Definitions pertaining to Dental Hygiene Functions:
INDIRECT SUPERVISION: The dentist authorizes the
procedures and remains in the treatment facility while the procedures are being
performed.
OPERATIVE SUPERVISION: The dentist authorizes the
procedures, remains in the operatory while 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.
I.
EXCLUSIVE FUNCTIONS TO BE PERFORMED
BY A DENTAL HYGIENIST WHEN DELEGATED BY A DENTIST
a.) 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.
b.) The following functions may only be
delegated to a licensed dental hygienist:
1.)
Oral examinations. Elements of these examinations include charting of carious
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.
2.) Application of pit and
fissure sealants.
3.) Oral
prophylaxis, scaling, root planing, and curettage.
4.) Using air driven, electric, sonic,
ultrasonic, or otherwise powered scalers or polishers (except for dental
assistants possessing an expanded duties permit for polishing).
5.) Placing medicaments as prescribed by the
supervising dentist into the sulcus or periodontal pockets, for periodontal
diseases.
II.
PROHIBITED ACTIVITY: The following functions and procedures may
NOT be delegated to dental hygienists
under any level
of supervision because effective and safe
performance is dependent upon making judgments that require synthesis and
application of knowledge acquired in professional dental education. The
functions include:
a.) Diagnosis and treatment
planning
b.) Surgical or cutting
procedures on hard or soft tissue,
c.) Prescription, injection, inhalation, and
parenteral administration of drugs (except where permitted by Board)
d.) Placement, seating or removal of any
final or permanent restorations.
e.) Final placement of orthodontic
brackets
f.) Any procedure that
contributes to or results in irreversible alteration of the oral
anatomy.
g.) Performance of any of
the following expanded duties without a permit:
1.) Administration of local
anesthesia
2.) Administration of
nitrous oxide/oxygen analgesia
III.
SUPERVISION LEVELS FOR AUTHORIZED
FUNCTIONS OF A DENTAL HYGIENIST
a.)
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
II of this Article or those tasks
that require operative supervision.
b.) Under OPERATIVE SUPERVISION, a hygienist
may perform the following procedures:
1.) Any
procedure allowed under Indirect Supervision.
2.) Administer certain local anesthesia
injections as provided in Article XVI of these Rules and Regulations.
c.) Under GENERAL SUPERVISION, the
following restrictions apply:
1.) 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 consecutive days.
2.) The supervising dentist maintains full
control as to whether general supervision will be utilized in his/her office or
practice setting.
3.) General
supervision is allowed only in dental clinics, community health centers or
government sponsored dental facilities.
4.) Hygienists must comply with written
protocols for emergencies as established by the supervising dentist.
5.) 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.
6.) Hygienists must have one (1) full year of
full-time service before being able to function under general supervision of a
dentist.
7.) Patients must be
notified in advance that the doctor may not be in the treatment
facility.
8.) The supervising
dentist must have examined the patient(s) not more than twelve (12) months
prior.
9.) Hygienist may perform
any procedure allowed under Indirect Supervision with the exception of root
planing, subgingival curettage, local anesthesia, administration of nitrous
oxide.
10.) 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.
11.) A registered dental hygienist may not
delegate functions to a registered dental assistant when the treating dentist
is not in the facility.