RULE 038.00.13-002 - Article XVII - Dental Assistant Functions

RULE 038.00.13-002. Article XVII - Dental Assistant Functions

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.

(8/30/2013)

The following state regulations pages link to this page.