43-11-54. Requirements and limitations of teledentistry.

1. (a)

   As used in this Code section, the term:#

   1. (1)

      “Authorizing dentist” means a dentist licensed by and in good standing with the board and practicing in the State of Georgia.#

   2. (2)

      “Dental hygienist” means a licensed dental hygienist in good standing with the board who meets the requirements to perform the specific dental hygiene functions permitted under general supervision under Code Section 43-11-74.#

   3. (3)

      “Digital scan” means a computer generated replica of the hard and soft tissues of the oral cavity created with digital technology and enhanced digital photography.#

   4. (4)

      “Direct supervision” shall have the same meaning as set forth in Code Section 43-l1-74.#

   5. (5)

      “General supervision” shall have the same meaning as set forth in Code Section 43-11-74.#

   6. (6)

      “Referred dentist” means a dentist licensed by and in good standing with the board practicing in this state to provide in-person dental treatment to patients receiving dental care through a teledentistry interaction under this Code section.#

   7. (7)

      “Store and forward technologies” means technologies that allow for the electronic transmission of dental and health information, including images, photographs, documents, and health histories, through a secure communication system.#

   8. (8)

      “Synchronous, real-time communication” means a live, two-way interaction between the authorizing dentist and a dental hygienist or patient permitted under this Code section using audiovisual telecommunications technology but shall not constitute direct supervision for the purposes of Code Section 43-l1-74 and the practice of dentistry in this state.#

   9. (9)

      “Teledentistry” means the delivery of dental care through the use of synchronous, real-time communication in conjunction with and supported by store and forward technologies under the general supervision of the authorizing dentist when dental care is provided to a patient physically located at a site in this state that is different from the site where the authorizing dentist is physically located. A teledentistry interaction shall not constitute or be considered the equivalent of an in-person, clinical examination by a licensed dentist.#

2. (b)

   No licensed dentist in this state shall provide dental care through teledentistry except under the conditions specified in this Code section.#

3. (c)

   A licensed dentist who intends to provide dental care through teledentistry pursuant to this Code section shall notify the board of such intent and provide written documentation evidencing that such dentist has:#

   1. (1)

      A physical office for the provision of dental services in this state; and#

   2. (2)

      Established a referral relationship with a referred dentist who practices dentistry and treats patients in a physical and operational dental office located in this state.#

   3. Such dentist shall provide other reasonably pertinent information as prescribed by the board.

4. (d)

   Subject to the conditions specified in subsection (e) of this Code section, an authorizing dentist shall only be allowed to:#

   1. (1)

      Authorize a dental hygienist to perform the specific dental hygiene functions permitted under general supervision in accordance with the requirements of Code Section 43-11-74, except as otherwise provided in paragraph (1) of subsection (e) of this Code section;#

   2. (2)

      Prescribe a medication that is not a controlled substance for a patient receiving dental care through a teledentistry interaction;#

   3. (3)

      Authorize the performance of digital scans by a dentist or dental hygienist;#

   4. (4)

      Authorize the use of store and forward technologies to transmit patient records, images, digital scans, X-rays, and other relevant health information between the authorizing dentist and a dental hygienist for the purposes of evaluating a patient’s oral health condition and authorizing the performance of dental care permitted under this Code section. The authorizing dentist shall be the custodian of all patient records for the purposes of this Code section unless the patient is treated by a referred dentist. In such instance, the referred dentist shall be the custodian of the patient’s records associated with the dental care the referred dentist provides to the patient, and such referred dentist shall furnish copies of these records to the authorizing dentist;#

   5. (5)

      Provide consultation to another provider regarding the patient’s care; and#

   6. (6)

      Provide the following teledentistry services that are appropriately delivered without an in-person clinical examination:#

      1. (A)

         Emergency evaluation;#

      2. (B)

         Rendering second opinions; and#

      3. (C)

         Assessment, diagnosis, consultation, treatment, and monitoring of a patient.#

      4. Teledentistry services described in this paragraph do not include orthodontics, delivering of dental appliances, or the supervision of a dental hygienist.

5. (e)

   Authorizing and referring dentists as well as those acting under their supervision shall be subject to the following conditions when providing dental care through teledentistry as authorized in subsection (d) of this Code section:#

   1. (1)

      Teledentistry services shall be consistent with how dental treatment is provided in person and shall adhere to the standards of appropriate patient care required in other dental care settings, including, but not limited to, appropriate patient examination, the taking and review of X-rays, and review of a patient’s medical and dental history;#

   2. (2)

      1. (A)

         Initial consultations with new patients may be conducted via teledentistry, provided that the authorizing dentist establishes a bona fide dentist-patient relationship by reviewing the patient’s medical and dental history and verifying the patient’s identity and physical location to ensure the patient is physically located in this state when dental care is provided and shall obtain the requisite consent from a parent or guardian if the patient is a minor.#

      2. (B)

         An in-person clinical examination shall be performed immediately prior to providing or authorizing services or treatments to patients that are not reversible or that otherwise result in increased risk to the patient. For ongoing dentist-patient relationships, dentists shall strongly encourage patients to be seen in person at least annually.#

   3. (3)

      The authorizing dentist shall prepare a written authorization, which shall be given to the patient and included in the patient’s record, providing the name and license number of the authorizing dentist and the name and license number of the dental hygienist treating the patient during the teledentistry interaction, as well as any other information the authorizing dentist or board deems appropriate;#

   4. (4)

      Prior to first performing teledentistry services, and at least annually thereafter, informed consent shall be obtained from the patient, or from the parent or guardian if the patient is a minor, explaining the alternatives to and the capabilities and limitations of teledentistry, which shall include a written statement advising that a teledentistry interaction is not equivalent to an in-person clinical examination and that the authorizing dentist shall not be physically present during the delivery of dental care. Such informed consent shall also be documented and included in the patient’s record;#

   5. (5)

      The authorizing dentist shall provide dental services through teledentistry only if such dental services are appropriate for the patient, as determined by such authorizing dentist;#

   6. (6)

      1. (A)

         The authorizing dentist shall provide the name, license number, office mailing address, and office phone number of the referred dentist to the patient after each teledentistry interaction.#

      2. (B)

         The referred dentist shall accept a referral to treat all dental emergencies and provide all necessary dental care, as determined by and in consultation with the authorizing dentist.#

   7. (7)

      1. (A)

         An authorizing dentist may only authorize up to four dental hygienists to perform the functions permitted in subsection (d) of this Code section at any one time. This requirement shall not apply to the performance of dental hygiene duties by personnel of the Department of Public Health or county boards of health.#

      2. (B)

         A dental hygienist performing the functions permitted in subsection (d) of this Code section via teledentistry shall have at least two years of experience in the practice of dental hygiene, shall be in compliance with continuing education requirements pursuant to Code Section 43-11-73.1 and cardiopulmonary resuscitation certification requirements contained in Code Section 43-11-73, and shall be licensed in good standing.#

      3. (C)

         A dental hygienist practicing under general supervision via teledentistry pursuant to this Code section shall maintain professional liability insurance in accordance with board rules and regulations; provided, however, that this subparagraph shall not apply to an entity covered under sovereign immunity;#

   8. (8)

      No authorizing dentist or dental hygienist shall attempt to waive liability for teledentistry services in advance of delivering such services, and no authorizing dentist or dental hygienist shall attempt to prevent a patient from filing any complaint with any governmental agency or authority relating to the provision of dental care through teledentistry; and#

   9. (9)

      The authorizing dentist shall ensure that the use of teledentistry complies with the privacy and security requirements of the federal Health Insurance Portability and Accountability Act of 1996, in effect on January 1, 2025, as well as those of Chapter 33 of Title 31.#

6. (f)

   Nothing in this Code section shall be construed to:#

   1. (1)

      Require a licensed dentist in this state to practice teledentistry;#

   2. (2)

      Require a licensed dentist to authorize a dental hygienist to perform the functions permitted in this Code section via teledentistry;#

   3. (3)

      Require a school or facility receiving dental hygiene services provided pursuant to subsection (h) or (i) of Code Section 43-ll-74 to purchase any equipment to provide dental care through teledentistry; or#

   4. (4)

      Expand the scope of practice for dental hygienists or establish independent dental hygiene practice.#

7. (g)

   The board shall promulgate rules and regulations that are reasonably necessary to implement the provisions of this Code section.#

Reading note: a word broken across two lines in the printed volume was joined by rule and could not be checked against the volume's own vocabulary. The official page linked below settles any doubt.