Public Health Dental Hygienist (PHDH) Toolkit
Mobile/Portable Dental Program
Office of Oral Health
Massachusetts Department of Public Health

Mobile and Portable Dental Operations

SCOPE
•	The Board of Registration in Dentistry may issue a permit for operation of a Mobile Dental Facility (MDF) or Portable Dental Operation (PDO) to a dentist licensed pursuant to MGL 112.45 and to a dental hygienist practicing pursuant to MGL 112.51 provided that services are limited to those provided in a public health setting described in 234 CMR 5.00 et seq.
•	This shall take effect on February 16, 2011
•	An MDF or PDO which is in operation on or before February 16, 2011 must submit an application for a Facility D-P Permit (234 CMR 6.00 et seq) on or before February 16, 2011.
•	An MDF or PDO commencing operation after February 16, 2011 shall not do so with obtaining a Facility D-Permit.

Mobile and Portable Dentistry
▪Mobile Dental Facility (MDF)
A MDF is any self-contained facility where 
dentistry will be practiced, which may be 
driven, moved, towed or transported from 
one location or another.

Picture- Drawing of mobile dental van

▪Portable Dental Operation (PDO)
A PDO is any dental practice where a portable 
dental units is transported to and utilized on a 
temporary basis at an out-of-office location.

Picture- Portable dental equipment

Who can practice dentistry in MDF or PDO?

•	Licensed Dentists or PHDH Dental Hygienists with a MDF or PDO Permit are the only dental professionals that can provide dental services through the use of dental instruments and materials taken out of a dental office 
•	Exceptions:                                                                                                         
 ▪ The service is provided as emergency treatment                                                                                     ▪ A patient of record is homebound                                                                                                        ▪ The services rendered are limited to dental screening only

Pictures- emergency sign, older man with a dental hygienist, and child with a dental hygienist

Permit M: 
Application for MDF and/or PDO
•	Initial Application: The Board may issue Permit to qualified dentists or dental hygienists.                                                                                                                                 ▪ Requirements:                                                                                   	                                                                           	▪ Valid License                                                                           	                                                                         	▪ Good moral character                                                                                       	                                                   	▪ Complete eligibility requirements including accurate and signed 	application
•	Renewal of Permit: Biennial renewal required
•	On-Site Inspection: May be necessary prior to the issuance of a permit
Permit is NOT transferable to another person or entity.

General Requirements
•	Official Business or Mailing Address of a MDF or PDO operator shall be filed with the Board
•	Change of address or phone number shall be provided to the Board within 30 days of the change
•	All written or electronic documents and publications issued by a MDF or PDO operator  shall include:                                                                                                                                                    ▪ Name of  MDF or PDO director                                                                                                                                      ▪ Official telephone number                                                                                                                               ▪ Address for the MDF or PDO

Picture- file folders and compact discs

Written Informed Consent
•	The MDF or PDO shall obtain a signed written consent form the patient or legal representative which conforms to the requirements of 234 CMR 5.15(3)(f)

Picture- form being signed

Additional Requirements 234 CMR 5.15(3)(f)(3)
•	An explanation of the scope of services that may be rendered;
•	Notice that the patient may continue to obtain dental care through any other provider;
•	Notice that the treatment of the patient may affect the future rights and benefits due the patient under private insurance, Medicaid, or the children’s health insurance program;
•	Information on how the patient or legal representative can contact the mobile or portable dental operation or public health dental services program; and IF APPLICABLE…
•	A request for permission to allow the patient’s dental insurance carrier to be billed for treatment provided to the patient; and
•	A request for permission to provide the official designated by the school,  nursing home, residential facility or institution with a written summary of the examination.

General Requirements 
                                                                                 continued…                                       
•	Patients Records shall be in accordance with 234 CMR 5.14 and 5.15.  In addition, the MDF or PDO shall comply with:                                                                                                                                            ▪ Treatment in School Settings                                                                                                                        Where consent has been granted by the patient or legal representative, a copy of the patient’s information sheet or other summary of screening, exam, or treatment shall be provided to the official designated by the school          
   ▪ Treatment in a Nursing Home, Residential Treatment Facility or Similar Institutionalized Setting                                                                                                                                                                    Copy of the patient’s information sheet or other summary of screening, exam, or treatment shall be provided to the official designated by the nursing home or residential treatment facility and shall become part of the patient’s record

General Requirements 
                                                                                 continued…
•	Informed consent shall be obtained from the patient or legal representative in accordance with 234 CMR 5.15(3)(f)
•	 Discharge and Referral                                                                                                                                   ▪ MDF or PDO shall give a written report to the patient or institutional facility that include:                                                    	                                                                            ▪ Results of dental or dental hygiene examination                                                                                                          	▪ Name(s) of dentist or hygienists who provided services                                                      	                                                         	                                                                                                                 ▪ Description of treatment rendered (including service codes and fees)                                                                                                                                 ▪ Contact information of MDF or PDO                                                 	                                                                               ▪ Timely and appropriate referral to a dentist                                                                               ▪ Names of dentists or organizations that are in reasonable location from pt’s home and with whom the MDF or PDO has communicated regarding the acceptance of referrals

General Requirements 
                                                                                 continued…
•	Emergency or Other Follow-up Treatment                                                                                            ▪ The MDF or PDO shall:
     	▪ Have a written procedure for referral of patients for emergency or 	   	   	other follow-up treatment                                                                                        	           	▪ Provide necessary follow-up treatment or timely referral to the   	  	   	patient’s dentist of record or by another dentist with whom MDF or PDO has 	communicated regarding acceptance of referrals                                                                                                             	▪ Provide names of dentists, community health centers or dental 	  	   	school clinics located within a reasonable geographic distance from patient’s 	home 
		AND…	                                                                                                                      	▪ Where consent has been granted, provide the subsequent 	 	   	provider with treatment information, including a copy of 	  	      	   	radiographs, within a reasonable period of time
General Requirements 
                                                                                 continued…
•	Emergency Protocol                                                                                                                               ▪MDF or PDO shall have the following:                                                             	           	▪ Written protocol for managing medical or dental emergencies                                                                                                   	▪ Communication equipment that ensures rapid access to 		   	emergency responders                                                                                	                                                   	▪ All staff that are trained in emergency protocols when hired and at least 	annually thereafter
•	Identification of Personnel shall be worn by any person providing dental services on behalf of a MDF or PDO                                                                                                       	▪ Name tag shall state name, professional title, and function

General Requirements 
                                                                                 continued…
•	Log that includes dates, locations where services were provided, and names of all individuals providing services shall be kept by the MDF or PDO
•	Original or copy of all licenses and permits shall be displayed at the location where services are provided and where patients can view them
•	Background Checks for Personnel shall be done and in accordance with any rules, regulations or statutory requirements for performance of Criminal Offender Record Information (CORI) and background checks of personnel serving vulnerable populations (e.g. children, elderly or disabled person(s)

Physical Requirements for MDF or PDO
•	MDF or PDO shall comply with the following:                                                                                        ▪ Local, state, federal statues, and regulations or ordinances                                                                                                                   ▪ CDC Guidelines at 234 CMR 5.05(1)                                                                                    ▪ OSHA Standards at 224 CMR 5.05(2) Massachusetts Radiation Control statutes and regulations at 234 CMR 5.05(3)
•	MDF or PDO shall have the following:                                                                                                      ▪ Handicap access                                                                                                                                    ▪ Ready access to an adequate supply of potable water                                                                 ▪ Ready access to hand-washing and toilet facilities                                                                   ▪ Equipment necessary for services being provided
•	Covered non-corrosive container for deposit of refuse and waste material as required by 310 CMR 73.00

Pictures- Handicap sign, portable water sampler PVS4100, hand washing sign, and restroom sign

Cessation of Operations and Transfer of Ownership or Control
•	Upon cessation of operation, the permit holder shall:                                                                        ▪ Within 30 days notify the Board in writing of the last day of operations and                          the disposition of patient records                                                                                                        ▪ Notify all of the permit holder’s patients who have received treatment within two years of how patients may obtain a copy of their dental records                                                                                                             ▪ Within 30 days make arrangements with the patients of the MDF or PDO for the transfer of patients’ records                                                                                                              ▪ A minimum of 30 days prior to cessation notify any and all entities for whom the MDF or PDO is providing services or who are hosting said services 
•	Existing MDF or PDO’s Permit M is NOT transferable
•	Licensee who intends to purchase an existing MDF or PDO shall file an application for Permit M at least 30 days before the anticipated sale or acquisition

Additional Information
•	For detailed information on the Rules and Regulations concerning Mobile Dental Facilities and Portable Dental Operations go to 234 CMR 7.00
•	For answers to specific questions or to obtain a Facility D-P Permit application contact the Board of Registration in Dentistry at 
    Phone: 1-800-414-0168 or 617-973-0971
 Email: Dentistry.Admin@state.ma.us  

 What’s next?
•	The next PowerPoint presentation in this toolkit will review evidence-based oral disease prevention strategies to inform a dental hygienist working in public health settings.