1. (1) Pursuant to 37-4-405, MCA, the LAP dental hygienist practicing under public health supervision, including providing prescriptive services, shall adhere to the following guidelines:

   1. (a) The LAP dental hygienist shall gather and review the patient's current medical history, including but not limited to:

      1. (i) diagnosed chronic diseases;
      2. (ii) surgical procedures;
      3. (iii) medications;
      4. (iv) drug allergies and/or adverse reactions;
      5. (v) blood pressure and pulse rate; and
      6. (vi) previous difficulty associated with dental procedures.

   2. (b) The LAP dental hygienist may provide dental hygiene preventative services to a patient without prior physician, dentist, nurse practitioner, or physician assistant authorization, unless the patient has:

      1. (i) a medical condition requiring premedication;
      2. (ii) uncontrolled hypertension; or
      3. (iii) uncontrolled diabetes.
   3. (c) If a patient has one or more severe systemic diseases, the LAP dental hygienist shall consult with a physician, dentist, nurse practitioner, or physician assistant responsible for the patient's care regarding the appropriateness of treatment and the conditions under which to provide dental hygiene preventative services.

2. (2) Pursuant to 37-4-405, MCA, the LAP dental hygienist practicing under public health supervision shall adhere to the following guidelines:

   1. (a) The LAP dental hygienist shall provide the public health facility or school-based oral health program with a disclaimer indicating that the dental hygiene preventative services provided do not preclude the need for a comprehensive examination by a licensed dentist.
   2. (b) The LAP dental hygienist shall recommend patient referral to a licensed Montana dentist once each calendar year, or as the patient's dental health status indicates. The patient's records shall be made available for continued comprehensive dental care.
   3. (c) The LAP dental hygienist shall document the patient dental history and conduct a screening appraisal prior to providing dental hygiene preventative services.
   4. (d) If a LAP dental hygienist exposes radiographs, a licensed Montana dentist shall evaluate the radiographs within 30 days of exposure.

   5. (e) The LAP dental hygienist is responsible for maintaining a dental record including, but not limited to:

      1. (i) adverse medical history;
      2. (ii) dental history and charting;
      3. (iii) results of dental screening;
      4. (iv) summary of discussions and consultations with a physician(s) and/or dentist(s);
      5. (v) dental hygiene preventative services provided;
      6. (vi) any agent prescribed, administered, or dispensed including dose amount and refill, date of the action, and rationale for prescribing; and
      7. (vii) any radiographs exposed.

Authorizing statute(s): 37-1-131, 37-4-205, 37-4-401, 37-4-405, MCA

Implementing statute(s): 37-1-131, 37-4-401, 37-4-405, MCA

History: NEW, 2004 MAR p. 1955, Eff. 8/20/04; AMD, 2014 MAR p. 1837, Eff. 8/8/14; AMD, 2018 MAR p. 1279, Eff. 7/7/18; AMD, 2025 MAR, Notice No. 2025-273, Eff. 12/20/25.