administrative regulation are difficult to determine due to indirect personnel and overhead costs; however, total agency expenditures are approximately $1,400,000 every fiscal biennium.
Other Explanation:
Not applicable.
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None
(c) How much will it cost the regulated entities for the first year?
No additional cost as a result of this administrative regulation. This administrative regulation does not contain specific fees, which are provided for in a separate administrative regulation.
(d) How much will it cost the regulated entities for subsequent years?
There will be no additional cost as a result of this administrative regulation. This administrative regulation does not contain specific fees, which are provided for in a separate administrative regulation.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. This administrative regulation does not directly have a major economic impact as it does not contain specific fee amounts. When administered in conjunction with the current fees established elsewhere, it impacts the dental health community by just over $500,000 per year, primarily from licensure fees.