North Dakota Code § 43-28-11.3

Standard of care and professional ethics - Telehealth
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A dentist is held to the same standard of care and ethical standards, whether practicing 
traditional in-person dentistry or telehealth. The following apply in the context of telehealth:
1. Professional ethical standards require a dentist to practice only in areas in which the 
dentist has demonstrated competence, based on the dentist's training, ability, and 
experience.
2. A dentist may not practice telehealth unless a bona fide dentist-patient relationship is 
established in person or through telehealth. A dentist practicing telehealth shall verify 
the identity of the patient seeking care and shall disclose to the patient the dentist's 
identity, physical location, contact information, and licensure status.
3. Before a dentist initially diagnoses or treats a patient for a specific illness, disease, or 
condition, the dentist shall perform an examination or evaluation. A dentist may 
perform an examination or evaluation entirely through telehealth if the examination or 
evaluation may be performed in accordance with the standard of care required for an 
in-person dental examination or evaluation. A dentist may not use telehealth to perform 
an initial examination or evaluation in circumstances in which the standard of care 
necessitates an in-person dental examination.
a. An appropriate telehealth examination or evaluation may include an examination 
utilizing secure videoconferencing in conjunction with store -and-forward 
technology or appropriate diagnostic testing that would be required during an 
in-person examination or evaluation or an examination conducted with an 
appropriately licensed intervening dental health care provider, practicing within 
the scope of the dental health care provider's profession, providing necessary 
physical findings to the dentist during a live, two -way telehealth encounter. An 
examination or evaluation consisting only of a static online questionnaire or an 
audio conversation does not meet the standard of care.
b. The use of telehealth does not expand the scope of practice for a dental health 
care provider, and may not be used to circumvent the licensure requirements 
established for dental health care providers in this state.
c. A dentist who practices telehealth in this state must have adequate knowledge of 
the availability and location of local dentists and dental health care providers to 
provide followup care to a patient following a dental telehealth encounter, 
including emergent and acute care facilities, in order to enable a patient to 
receive followup care. Once a dentist conducts an appropriate examination or 
evaluation, whether in -person or by telehealth, and establishes a patient -dentist 
relationship, subsequent followup care may be provided as deemed appropriate 
by the treating dentist, or by another dentist licensed by the board designated by 
the treating dentist to act temporarily in the treating dentist's absence.
4. A dentist practicing telehealth is subject to all North Dakota laws governing the 
adequacy of dental records and the provision of dental records to the patient and other 
dental health care providers treating the patient.

5. A dentist practicing telehealth must have procedures for providing in -person services 
or for the referral of a patient requiring dental services that cannot be provided by 
telehealth to another dentist who practices in the area of the state and the patient can 
readily access.

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