Okla. Admin. Code § 195:15-1-4 - Education and Training for expanded duty permits for dental assistants

(a) Dental assistants may apply for up to seven (7) expanded duty permits as found at 59 O.S., Section 328.24, upon successful completion of the following education and training requirements:

(b) Courses for dental assistant expanded duties as found at 59 O.S. §328.24(D), shall be provided in a CODA (Commission on Dental Accreditation) accredited school or affiliated with a CODA approved program, or another course meeting the same requirements as a CODA approved program and approved by the Board. Within thirty (30) days of completion of the course, each program shall send a copy of the syllabus and a list of the students that have passed the course to the Board. Programs must maintain class and syllabus records for five (5) years. Courses offered pursuant to this rule are subject to unannounced audits by the Board. Any Board member or designee of the Board shall be provided full access to course materials or the classroom or clinic during instruction. Failure to provide access pursuant to this provision may subject the provider to invalidation of course results.

(c) Courses and/or certification programs for assisting a dentist with anesthesia, vaccinations, venipuncture and phlebotomy shall be approved by the Board.

(d) All courses shall include State Dental Act statutes and rules and the United States Center for Disease Control (CDC) and United States Safety and Health Administration (OSHA) guidelines, safety protocols and requirements as utilized with each expanded duty.

(e) Written examinations over didactic portions shall have a requirement of a 70% accuracy rate.

(f) Student faculty ratio for each course shall be as required by CODA.

(g) Students must submit an application for the expanded duty to the Board within two (2) years after the date of the completion of the course or the course will have to be repeated.

(h) A dental assistant that has a previous action or sanction by the board within the previous (5) five years, shall not be eligible for an elder care public health permit.

(1) Radiation Safety.

(A) Definition: A dental assistant holding this expanded duty permit may expose intraoral and extraoral radiographs.

(B) Requirements: Satisfactory completion of a course of study in radiation safety and protection, consisting of a minimum of four (4) hours of instruction.

(C) The Radiation safety course shall be taught by licensed dentists or hygienists; or a dental assistant with a minimum of five (5) years of experience with a valid expanded duty permit. This course will train dental assistants with a valid permit, to expose intraoral and extraoral radiographs.

(D) The didactic portion shall include radiation physics and biology, health safety and protection and radiographic quality.

(2) Coronal Polishing/Topical Fluoride.

(A) Definition: A dental assistant holding this expanded duty permit may

(i) polish coronal surfaces of teeth, or prepare teeth for band cementation or bonding of brackets utilizing a slow speed rotary hand piece and rubber cup or brush, polishing agent and the polishing is not prophylaxis. Examinations, for calculus and scaling must be done by a dentist or dental hygienist.

(ii) apply topical fluoride and desensitizing agents. A dental assistant may not use a prophy jet or any other instrument unless approved by the Board.

(B) Requirements: Satisfactory completion of a course, including two (2) hours of didactic education and six (6) hours of clinical training, including demonstration, in coronal polishing and the application of topical fluoride and desensitizing agents.

(C) The coronal polishing course shall be taught by a licensed dentists or licensed dental hygienist; or a dental assistant who have current expanded duty permits in coronal polishing and five (5) years of experience. Upon completion of the course, the student should be able to manipulate polishing instruments correctly and remove all plaque and extrinsic stains that do not require scaling from the exposed surfaces of teeth without trauma to the teeth or gingiva and demonstrate the ability to apply desensitizing and fluoride agents to accomplish caries prevention.

(D) The didactic portion shall include instruction in:

(i) Principles and clinical appearance of plaque, stain formation and the clinical appearance of clean and polished teeth;

(ii) Tooth morphology and the anatomy of the oral cavity as they relate to the retention of plaque, stain and polishing techniques;

(iii) Principles of selecting abrasives and polishing agents and their effect on tooth structure and restorative materials;

(iv) Principles of polishing, including the selection and care of the armamentarium, instrumentation techniques and precautions, including the care of the mouth with fixed or removable prostheses and/or orthodontic appliances;

(v) Principles of selecting and applying fluoride and disclosing agents, including armamentarium, isolation of teeth, technique and precautions;

(vi) Principles of the preparation of teeth and the oral cavity for fluoride applicationand the reaction of fluorides with tooth structure;

(E) The clinical portion of the course shall include significant portions of the didactic portion and a patient-based experience in:

(i) Identifying calculus, plaque, and intrinsic and extrinsic stains and evaluating the extent of plaque and stain removal;

(ii) Polishing exposed surfaces of teeth including the application of disclosing agents and fluoride to the exposed surface of teeth;

(3) Sealants.

(A) Definition: A dental assistant holding this expanded duty permit may place pit and fissure sealants.

(B) Requirements: Satisfactory completion of a course of study in the placement of pit and fissure sealants, consisting of a minimum of six (6) hours, to include 1 hour of didactic training and 5 clinical hours of training.

(C) The course shall be taught by licensed dentists or a dental hygienist with two (2) years of experience. The course shall require a clinical portion in which each student shall successfully complete pit and fissure sealants on at least four teeth on a mannequin or live patient.

(D) The didactic portion of the course shall include instruction in

(i) Indication/contraindications for sealants;

(ii) Preparation, materials, armamentarium and proper isolation of teeth for sealants;

(iii) Education of patient and/or parent regarding sealants;

(4) Nitrous Oxide.

(A) Definition: A dental assistant holding this expanded duty permit may monitor and assist a dentist or a dental hygienist who holds an advanced procedure permit in the administration of nitrous oxide. A dental assistant may turn on oxygen, but the level and adjustment of nitrous oxide can only be determined and administered by the dentist or hygienist. A dental assistant may adjust the level of nitrous oxide at the verbal direction of a dentist under direct supervision. Patients utilizing nitrous oxide must be visually monitored at all times.

(B) Requirement: Satisfactory completion of a course of study in nitrous oxide administration, consisting of a minimum of twelve (12) hours, approved by the Board. Student must have a current basic life support (B.L.S.) certification prior to beginning this course.

The course shall be taught by licensed dentists or a licensed dental hygienist with a minimum of one (1) year of clinical experience in nitrous oxide administration.

The minimum course length shall be twelve (12) hours including ten (10) hours of didactic and two (2) hours of clinical instruction.

(C) The didactic portion of the course shall include:

(i) The history, philosophy and psychology of nitrous oxide-oxygen inhalation sedation;

(ii) Definition and descriptions of the physiological and psychological aspects of pain and anxiety;

(iii) A description of the stages of drug induced central nervous system depression through all levels of consciousness and unconsciousness, with special emphasis on the distinction between the conscious and unconscious state;

(iv) The anatomy and physiology of respiration including the pharmacological and physiological effects of nitrous oxide for analgesia and sedation, including physical properties, action, side effects, absorption, excretion and toxicity;

(v) The advantages and disadvantages of inhalation sedation with nitrous oxide;

(vi) The management of reaction to, or complications of nitrous oxide;

(vii) Matters regarding patient status assessment, including:

(I) Taking and reviewing a thorough health history, including vital signs;

(II) Implications of health history problems related to sedation;

(III) Indications and contraindications of inhalation sedation;

(IV) Patient monitoring, specifically to include vital signs and reflexes related to consciousness;

(V) Possible reaction to nitrous oxide;

(VI) The recognition, prevention and management of complications and life-threatening situations related to nitrous oxide;

(viii) Return of the patient to pre inhalation sedation status and instructions for post-operative care;

(ix) Hazards of nitrous oxide to the patient and operator;

(x) The introduction to potential health hazards of trace anesthetics and proposed techniques for the elimination thereof.

(D) The clinical portion of the course shall include:

(i) Patient status assessment, introduction and monitoring of nitrous oxide to the patient;

(ii) Return of the patient to pre inhalation sedation status and post-operative care of the patient and provision of instructions to the patient including basic life support;

(5) Assisting a dentist who holds a parenteral or pediatric anesthesia permit.

(A) Definition: A dental assistant may assist a dentist while the dentist administers anesthesia and assess the patient's level of sedation. No dental assistant shall administer, evaluate or assess a level of anesthesia on a patient. This permit shall only include training for rescue of a patient as directed by a dentist with a valid provider permit during the administration of anesthesia on a patient.

(B) Requirements: The requirements of this permit shall be the same as required for an OMS assistant pursuant to 59 O.S. §328.25.

(6) Vaccinations, venipuncture and phlebotomy.

(A) Definition: A dental assistant may administer vaccinations or draw blood for a platelet rich plasma procedure (PRP) or other testing under the direct supervision of a dentist.

(B) Requirements: Completion of a phlebotomy certification program as approved by the Board. A course approved by the Board shall include a minimum of four (4) hours of safe-needle and blood-born pathogens procedures under the guidelines of the CDC.

(7) Elder care advanced procedure pursuant to meeting the requirements in 59 O.S. § 328.58.

Notes

Okla. Admin. Code § 195:15-1-4

Amended at 15 Ok Reg 2200, eff 7-1-98; Amended at 22 Ok Reg 1436, eff 7-1-05

Amended by Oklahoma Register, Volume 40, Issue 24, September 1, 2023, eff. 9/11/2023