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<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-20</ns0:ActionDate>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Assembly Member Solache</ns0:AuthorText>
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<ns0:House>ASSEMBLY</ns0:House>
<ns0:Name>Solache</ns0:Name>
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<ns0:Title> An act to amend Sections 1628, 1634.1, and 1636.5 of, and to repeal and add Section 1636.6 of, the Business and Professions Code, relating to healing arts. </ns0:Title>
<ns0:RelatingClause>healing arts</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Dental Practice Act: foreign dental schools.</ns0:Subject>
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<html:p>Existing law, the Dental Practice Act, provides for the licensure and regulation of dentists by the Dental Board of California within the Department of Consumer Affairs. Existing law requires an applicant for licensure to meet specified requirements, including, among others, furnishing satisfactory evidence of having graduated from a dental college approved by the board or by the Commission on Dental Accreditation of the American Dental Association (CODA). Prior law provided for the approval of foreign dental schools by the board. Beginning January 1, 2024, existing law requires foreign dental schools seeking approval by the board to complete the international consultative and accreditation process with CODA or a comparable accrediting body approved by the board. Notwithstanding that requirement, existing law maintained the approval of any foreign dental schools whose program was renewed
by the board prior to January 1, 2020, through any date between January 1, 2024, and June 30, 2026, through that renewal date.</html:p>
<html:p>This bill would, instead, maintain the approval of a foreign dental school whose program was approved by the board prior to January 1, 2020, if that school applied for accreditation by an accrediting body, or CODA, on or before January 31, 2026, while that accreditation process is ongoing, as specified. The bill would require the foreign dental school to, commencing with January 1, 2027, and every 6 months thereafter, provide an update to the board on the status of the foreign dental school’s accreditation application. The bill would authorize the board to terminate the maintained approval of a foreign dental school for failure to submit that update, as specified.</html:p>
<html:p> Existing law makes a graduate of a foreign dental school whose program was approved by the board prior to January 1, 2020, through any
date before January 1, 2024, who enrolled in the program prior to January 1, 2020, eligible for licensure, as specified.</html:p>
<html:p> This bill would, instead, deem a graduate of a foreign dental school that was approved at the time of the graduate’s enrollment to have graduated from an approved dental school for purposes of the act, regardless of whether the foreign dental school’s approval expired before the graduate’s graduation. The bill would make a graduate of a foreign dental school with maintained approval pursuant to the bill’s provisions who enrolled in the school on or after July 1, 2026, eligible for licensure under the act. The bill would make related conforming changes and would make findings and declarations related to the history of, and need for, foreign dental schools.</html:p>
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<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_48009B92-F904-4850-900A-BA6EE77120DC">
<ns0:Num>SECTION 1.</ns0:Num>
<ns0:Content>
<html:p>The Legislature finds and declares all of the following relating to the shortage or maldistribution of dentists throughout California, including a lack of Latino and Black dental students and licensed dentists in proportion to their population in the state:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
California faces a worsening shortage of oral health care access, with nearly 3 million residents unable to obtain routine dental services. More than 2.7 million Californians live in dental health professional shortage areas, a 22.7 percent increase since 2017. Workforce shortages are intensifying due to an aging dentist population, with 42 percent of dentists being over the age of 55. Changes to federal H-1B visa fees, established at $100,000, will disproportionately affect
rural regions that rely on H-1B visa dentists.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Rural and underserved areas are disproportionately impacted as rural counties report declining dentist-to-population ratios, with some having fewer than one dentist per 5,000 residents. Only 3 percent of rural dentists accept Medicaid compared to 11 percent of dentists in urban areas, deepening inequities and increasing emergency dental expenditures.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
The increasing cost of dental education accentuates the access to oral health care problem as the state’s dental education costs are among the highest nationally, often exceeding $450,000 at public institutions and $500,000 at private schools. High debt, now averaging more than $305,000, limits graduates’ ability to work in underserved communities, and loan repayment programs overwhelmingly benefit urban areas over rural regions.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The State Department of Public Health’s California Oral Health Plan 2018–2028 and a study by the Healthforce Center at the University of California at San Francisco (UCSF) identified the following major oral health issues in California:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
There are marked oral health disparities in California with respect to race and ethnicity, income, and education. The uneven distribution of the oral care workforce and inadequate infrastructure and capacity in the public health system have presented difficulties in delivering preventive and early treatment for oral care services to millions of Californians.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Approximately 2.2 million Californians live in dental health professional shortage areas, which are largely concentrated in the northern Sierra counties, the central valley, and the Inland Empire.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
According to the United States Department of Health and Human Services, rural populations have a higher prevalence of cavities and tooth loss, a lower degree of private dental insurance, and limited access to public dental services. Rural areas often have inadequate public transportation systems, making it very difficult to access dentists outside the proximal area.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
A disproportionate number of people living in poverty and the working poor reside in geographically isolated areas with a maldistribution of dentists and a limited number of Medicaid providers. As a result, those who need dental care the most are often the least likely to receive it.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
According to the UCSF study, estimates of the total supply of dentists in California do not reflect the supply available to care for medically underserved communities and individuals covered by Medi-Cal, which
covers 26 percent of the state’s population and nearly half (43 percent) of the state’s children.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
In 2016, only 15.7 percent of California dentists participated in Medi-Cal or the Healthy Families Program, the second lowest in the nation.
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
In 2024, the Little Hoover Commission, after conducting additional reviews of the program, stated that California still ranks among the worst in the nation when it comes to care and treatment of pediatric dental disease.
</html:p>
<html:p>
(j)
<html:span class="EnSpace"/>
The racial and ethnic diversity of the workforce is not congruent with California’s population, affecting access to services and culturally appropriate delivery of dental care.
</html:p>
<html:p>
(k)
<html:span class="EnSpace"/>
Despite the Latino population comprising approximately 38 percent of the people in California, only 6 percent
of practicing dentists are Latino, according to data from the California Health and Human Services Open Data Portal.
</html:p>
<html:p>
(l)
<html:span class="EnSpace"/>
Similarly, Black dentists make up 2 percent of the California dentist workforce despite the Black population making up 6 percent of California’s population.
</html:p>
<html:p>
(m)
<html:span class="EnSpace"/>
The deficient number of Latino and Black dentists contributes to and accentuates the access to dental care problem as it is well documented that cultural competency in the delivery of oral health effectively addresses societal barriers in accessing and receiving preventative and treatment services.
</html:p>
<html:p>
(n)
<html:span class="EnSpace"/>
In 1998, to alleviate the shortage or maldistribution of dentists, the Legislature created a program requiring the Dental Board of California (the board) to evaluate and, if qualified, approve foreign dental schools.
</html:p>
<html:p>
(o)
<html:span class="EnSpace"/>
Under this program, the board established an evaluation process conducted by experts in the dental arena to assess curriculum, faculty qualifications, facilities, and other relevant factors to ensure that the schools would provide an education that is equivalent to that of similar accredited institutions in the United States and that would adequately prepare students for the practice of dentistry.
</html:p>
<html:p>
(p)
<html:span class="EnSpace"/>
The board approved two foreign dental schools: the University of De La Salle Bajío School of Dentistry (La Salle University) in Guanajuato, Mexico, in 2004, and the State University of Medicine and Pharmacy “Nicolae Testemitanu” in Moldova (Moldova University) in 2016.
</html:p>
<html:p>
(q)
<html:span class="EnSpace"/>
Moldova University has been a center of undergraduate and postgraduate education of doctors and pharmacists since 1945, and of dentistry since
1959.
</html:p>
<html:p>
(r)
<html:span class="EnSpace"/>
La Salle University, founded in 1975, is ranked as one of the best dental schools in Mexico.
</html:p>
<html:p>
(s)
<html:span class="EnSpace"/>
In order to become approved foreign dental schools, La Salle University and Moldova University underwent extensive approval and evaluation processes conducted by the board that took years to complete.
</html:p>
<html:p>
(t)
<html:span class="EnSpace"/>
Graduates from these approved schools were required to pass the same licensure standards as graduates from schools within the United States.
</html:p>
<html:p>
(u)
<html:span class="EnSpace"/>
Since the inception of this program, approximately 900 graduates from La Salle University and Moldova University have passed the required California exams and are practicing in California. Many are practicing in low-income, underserved communities, like Yuba City, Madera, Bakersfield, Fresno, and Los
Angeles.
</html:p>
<html:p>
(v)
<html:span class="EnSpace"/>
Chapter 865 of the Statutes of 2019 (Assembly Bill No. 1519) eliminated the board’s authority to approve additional foreign dental schools, and required that, to maintain their status as board-approved schools, La Salle University and Moldova University must successfully complete the international consultative and accreditation process with the Commission on Dental Accreditation of the American Dental Association (CODA) by January 1, 2024.
</html:p>
<html:p>
(w)
<html:span class="EnSpace"/>
Moldova University began the CODA accreditation process on March 15, 2021. CODA responded that they would not be conducting reviews of international dental schools in the foreseeable future because of travel restrictions resulting from the COVID-19 pandemic.
</html:p>
<html:p>
(x)
<html:span class="EnSpace"/>
Moldova University recently completed and filed with CODA its preliminary accreditation consultation
visit application.
</html:p>
<html:p>
(y)
<html:span class="EnSpace"/>
La Salle University began the CODA accreditation process in 2007, was denied accreditation in March 2019, and is currently in the process of appealing the decision.
</html:p>
<html:p>
(z)
<html:span class="EnSpace"/>
CODA began its process of creating an international school accreditation process in 2005, completed this process in 2006, and began accepting applications in 2007. Documentation from CODA shows that in 2007, 10 international dental programs submitted applications.
</html:p>
<html:p>
(aa)
<html:span class="EnSpace"/>
In 2019, CODA approved its first foreign dental school, King Abdulaziz University in Jeddah, Saudi Arabia. The process took approximately 12 years to complete.
</html:p>
<html:p>
(ab)
<html:span class="EnSpace"/>
In 2024, CODA approved its second foreign school, Yeditepe University in Istanbul, Turkey. The process took approximately 17 years to
complete.
</html:p>
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<ns0:Num>SEC. 2.</ns0:Num>
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Section 1628 of the
<ns0:DocName>Business and Professions Code</ns0:DocName>
is amended to read:
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<ns0:Num>1628.</ns0:Num>
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<html:p>Any person over 18 years of age is eligible to take an examination before the board upon making application therefor and meeting all of the following requirements:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
Paying the fee for applicants for examination provided by this chapter.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Furnishing satisfactory evidence of having graduated from a dental college approved by the board or by the Commission on Dental Accreditation of the American Dental Association and presenting satisfactory evidence of having completed at dental school or schools the full number of academic years of undergraduate courses required for graduation. For purposes of this article, “dental college approved by the board” or “approved dental school” include
both a foreign dental school accredited by a body that has a reciprocal accreditation agreement with any commission or accreditation organization whose findings are accepted by the board and any foreign dental school with maintained approval pursuant to Section 1636.5.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Furnishing the satisfactory evidence of financial responsibility or liability insurance for injuries sustained or claimed to be sustained by a dental patient in the course of the examination as a result of the applicant’s actions.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
If the applicant has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school, the applicant shall
furnish all of the following documentary evidence to the board:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
That the applicant has completed, in a dental school or schools approved by the board pursuant to Section 1636.4, a resident course of professional instruction in dentistry for the full number of academic years of undergraduate courses required for graduation.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Subsequent thereto, the applicant has been issued by the dental school a dental diploma or a dental degree, as evidence of the successful completion of the course of dental instruction required for graduation.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
Any applicant who has been issued a dental diploma from a foreign dental school that has not, at the time of the applicant’s graduation from the school, been approved by the board pursuant to Section 1636.4 shall not be eligible for examination until the applicant has successfully
completed a minimum of two academic years of education at a dental college approved by the board pursuant to Article 1 (commencing with Section 1024) of Chapter 2 of Division 10 of Title 16 of the California Code of Regulations and has been issued a degree of doctor of dental medicine or doctor of dental surgery or its equivalent. This subdivision shall not apply to applicants who have successfully completed the requirements of Section 1636 as it read before it was repealed on January 1, 2004, on or before December 31, 2003, or who have successfully completed the requirements of Section 1628.2 on or before December 31, 2008. An applicant who has successfully completed the requirements of Section 1636 as it read before it was repealed on January 1, 2004, on or before December 31, 2003, or who has successfully completed the requirements of Section 1628.2 on or before December 31, 2008, shall be eligible to take the examination required by Section 1632, subject to the limitations set forth in subdivisions (b)
and (c) of Section 1633.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
Subdivisions (d) and (e) do not apply to a person who has been issued a degree of doctor of dental medicine or doctor of dental surgery by a foreign dental school accredited by a body that has a reciprocal accreditation agreement with any commission or accreditation organization whose findings are accepted by the board.
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<ns0:Num>SEC. 3.</ns0:Num>
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Section 1634.1 of the
<ns0:DocName>Business and Professions Code</ns0:DocName>
is amended to read:
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<ns0:Num>1634.1.</ns0:Num>
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<html:p>Notwithstanding Section 1634, the board may grant a license to practice dentistry to an applicant who submits all of the following to the board:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
A completed application form and all fees required by the board.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Satisfactory evidence of having graduated from a dental school approved by a national accrediting body approved by the board or by the Commission on Dental Accreditation of the American Dental Association or from any foreign dental school with maintained approval pursuant to Section 1636.5.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Satisfactory evidence of having completed a clinically based advanced education program in general dentistry or an advanced education program in general practice residency that is, at minimum, one year in duration and is accredited by either the Commission on Dental Accreditation of the American Dental Association or a national accrediting body approved by the board. The advanced education program shall include a certification of clinical residency program completion approved by the board, to be completed upon the resident’s successful completion of the program in order to evaluate the resident’s competence to practice dentistry in the state. The certification shall be within two years prior to the date of the resident’s application for a license under this section. Completion of the program shall be within two years prior to the date of their application for a license under this section.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
Satisfactory evidence of having successfully completed the written examination of the National Board Dental Examination of the Joint Commission on National Dental Examinations.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
Satisfactory evidence of having successfully completed an examination in California law and ethics.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
Proof that the applicant has not failed a state, regional, or national examination for licensure to practice dentistry under this chapter within five years prior to the date of the application for a license under this chapter. If the applicant subsequently passed the examination for licensure, the prior failure shall not make the applicant ineligible under this subdivision.
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<ns0:Num>SEC. 4.</ns0:Num>
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Section 1636.5 of the
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is amended to read:
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<ns0:Num>1636.5.</ns0:Num>
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<html:p>
(a)
<html:span class="EnSpace"/>
Notwithstanding Section 1636.4, any foreign dental school whose program was approved by the board prior to January 1, 2020, shall maintain approval
if it complies with all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The foreign dental school applied for accreditation by a national accrediting body approved by the board or by the Commission on Dental Accreditation of the American Dental Association on or before January 31, 2026.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The foreign dental school is undergoing the accreditation process it applied for pursuant to paragraph (1).
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Commencing January 1, 2027, and every six months thereafter, the foreign dental school provides an update to the board on the status of the school’s accreditation application.
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
The board may terminate the approval of a foreign dental school that fails to
provide an update required by this paragraph.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
The board, before termination pursuant to subparagraph (A), shall give the foreign dental school both notice of their failure to report the status of their application and 45 days from the delivery of that notice to correct that failure.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A foreign dental school with extended approval pursuant to subdivision (a) shall maintain that approval until either the school has been issued a denial of accreditation from the national accrediting body approved by the board or the Commission on Dental Accreditation of the American Dental Association or the school withdraws its application for accreditation from the national accrediting body approved by the board or the Commission on Dental Accreditation of the American Dental Association.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A foreign
dental school whose approval has been terminated pursuant to this subdivision may regain approval pursuant to Section 1636.4
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<ns0:Num>SEC. 5.</ns0:Num>
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Section 1636.6 of the
<ns0:DocName>Business and Professions Code</ns0:DocName>
is repealed.
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<ns0:Num>SEC. 6.</ns0:Num>
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Section 1636.6 is added to the
<ns0:DocName>Business and Professions Code</ns0:DocName>
, to read:
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<ns0:LawSection id="id_C880F3D6-C532-46F6-A83F-0CDFDC866AFC">
<ns0:Num>1636.6.</ns0:Num>
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<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
A graduate of a foreign dental school with maintained approval pursuant to Section 1636.5 who enrolled in the school on or after July 1, 2026, shall be eligible for licensure to practice dentistry pursuant to this chapter.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Notwithstanding any other law, a graduate of a foreign dental school that was approved at the time of the graduate’s enrollment shall be deemed to have graduated from an approved dental school for purposes of this chapter regardless of whether the foreign dental school’s approval expired prior to the graduate’s graduation.
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