# What changed in California dental law and ethics prep > Dentovio keeps a public updates hub for California rule changes and stale-prep traps that can change the safest answer on the exam. ## Changes that matter now # What Changed in 2025-2026 ## Purpose Collect the freshness-sensitive rule changes and stale-prep traps most likely to cause wrong answers on the California Dental Law & Ethics exam. Every entry names what changed, when it took effect, what old prep says, and what the current answer is. If your preparation materials predate the effective dates listed here, re-memorize these entries to ensure compliance with current regulations. ## 2025 Changes To Know All of these changes originate from Senate Bill 1453 (Ashby, Ch. 483, Stats. 2024), effective **January 1, 2025**—currently the single biggest source of stale preparation materials. * **Sedation permits were renamed:** The current permit categories are `GA` (General Anesthesia), `MGA` (Medical General Anesthesia, for physicians providing GA in a dental office), `MS` (Moderate Sedation), `PMS` (**Pediatric Minimal Sedation**—never "Pediatric Moderate Sedation"), and `OCS-A` (Oral Conscious Sedation – Adult).[^A20] Old prep teaches the retired "Conscious Sedation" *permit*; the current answer uses the new names. Note, however, that the *phrase* "conscious sedation" still appears in some statutes (such as BPC §1680(z)'s 7-day adverse event reporting rule), so do not automatically reject an answer choice simply for containing it.[^A15] * **Physical presence became explicit:** The dentist who administers or orders moderate sedation, deep sedation, or general anesthesia must be physically present in the treatment facility the entire time the patient is sedated, and a dentist applying for or renewing a GA permit must hold current ACLS.[^A20] Old prep treats "available nearby" as sufficient; the current answer is physical presence in the facility, full stop. * **The Licensure by Portfolio pathway was repealed:** Following a Department of Consumer Affairs (DCA) Office of Professional Examination Services psychometric review, SB 1453 removed the portfolio route from the Dental Practice Act.[^A64] Old study guides list portfolio as a fifth pathway; the current answer is that no candidate can pursue California dentist licensure through a portfolio. * **DA infection-control timing changed:** Unlicensed dental assistants must complete the Board-approved `8-hour` infection-control course—consisting of at least `4` hours didactic, `2` hours laboratory/preclinical, and `2` hours clinical instruction (16 CCR §1070.6)—*before* performing any basic supportive procedures that involve potential exposure to blood or saliva.[^A38] [^A70] Old prep allowed a one-year grace period; the current answer is that there is no grace period at all. * **The EF auxiliary cap was repealed:** The former statutory limit on concurrent extended-functions auxiliaries (former BPC §1753.7) is gone.[^A20] Old prep teaches a numeric EF cap per dentist; the current answer is that no EF cap exists—only the `5`-auxiliary telehealth-supervision cap under BPC §1684.5(d) remains.[^A15] * **Coronal polishing opened to DAs:** Under BPC §1750(f)(4), an unlicensed DA may perform coronal polishing after completing a Board-approved course (with the 8-hour infection control course and current BLS as prerequisites), under direct supervision only.[^A38] [^A6] Old prep treats this as an RDA-only duty. * **License display replaced name posting:** SB 1453 amended BPC §1700. Offices must display the actual license, permit, or registration of each person practicing dentistry where patients can easily see it (failure is a misdemeanor).[^A37] Old prep says "conspicuously post the names of all employees"; that rule has been repealed. * **OA/RDA experience barriers were repealed:** Old prep requiring months of DA work experience before qualifying for the OA/RDA pathways is stale; SB 1453 removed those barriers to entry.[^A20] * **Use the current Board duties table:** Always answer auxiliary-scope questions using the Dental Board of California's Table of Permitted Dental Auxiliary Duties, updated effective **January 1, 2025**.[^A6] Do not rely on older screenshots or pre-2025 role charts. ## 2026 Changes To Know * **Breach notice got a hard deadline (SB 446, effective 1/1/2026):** Civil Code §1798.82 now requires notice to affected California residents **no later than 30 calendar days** after discovering a breach, plus a sample notice to the Attorney General within `15 calendar days` of notifying individuals if more than 500 residents are affected.[^A48] Old prep says "without unreasonable delay"; that standard is a stale-prep trap. * **MICRA caps keep rising (AB 35, replacing the flat cap since 2023):** For 2026, noneconomic damages are capped at approximately `$470,000` (non-death) and `$650,000` (wrongful death), stackable up to `3` times across unaffiliated defendants, and rising annually toward `$750K/$1M` plateaus.[^A56] Old prep's flat `$250,000` answer is obsolete. * **Private equity clinical control is banned (SB 351, HSC §1191, effective 1/1/2026):** Private equity groups and hedge funds may not dictate diagnostic tests, referrals, patient quotas, treatment options, or coding/billing, nor can they own patient records.[^A59] Their non-compete and non-disparagement clauses are void. *Precision point:* MSOs are **not** named in §1191—old summaries stating "SB 351 bans MSOs" overstate the law; a PE-backed MSO is reached only through its controlling investors. * **MSOs answer to AB 1415 instead (effective 1/1/2026):** MSOs, private equity groups, and hedge funds are OHCA "noticing entities" that must give the Office of Health Care Affordability written notice at least `90 days` before material transactions.[^A81] * **CURES reporting carve-out (AB 82, effective 1/1/2026):** Prescribers and dispensers are prohibited from reporting testosterone or mifepristone prescriptions to CURES (HSC §11165(k)).[^A60] Old prep treats all controlled-substance dispensing as reportable. * **Medi-Cal coverage change (AB 116, effective 7/1/2026):** State-funded full-scope Medi-Cal dental benefits end for undocumented adults age 19 and older, leaving only restricted-scope emergency coverage for that population.[^A63] ## Current Official Guidance Worth Re-Memorizing These rules are not newly passed 2025-2026 bills, but older preparation materials routinely omit or misstate them—re-verify each against the dates and citations shown. * **The passing standard is criterion-referenced, not 75% (16 CCR §1031, amended effective 7/1/2022):** The passing score is set per test form by the modified Angoff method.[^A65] Prep teaching that "you need a 75% to pass" reflects the pre-July-2022 regulation and is outdated. *Related format trap:* The Candidate Information Bulletin publishes no fixed "75 questions / 90 minutes" for the dentist exam—that format belongs to other licensing boards.[^A1] * **Exam fees and retakes:** The Board application fee is `$125` (with a two-year eligibility window); each sitting—including the first attempt and every retake—carries a separate `$27.23` PSI examination fee, with re-registration taking `7–10 business days` after a failing result.[^A1] [^A2] * **Pediatric sedation staffing (SB 501, BPC §1647.2, operative 1/1/2022):** Moderate sedation on a patient under 13 requires at least two support personnel in addition to the operating dentist.[^A80] The dentist and at least one personnel member must hold current PALS-and-airway certification, and the dentist must hold a pediatric-endorsed MS or GA permit (a PMS permit never covers moderate sedation). * **CMIA authorizations accept e-signatures (AB 1697, effective 1/1/2024):** Civil Code §56.11 validates medical release authorizations "signed, including with an electronic or handwritten signature."[^B1] Old prep implying a wet-ink signature requirement is stale; however, the 14-point-type and separate-signature formatting rules still apply. * **Record copy fees are capped (SB 815, HSC §123110(j), effective 1/1/2024):** Patient-requested copies max out at `$0.25` per page (`$0.50` per page from microfilm).[^A9] * **Medi-Cal record retention is 10 years (WIC §14124.1):** The `10-year` floor—measured from the date of service, audit completion, or contract end, whichever is later—overrides the generic `7-year` closure rule for every Medi-Cal (Denti-Cal) chart.[^A67] * **The §650(h) digital safe harbor exists (AB 457, effective 1/1/2022):** Referral-fee prohibitions under BPC §650 do not apply to fees paid to neutral, non-endorsing internet advertising or appointment-booking platforms.[^A33] Old prep teaching that "any per-booking platform fee is an illegal kickback" is stale—but steering or endorsing a specific dentist still invalidates the safe harbor, and BPC §650.01 still *flatly* bans self-referral for enumerated services (no disclosure cure; only §650.02 exceptions like own-office services apply).[^A82] [^A83] * **Knox-Keene continuity windows (HSC §1373.96):** After a provider's contract termination, plans must allow completion of covered treatment: `12 months` for serious chronic conditions (such as in-progress orthodontics), newborn care (to 36 months), and maternal mental health; the full duration of care for acute, terminal, and pregnancy care; and authorized surgeries within `180 days`.[^A84] Orthodontic completion has no statutory full-duration carve-out. * **AB 2338 default surrogates:** For adults lacking capacity with no advance directive or designated agent, the Probate Code framework added by AB 2338 follows specified family priorities.[^A52] The correct consent lane order is: recorded designation → agent under power of attorney → conservator → default surrogate. * **Pediatric anesthesia warning language (AB 1622, since 2019):** The BPC §1682 informed consent warning tells the parent to "consult with your dentist, family physician, or pediatrician as needed"—incorporating all three professionals, not "consult a pediatrician" alone.[^A40] * **California is not in the dental compact:** The Dentist and Dental Hygienist Compact (DDHC) has 13 member states as of mid-2026 (Oklahoma joined as the thirteenth in May 2026), but California is not a member, and no compact privileges are being issued anywhere yet.[^A62] An out-of-state dentist treating a patient located in California needs a full California license. * **16 CCR §1005 is under active rulemaking:** The Board is amending the infection-control minimum standards, but the operative text remains unchanged since 2011.[^A85] Answer from the current version, and use the correct terminology: §1005 says "standard precautions," not "universal precautions."[^A14] * **CURES uses current `7-day` nonrefillable exemption language:** The official DCA flyer uses `7-day` (not the stale `5-day`) wording in the emergency-department, surgical/procedural, and timely-access exception lanes.[^A13] * **Good Samaritan immunity is a "scene, not office" concept:** Good Samaritan immunity never excuses ordinary negligence in a scheduled office setting, and BPC §2395 protects physicians and podiatrists, not dentists (a dentist's shields are BPC §1627.5 and HSC §1799.102).[^A53] [^A88] * **2025 ADA Code updates:** Advisory Opinion 5.F.7 holds social-media influencer statements made on behalf of a practice to strict veracity standards.[^C1] Updated Advisory Opinion 4.E.1 clarifies that paying an influencer a percentage of professional fees collected constitutes illegal and unethical fee-splitting. ## What To Purge From Old Prep * "You need 75% to pass" (the standard has been criterion-referenced via modified Angoff since July 2022)—and "the exam is exactly 75 questions in 90 minutes." * "Licensure by Portfolio is a current California pathway." * "California breach notice is simply prompt / without unreasonable delay." * "DAs have a one-year grace period to get their infection-control course"—and "the 8-hour course is 6 hours didactic / 2 hours lab" (it is 4/2/2). * "A dentist may supervise at most 2 (or 3) EF auxiliaries"—this concurrent EF auxiliary limit was repealed. * "PMS means Pediatric Moderate Sedation"—it stands for Pediatric **Minimal** Sedation; moderate sedation under 13 requires a pediatric-endorsed MS or GA permit plus PALS. * "Coronal polishing is RDA-only" and "you must post all employee names on the wall." * "The mandatory CE core is 2-2-2"—it is four core requirements: 2 DPA + 2 IC + 2 CA-Opioid + hands-on BLS. * "BPC §1683.6 requires a written estimate over $300 or 4 visits, with re-consent at 5% variance"—no such section exists in the current Dental Practice Act; the correct duty is BPC §654.3(h)'s written plan before third-party credit. * "MICRA is still a flat $250,000." * "SB 351 explicitly bans MSOs." * "All per-patient platform booking fees are kickbacks." * "Every kickback or self-referral problem can be fixed with written disclosure"—BPC §650.01's self-referral ban for enumerated services has no disclosure cure. * "Testosterone and mifepristone are CURES-reportable" (AB 82 ended this in 2026). * "The current CURES emergency-style exemption is 5 days." * "Adult records are always 7 years"—Medi-Cal charts carry the 10-year WIC §14124.1 floor. * "CMIA authorizations must be wet-signed." * "Good Samaritan immunity covers routine office care if the dentist meant well"—and "BPC §2395 protects dentists." * "California joined the dental licensure compact." * "Reject any answer choice containing the phrase 'conscious sedation'"—the permit was renamed, but BPC §1680(z)'s reporting text still uses the phrase. ## Footnotes [^A1]: `A1` Dental Board of California, Candidate Information Bulletin (Dental Law and Ethics Examination). [^A2]: `A2` Dental Board of California, Application to Obtain Eligibility to Take the Law and Ethics Examination. [^A6]: `A6` Dental Board of California, Table of Permitted Dental Auxiliary Duties, effective 1/1/2025. [^A9]: `A9` California Health & Safety Code §123110 — patient inspection, copies, and the §123110(j) per-page fee caps. [^A13]: `A13` DCA CURES mandatory-consultation flyer and exemptions. [^A14]: `A14` Dental Board of California minimum standards for infection control, 16 CCR §1005. [^A15]: `A15` California Business & Professions Code §§1680 and 1684.5 — unprofessional conduct, Board records demands, 7-day reporting, telehealth-supervision cap, and patient-of-record limits. [^A20]: `A20` Dental Board of California, SB 1453 alert for anesthesia and sedation changes effective 1/1/2025. [^A33]: `A33` California Business & Professions Code §650 — anti-kickback limits and the §650(h) platform safe harbor. [^A37]: `A37` California Business & Professions Code §1700 — current license, permit, and registration display. [^A38]: `A38` California Business & Professions Code §1750 — DA definition, basic supportive procedures, infection control, and coronal polishing. [^A40]: `A40` California Business & Professions Code §1682 — anesthesia informed consent and the AB 1622 pediatric warning language. [^A48]: `A48` SB 446 amending California Civil Code §1798.82 — 30-calendar-day breach-notice deadline effective 1/1/2026. [^A52]: `A52` California Probate Code §§4683, 4711, 4712, plus AB 2338 default-surrogate framework for adults lacking capacity. [^A53]: `A53` California Business & Professions Code §1627.5 — dentist Good Samaritan immunity. [^A56]: `A56` AB 35 (2022) — MICRA noneconomic-damages schedule replacing the old flat $250,000 cap; 2026 figures approximately $470K non-death and $650K wrongful death. [^A59]: `A59` Senate Bill 351 (2025), codified at California Health & Safety Code §1191 — private equity and hedge fund clinical-control prohibitions, effective 1/1/2026. [^A60]: `A60` Assembly Bill 82 (2025); HSC §11165(k) — CURES reporting exemptions for testosterone and mifepristone, effective 1/1/2026. [^A62]: `A62` Dentist and Dental Hygienist Compact (DDHC) — member-state status (13 states as of May 2026; California not a member). [^A63]: `A63` Assembly Bill 116 Health Omnibus — elimination of State-only Medi-Cal dental benefits for undocumented adults effective July 1, 2026. [^A64]: `A64` Assembly Business & Professions Committee, Analysis of SB 1453 (Ashby, Ch. 483, Stats. 2024) — repeal of the Licensure by Portfolio pathway, effective 1/1/2025. [^A65]: `A65` 16 CCR §1031 — criterion-referenced passing score set by the modified Angoff method, amended effective 7/1/2022. [^A67]: `A67` California Welfare & Institutions Code §14124.1 — 10-year minimum record retention for Medi-Cal (Denti-Cal) providers. [^A70]: `A70` 16 CCR §1070.6 — Board-approved 8-hour infection-control course content for dental assistants. [^A80]: `A80` California Business & Professions Code §1647.2 — pediatric moderate-sedation requirements for patients under 13. [^A81]: `A81` Assembly Bill 1415 (2025) — OHCA "noticing entities" material-transaction notice. [^A82]: `A82` California Business & Professions Code §650.01 — self-referral ban for enumerated services. [^A83]: `A83` California Business & Professions Code §650.02 — exceptions to the §650.01 self-referral ban. [^A84]: `A84` California Health & Safety Code §1373.96 — Knox-Keene continuity of care after provider contract termination. [^A85]: `A85` Dental Board of California — Board Meeting Agenda, February 5–6, 2026 (rulemaking update on 16 CCR §1005). [^A88]: `A88` California Business & Professions Code §§2395 and 2041 — Medicine-chapter Good Samaritan immunity limits (excludes dentists). [^B1]: `B1` California Confidentiality of Medical Information Act (CMIA), Civil Code §56 et seq.; valid-authorization requirements. [^C1]: `C1` American Dental Association — Principles of Ethics and Code of Professional Conduct (2025 online edition; Advisory Opinions 5.F.7 and 4.E.1). ## Individual update notes - [California breach notice changed to a 30-day deadline in 2026](https://dentovio.com/what-changed/california-breach-notice-deadline-2026/index.html.md): Study the current California 30-calendar-day breach-notice deadline instead of the older "without unreasonable delay" shortcut. - [California dental sedation rules changed in 2025](https://dentovio.com/what-changed/sedation-anesthesia-changes-2025/index.html.md): Use the current permit names, staffing expectations, and adverse-event framing instead of pre-2025 sedation shorthand. - [CURES exemptions use current 7-day language, not stale 5-day wording](https://dentovio.com/what-changed/cures-seven-day-exemption-language/index.html.md): Use the current DCA flyer language that describes a 7-day nonrefillable exemption lane instead of outdated 5-day shorthand. - [The old flat MICRA cap is stale for 2026 prep](https://dentovio.com/what-changed/micra-cap-schedule-for-2026-prep/index.html.md): For 2026 prep, stop answering from the old flat $250,000 MICRA cap and switch to the AB 35 schedule framing.