Definitions pertaining to Dental Hygiene Functions:
INDIRECT SUPERVISION: The dentist authorizes the
procedures and remains in the treatment facility white the procedures are being
performed.
OPERATIVE SUPERVISION: The dentist authorizes the
procedures, remains in the operatory whlie the procedures are being performed,
and evaluates the results prior to leaving the operatory.
GENERAL SUPERVISION: The dentist authorizes the
procedures but is not required to be present In the treatment facility while
the procedures are being performed by the dental hygienist.
A. EXCLUSIVE FUNCTIONS TO BE PERFORMED BY A
DENTAL HYGIENIST WHEN DELEGATED BY A DENTIST
1. Effective and safe delivery of certain
services to the public is dependent upon making judgments and utilizing skills
that require synthesis and application of knowledge acquired in accredited
dental hygiene education programs and cannot be delegated to any dental staff
member other than a licensed, registered dental hygienist.
2. The following functions may only be
delegated to a licensed dental hygienist;
a.
Oral examination. Elements of these examinations include charting of canous
lesions and other abnormalities, periodontal charting and assessment of
periodontal conditions, treatment planning for dental hygiene services and oral
cancer screening. The dental hygienist may dictate the examination findings to
a dental assistant who may then record the data on the patient's dental
record.
b. Oral prophylaxis,
scaling, root planning and curettage. If a laser instrument is used, the dental
hygienist and their supervising dentist must submit to the Board proof of
successful completion of an approved educational course on the use of that type
of laser prior to its usage for any patient treatment.
c. Using air driven, electric, sonic,
ultrasonic, or otherwise powered scalers or polishers (except dental assistants
possessing an expanded duties permit for polishing).
d. Placing medicaments as prescribed by the
supervising dentist into the sulcus or penodontal pockets, for periodontal
diseases.
e. Place Silver Diamine
Fluoride (SDF) under general supervision. If SDF is used, the dental hygienist
and their supervising dentist must submit to the Board proof of successful
completion of an approved educational course on SDF prior to its usage for and
patient treatment.
B. PROHIBITED ACTIVITY. The following
functions and procedures may NOT be delegated to dental hygienists. The
functions include:
1. Diagnosis and treatment
planning
2. Surgical or cutting
procedures on hard or soft tissue
3. Prescription, injection, inhalation, and
parenteral administration of drugs (except where permitted by the
Board)
4. Placement, seating or
removal of any final or permanent restorations
5. Final placement of orthodontic
brackets
6. Any procedure that
contributes to or results in irreversible alteration of the oral
anatomy
7. Performance of any of
the following expanded duties without a permit:
a. Administration of local
anesthesia
b. Administration of
nitrous oxide/oxygen analgesia
C. SUPERVISION LEVELS FOR AUTHORIZED
FUNCTIONS OF A DENTAL HYGIENIST
1. Under
INDIRECT SUPERVISION a hygienist may perform any dental task or procedure
assigned by the supervising dentist to the hygienist that does not require the
professional skills of a licensed dentist except for those functions prohibited
in Section B of this Article or those tasks that require operative
supervision.
2. Under OPERATIVE
SUPERVISION, a hygienist may perform the following procedures;
a. Any procedure allowed under Indirect
Supervision.
b. Administer certain
local anesthesia injections as provided in Article XVI of these Rules and
Regulations.
3. Under
GENERAL SUPERVISION, the following restrictions apply:
a. A hygienist may render services only with
the expressed consent of the supervising dentist and only for brief intervals
when the supervising dentist cannot be in the treatment facility not to exceed
two (2) consecutive days. A hygienist may render services for up to five (5)
consecutive days in a five day work week. A work week being defined as Monday
thru Friday. The hygienist must have the expressed consent of the supervising
dentist, when the dentist cannot be present in the treatment facility during
the work week. This arrangement cannot exceed two (2) weeks without the dentist
returning to work in the treatment facility.
b. The supervising dentist maintains full
control as to whether general supervision will be utilized in his/her office or
practice setting.
c. General
supervision is allowed only in dental clinics, community health centers or
government sponsored dental facilities,
d. Hygienists must comply with written
protocols for emergencies as established by the supervising dentist
e. Hygienists must practice under the
supervision of a licensed dentist and may not practice independently or
establish an office devoted primarily to dental hygiene services.
f. Hygienists must have one (1) full year of
full-time service before being able to function under general supervision of a
dentist.
g. Patients must be
notified in advance that the doctor may not be in the treatment
facility.
h. The supervising
dentist must have examined the patient(s) not more than twelve (12) months
prior.
I. Hygienists may perform
any procedure allowed under Indirect Supervision with the exception of root
planing, subgingival curettage, local anesthesia, and administration of nitrous
oxide.
j. The hygienist may place
sealants if it has not been more than thirty days since the teeth to be sealed
were examined by the dentist.
k. A
registered dental hygienist may not delegate functions to a registered dental
assistant when the treating dentist is not in the facility.
Amended 1/12/01, 4/9/04, 1/20/2012 and
11/16/2018.