S. 453 creates a new Article 5 in Title 40, Chapter 15 of the South Carolina Code to regulate teledentistry. It defines key terms such as teledentistry, asynchronous transmission, originating site, distant site, emergent care, and public health program, and it treats teledentistry as a form of telehealth for dental practice purposes. The bill sets a framework for when and how dental services may be delivered remotely, while preserving the Board of Dentistry’s authority to adopt implementing regulations.
The bill generally requires a dentist or other licensee to establish a bona fide patient relationship before providing teledentistry services, with limited exceptions for emergent care, public health programs, and certain orthodontic initial diagnoses that must later be confirmed in person. It also bars treatment based solely on an online questionnaire, restricts delegation of tasks to auxiliaries beyond their lawful scope, and prohibits experimental or non-evidence-based remote treatment. Additional requirements include identity verification, location confirmation, informed written consent, disclosure of provider information, emergency planning, and a continuing dentist-of-record requirement in most cases. The bill also requires certain teledentistry advertisements to carry a warning that an in-person examination is recommended before telehealth treatment.
The bill’s impact on state law is to add a detailed dental-specific telehealth regime that supplements and, where conflicting, overrides the Telehealth and Telemedicine Modernization Act as applied to dental licensees. It also expressly makes it unprofessional conduct for a provider to require patients to waive complaints, lawsuits, class actions, governmental reports, or to agree to binding arbitration as a condition of receiving teledentistry services. The Board of Dentistry must adopt regulations, but the fiscal note says implementation should be handled within existing resources and should not materially affect agency responsibilities.
Overall sentiment appears strongly favorable. The bill passed the Senate 44-0 and the House 105-2, indicating broad bipartisan support for establishing guardrails around remote dental care. The committee report recommended that the bill do pass, and there is no recorded committee transcript showing significant opposition.
The main points of contention, as reflected in the bill text rather than recorded debate, are the scope of permissible remote treatment and the limits placed on providers. The most notable restrictions are the requirement for an in-person relationship in most cases, the ban on treatment based only on online questionnaires, the limits on delegation to hygienists and assistants, and the prohibition on liability waivers and mandatory arbitration agreements. These provisions suggest the bill is aimed at consumer protection and clinical oversight, while still allowing teledentistry in limited, defined circumstances.
This bill adds a new statutory article governing teledentistry in South Carolina’s Dental Practice Act, creating binding requirements for dental licensees who provide care remotely. It establishes practice standards, consent and disclosure rules, advertising disclaimers, emergency referral duties, and unprofessional-conduct provisions, while directing the Board of Dentistry to promulgate regulations. Where the new article conflicts with the state telehealth law, it controls for dental licensees, thereby carving out a dental-specific framework within existing telehealth statutes.
The bill appears to have enjoyed broad support and little visible opposition. It passed the Senate unanimously and the House by an overwhelming margin, and the committee report recommended passage. The available record suggests lawmakers viewed the measure as a reasonable way to regulate a growing form of care while protecting patients and preserving professional standards.
The bill’s most notable tensions are between expanding access to remote dental services and imposing strict safeguards on how those services may be delivered. Potentially contentious provisions include the requirement for an in-person exam before most teledentistry, the ban on diagnosis or treatment based solely on an online questionnaire, limits on delegation to auxiliaries, and the prohibition on mandatory arbitration or liability waivers. These restrictions are aimed at patient protection and accountability, while providers seeking more flexibility in remote care could view them as limiting the utility of teledentistry.