Orthodontic Treatment In-Person Exam Req.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 1205

Short Title: Orthodontic Treatment In-Person Exam Req. (Public)
Sponsors: Representative G. Pierce.
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Appropriations, if favorable, Rules, Calendar, and Operations of the House
May 5, 2026
*H1205-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REQUIRE AN IN-PERSON EVALUATIO N FOR PATIENTS PRIOR TO 2
ORTHODONTIC DEVICE SERVICES. 3
The General Assembly of North Carolina enacts: 4
SECTION 1. Article 2 of Chapter 90 is amended by adding a new section to read: 5
"§ 90-29.6. Certain orthodontic device and treatment requirements. 6
(a) Definitions. – The following definitions apply in this section: 7
(1) Licensed dentist. – As defined in G.S. 90-30.2(a). 8
(2) Orthodontic device. – Any Class II or Class III medical device, as defined by 9
21 U.S.C. § 360c and 21 CFR § 860.3 that meets all of the following: 10
a. Used in orthodontic treatment to (i) move a patient 's teeth or jaw or 11
(ii) correct a misalignment or malposition. 12
b. Manufactured to address the specific orthodontic needs of an 13
individual patient. 14
(b) Limitation. – A person shall not sell an orthodontic device or provide a service related 15
to the design or manufacture of an orthodontic device to a patient, unless the person is a licensed 16
dentist who is in compliance with subsection (c) of this section, or receives written or electronic 17
confirmation from a licensed dentist who has provided the services prescribed in subsection (c) 18
of this section. 19
(c) Criteria. – A person shall not sell an orthodontic device or provide a service related 20
to the design or manufacture of an orthod ontic device to a patient in this State who has not 21
received all of the following: 22
(1) An in-person intraoral dental examination and an examination of the patient's 23
head and neck. 24
(2) A review of rec ently performed x -rays, panoramic x -rays, computed 25
tomography, bone imaging scans, or other appropriate diagnostic imaging 26
sufficient to allow the licensed dentist to detect the patient conditions that 27
preclude or contraindicate the provision of safe ortho dontic treatment, 28
including the following: 29
a. Untreated caries. 30
b. Gingivitis and periodontal disease. 31
c. Issues with the roots of teeth in the periodontium, including short 32
roots. 33
d. The presence of an osseointegrated dental implant or other fixed dental 34
appliance. 35
General Assembly Of North Carolina Session 2025
Page 2 House Bill 1205-First Edition
e. Fractured, cracked, or split teeth or roots. 1
f. Any other oral pathology or condition that precludes orthodontic 2
treatment. 3
(3) A prescription for an orthodontic device issued by either of the following: 4
a. The licensed dentist who (i) provided the examination under 5
subdivision (1) of this subs ection and (ii) reviewed the appropriate 6
diagnostic imaging under subdivision (2) of this subsection. 7
b. The licensed dentist who (i) will conduct and monitor the patient 's 8
orthodontic treatment and (ii) has received or requested either of the 9
following: 10
1. A referral from the patient's licensed dentist under subdivision 11
(1) of this subsection. 12
2. Clearance for orthodontic treatment from the patient's licensed 13
dentist. 14
(4) Subject to sub section (d) of this section, advice and counsel by a licensed 15
dentist under subdivision (3) of this subsection regarding available 16
orthodontic treatment options and the risks associated with those treatments. 17
(5) A review of the patient's medical and dental health histories. 18
(d) Consent. – The required advice and counsel under subdivision (c)(4) of this section 19
must be signed by the patient acknowledgin g and verifying that the patient received the advice 20
and counsel from the licensed dentist. The licensed dentist that provides the advice and counsel 21
shall attach and maintain the patient's written acknowledgement and verification in the patient 's 22
file. 23
(e) Records. – A licensed dentist shall maintain all records and documents regarding a 24
sale of an orthodontic device to a patient or provision of services related to the design or 25
manufacture of that device for no less than seven years after the date of sale or provision of those 26
services. 27
(f) Condition. – A licensed dentist shall not require a patient to agree to use a particular 28
type of orthodontic device as a condition of performing the examination or review described in 29
this section. 30
(g) Disclosure of Records. – Upon request of another licensed dentist, the dentist 31
providing an orthodontic device or related services to a patient must disclose and provide any 32
patient records collected under this section in the course of treatment." 33
SECTION 2. The North Carolina State Board of Dental Examiners may adopt rules 34
to implement the provisions of this act. 35
SECTION 3. There is appropriated from the General Fund to the Department of 36
Health and Human Services, the sum of fifty thousand dollars ($50,000) for the 2026-2027 fiscal 37
year to educate the public of the prov isions of this act. The Department shall consult with the 38
North Carolina State Board of Dental Examiners in educating the public. 39
SECTION 4. Section 3 of this act becomes effective July 1, 2026. Section 1 of this 40
act becomes effective October 1, 2026. The remainder of this act is effective when it becomes 41
law. 42