Agencies | Governor
Virginia Regulatory Town Hall
Department of Health Professions
Board of Dentistry
Regulations Governing the Practice of Dentistry [18 VAC 60 ‑ 21]
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7/10/19  9:13 pm
Commenter: Deborah Bassham


 I am in agreement with the AAO whom strongly agrees with the Petition that a digital scan is the practice of dentistry. Prior to treatment, as in any medical field, a thorough examination is needed in order to evaluate the oral health of the patient to see if the proposed treatment should even be a consideration.  Informed consent should occur after the patient is aware of their dental health through examination prior to any treatment realizing the limitations or risks possible from their individualized treatment plan by a licensed Virginia dentist.

To begin with, Va. Code Ann. § 54.1-2711(iv) clearly provides that “Any person shall be deemed to be practicing dentistry who  takes impressions for the fabrication of appliances or dental prosthesis, supplies or repairs artificial teeth as substitutes for natural teeth, or places in the mouth and adjusts such substitutes.”  I believe that the term “impressions” under Va. Code Ann. § 54.1-2711(iv) already applies to “digital scans,” since the a “digital scan” and/or “digital impression,” especially when used for the fabrication of appliances.  Nevertheless, an amendment would only further support and clarify this point.  I also see the importance of establishing a doctor/patient relationship via a face-to-face encounter because there are certain diagnoses and evaluations that can only be performed in-person or are best performed in-person (x-rays, etc.).  There are a number of categories of problems/conditions that a dentist usually looks for as part of a physical examination at the outset of traditional in-person treatment.  These include conditions or problems that can be quite serious, such as oral cancer, periodontal problems, advanced decay, gum disease, etc.  If an in-person examination of the patient by a dentist does not occur, there may be no examination of the patient by a dentist to detect such problems.  With that in mind, the AAO believes dental and orthodontic treatment should not occur before a physical, in-person examination/evaluation of the patient has occurred by a Virginia licensed dentist in order to establish the doctor/patient relationship.  Moreover, and as stated in the Court’s Memorandum Opinion in Blaine Leeds and SmileDirectClub v. Board of Dental Examiners of Alabama.