Okla. Admin. Code § 195:15-1-6.1 - Advanced procedures for dental hygienists

(a) It is the determination of the Board that certain procedures may be performed by a dental hygienist who has satisfactorily completed a course of study regarding the performance of such procedures. Pursuant to 59 O.S., Section 328.34, the Board hereby establishes six (6) advanced procedures for dental hygienists with, requirements, and course guidelines as follows:
(b) Each training program for an advanced procedure for hygienists must meet the same requirements as listed in 195:15-1-4(a) through (g).
(c) An application by a dental hygienist for authorization to perform an advanced procedure shall be made on a form prescribed by the Board.
(d) Advanced procedures permitted for dental hygienists who graduate from accredited dental hygiene programs in Oklahoma which provide Board approved instruction, will automatically be authorized after licensure.
(1) Nitrous oxide.
(A) Definition: A dental hygienist authorized by the Board to perform this advanced procedure may administer nitrous oxide.
(B) Requirement: Hygienists must complete the requirements as listed in 195:15-1-4(4) all requirements for a permit to administer nitrous oxide and in addition:
(i) Students shall be trained in the proper administration of nitrous oxide, to include:
(ii) Determining dosages and needs of a patient. Each course
(2) Local anesthesia.
(A) Definition: A dental hygienist authorized by the Board to perform this advanced procedure may administer local anesthesia.
(B) Requirement: Satisfactory completion of a course of study in local anesthesia, consisting of a minimum of 20 ½ hours, approved by the Board.
(i) Instruction shall be provided in a properly equipped setting and under the supervision of a CODA approved program or a program affiliated with a CODA approved school or other program as approved by the Board.
(ii) The course shall train students in B.L.S. This requirement may be waived for students with current B.L.S. training.
(iii) The course provider shall conduct formal clinical testing of the student's ability to perform the advanced procedure involved.
(iv) Each student in the course shall competently administer injections on patients.
(v) Faculty shall be licensed dentists and licensed dental hygienists who are currently employed or have been employed in a dental or dental hygiene school and have experience in teaching or providing this advanced procedure.
(vi) Course instruction shall include:
(I) Theory of pain control;
(II) Selection of pain control modalities;
(III) Anatomy;
(IV) Neurophysiology;
(V) Pharmacology of local anesthetics and vasoconstrictors;
(VI) Pharmacological aspects of pain control;
(VII) Systematic complications;
(VIII) Techniques of maxillary and mandibular anesthesia;
(IX) Safe needle and bloodborne pathogens including infection control;
(X) Local anesthesia medical emergencies.
(3) Neuromodulator administration.
(A) Definition: A dental hygienist authorized by the Board to perform this advanced procedure may administer neuromodulator under direct supervision of a dentist.
(B) A holder of a license to practice dental hygiene with a minimum of two (2) years of experience and holds an advanced procedure for the administration of local anesthesia, may apply for an advanced procedure permit to allow them to inject a neuromodulator that is derived from Clostridium botulinum or that is biosimilar to or the bioequivalent of such a neuromodulator or who injects a dermal or soft tissue filler upon completion of a course approved by the Board that meets the minimum requirements:
(C) Each hygienist must provide a statement along with their application for this advanced procedure certifying that each neuromodulator that has been or will be injected by the holder, and each dermal or soft tissue filler that has been or will be injected by the holder is approved for the use in dentistry by the United States Food and Drug Administration and;
(D) Maintain malpractice insurance and provide proof of insurance annually.
(E) A hygienist holding this advanced procedure permit shall not administer such an injection to a person other than a patient of record;
(F) The training must be a minimum of twenty-four (24) total hours in length including a minimum of 4 hours of didactic and 4 hours of clinical training in each of the following subjects;
(i) The use of neuromodulators that are derived from Clostridium botulinum or that are biosimilar to or the bioequivalent of such a neuromodulator in the treatment of temporomandibular joint disorder and myofascial pain syndrome;
(ii) The use of neuromodulators that are derived from Clostridium botulinum that are biosimilar to or the bioequivalent of such a neuromodulator for dental and facial esthetics; and
(iii) The use of dermal and soft tissue fillers for dental and facial esthetics;
(4) Therapeutic use of lasers.
(A) A hygienist may apply for an Advanced Procedure permit for the therapeutic use of lasers under the direct/indirect supervision of a dentist.
(B) Definition: A hygienist with an advanced procedure permit to use a laser may be used, but limited to soft tissue decontamination, sulcular bacterial reduction, tissue disinfection.
(C) Requirements:
(i) The hygienist must successfully complete an educational program as approved by the Board on laser use that is a minimum of 8 hours and includes both didactic and live, in-person clinical simulation training;
(ii) A certificate of successful course completion from the dental laser training entity shall be submitted to the Board of Dentistry.
(I) A hygienist may use the laser within the scope of hygiene practice;
(II) A laser may not be used for the intentional cutting of hard or soft tissue;
(III) All lasers must be used in accordance with accepted safety guidelines and approved by the United States Federal Drug Administration for use in dentistry.
(IV) When utilizing a laser pursuant to this Rule, at a minimum, the type of laser, settings used and details of procedures performed, must be documented in the patient's record.
(5) Elder care and public health advanced procedure.
(A) A dental hygienist having a minimum of two (2) years of experience may apply for a Public Health Advanced Procedure permit pursuant to 59 O.S. § 328.58.
(B) A hygienist with a prior action from the Board within the previous five (5) years shall not be eligible for this advanced procedure.
(6) Vaccinations, venipuncture and phlebotomy
(A) Definition: A dental hygienist may administer vaccinations or draw blood for a platelet rich plasma procedure (PRP) or other testing under the direct or indirect 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.

Notes

Okla. Admin. Code § 195:15-1-6.1
Added at 15 Ok Reg 2200, eff 7-1-98; Amended at 20 Ok Reg 2344, eff 7-11-03
Amended by Oklahoma Register, Volume 40, Issue 24, September 1, 2023, eff. 9/11/2023

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