Maryland is one of the more legible states for a practice owner. The dental board publishes a quick-reference CE chart with the mandatory courses spelled out, the Department of the Environment publishes actual dollar figures for radiation machine registration including a dental-specific rate, and the Legislature has written non-compete limits for health care workers directly into statute with a salary threshold attached. This page collects those sources and notes where they stop.
Key takeaways
- Dentists and dental hygienists complete 30 hours of CE over a two-year renewal cycle, with the completion period running January 1 through December 31 of the following year.
- Mandatory content rotates. A 2-hour infection control course is required every cycle. CPR, a 2-hour proper prescribing and disposal course for dentists, and a 2-hour abuse and neglect course covering Maryland law are each required every other cycle.
- Radiation machines are registered with the Maryland Department of the Environment, per tube, annually. For calendar year 2026 the dental and veterinary dental rate is $80 per tube, compared with $292 for hospital, medical office, industrial and veterinary tubes.
- Under Labor and Employment 3-716, a non-compete is void for a licensed health occupations professional providing direct patient care who earns $350,000 or less. Above that figure, a covenant may not exceed one year or ten miles from the primary place of employment.
Rules change, so verify before you act. Everything below was checked against an official Maryland or federal source in September 2026. Radiation fees are adjusted for cost of living, and the non-compete statute has been amended recently. Confirm with the agency, and take contract and tax questions to a Maryland attorney or CPA.
Who regulates what
| Topic | Agency | Official link |
|---|---|---|
| Dentist and hygienist licensure and renewal | Maryland State Board of Dental Examiners, Maryland Department of Health | Maryland State Board of Dental Examiners |
| Continuing education | Maryland State Board of Dental Examiners | CE quick reference chart |
| Continuing education regulation | COMAR 10.44.22 | COMAR 10.44.22, continuing education |
| Radiation machine facility registration and fees | Maryland Department of the Environment, Radiological Health Program | MDE x-ray applications, forms and guidance |
| Registering a new facility | Maryland OneStop | Radiation machine facility registration |
| Amalgam separators and dental wastewater | US EPA rule, enforced by your local pretreatment control authority | EPA dental effluent guidelines |
| Non-competes | Maryland General Assembly, Labor and Employment 3-716 | Labor and Employment 3-716 |
| Bloodborne pathogens, hazard communication, PPE | Maryland Occupational Safety and Health, plus federal OSHA standards | OSHA |
License renewal and continuing education
The board publishes a one-page quick reference that is the most useful document in Maryland dental compliance. Dentists and dental hygienists both complete 30 hours of CE over a two-year renewal cycle, and the completion period runs from January 1 through December 31 of the following year, with the deadline landing on December 31 of the year before renewal. That offset is the detail people get wrong: your CE year is not your renewal year.
The mandatory items rotate on two different clocks:
| Requirement | Frequency | Counts toward the 30? |
|---|---|---|
| Infection control, 2 hours | Every renewal cycle | Yes |
| CPR certification | Every other cycle, maintained without lapse | No CE credit |
| Proper prescribing and disposal of prescription drugs, 2 hours, board approved | Every other cycle, dentists | Yes |
| Abuse and neglect covering Maryland law, 2 hours, board approved | Every other cycle | Yes |
Hygienists may take the prescribing and disposal course for credit but are not required to. On CPR, Maryland names acceptable programs: the American Heart Association's Basic Life Support for Healthcare Providers or the American Red Cross's Cardiopulmonary Resuscitation for Professional Rescuers, and it excludes online-only courses.
The chart also sets ceilings rather than floors on the flexible portion: up to 17 hours of self-study, up to 8 hours of pro bono service, and up to 4 hours combined in cultural competency or military culture courses.
"Every other cycle" requirements are the ones that fail audits, because they are invisible in the cycle where you do not need them. Write the year, not the interval, into your calendar: note in your CE file which cycle you last took prescribing, abuse and neglect, and CPR, so the next owner of that spreadsheet can see it at a glance.
X-ray equipment: registration and inspection
Radiation machine registration in Maryland sits with the Department of the Environment, not the health department. The program charges per tube, annually, and publishes the schedule. For calendar year 2026 the groups are:
| Facility group | Annual fee per tube |
|---|---|
| Dental and veterinary dental | $80 |
| Hospital, medical office, industrial, research and academic, veterinary, mammography | $292 |
| Particle accelerators and medical accelerators | $1,154 |
Fees are due annually following initial registration, and MDE asks that renewal documentation be submitted at least 14 days before the facility expiration date. Renewal runs on form RX-1, the facility registration renewal form, which reports the machines at the facility.
Two obligations attach to the machines themselves. MDE requires preventive maintenance performed on the schedule recommended by the machine manufacturer, reported within 30 days. And when a facility terminates, MDE requires a disassembly and removal report, form RX-24, accounting for each machine.
That RX-24 requirement is the one to remember in a closure or a consolidation. Maryland wants to know where every tube went, machine by machine. Our guide to closing a dental practice covers the rest of that process, and x-ray registration and inspections covers the general mechanics.
The fee document we read does not state inspection intervals, so treat inspection frequency as a question for the Radiological Health Program.
Buying and selling used equipment in Maryland
Per-tube fees change the math on a cheap third unit
At $80 per dental tube per year, an extra used intraoral unit is not a rounding error but it is not a barrier either. The number worth running is total tubes times the annual fee, plus preventive maintenance on the manufacturer's schedule, reported within 30 days. A practice with eight operatories and a pan is registering nine tubes, and that is the real annual compliance cost of the imaging footprint you are buying.
Diligence questions that are Maryland-specific
Ask the seller for the most recent RX-1 renewal and compare its machine list against the building. Ask for the preventive maintenance records, since MDE requires them on the manufacturer's schedule and a gap is both a compliance issue and a condition signal. If the seller is closing rather than transferring, ask whether an RX-24 disassembly and removal report is being filed and for which machines, so you are not inheriting a reporting mismatch. Our pre-purchase equipment checklist and hidden costs of buying used equipment cover the broader diligence.
Amalgam separators and wastewater
The federal EPA rule at 40 CFR Part 441 applies to dental offices that place or remove amalgam and discharge to a publicly owned treatment works. Operate and maintain a separator, do not discharge scrap amalgam or use certain line cleaners, and file a one-time compliance report with your pretreatment control authority, usually the local sewer utility. Ask that authority what it wants from an incoming owner, since EPA's guidance does not address transfers. See amalgam separators and dental waste disposal.
Non-competes and employment
Maryland put its rules in Labor and Employment 3-716, and for a dental practice they are consequential.
The general wage floor voids a non-compete as against the public policy of the state for workers earning at or below 150 percent of the state minimum wage. That reaches part of a dental team on its own.
The health care provisions go much further. The statute covers employees who are required to be licensed under the Health Occupations Article and who are in a position providing direct patient care, along with licensed veterinary practitioners and veterinary technicians. For those workers earning $350,000 or less annually, a non-compete or conflict of interest provision is void. Above $350,000, a covenant is permitted but bounded: it may not exceed one year from the last day of employment, and its geographic scope may not exceed ten miles from the primary place of employment.
Read that in a dental context. A dentist, hygienist or any other Health Occupations licensee providing direct patient care whose compensation is at or below $350,000 is, by the plain terms of the statute, outside the reach of a non-compete. Most associates in Maryland are under that number. Owners drafting associate agreements should have counsel confirm whether the covenant they are about to hand someone is enforceable at all.
The statute page we read does not state the effective dates of the health care provisions, and Maryland amended this area recently, so an agreement signed before the amendment and one signed after may be treated differently. That is a question for a Maryland employment attorney and not one to guess at.
At the federal level, the FTC's non-compete rule is not in effect. On September 5, 2025 the Commission voted to dismiss its appeals and accede to the vacatur of the rule after a district court held the agency lacked authority to issue it, so Maryland law controls. See non-compete agreements for dentists, the associate contract review checklist, and associate contract red flags.
What we could not confirm
- The effective dates of the health care provisions in Labor and Employment 3-716, and whether they apply to agreements signed before those dates. The statute text page we read does not state them.
- How "earns $350,000 or less" is measured for a production-based associate. Ask counsel how the statute treats variable compensation.
- Inspection intervals for dental x-ray facilities in Maryland. The fee document does not address them.
- The procedure for reporting a newly acquired machine or an address change between renewals. The renewal document we read covers renewal and termination but not those events.
- What credential a dental assistant must hold before exposing radiographs in Maryland. We did not confirm this from the board pages we read.
- Maryland limits on non-dentist ownership of a dental practice.
- Sales and use tax treatment of dental equipment, including private-party purchases. Confirm with the Comptroller of Maryland and your CPA.
Where to verify
- Maryland State Board of Dental Examiners: board home, the CE quick reference chart, and COMAR 10.44.22
- Maryland Department of the Environment: x-ray applications, forms and guidance and the 2026 radiation fees and facility responsibilities notice
- Maryland OneStop: radiation machine facility registration
- Maryland General Assembly: Labor and Employment 3-716
- US Environmental Protection Agency: dental effluent guidelines, 40 CFR Part 441
- Federal Trade Commission: September 2025 statement acceding to vacatur of the non-compete rule
Putting it to work
Maryland rewards a practice that keeps two simple files. One is a CE file that records the year you last completed each rotating requirement, because the every-other-cycle items are what auditors find. The other is a machine file: an RX-1 copy, a tube count, and preventive maintenance records on the manufacturer's schedule, which doubles as diligence material when you eventually sell.
On employment, the $350,000 line in the statute is the first thing to check before anyone signs or enforces a covenant. Have counsel run that analysis before you spend money on a dispute.
Related reading: non-compete agreements for dentists, x-ray registration and inspections, the compliance chapter of the operations guide, and the rest of the state resources directory.
This guide is educational content and does not constitute legal, financial, tax, or clinical advice. Laws and regulations vary by state and change over time. Consult your own dental-specific attorney, CPA, and state dental board before acting.