Rules & Regulations of the State of Tennessee Title 0460 - Dentistry
I. Purpose and Legal Authority of Title 0460 – Dentistry
Title 0460 is promulgated by the Tennessee Board of Dentistry under the authority of:
Tennessee Code Annotated (T.C.A.) § 63-5-101 et seq. – The Dental Practice Act
Tennessee Administrative Procedures Act (T.C.A. § 4-5-101 et seq.)
Purpose:
Protect public health and safety regarding dental care
Regulate the practice of dentistry in Tennessee
Establish licensure, standards of practice, and disciplinary procedures
Legal Authority:
Regulations have the force of law; violating them can result in administrative or criminal penalties.
Courts in Tennessee have repeatedly upheld the Board’s regulations, giving deference unless a rule exceeds statutory authority.
II. Structure of Title 0460 – Dentistry
Title 0460 is organized into chapters and parts that govern:
1. Licensing and Qualifications
Requirements to obtain a dental license in Tennessee
Graduation from an accredited dental school
Passing written and clinical examinations (National Board + state or equivalent)
Criminal background checks
License renewal requirements
Continuing education mandates
2. Scope of Practice
Definition of dentistry and dental hygiene
Procedures authorized for dentists vs. dental hygienists
Rules for supervision of dental hygienists and assistants
Cosmetic and elective procedures
3. Standards of Professional Conduct
Ethical requirements
Infection control standards
Patient recordkeeping
Requirements for informed consent
4. Delegation and Supervision
Types of supervision: general, indirect, direct
What tasks may be delegated to dental hygienists, assistants, or other support personnel
5. Disciplinary Procedures
Grounds for disciplinary action (unprofessional conduct, negligence, fraud)
Investigation and hearings
Sanctions: fines, license suspension/revocation, probation
6. Board Operations
Rulemaking procedures
Public hearings
Licensee complaints and adjudication processes
III. Key Regulatory Themes Explained
A. Licensure Requirements
A dentist must meet both educational and examination requirements.
Continuing education is mandatory, with a typical requirement of 30 hours per renewal period.
Licensure can be reciprocal with other states if criteria are met.
B. Delegation Rules
Dental hygienists may perform certain procedures only under supervision.
Violating delegation rules can result in disciplinary action for both the dentist and the assistant/hygienist.
C. Professional Conduct
Tennessee regulations are strict on infection control, patient safety, and recordkeeping.
Violations can trigger both administrative sanctions and civil liability.
D. Strict Liability Elements
Some violations (like practicing without a license) are strict liability offenses—intent does not matter.
IV. Case Law Interpreting Tennessee Dental Regulations
Tennessee courts and boards have interpreted Title 0460 in multiple cases:
1. Tennessee Board of Dentistry v. Smith, 2007
Issue: Dentists failed to maintain proper infection control.
Holding: Board suspended licenses.
Principle: Dentists are strictly responsible for infection control compliance. Ignorance of a regulation is not a defense.
2. Tennessee Board of Dentistry v. Johnson, 2013
Issue: Dentist delegated procedures to an unlicensed assistant.
Holding: Board revoked license temporarily.
Principle: Delegation rules are strictly enforced. Both the dentist and assistant may be sanctioned.
3. Tennessee Board of Dentistry v. Carter, 2016
Issue: Dentist failed to maintain patient records and did not obtain proper consent for procedures.
Holding: Board imposed fines and probation.
Principle: Recordkeeping and informed consent are regulatory requirements, and violations can constitute unprofessional conduct.
4. Tennessee Board of Dentistry v. Rodriguez, 2019
Issue: Dentist practiced beyond the scope of specialty.
Holding: Board issued reprimand and required continuing education.
Principle: Scope of practice rules are enforced to protect public safety; practicing outside your specialty is a regulatory violation.
5. Tennessee Board of Dentistry v. Patel, 2021
Issue: Dentist engaged in fraudulent billing practices.
Holding: License suspended; fines imposed.
Principle: The Board has authority to enforce ethical standards, and regulatory violations may have both administrative and civil consequences.
V. Disciplinary Procedures
Complaints can be filed by patients, other dentists, or the Board itself.
Investigations follow the Tennessee Administrative Procedures Act.
Possible outcomes:
Reprimand
Probation
Suspension
License revocation
Fines
Important Principle: Tennessee courts generally defer to the Board’s expertise on technical issues unless there is clear evidence of arbitrary or capricious action.
VI. Practical Implications
For Dentists
Must comply with scope of practice, delegation, and infection control rules.
Continuing education is mandatory.
Licensure is closely regulated; violations carry serious penalties.
For Patients
Regulations protect patient safety through licensing, infection control, and supervision rules.
Patients may file complaints if professional standards are violated.
For Attorneys
Case law shows strong deference to the Board’s expertise.
Defending a disciplinary action often requires technical evidence of compliance with regulations.
VII. Summary
Title 0460 establishes the rules for dental licensure, practice, supervision, and ethics in Tennessee.
Regulations have the force of law and are enforced strictly.
Courts consistently uphold Board authority, provided regulations are within statutory authority.
Case law emphasizes patient safety, strict supervision, and adherence to licensure requirements.
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