Alabama Administrative Code Chapter 270-X-3 — Dental Hygienists

270 Board of Dental Examiners of Alabama

Ala. Admin. Code r. 270-X-3-.01 Examination Rules For Dental Hygienists

(1) Applicants for a license to practice dental hygiene in Alabama must pass examinations specified by the Board of Dental Examiners. No person other than members of the Board of Dental Examiners, their designees and applicants for licensure shall be present in the rooms when and where examinations, either written, clinical, or laboratory procedures, are being conducted except by permission of the examiner(s) in charge.

(2) Any falsification or intentional misrepresentation of application requirements, collusion, dishonesty, or use of unwarranted assistance during the course of the examination shall automatically result in failure of the entire examination by any candidate, who may not retake the examination for one year. A person accused of any of the above may write a letter to the Board explaining why they were incorrectly accused and asking for an appeal.

(3) No smoking is allowed during examinations in examination facilities.

(4) All written examinations must be written in the English language.

(5) Board members are not permitted to interview applicants who have failed the examination. All such matters shall be directed to the secretary-treasurer in writing by the applicant.

(6) Board members are not permitted to disclose grades made by any applicant to anyone other than the applicant.

(7) When an applicant for licensure successfully passes either the written or clinical examination, that passing grade shall carry over and be valid only for the next three (3) examinations but within the next sixteen (16) months following the initial examination unless a written request for an exception is submitted in writing by the applicant and granted by the Board.

(8) In addition, examinations shall be conducted and licenses issued in compliance with Code of Ala. 1975, §34-9-11.

(9) If the applicant for licensure is unsuccessful after three (3) attempts or within the sixteen (16) month period following the initial examination then the applicant shall be required to remediate by successfully completing a Board approved hygiene school or training program before he/she will be allowed to reapply for a license.

History

• Author: Board of Dental Examiners
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-4, 34-9-26, 34-9-43.
• Filed September 28, 1982. Amended: Filed April 3, 1997; May 8, 1997. Amended: Filed September 4, 1998; effective October 11, 1998. Amended: Filed May 17, 1999; effective June 21, 1999. Amended: Filed February 22, 2012; effective March 28, 2012. Amended: Filed January 16, 2013; effective February 20, 2013. Amended: Published November 30, 2021; effective January 14, 2022.

Ala. Admin. Code r. 270-X-3-.02 Replacement Certificate For Dental Hygienists (Repealed 8/25/09)

(Repealed)

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-4, 34-9-13, 34-9-16, 34-9-43.
• Filed September 28, 1982. Amended: Filed March 8, 2007; effective June 30, 2007. Repealed: Filed July 21, 2009; effective August 25, 2009.

Ala. Admin. Code r. 270-X-3-.03 Education Requirements For Examination, Qualifications, Application, Examination And Licensure Of Dental Hygienists

(1) Education Requirements for Examination.

(a) Graduate of a school or college of dental hygiene approved by the Board.

(b) Graduate of the Alabama Dental Hygiene Program conducted by the Board pursuant to Code of Ala. 1975, §34-9-26.

(2) Applications for Hygiene Licensure Examinations.

(a) Applications and fee in an amount fixed by the Board must be filed with the Board at least thirty (30) days prior to the date of the examination.

(b) If the applicant is a graduate of a college approved by the Board, a copy of a transcript of the applicant's grades from said college must accompany the application.

(c) If the applicant is a graduate of the ADHP, the secretary of the Board shall attach a copy of the applicant's grades to the application at least five (5) days prior to the date of the examination.

(d) No part of the above fees are refundable.

(e) All applicants must otherwise comply with all requirements established by law.

(3) All applicants for licensure shall also comply with Code of Ala. 1975, §34-9-26.

(4) No person shall be granted a license to practice dental hygiene unless he/she has met the requirements of Code of Ala. 1975, §34-9-26.

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-4, 34-9-16, 34-9-26, 34-9-43.
• Filed September 28, 1982. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.04 Alabama Dental Hygiene Program Requirements

(1) Each applicant for the ADHP must be at least nineteen (19) years of age when applying to begin training, of good moral character, either free of communicable diseases covered by Title 22, Chapter 11A, Article 3 of the Alabama Code or cleared to practice, with or without conditions, by the State Health Officer pursuant to that statute, a citizen of the United States or a person who is legally present in the United States with appropriate documentation from the federal government, and must be a graduate of an accredited high school or hold a GED certificate.

(2) Each ADHP student must have had at least twenty-four (24) full months of full-time employment as a dental assistant, or the equivalent of twenty-four (24) full months in part-time employment within the three (3) years immediately preceding the student’s enrollment in the ADHP. That time must have been spent assisting a dentist(s) at the chair, and at least twelve (12) months must have been spent assisting the sponsoring dentist. Full-time shall mean employment of at least three and one-half (3-1/2) days or thirty (30) hours of Board approved employment per week. The prerequisites to entry into the ADHP program established by this subsection shall be deemed satisfied as to any applicant who either:

(a) Is a graduate of a CODA-accredited school of dental assisting within the three years immediately preceding the student’s enrollment in the ADHP and who has performed chair-side dental assisting work described in the above subsection (2) for at least fifteen (15) months in the immediately-preceding three (3) years; or

(b) Holds the foreign equivalent of Doctor of Dental Surgery (D.D.S.) or Doctor of Medicine in Dentistry (D.M.D.) degree awarded by an institution not accredited by the American Dental Association Commission on Dental Accreditation, which educational credential shall be verified to the satisfaction of the Board by means of the “U.S. Course by Course Report” issued by Educational Credential Evaluators, Inc.

(3) Each ADHP student must be and remain employed full time during the effective period of the training permit. Full time shall mean employment of at least three and one-half (3-1/2) days or thirty (30) hours of Board approved employment per week with their primary certified dentist instructor whose name appears on the training permit. “Board approved employment” means employment that can provide the student the opportunity to perform the types and quantities of procedures required by the ADHP. Any dentist licensed and practicing dentistry full time in the State of Alabama may be issued an “ADHP Instructor Certificate” upon completion of the ADHP Instructor Certification Training and application to the Board of Dental Examiners, which shall have the discretion to grant or deny such certification. The issued certification shall be valid for three (3) years from the date of issuance.

(4) ADHP students may practice only under the direct supervision of the dentist whose name appears on the training permit; however, another dentist employed in the same office who is certified pursuant to this Rule may perform pre and post prophylactic examinations of the ADHP student’s patients.

(5) The closing date for accepting applications for training permits for each year will be determined by the ADHP.

(6) ADHP students are allowed one transfer of their training permit per course year, upon written request, and only upon approval by the ADHP or the Board. During the period of the ADHP student training permit, should the student’s employment with their initial instructor-dentist be terminated, the student will be allowed to continue in the program only if their employment was terminated for a reason acceptable to the Board. Any ADHP student who fails to be employed or supervised by an instructor certified dentist for more than thirty (30) calendar days during the course of the program shall be dismissed from the ADHP. An ADHP student who has participated in the Alabama Dental Hygiene Program twice unsuccessfully may apply to participate in the program a third time at the discretion of the Board after two (2) years of continual full-time employment as a dental assistant.

(7) Each ADHP student must attend every academic instruction session. A student who fails to attend any session of academic instruction shall be dismissed from ADHP unless the student submits a written explanation of the absence within five (5) business days of the absence to the Board office, and receives permission from the Board to continue in the program.

(8) No dentist shall be permitted to train more than one (1) ADHP student at a time.

(9) ADHP students who obtain training in the ADHP must pay a fee in an amount fixed by the Board (this includes training permit, education, and instructional materials fees), which must be enclosed with the application.

(10) Any instance of dishonesty of any kind in any way related to the ADHP shall result in dismissal from the program.

(11) The Board may limit the number of participants to ensure adequate function and integrity of the ADHP.

(12) Any ADHP student who is in good academic standing but, due to pregnancy or maternity, becomes unable to complete the ADHP program (including inability to satisfy the continual employment requirements imposed by subsection (3)) may apply to the Board for permission to withdraw from the current ADHP session and to re-enroll in the next following ADHP session, without payment of the application fee or tuition applicable to the next session.

History

• Author: Alabama Board of Dental Examiners
• Authority: Code of Ala. 1975, §§34-9-26, 34-9-43.
• Filed September 28, 1982. Amended: Filed December 19, 1994; effective January 23, 1995. Amended: Filed April 3, 1997; effective May 8, 1997. Amended: Filed January 30, 1998; effective March 6, 1998. Amended: Filed September 26, 2000; effective October 31, 2000. Amended: Filed February 18, 2003; effective March 25, 2003. Amended: Filed August 11, 2004; effective September 15, 2004. Amended: Filed August 10, 2006; effective September 14, 2006. Amended: Filed December 16, 2008; effective January 20, 2009. Amended: Filed July 21, 2009; effective August 25, 2009. Amended: Filed February 22, 2012; effective March 28, 2012. Amended: Filed December 21, 2012; effective January 25, 2013. Amended: Filed December 10, 2014; effective January 14, 2015. Amended: Filed July 14, 2015; effective August 18, 2015. Amended: Filed January 22, 2018; effective March 8, 2018. Amended: Published November 30, 2020; effective January 14, 2021. Amended: Published November 30, 2021; effective January 14, 2022. Amended: Published August 29, 2025; effective October 13, 2025.

Ala. Admin. Code r. 270-X-3-.05 Replacement And/Or Duplicate Certificate

(1) Replacement

(a) Replacement certificate must be requested in writing. The request for replacement must include the reason for request

(b) Replacement certificate must be marked "replacement certificate."

(c) Replacement certificate should contain date that original certificate was issued and must be signed by the entire Board and contain the date the duplicate is issued.

(d) Fee to be set by the Board

(2) Change of name on license certificate

(a) Any individual desiring a change of name on their certificate must notify the Board in writing and enclose the following.

(i) The reason for the name change (i.e. the legal document used to change the name)

(ii) Original license certificate, if available

(iii) Fee to be set by the Board

(b) The original license certificate will be destroyed upon issuance of a new certificate so marked as “change of name certificate”.

(3) Duplicate certificate.

(a) Any licensee requesting a duplicate certificate must notify the Board in writing and enclose the following:

(i) The reason they are requesting a duplicate certificate and where it will be held.

(ii) Fee to be set by the Board.

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-4, 34-9-16, 34-9-43.
• Filed September 28, 1982. Repealed and New Rule: Filed July 21, 2009; effective August 25, 2009. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.06 Direct Supervision Defined

Direct supervision is defined as supervision by a dentist who authorizes the intraoral procedure to be performed, is physically present in the dental facility and available during performance of the procedure, examines the patient during the procedure and takes full professional responsibility for the completed procedure.

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-27, 34-9-43.
• Filed September 28, 1982. Amended: April 3, 1997; effective May 8, 1997. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.07 Annual Registration For Hygienists

(1) No person shall practice dental hygiene in the State of Alabama unless licensed by the Board and registered annually as required by Code of Ala. 1975.

(2) The secretary-treasurer of the Board shall furnish to every dental hygienist currently licensed and registered to practice in the State of Alabama on or before September 1 of each year, a registration form which shall contain space for the insertion of his/her name, address, date, and number of his/her license certificate and such other information as the Board shall deem necessary.

(3) No later than September 30 of each year, every dental hygienist licensed and registered to practice in the State of Alabama shall transmit to the secretary of the Board the completed form prescribed by the Board, together with the prescribed annual registration fee. The valid period of a certificate of registration shall be exactly one year, commencing on October 1 and ending on September 30 of the following calendar year, without regard to the date on which the annual registration takes place. On October 1 of each year, the license of any dental hygienist who shall have failed to complete the annual registration process as provided in this subsection shall be converted to expired status.

(4) Between October 1 and December 31 of each year, any dental hygienist whose license is converted to expired status as provided in subsection (3) may reinstate his or her license to active status by meeting all applicable requirements for renewal, and by paying the prescribed annual registration fee.

(5)On or about December 1 of each year, the Executive Director shall cause the issuance of the written notices described in Ala. Code §34-9-15(c)(2), via U.S. Mail, to all dental hygienists who, as of such date shall not have completed the annual registration process.

(6) On January 1 of each year, the licenses of all dental hygienists who shall have failed to complete the annual registration process shall automatically be suspended. Any dental hygienist whose license is automatically suspended as provided in this subsection and has remained suspended for less than five years may reinstate his or her license by completing all of the following:

(a) meeting all applicable requirements for reinstatement;

(b) paying the prescribed annual registration fee for all intervening years up to a maximum of five years; and

(c) paying the statutory maximum reinstatement penalty as prescribed by Ala. Code §34-9-16.

(7) Any person who performs any act constituting the practice of dental hygiene without a valid license and annual registration as prescribed by law shall be subject to disciplinary action.

(8) In no case shall a dental hygienist be permitted to complete the annual license registration process unless he or she demonstrates that he or she has fulfilled the continuing education requirements prescribed by Rule 270-X-4-.04.

History

• Author: Board of Dental Examiners of Alabama
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-4, 34-9-28, 34-9-43.
• Filed September 28, 1982. Amended: Filed January 30, 1998; effective March 6, 1998. Amended: Filed July 21, 2009; effective August 25, 2009. Amended: Filed February 22, 2012; effective March 28, 2012. Amended: Published April 30, 2024; effective June 14, 2024.

Ala. Admin. Code r. 270-X-3-.08 Change Of Address Of Dental Hygienists

Every licensed dental hygienist upon changing his/her mailing address or employer shall within thirty (30) days thereafter furnish the secretary-treasurer of the Board with their new address or the address of the new employer.

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-14, 34-9-43.
• Filed September 28, 1982. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.09 Grounds For Disciplinary Action Pertaining To Dental Hygienist License

The Board may refuse to issue the license or license certificate provided for in Code of Ala. 1975, §34-9-1, et seq., or may impose any of the penalties outlined in Code of Ala. 1975, §34-9-18(b), whenever it shall be established to the satisfaction of the Board, after a hearing as provided in Code of Ala. 1975, §§34-9-18, 34-9-24, and the Alabama Administrative Procedure Act, that any licensed dental hygienist has been guilty of any of the provisions of Code of Ala. 1975, §§34-9-1, et seq., including but not limited to Code of Ala. 1975, §34-9-18.

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-18, 34-9-24, 34-9-43.
• Filed September 28, 1982. Amended: Filed April 19, 1989. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.10 Duties Of Allied Dental Personnel

Allied dental personnel are dental hygienists, dental assistants and dental laboratory technicians. Subject to the prohibition that no intra-oral procedure can be performed unless under the direct supervision of a duly licensed dentist as defined by Board rule, the following allied dental personnel may perform the following:

(1) Dental Laboratory Technicians:

(a) No intra-oral duties are allowable other than assisting the dentist in determining tooth color.

(2) Dental Assistants and Dental Hygienists:

(a) Preliminary charting and inspection of the oral cavity. (Final examination and diagnosis must be made by a dentist before treatment can be instituted.)

(b) Apply topical agents under direct supervision of the dentist.

1. Apply topical anesthetics.

2. Oxygenating Agents. (Excluding endodontic therapy.)

3. Apply anti-inflammatory agents.

4. Apply astringents.

5. Desensitizing agents.

6. Topical fluoride.

7. Apply light-cured medicinal bonding agents.

8. Apply etchant materials.

(c) Place and remove rubber dam.

(d) Place and remove periodontal dressings.

(e) Place and remove alveolar socket dressings.

(f) Construct and remove with hand instruments only interim restorations. (Interim restorations being any restoration placed while a more permanent restoration is being completed.)

(g) Construct and place temporary crowns (excluding stainless steel crowns placed with intentions of reasonable permanency.)

(h) Contour stainless steel or chrome crowns but cannot cement them.

(i) Pre-fit and pre-contour orthodontic appliances either extra-orally or intra-orally for final adaptation by the dentist.

(j) Remove excess cement with hand instruments from around permanent dental restorations and orthodontic appliances.

(k) Make impressions for diagnostic casts or opposing casts.

(l) Place, wedge and remove matrices for operative dentistry.

(m) Take and record case history, blood pressure, pulse, and oral temperature.

(n) Remove intraoral sutures. (Excluding wire sutures.)

(o) Make dental radiographs or digital images.

(p) Give oral hygiene instructions including plaque staining, flossing, brushing, and caries susceptibility tests.

(q) Place cavity liners and bases. (Excluding capping of exposed pulpal tissues.)

(r) Assist in the administering of N20 and 02.

(s) Insert into the mouth of the patient wax models of dentures, partial dentures, or any other structures and make adjustments outside the mouth of the patient to such wax models pursuant to written or verbal instructions or directions from the dentist; provided, however,

1. That the dental hygienist or dental assistant may use these wax models of dentures, partial dentures or any other structure to register the jaw relationships or occlusal relationships of the patient, and

2. That before such wax models may be used for the manufacture of dentures, partial dentures or other structures the dentist shall personally consult with the patient, examine such wax models, and make such additional adjustments as may be required.

(t) Insert into the mouth of the patient dentures, partial dentures, removable orthodontic appliances, prostheses, devices to treat sleep apnea or anti-snoring devices, or any other structures and make adjustments outside the mouth of the patient to the dentures, prostheses (fixed or removable), removable orthodontic appliances, prosthetic appliances, bridges, or other structures pursuant to written or verbal instructions or directions from the dentist; provided, however,

1. That before such prostheses (fixed or removable), removable orthodontic appliances, or other structures are delivered to the patient leaving the dental office with such removable orthodontic appliances, prostheses (fixed or removable) or other structures the dentist shall personally consult with the patient, examine such prostheses (fixed or removable), removable orthodontic appliances, or other structures, and make such additional adjustments as may be required; and

2. That final placement and cementation of all fixed appliances, fixed prostheses and other fixed structures shall be performed by the dentist.

(u) Apply reversible liners and bases to prostheses, orthodontic appliances, or any other structures. However, the dentist shall personally consult with the patient and examiner such liners and bases, and make such additional adjustments as may be required.

(v) Place and remove gingival retraction materials.

(w) Make final impressions for removable and fixed prostheses, orthodontic appliances, retainers, devices to treat sleep apnea or anti-snoring devices, and medicament/whitening delivery trays. However, before said impressions may be used for the manufacture of prostheses and appliances, the dentist shall examine and approve such impressions for accuracy.

(x) Use laser and/or narrow band (light) imaging technology for preliminary diagnostic purposes only with the dentist’s final examination and diagnosis.

(y) Perform coronal polishing under the direct supervision of a duly licensed dentist; provided the final evaluation of the patient’s oral condition and determination of the need for additional prophylaxis or periodontal treatment shall be made by the supervising dentist, as permitted by law.

(z) Place pit and fissure sealants under the direct supervision of a duly licensed dentist; provided the supervising dentist shall make the final evaluation of the patient’s oral condition and determine the overall treatment plan.

(3) Dental Hygienists Only:

(a) Remove extrinsic stains, accretions, and calcareous deposits from teeth.

(b) Gingival curettage.

(c) Root planning.

(d) Place resorbable chlorhexidine chips.

(e) Place topical or sub-gingival antimicrobial or antibacterial agents.

(f) Periodontal probing.

(g) Bleaching of teeth.

History

• Author: Board of Dental Examiners
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-6, 34-9-27, 34-9-43.
• Filed September 28, 1982. Amended: Filed February 12, 1985; June 9, 1987. Amended: Filed April 3, 1997; effective May 8, 1997. Amended: Filed September 26, 2000; effective October 31, 2000. Amended: Filed July 11, 2003; effective August 15, 2003. Amended: Filed March 8, 2007; effective April 12, 2007. Amended: Filed February 22, 2012; effective March 28, 2012. Amended: Filed November 6, 2012; effective December 11, 2012. Amended: Filed May 17, 2016; effective July 1, 2016. Amended: Filed January 22, 2018; effective March 8, 2018. Amended: Published February 27, 2026; effective April 13, 2026.

Ala. Admin. Code r. 270-X-3-.11 Statement Of Charges And Notice Of Hearing Before Imposition Of Disciplinary Penalties

No imposition of any of the disciplinary penalties set forth and outlined in Code of Ala. 1975, §34-9-18(b), shall be taken until the licensee has been furnished a statement in writing of the charges against him/her and with a notice of the time and place of the hearing. The statement of charges shall be in compliance with Code of Ala. 1975, §§34-9-24, 41-22-12(b).

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-24, 34-9-43, 41-22-12.
• Filed September 28, 1982. Amended: Filed April 19, 1989. Amended: Filed February 22, 2012; effective March 28, 2012.

Ala. Admin. Code r. 270-X-3-.12 Dental Hygiene Advisor (Repealed 3/06/98)

(Repealed)

History

• Author: James S. Ward
• Authority: Code of Ala. 1975, §§34-9-2, 34-9-43(1)(8)(10).
• Filed June 24, 1985. Amended: Filed September 26, 1989. Repealed: Filed January 30, 1998; effective March 6, 1998.