DENTAL HYGIENISTS IN DENTAL HEALTH ACT

HB0258

HOUSE BILL 258

57th legislature - STATE OF NEW MEXICO - second session, 2026

INTRODUCED BY

Pamelya Herndon

AN ACT

RELATING TO LICENSURE; AMENDING THE DENTAL HEALTH CARE ACT TO
EXPAND THE SCOPE OF PRACTICE OF CERTAIN TYPES OF DENTAL
HYGIENISTS.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

SECTION 1.
Section 61-5A-3 NMSA 1978 (being Laws 1994,
Chapter 55, Section 3, as amended) is amended to read:

"61-5A-3. DEFINITIONS.--As used in the Dental Health Care
Act:

A. "assessment" means the review and documentation
of the oral condition, and the recognition and documentation of
deviations from the healthy condition, without a diagnosis to
determine the cause or nature of disease or its treatment;

B. "board" means the New Mexico board of dental
health care;

C. "certified dental assistant" means [
an
individual
]
a person
certified by the dental assisting national
board;

D. "collaborating dentist" means a dentist who has
entered into an agreement to provide consultation and create
protocols with a collaborating dental hygienist in accordance
with the rules of the board and the committee;

[
D.
]
E.
"collaborative dental hygiene practice"
means [
a New Mexico licensed dental hygienist practicing
according to Subsections D through G of Section 61-5A-4 NMSA
1978
]
the application of the science of prevention and
treatment of oral disease through the practice of dental
hygiene and in a cooperative working relationship with a
collaborating dentist
;

[
E.
]
F.
"committee" means the New Mexico dental
hygienists committee;

[
F.
]
G.
"community dental health coordinator" means
a dental assistant, a dental hygienist or other trained
personnel certified by the board as a community dental health
coordinator to provide educational, preventive and limited
palliative care and assessment services working collaboratively
under the general supervision of a licensed dentist in settings
other than traditional dental offices and clinics;

[
G. "consulting dentist" means a dentist who has
entered into an approved agreement to provide consultation and
create protocols with a collaborating dental hygienist and,
when required, to provide diagnosis and authorization for
services, in accordance with the rules of the board and the
committee;

H. "dental hygiene-focused assessment" means the
documentation of existing oral and relevant system conditions
and the identification of potential oral disease to develop,
communicate, implement and evaluate a plan of oral hygiene care
and treatment;

I.
]
H.
"dental assistant certified in expanded
functions" means a dental assistant who meets specific
qualifications set forth by rule of the board;

I. "dental hygiene diagnosis" means the
professional judgment rendered by a licensed dental hygienist
to identify, interpret and determine oral health conditions,
risks and patient needs that are within the dental hygienist's
scope of practice and that may be addressed through preventive,
therapeutic or nonsurgical dental hygiene services, education,
counseling and referral;

J. "dental hygienist" means [
an individual
]
a
person
who has graduated and received a degree from a dental
hygiene educational program that is accredited by the
commission on dental accreditation, that provides a minimum of
two academic years of dental hygiene curriculum and that is an
institution of higher education; and "dental hygienist" means,
except as the context otherwise requires, [
an individual
]
a
person
who holds a license to practice dental hygiene in New
Mexico;

K. "dental laboratory" means any place where dental
restorative, prosthetic, cosmetic and therapeutic devices or
orthodontic appliances are fabricated, altered or repaired by
one or more persons under the orders and authorization of a
dentist;

L. "dental technician" means [
an individual
]
a
person
, other than a licensed dentist, who fabricates, alters,
repairs or assists in the fabrication, alteration or repair of
dental restorative, prosthetic, cosmetic and therapeutic
devices or orthodontic appliances under the orders and
authorization of a dentist;

M. "dental therapist" means [
an individual
]
a
person
who:

(1) is licensed as a dental hygienist;

(2) has provided, in accordance with board
rules, evidence to the board that the [
individual
]
person
has
graduated and received a degree from a dental therapy education
program that is accredited by the commission on dental
accreditation; and

(3) except as the context otherwise requires,
is licensed to practice dental therapy in the state;

N. "dental therapy post-graduate clinical
experience" means advanced training in patient management and
technical competency:

(1) that is approved by the board, based on
educational and supervisory criteria developed by the board and
established by board rule;

(2) that is sanctioned by a regionally
accredited educational institution with a program accredited by
the commission on dental accreditation;

(3) that consists of two thousand hours of
advanced training or, if the dental therapy educational program
graduate has five years of experience as a dental hygienist,
one thousand five hundred hours of advanced training; and

(4) for which the dental therapist may have
been compensated;

O. "dental therapy practice agreement" means a
contract between a supervising dentist and a dental therapist
that outlines the parameters of care, level of supervision and
protocols to be followed while performing dental therapy
procedures on patients under the supervising dentist's and
dental therapist's care;

P. "dentist" means [
an individual
]
a person
who has
graduated and received a degree from a school of dentistry that
is accredited by the commission on dental accreditation and,
except as the context otherwise requires, who holds a license
to practice dentistry in New Mexico;

Q. "direct supervision" means the process under
which an act is performed when a dentist licensed pursuant to
the Dental Health Care Act:

(1) is physically present throughout the
performance of the act;

(2) orders, controls and accepts full
professional responsibility for the act performed; and

(3) evaluates and approves the procedure
performed before the patient departs the care setting;

R. "expanded-function dental auxiliary" means a
dental assistant, dental hygienist or other dental practitioner
that has received education beyond that required for licensure
or certification in that [
individual's
]
person's
scope of
practice and that has been certified by the board as an
expanded-function dental auxiliary who works under the direct
supervision of a dentist;

S. "federally qualified health center" means a
health facility that the United States department of health and
human services has deemed to qualify for federal funds as a
federally qualified health center;

T. "federally qualified health center look-alike
facility" means a health facility that the federal centers for
medicare and medicaid services certifies as a federally
qualified health center look-alike facility;

U. "general supervision" means the authorization by
a dentist of the procedures to be used by a dental therapist,
community dental health coordinator, dental hygienist, dental
assistant or dental student and the execution of the procedures
in accordance with a dentist's diagnosis and treatment plan at
a time the dentist is not physically present and in facilities
as designated by rule of the board;

V. "indirect supervision" means that a dentist, or
in certain settings, a dental therapist, dental hygienist or
dental assistant certified in expanded functions, is present in
the treatment facility while authorized treatments are being
performed by a dental therapist, dental hygienist, dental
assistant or dental student;

W. "long-term care facility" means a nursing home
licensed by the [
department of
] health
care authority
to
provide intermediate or skilled nursing care;

X. "non-dentist owner" means [
an individual
]
a
person
not licensed as a dentist in New Mexico or a corporate
entity not owned by a majority interest of a New Mexico
licensed dentist that employs or contracts with a dentist or
dental hygienist to provide dental or dental hygiene services;

Y. "nonprofit community dental organization" means
a community-supported entity that:

(1) provides clinical dental services
primarily to low-income patients or medicaid recipients; and

(2) has demonstrated to the taxation and
revenue department that it has been granted exemption from the
federal income tax by the United States commissioner of
internal revenue as an organization described in Section
501(c)(3) of the United States Internal Revenue Code of 1986,
as amended or renumbered;

Z. "palliative procedures" means nonsurgical,
reversible procedures that are meant to alleviate pain and
stabilize acute or emergent problems; [
and
]

AA. "public health dental hygienist" means a
licensed dental hygienist who is certified by the committee to
practice without supervision in public health and
nontraditional settings by delivering educational, assessment,
preventive, clinical, therapeutic and dental hygiene diagnostic
services within the dental hygienist's scope of practice; and

[
AA.
]
BB.
"teledentistry" means a dentist's, dental
hygienist's or dental therapist's use of electronic
information, imaging and communication technologies, including
interactive audio, video and data communications as well as
store-and-forward technologies, to provide and support dental
health care delivery, diagnosis, consultation, treatment,
transfer of dental data and education."

SECTION 2.
Section 61-5A-4 NMSA 1978 (being Laws 1994,
Chapter 55, Section 4, as amended) is amended to read:

"61-5A-4. SCOPE OF PRACTICE.--

A. As used in the Dental Health Care Act, "practice
of dentistry" means:

(1) the diagnosis, treatment, correction,
change, relief, prevention, prescription of remedy, surgical
operation and adjunctive treatment for any disease, pain,
deformity, deficiency, injury, defect, lesion or physical
condition involving both the functional and aesthetic aspects
of the teeth, gingivae, jaws and adjacent hard and soft tissue
of the oral and maxillofacial regions, including the
prescription or administration of any drug, medicine, biologic,
apparatus, brace, anesthetic or other therapeutic or diagnostic
substance or technique by [
an individual
]
a person
or the
[
individual's
]
person's
agent or employee gratuitously or for
any fee, reward, emolument or any other form of compensation
whether direct or indirect;

(2) representation of an ability or
willingness to do any act mentioned in Paragraph (1) of this
subsection;

(3) the review of dental insurance claims for
therapeutic appropriateness of treatment, including but not
limited to the interpretation of radiographs, photographs,
models, periodontal records and narratives;

(4) the offering of advice or authoritative
comment regarding the appropriateness of dental therapies, the
need for recommended treatment or the efficacy of specific
treatment modalities for other than the purpose of consultation
to another dentist; or

(5) with specific reference to the teeth,
gingivae, jaws or adjacent hard or soft tissues of the oral and
maxillofacial region in living persons, to propose, agree or
attempt to do or make an examination or give an estimate of
cost with intent to, or undertaking to:

(a) perform a physical evaluation of a
patient in an office or in a hospital, clinic or other medical
or dental facility prior to, incident to and appropriate to the
performance of any dental services or oral or maxillofacial
surgery;

(b) perform surgery, an extraction or
any other operation or to administer an anesthetic in
connection therewith;

(c) diagnose or treat a condition,
disease, pain, deformity, deficiency, injury, lesion or other
physical condition;

(d) correct a malposition;

(e) treat a fracture;

(f) remove calcareous deposits;

(g) replace missing anatomy with an
artificial substitute;

(h) construct, make, furnish, supply,
reproduce, alter or repair an artificial substitute or
restorative or corrective appliance or place an artificial
substitute or restorative or corrective appliance in the mouth
or attempt to adjust it;

(i) give interpretations or readings of
dental radiographs;

(j) provide limited diagnostic and
treatment planning via teledentistry; or

(k) do any other remedial, corrective or
restorative work.

B. As used in the Dental Health Care Act, "the
practice of dental hygiene" means the application of the
science of the prevention and treatment of oral disease through
the provision of educational, assessment, preventive, clinical,

dental hygiene diagnostic
and other therapeutic services [
under
the general supervision of a dentist
]. A dental hygienist in a
collaborative practice [
may perform the procedures listed in
this section without general supervision while the hygienist is
in a cooperative working relationship with a consulting
dentist
]
or a public health dental hygienist may perform the
procedures listed in this section
, pursuant to rules
promulgated by the board and the committee. "The practice of
dental hygiene" includes:

(1) prophylaxis, which is the removal of
plaque, calculus and stains from the tooth structures as a
means to control local irritational factors;

(2) removing diseased crevicular tissue and
related nonsurgical periodontal procedures;

(3) except in cases where a tooth exhibits
cavitation of the enamel surface, assessing without a dentist's
evaluation whether the application of pit and fissure sealants
is indicated;

(4) except in cases where a tooth exhibits
cavitation of the enamel surface, applying pit and fissure
sealants without mechanical alteration of the tooth;

(5) applying fluorides and other topical
therapeutic and preventive agents;

(6) exposing and assessing oral radiographs
for abnormalities;

(7) screening to identify indications of oral
abnormalities;

(8) performing dental [
hygiene-focused
assessments
]
hygiene diagnosis
;

(9) assessing periodontal conditions; and

(10) such other closely related services as
permitted by the rules of the committee and the board.

C. In addition to performing dental hygiene as
defined in Subsection B of this section, a dental hygienist may
apply preventive topical fluorides and remineralization agents
without supervision in public and community medical facilities,
schools, hospitals, long-term care facilities and such other
settings as the committee may determine by rule ratified by the
board, so long as the dental hygienist's license is not
restricted pursuant to the Impaired Dentists and Dental
Hygienists Act.

D. In addition to performing dental hygiene as
defined in Subsection B of this section, dental hygienists who
have met the criteria as the committee shall establish and the
board shall ratify may administer local anesthesia under
indirect supervision of a dentist.

E. The board may certify a dental hygienist to
administer local anesthetic under the general supervision of a
dentist if the dental hygienist, in addition to performing
dental hygiene as defined in Subsection B of this section:

(1) has administered local anesthesia under
the indirect supervision of a dentist for at least two years,
during which time the dental hygienist has competently
administered at least twenty cases of local anesthesia and can
document this with a signed affirmation by the supervising
dentist;

(2) administers local anesthetic under the
written prescription or order of a dentist; and

(3) emergency medical services are available
in accordance with rules promulgated by the board.

F. The board may certify a public health dental
hygienist or a dental hygienist certified for collaborative
dental hygiene practice
to administer local anesthetic without
supervision if the dental hygienist, in addition to performing
dental hygiene as defined in Subsection B of this section, has
administered local anesthesia under the indirect supervision of
a dentist for at least two years, during which time the dental
hygienist has competently administered at least twenty cases of
local anesthesia and can document this with a signed
affirmation by the supervising dentist
.

[
F.
]
G.
A dental hygienist:

(1) may prescribe, administer and dispense a
fluoride supplement, topically applied fluoride or topically
applied antimicrobial only when the prescribing, administering
or dispensing is performed:

(a) under the supervision of a dentist,

unless the dental hygienist is a public health dental hygienist
or certified for collaborative dental hygiene practice
;

(b) pursuant to rules the board and the
committee have adopted;

(c) within the parameters of a drug
formulary approved by the board in consultation with the board
of pharmacy;

(d) within the parameters of guidelines
established pursuant to Section 61-5A-10 NMSA 1978; and

(e) in compliance with state laws
concerning prescription packaging, labeling and recordkeeping
requirements; and

(2) shall not otherwise dispense [
dangerous
drugs or
] controlled substances.

[
G.
]
H.
A New Mexico licensed dental hygienist may
be certified:

(1)
for collaborative dental hygiene practice
in accordance with the educational and experience criteria
established collaboratively by the committee and the board;
and

(2) as a public health dental hygienist to
practice without supervision or collaborative agreement in
public health settings and in accordance with the educational
and experience criteria established by the committee
.

[
H.
]
I.
An expanded-function dental auxiliary may
perform the following procedures under the direct supervision
of a dentist:

(1) placing and shaping direct restorations;

(2) taking final impressions, excluding those
for fixed or removable prosthetics involving multiple teeth;

(3) cementing indirect and provisional
restorations for temporary use;

(4) applying pit and fissure sealants without
mechanical alteration of the tooth;

(5) placing temporary and sedative restorative
material in hand-excavated carious lesions and unprepared tooth
fractures;

(6) removal of orthodontic bracket cement; and

(7) fitting and shaping of stainless steel
crowns to be cemented by a dentist.

[
I.
]
J.
An expanded-function dental auxiliary may
re-cement temporary or permanent crowns with temporary cement
under the general supervision of a dentist in a situation that
a dentist deems to be an emergency.

[
J.
]
K.
An expanded-function dental auxiliary may
perform other related functions for which the expanded-function
dental auxiliary meets the training and educational standards
established by the board and that are not expressly prohibited
by the board.

[
K. For the purpose of this section, "collaborative
dental hygiene practice" means the application of the science
of the prevention and treatment of oral disease through the
provision of educational, assessment, preventive, clinical and
other therapeutic services as specified in Subsection B of this
section in a cooperative working relationship with a consulting
dentist, but without general supervision as set forth by the
rules established and approved by both the board and the
committee.
]"

SECTION 3.
Section 61-5A-5 NMSA 1978 (being Laws 1994,
Chapter 55, Section 5, as amended) is amended to read:

"61-5A-5. LICENSE REQUIRED--EXEMPTIONS.--

A. Unless licensed to practice as a dentist under
the Dental Health Care Act, no person shall:

(1) practice dentistry;

(2) use the title "dentist", "dental surgeon",
"oral surgeon" or any other title, abbreviation, letters,
figures, signs or devices that indicate the person is a
licensed dentist; or

(3) perform any of the acts enumerated under
the definition of the practice of dentistry as defined in the
Dental Health Care Act.

B. The following, under the stipulations described,
may practice dentistry or an area of dentistry without a New
Mexico dental license:

(1) regularly licensed physicians or surgeons
are not prohibited from extracting teeth or treating any
disease coming within the province of the practice of medicine;

(2) New Mexico licensed dental hygienists and
community dental health coordinators may provide those services
within their scope of practice that are also within the scope
of the practice of dentistry;

(3) any dental student duly enrolled in an
accredited school of dentistry recognized by the board, while
engaged in educational programs offered by the school in
private offices, public clinics or educational institutions
within the state of New Mexico under the indirect supervision
of a licensed dentist;

(4) any dental hygiene or dental assisting
student duly enrolled in an accredited school of dental hygiene
or dental assisting engaged in procedures within or outside the
scope of dental hygiene that are part of the curriculum of that
program in the school setting and under the indirect
supervision of a faculty member of the accredited program who
is a licensed dentist, dental hygienist or dental assistant
certified in the procedures being taught;

(5) unlicensed persons performing for a
licensed dentist merely mechanical work upon inert matter in
the construction, making, alteration or repairing of any
artificial dental substitute, dental restorative or corrective
appliance, when the casts or impressions for the work have been
furnished by a licensed dentist and where the work is
prescribed by a dentist pursuant to a written authorization by
that dentist;

(6) commissioned dental officers of the
uniformed forces of the United States and dentists providing
services to the United States public health service, the United
States department of veterans affairs or within federally
controlled facilities in the discharge of their official
duties; provided that such persons who hold dental licenses in
New Mexico shall be subject to the provisions of the Dental
Health Care Act;

(7) dental assistants performing adjunctive
services to the provision of dental care, under the indirect
supervision of a dentist, as determined by rule of the board if
such services are not within the practice of dental hygiene as
specifically listed in Subsection B of Section 61-5A-4 NMSA
1978, unless allowed in Subsection F of this section;

(8) a dental therapy student or graduate of a
dental therapy educational program enrolled in a board-approved
program while engaged in an educational program offered by the
dental therapy educational program or dental therapy post-graduate clinical experience in a private office, public clinic
or educational institution within the state of New Mexico under
the indirect supervision of a licensed dentist; and

(9) a dental therapist who is licensed in New
Mexico working under the supervision of a dentist and
performing the procedures in accordance with the provisions of
Section [
9 of this 2019 act
]
61-5A-13.1 NMSA 1978
.

C. Unless licensed to practice as a dental
therapist under the Dental Health Care Act, no person shall:

(1) practice as a dental therapist;

(2) use the title, abbreviation "D.T.",
letters, figures, signs or devices that indicate the person is
a licensed dental therapist; or

(3) perform any of the acts defined as the
practice of dental therapy in the Dental Health Care Act.

D. Unless licensed to practice as a dental
hygienist under the Dental Health Care Act, no person shall:

(1) practice as a dental hygienist;

(2) use the title "dental hygienist" or
abbreviation "R.D.H." or any other title, abbreviation,
letters, figures, signs or devices that indicate the person is
a licensed dental hygienist; or

(3) perform any of the acts defined as the
practice of dental hygiene in the Dental Health Care Act.

E. The following, under the stipulations described,
may practice dental hygiene or the area of dental hygiene
outlined without a New Mexico dental hygiene license:

(1) students enrolled in an accredited dental
hygiene program engaged in procedures that are part of the
curriculum of that program and under the indirect supervision
of a licensed faculty member of the accredited program;

(2) dental assistants and community dental
health coordinators working under general supervision who:

(a) expose dental radiographs after
being certified in expanded functions by the board;

(b) perform rubber cup coronal
polishing, which is not represented as a prophylaxis, having
satisfied the educational requirements as established by rules
of the board;

(c) apply fluorides as established by
rules of the board; and

(d) perform those other dental hygienist
functions as recommended to the board by the committee and set
forth by rule of the board; and

(3) dental assistants certified in expanded
functions, working under the indirect supervision of a dental
hygienist certified for collaborative practice and under the
protocols established in a collaborative practice agreement
with a [
consulting
]
collaborating
dentist.

F. Dental assistants working under the indirect
supervision of a dentist and in accordance with the rules and
regulations established by the board may:

(1) expose dental radiographs;

(2) perform rubber cup coronal polishing that
is not represented as a prophylaxis;

(3) apply fluoride and pit and fissure
sealants without mechanical alteration of the tooth;

(4) perform those other dental hygienist
functions as recommended to the board by the committee and set
forth by rule of the board; and

(5) perform such other related functions that
are not expressly prohibited by statute or rules of the board.

G. A community dental health coordinator working
under the general supervision of a dentist and in accordance
with the rules established by the board may:

(1) place temporary and sedative restorative
material in unexcavated carious lesions and unprepared tooth
fractures;

(2) collect and transmit diagnostic data and
images via telemetric connection;

(3) dispense and apply medications on the
specific order of a dentist;

(4) provide limited palliative procedures for
dental emergencies in consultation with a supervising dentist
as allowed by the rules the board has promulgated; and

(5) perform other related functions for which
the community dental health coordinator meets training and
educational standards established by the board and that are not
expressly prohibited by statute or rules promulgated by the
board.

H. Unless licensed as a dentist or non-dentist
owner, or as otherwise exempt from the licensing requirements
of the Dental Health Care Act, no individual or corporate
entity shall:

(1) employ or contract with a dentist or
dental hygienist for the purpose of providing dental or dental
hygiene services as defined by their respective scopes of
practice; or

(2) enter into a managed care or other
agreement to provide dental or dental hygiene services in New
Mexico.

I. The following, under stipulations described, may
function as a non-dentist owner without a New Mexico license:

(1) government agencies providing dental
services within affiliated facilities;

(2) government agencies engaged in providing
public health measures to prevent dental disease;

(3) spouses of deceased licensed dentists or
dental hygienists for a period of one year following the death
of the licensee;

(4) accredited schools of dentistry, dental
hygiene and dental assisting providing dental services solely
in an educational setting;

(5) dental hygienists licensed in New Mexico
or corporate entities with a majority interest owned by a
dental hygienist licensed in New Mexico;

(6) federally qualified health centers, as
designated by the United States department of health and human
services, providing dental services;

(7) nonprofit community dental organizations;
and

(8) hospitals licensed by the [
department of
]
health
care authority
."

- 23 -