California RDH Law & Ethics Exam Area 2B: Professional Practices

This subarea covers the business and administrative side of California dental hygiene practice. It tests the rules that govern how you document and store patient records, how you disclose and collect fees, and what you may lawfully advertise to the public. Mastering this area means understanding that the Dental Hygiene Board of California (DHBC) regulates your paperwork, financial integrity, and public communications just as strictly as your chairside clinical care.

At a glance

What the exam expects you to know

T15 — Documenting, storing, and disposing of patient records

The patient chart is a legal document with a strictly regulated life cycle. You must create entries correctly, keep the record secure for as long as you hold it, and dispose of it in a way that protects patient privacy.

Charting mechanics and integrity. Every service you perform must be traceable directly to you. Under the Dental Hygiene Practice Act, a hygienist who performs a service in a dental office must identify themselves in the patient record by signing their name or identification number and initials next to the service performed, and must date those treatment entries. ⁴ A repeated violation of this identification rule is unprofessional conduct. ⁴ Truthfulness in charting is enforced even more harshly. The alteration of a patient's record with intent to deceive, or knowingly making a false statement in a document, are independent disciplinary offenses. ⁷

Storage, retention, and disposal. Stored records must remain confidential and secure. California's Confidentiality of Medical Information Act (CMIA) prohibits a provider of health care from disclosing medical information regarding a patient without first obtaining an authorization, except in specified circumstances. ⁸ Federal HIPAA regulations add two layers: the Privacy Rule protects protected health information (PHI) across all media, while the Security Rule's safeguards apply specifically to electronic PHI. ⁹

The DHBC sources cited here set no general RDH record-retention period. The seven-year rules (16 CCR §§1116, 1116.5) bind mobile-clinic and RDHAP facility owners. ^{2 3}

Breach notification. If storage security fails and computerized personal data is breached, strict notification clocks begin. Under California law, an entity must notify affected California residents no later than 30 calendar days after discovering the breach. ⁵ This 30-day deadline is subject to only two narrow delay lanes: a law enforcement agency determines that notification will impede a criminal investigation, or delay is necessary to determine the scope of the breach and restore the reasonable integrity of the data system. If more than 500 Californians are affected, a sample copy of the notice must be submitted to the California Attorney General within 15 calendar days after the affected consumers are notified. ⁵

Producing records to the board. The DHBC has its own authority to demand records. If the board requests a patient's dental hygiene records and includes the patient's written authorization, a licensee has 15 days to produce them. Failing to do so without good cause results in a penalty of up to $250 per day after the 15th day, capped at $5,000. ⁴ Health care facilities have 30 days to comply under the same penalty scale. ⁴

T16 — Billing, fee disclosures, and collection

Financial rules exist to protect patients from exploitation. Fees must be represented honestly, collected only for services actually provided, and never inflated or leveraged against the patient's own records.

Fee disclosures and changes. Any fee you state to a patient must be honest and complete. California law makes it unlawful to disseminate a misleading fee statement, which includes stating a price without fully and specifically disclosing all variables and other material factors. ¹⁰ A fee statement may still give a standard consultation fee or a range of fees for specific types of services (§651(b)(4)). Price advertising must be exact (no 'as low as' or 'and up'), and each service's price must be clearly identifiable (§651(c)). ¹⁰ Obtaining any fee by fraud or misrepresentation is unprofessional conduct. ⁷ This aligns with the ethical core value of veracity, which obligates you to be truthful in all financial dealings. ¹¹

Fraud, kickbacks, and excessive treatment. Three specific unprofessional conduct rules govern how money changes hands. First, obtaining any fee by fraud or misrepresentation is prohibited. Second, accepting or receiving any commission, or rebating fees in any form for professional services, radiographs, or supplies, violates the state's strict ban on fee-splitting and kickbacks. Third, the clearly excessive use of treatment procedures or facilities is not only unprofessional conduct but also a misdemeanor punishable by a fine, imprisonment, or both. ⁷

Collection boundaries. You may pursue unpaid debts through lawful collection, but you may never hold a patient's health records hostage. California law strictly prohibits withholding a patient's records or summaries because of an unpaid bill. ⁶ When a patient requests copies of their records, you may charge a reasonable, cost-based fee. This fee is limited to copying labor, supplies, postage, and any agreed-upon summary. The per-page caps apply to paper and microfilm copies; electronic copies remain limited to reasonable, cost-based fees. ⁶

T17 — Advertising qualifications and services

You may truthfully advertise your name, qualifications, services, and fees. However, California law heavily regulates how you persuade the public, utilizing a two-layered system: the general healing arts advertising statute defines the rules, and the Dental Hygiene Practice Act turns violations into license discipline.

Prohibited claims. It is unprofessional conduct to disseminate any advertising that is false, fraudulent, misleading, or deceptive. ^{10 7} Specifically, you may not advertise professional superiority or claim to perform services in a superior manner unless the claim is relevant to the service and can be substantiated with objective scientific evidence. ¹⁰ Furthermore, advertising to guarantee any dental hygiene service, or promising to perform any procedure painlessly, is defined as unprofessional conduct. ⁷

Names and registration numbers. Identity in advertising is strictly controlled. Practicing or advertising under any false, assumed, or fictitious name, rather than the name you are licensed under, is unprofessional conduct. The fictitious-name permit exception (§1962) is available only to RDHAPs. ^{7 4} Additionally, the DHBC requires that mobile dental hygiene clinics and RDHAP physical facilities include their facility name, physical address of record, and registration number on every advertisement, letterhead, telephone listing, website, and written solicitation. ^{2 3} Finally, employing paid solicitors to drum up patients is expressly prohibited. ⁷

Common traps

• Assuming any signature on the chart is sufficient. A supervising dentist's signature at the bottom of a page does not satisfy the law for your services. You must sign your own name or identification number and initials next to the service performed, and date it. ⁴
• Deleting and rewriting a mistaken chart entry. Overwriting or deleting an old entry to make the chart look perfectly accurate invites discipline for alteration with intent to deceive. ⁷
• Withholding records until the patient pays their bill. This is never lawful. Debt collection and records access run on entirely separate tracks; you must release the records on the statutory clock regardless of an outstanding balance. ⁶
• Assuming HIPAA's breach notification window overrides state law. California's 30-calendar-day deadline is stricter and controls here. It is subject only to narrow delay lanes for law enforcement investigations or restoring system integrity. ⁵
• Believing a guarantee shows lawful clinical confidence. Advertising to guarantee any dental hygiene service, or to perform it painlessly, is explicitly defined as unprofessional conduct. ⁷

Check yourself

Answer the original practice item, then take the free 15-question practice test to see every area.

How to study this area

Subarea 2B represents 15% of the 2025 outline (the exam has 60 questions, 50 scored, in 90 minutes). Mastering this area requires applying the rules to paperwork, billing protocols, and website copy rather than chairside care.

To master this subarea, focus on the rigid boundaries of business conduct and the specific numbers attached to them. Do not rely on what seems like "standard office policy," as many common practices violate the letter of the law.

1. Memorize the timelines: 30 calendar days for individual breach notice, 15 days for Attorney General breach notice, and 15 days to produce records to the board.
2. Sort advertising rules: Create two mental bins. Truthful information (name, license, honest fees) is lawful. Guarantees, "painless" promises, unsubstantiated superiority claims, and hidden fee variables are defined as unprofessional conduct.
3. Separate patient access from board demands: A patient asking for their own records triggers access rights and copy-fee caps; the board asking for records triggers a 15-day deadline and daily financial penalties for noncompliance.

Questions candidates ask

Can I charge a flat fee for copying records?

Only if it is a reasonable, cost-based fee made up solely of copying labor, supplies, postage and any agreed summary, and paper copies may not exceed $0.25 per page. ⁶

Does HIPAA override California's breach notification laws?

No. Civil Code §1798.82(e) says HIPAA compliance satisfies only the content rules in subd. (d); the 30-day timing still applies to a HIPAA covered entity. ⁵

Is it legal to advertise a discounted cleaning?

Yes, provided the advertisement fully and specifically discloses all variables and other material factors. Advertising a low fee that quietly hides mandatory additional charges (like an exam or radiographs required to get the cleaning) is misleading and constitutes unprofessional conduct. ^{10 7}

Footnotes

1. PSI Services LLC / DHBC, Registered Dental Hygienist (RDH) Laws and Ethics Written Examination — Candidate Information Bulletin, January 2026 edition — RDH exam logistics and blueprint. PSI Services LLC / DHBC, *Registered Dental Hygienist ↩

2. 16 CCR § 1116 — Mobile Dental Hygiene Clinics; Issuance of Approval. Reprinted in DHBC 2025 Laws and Regulations, pp. 105–108 — Mobile dental hygiene clinics. 16 CCR § 1116 ↩ ↩² ↩³

3. 16 CCR § 1116.5 — RDHAP Physical Facility Registration. Reprinted in DHBC 2025 Laws and Regulations, pp. 108–111 — RDHAP physical facility registration requirements. 16 CCR § 1116.5 ↩ ↩² ↩³

4. Dental Hygiene Board of California, 2025 Dental Hygiene Board of California Laws and Regulations, revised January 2025 — The first publication on the CIB's list of recommended preparation references (recommended, not the corpus the exam is written from). Dental Hygiene Board of California, 2025 Dental Hygiene Board of California Laws and Regulations, revised January 2025 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

5. Cal. Civ. Code § 1798.82 — Breach Notification — Security-breach notification for computerized personal data, as amended by SB 446 (Stats. 2025, eff. 2026-01-01). Cal. Civ. Code § 1798.82 ↩ ↩² ↩³ ↩⁴ ↩⁵

6. Cal. Health & Safety Code § 123110 et seq. — Patient Access to Health Records — Patient access to health records. Cal. Health & Safety Code § 123110 et seq ↩ ↩² ↩³ ↩⁴ ↩⁵

7. Cal. Bus. & Prof. Code § 1950.5 — Unprofessional Conduct Defined — Unprofessional conduct defined, subds. (a)–(z). Cal. Bus. & Prof. Code § 1950.5 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

8. Cal. Civ. Code § 56.10 et seq. — Confidentiality of Medical Information Act — Confidentiality of Medical Information Act. Cal. Civ. Code § 56.10 et seq ↩

9. 45 CFR Parts 160 and 164 (HHS HIPAA Privacy Rule) — HIPAA Privacy and Security Rules. 45 CFR Parts 160 and 164 ↩

10. Cal. Bus. & Prof. Code § 651 — Advertising by Healing Arts Licensees — Healing-arts advertising. Cal. Bus. & Prof. Code § 651 ↩ ↩² ↩³ ↩⁴ ↩⁵

11. American Dental Hygienists' Association, Code of Ethics (revised October 2024); on the PSI bulletin's recommended preparation list via adha.org — ADHA Code of Ethics. American Dental Hygienists' Association, Code of Ethics ↩