A. ALL FUNCTIONS DELEGATED TO A DENTAL
ASSISTANT MUST BE PERFORMED UNDER PERSONAL SUPERVISION. PERSONAL SUPERVISION
MEANS:
1. The Dentist is in the office or
treatment facility.
2. The Dentist
has personally diagnosed the condition to be treated.
3. The Dentist has personally authorized the
procedures.
4. The Dentist remains
in the office or treatment facility while the procedures are being
performed.
5. The Dentist evaluates
the performance of the Dental Assistant before the dismissal of the patient.
The supervising licensed Dentist is responsible for determining
the appropriateness of delegation of any specific function based upon knowledge
of the skills of the assistant, the needs of the patient, the requirements of
the task and whether proof of competence is required.
The Dentist is ultimately responsible for patient care. Nothing
contained in the authority given the Dentist by this rule to delegate the
performance of certain procedures shall in any way relieve the supervising
Dentist from the liability to the patient for negligent performance by a Dental
Assistant.
B.
DEFINITIONS
1. Dental Assistant: A staff
member of a duly licensed Dentist who is involved in direct patient care to
include a Certified Dental Assistant or a Registered Dental
Assistant.
2. Registered Dental
Assistant: A Dental Assistant who has obtained a permit(s) from the Board to
perform any or all of the following expanded duties:
a. Administration of nitrous oxide/oxygen
analgesia
b. Operation of dental
radiographic equipment
c. Coronal
polishing
d. Monitoring of patients
undergoing deep sedation or general anesthesia
3. Certified Dental Assistant: A Dental
Assistant who is currently certified by the Dental Assistant National
Board.
C. TASKS
AUTHORIZED TO BE PERFORMED BY DENTAL ASSISTANTS
With the exceptions listed below, a Dental Assistant may perform
any dental task or procedure assigned by the supervising dentist to the
assistant that does not require the professional skills of a licensed Dentist
or licensed dental hygienist, but only under the personal supervision of a
licensed Dentist on the premises. A dental assistant who has obtained a coronal
polishing permit may be delegated by the dentist to place dental sealants, but
only under the personal supervision of the licensed Dentist. These duties may
only be delegated when the effect of the procedure assigned is
reversible.
D. PROHIBITED
ACTIVITIES
The responsibility for diagnosis, treatment planning, or the
prescription of medications in the practice of Dentistry shall remain with a
licensed Dentist and may not be assigned or delegated to a Dental Assistant. No
dental procedure that will contribute to or result in an irreversible
alteration of the oral anatomy may be performed by anyone other than a licensed
Dentist. The following activities are prohibited for dental assistants:
1. Diagnosis and treatment planning
2. Scaling, root planing and
curettage
3. Surgical or cutting
procedures on hard or soft tissue.
4. Prescription, injection, inhalation, and
parenteral administration of drugs (except where permitted by the
Board)
5. Placement, seating, or
removal of any final or permanent restorations.
6. Final placement of orthodontic
brackets
7. Any procedure that
contributes to or results in irreversible alteration of the oral
anatomy
8. Performance of any of
the following expanded duties without a permit:
a. Administration of nitrous oxide/oxygen
analgesia
b. Operation of dental
radiographic equipment
c. Coronal
polishing
d. Monitoring of patients
undergoing deep sedation or general anesthesia
9. Those functions relegated to a dental
hygienist and stated in Regulation XI A.
E. REGISTERED DENTAL ASSISTANT EXPANDED
FUNCTION PERMITS
It is the responsibility of the Dental Assistant to provide the
Arkansas State Board of Dental Examiners with proof of competence in the
desired expanded function prior to receiving a permit from the Board.
1. A Dental Assistant may induce and monitor
nitrous oxide/oxygen analgesia after successful completion of a course approved
by the Board and the payment of a designated fee. At this time a permit will be
issued.
2. A Dental Assistant may
operate dental radiographic equipment after successful completion of an
education course as approved by the Board and submits proof of competency by
passing an examination and the payment of a designated fee. At this time, a
permit will be issued.
3. A Dental
Assistant may perform coronal polishing after successful completion of
education requirements as approved by the Board and submits proof of competency
by passing such examination as the Board requires, and the payment of a
designated fee. At this time a permit will be issued.
4. A Dental Assistant may monitor patients
who are under deep sedation or general anesthesia only in offices where the
dentist(s) is permitted to perform those services, after successful completion
of education requirements as approved by the Board and submits proof of
competency by passing such examination as the Board requires and the payment of
a designated fee. At that time, a permit will be issued.
5. A Certified Dental Assistant, or an
assistant who is a graduate of a school which is accredited or provisionally
accredited by the Council on Dental Accreditation of the American Dental
Association, need only submit proof of graduation or certification to the Board
along with the designated fee and a permit will be issued for any expanded duty
requested except Sedation Monitoring.
After receipt of one or more of the expanded function permits,
the Dental Assistant will then be considered a Registered Dental Assistant with
the Board. Those permits must be on display within the dental office or
treatment facility.
F. PROCESS FOR OBTAINING PERMIT FOR
ADMINISTRATION OF NITROUS OXIDE
A Dental Assistant desiring to obtain an expanded duty permit for
nitrous oxide/oxygen analgesia from the Board must do the following:
1. Successfully complete a nitrous oxide
administration and monitoring course as approved by the Board.
2. Submit a copy of the certificate of
completion to the Board along with any designated fee.
3. Successfully complete a jurisprudence
examination covering the Dental Practice Act and rules of the Board.
4. Show proof of current certification in
Healthcare Provider level of CPR.
G. PROCESS FOR OBTAINING PERMIT FOR
RADIOGRAPHY AND/OR CORONAL POLISHING
A Dental Assistant desiring to obtain an expanded duty permit for
radiography and/or coronal polishing from the Board must do the
following:
1. If applying for a
radiography permit, successfully complete and submit a Certificate of
completion of a radiography course approved by the Board.
2. If applying for a coronal polishing
permit, successfully complete and submit a certificate of completion of coronal
polishing course approved by the Board.
3. Submit completed forms and designated fees
as required by the Board.
4. If
applying for either permit, successfully complete a jurisprudence examination,
covering the Dental Practice Act and the rules and regulations of the
Board.
5. If applying for either
permit, show a proof of current certification in Healthcare Provider level of
CPR.
6. Dental assistants holding a
current radiography permit granted by the Arkansas State Board of Dental
Examiners dated prior to November 2011 will not be required to complete an
approved radiography course unless that dental assistant is operating any type
of imaging machine other than conventional flat film radiography, such as cone
beam computed axial tomography (CT) scan.
7. Any dental assistant operating imaging
machines other than conventional flat film radiography must complete a Board
approved course in radiography, even if having been issued a radiography permit
by the Board prior to 1 November 2011. Said completion of the course must be
accomplished and submitted to the Board prior to operating said machines and/or
renewal of the radiography permit.
H. PROCESS FOR OBTAINING PERMIT FOR SEDATION
MONITORING
A Dental Assistant desiring to obtain an expanded duty permit
for sedation monitoring from the Board must do the following:
1. Hold a current permit for nitrous oxide
administration
2. Hold and show
proof of a current certification in Healthcare Provider level of
cardiopulmonary resuscitation
3. Be
a Certified Dental Assistant, Registered Dental Assistant, Registered Nurse or
Licensed Practical Nurse
4. Submit
proof of successful completion of the American Association of Oral and
Maxillofacial Surgeons Anesthesia Assistant's training program or a Board
approved equivalent course within the two year period immediately previous to
submitting an application to be a Sedation Assistant.
5. Successfully complete a jurisprudence
examination covering the Dental Practice Act and rules of the Board.
6. Exemptions: License physicians with at
least six months experience in anesthesia and anesthesia monitoring and
Certified Registered Nurse Anesthetists are exempt from the educational and
permit requirements listing in this section. Other licensed health care
providers, who can show proof of successful completion of a course which meets
or exceeds those listed in this regulation, may obtain an exemption from the
Board on a case by case basis.
G. SAID PERMITS MUST BE RENEWED ON FORMS AS
PROVIDED BY THE BOARD PURSUANT TO ARK. CODE ANN
17-82-405. AS
STATED IN THAT SECTION OF THE CODE, THE PROCEDURES FOR REGISTRATION AND
PENALTIES FOR FAILURE TO REGISTER PERMITS OF DENTISTS AS STATED IN
17-82-310
THROUGH
17-82-314
WILL APPLY TO THE REGISTRATION OF PERMITS BY DENTAL ASSISTANTS.
H. A REGISTERED DENTAL ASSISTANT MUST PROVIDE
THE BOARD PROOF OF COMPLETING 2 HOURS OF CONTINUING EDUCATION EACH 2-YEAR
REPORTING PERIOD ON THE SUBJECT OF INFECTION CONTROL IN ORDER TO RENEW A PERMIT
TO PERFORM EXPANDED DUTIES. THE REGISTERED DENTAL ASSISTANT MUST REPORT THE
CONTINUING EDUCATION HOURS IN THE MANNER SET FORTH IN ARTICLE XIV OF THE BOARD.
Separated from Article XI and approved 1/12/01; amended 8/23/02,
4/29/05, AND 5/14/09 AND 11/1/2011.
