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Frequently Asked Questions

The CDA receives numerous phone calls and inquiries about dental and regulatory topics. Some of the most frequently asked questions and their answers are below. If your question isn't in this listing, please call the CDA at 303-740-6900 or 800-343-3010. Click on the questions below for the answers.

What records are my dentist required to give me upon written request?

The Patient Records Law of Colorado requires healthcare providers to provide a copy of the patient's treatment record when requested in writing. In addition, the American Dental Association's Principles of Ethics and Code of Professional Conduct states, "a dentist has the ethical obligation to furnish such records whether or not the patient's account is paid in full." Furthermore, the Dental Practice Law clearly states that it is a violation of the law for a dentist not to comply with the Patient Records Law.

Colorado rules that govern what a dentist or other healthcare provider may charge for records state that charges may "not exceed $12 for the first 10 or fewer pages and $.25 for every additional page. Actual postage costs may also be charged." In addition, if a patient requests copies of radiographs or other items "which cannot be reproduced without special equipment" the dental office may charge "the actual cost of such reproduction."

What are standard infection control measures?

Occupational Safety and Health Administration (OSHA) guidelines require dental offices to follow certain measures to control infections. Complete documentation may be found through the Center for Disease Control (CDC),

What are dental assistants allowed to do when delivering care to patients?

Only licensed dentists can perform procedures that contribute to or result in an irreversible change of the oral anatomy. A dental assistant MAY perform the following under the personal direction of a licensed dentist:

  • Smoothing and polishing natural and restored tooth surfaces;
  • Applying fluorides and other recognized topical agents to prevent oral disease;
  • Gathering and assembling information regarding patient history, oral inspection, and dental and periodontal charting;
  • Administering topical anesthetic to patients in the course of providing dental care;
  • Taking x-rays after completing appropriate training;
  • Administering and monitoring nitrous oxide on a patient, under the direct supervision of a licensed dentist;
  • Any other task or procedure that does not require the professional skill of a licensed dentist.

A dental assistant may also perform the following procedures necessary to make dentures, under the general supervision of a licensed dentist:

  • Taking preliminary and final impressions;
  • Taking bite-registration and determining vertical dimensions;
  • Making tooth selections;
  • Administering preliminary fitting of the trial denture, prior to fitting and written approval by a licensed dentist;
  • Adjusting the denture prior to the final examination of the denture.

Do dentists have to hire a sign language interpreter if necessary for communication?

According to Title III of the Americans with Disabilities Act, dentists are required to hire an interpreter if their client requests one.  The Americans with Disabilities Act defines a dental office as a public accommodation. Therefore, dental offices cannot discriminate against individuals with disabilities such as hearing loss. The Americans with Disabilities Act requires dentists to provide communication accessibility for their deaf or hard of hearing patients who use sign language. Sign language interpreters are instrumental in providing a way to establish communication so the dentist and the patient can understand each other more effectively and to minimize misunderstanding. It is important to have a qualified interpreter who can accurately convey what both the doctor and patient are saying, especially when discussing the patient's condition and recommended treatment. It is highly advisable to use an interpreter when providing complex or extensive information to obtain informed consent to a procedure that carries significant risk.

Who pays for the cost of a sign language interpreter?

Under the Americans with Disabilities Act, the dentist is responsible for the cost of an interpreter and could not pass the cost on to the patient as a supplemental charge or increased fee for the dental treatment. Should the dentist decline or refuse a request for an interpreter, the patient will be within his/her right to file a complaint through the U.S. Department of Justice and the dentist must be prepared to face lawsuit(s) and the possibility of heavy fines. For further information on Americans with Disabilities Act case laws go to

Are there alternatives to hiring an interpreter?

English is a second language for many deaf or hard of hearing sign language users.  Other communication means such as using office computers or written notes are not always sufficient or effective in carrying on a conversation. As for lip reading or speech reading, it is generally believed that deaf and hard of hearing people are capable of such skills. In reality, only a relative few are capable of speech reading. The best approach is to let the patient indicate the form of communication he/she prefers before the appointment. 

Can a family member or a friend of the patient interpret for them?
Family members/friends/associates or anyone who “claims to know” sign language are, in no way, qualified to interpret. Using unqualified interpreters may violate the Americans with Disabilities Act as well as the Colorado Consumer Protection Act.  In Colorado, there is an additional requirement that all sign language interpreters hold a national certification to be deemed “qualified.”

If the patient is unable to communicate and understand by any method other than sign language, should this be the indicator that an interpreter is needed?
If interpreting service has been requested by a client, it should not be arranged after “all else fails.” Deaf or hard of hearing sign language users know, by extensive personal experience, when or if they need an interpreter. If they request a sign language interpreter, “any methods other than sign language” are not considered “effective communication.”  For more information, see the “Americans with Disabilities Act Title III Technical Assistance Manual”: 

Does a patient have the right to bring a seeing-eye dog into my office?

The regulations under the AwDA specifically state that you must permit disabled people to bring service animals, such as seeing-eye dogs and hearing dogs, into your office. Nothing in the act requires you to allow service animals into the operatory if the patient does not require the service provided by the animal during the time the dental procedures. Public accommodations, including dental offices, are not required to supervise or care for service animals. A staff member should remain with the patient at all times and under all circumstances while they are separated from the animal. The only exception would be if a friend or relative accompanies them.

Are dentists legally bound to disclose if they are HIV positive?

Dentists, dental hygienists and dental assistants who are diagnosed as HIV positive are not currently required to report their status to the State Board of Dental Examiners or the Colorado Department of Public Health and Environment. However, the healthcare provider who makes the diagnosis that an individual is HIV positive is obligated to report that finding to the Colorado Department of Public Health and Environment. The department will review all new reports of HIV infection and determine if the individual is a healthcare worker. When a healthcare worker is identified the department will "convene an expert advisory panel to provide advice to the department...(and) make a recommendation on whether the healthcare worker's current practice represents a risk to patients. If a risk is determined, (the department) will counsel the healthcare worker . . .(and) will monitor the healthcare worker's voluntary compliance with the counseling message. If the healthcare worker disagrees with the department's recommendations, the matter may become a mandatory proceeding where the department would issue a public health order and the healthcare worker may challenge the order in a judicial proceeding."

Under what conditions can a dentist dismiss a patient?

According to the American Dental Association's Principles of Ethics and Code of Professional Conduct, "once a dentist has undertaken a course of treatment, the dentist should not discontinue that treatment without giving the patient adequate notice and the opportunity to obtain the services of another dentist. Care should be taken that the patient's oral health is not jeopardized in the process."

To avoid the abandonment of a patient, the Dentists Professional Liability Trust recommends that all emergency needs of the patient be addressed prior to dismissing a patient. If the patient is at a non-emergency point in their treatment and it is clear that a situation has developed that prevents the dentist from practicing quality dentistry to the level of the patient's needs, the dentist can terminate the patient from their practice by sending a letter advising the patient of the current situation. The patient should also be provided with names of various clinics or clinicians who might be in a position to assume their care. It is also strongly recommended that the dentist remains available for the following two weeks to handle any emergencies until the transfer of care can be arranged.

What is the Colorado Dental Association's position on the use of dental amalgams?

Dental amalgam, commonly referred to as "silver-colored fillings," contains various metals such as silver, copper and tin. Dental amalgam has been used for more than 150 years without any credible evidence that it is responsible for any health problems. Dental amalgam, one of the most effective and widely used tooth restoration materials, serves the dental healthcare needs of 100 million Americans. In extremely rare cases, some individuals are allergic to amalgams (fewer than 100 cases have been reported in dental literature). However, more than 99 percent of the general population should be able to have amalgam fillings with no allergic response. In the absence of allergic reactions, it is not advisable to have amalgams removed. Removing amalgams can cause damage to healthy teeth and can lead to further dental problems.

The U.S. and international agencies responsible for protecting public health — including the Centers for Disease Control and Prevention, Food and Drug Administration, World Health Organization, National Institutes of Health, and U.S. Public Health Service — have done research, reviewed the evidence, and independently concluded that dental amalgam is a safe and effective dental restorative material. Other organizations concerned about public health, such as the Alzheimer's Association, National Multiple Sclerosis Society and American Academy of Pediatrics have publicly stated that there is no scientific evidence linking dental amalgam with any disease or syndrome. 

The CDA supports the considerable research that has been done on dental amalgam and encourages further scientific inquiry and dialogue. The Colorado Dental Association concurs with the American Dental Association's position on amalgams, which can be found on the ADA's Web site,

Oral Health Topics

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