Iowa Admin. Code r. 481-574.11 - [Effective 4/9/2025] Public health supervision allowed

A dentist who meets the requirements of this rule may provide public health supervision to a dental hygienist or registered dental assistant if the dentist has an active Iowa license and the services are provided in public health settings as defined in rule 481-570.1(153).

(1) Minimum clinical practice required. A licensed dental hygienist or registered dental assistant is eligible to practice under public health supervision and provide services if the hygienist or assistant has an active license or registration and a minimum of one year of clinical practice experience.
(2) Public health supervision agreements. When working under a public health supervision relationship, a dental hygienist or dental assistant shall enter into a written agreement with a dentist that addresses and complies with the following items:
a. Specify the location or locations where the public health services will be provided.
b. Include the preferred method of contact for ongoing communication and consultation between the dental hygienist or dental assistant.
c. Have age- and procedure-specific standing orders for the performance of services. The standing orders should include consideration for medically compromised patients and medical conditions for which the standard of care would dictate that a dental evaluation occur prior to the provision of services.
d. Specify a period of time in which an examination by a dentist must occur prior to providing further services. This examination requirement does not apply to educational services, assessments, screenings, and fluoride if specified in the supervision agreement.
e. Specify whether the agreement permits the dental hygienists to apply silver diamine fluoride. The supervision agreement may include provisions for use of silver diamine fluoride if the dentist and the dental hygienist complete board-approved training and the provisions comply with board-approved protocols.
f. Specify a procedure for creating and maintaining dental records for the patients who are treated by the dental hygienist or dental assistant, including where these records are to be located.
g. Review the written agreement a minimum of once every two years, and maintain a copy of the agreement for reference.
h. File a copy of the agreement with dental and oral health program of the department of health and human services within 30 days of entering into or updating an agreement and provide a copy of the agreement to the board upon request.
(3) Dental hygiene and dental assistant services. A dental hygienist or dental assistant may provide the services specified in the public health supervision agreement pursuant to the following:
a. A dental hygienist may provide services that fall within the scope of practice pursuant to 481-Chapter 576, except for the administration of local anesthesia or nitrous oxide inhalation analgesia.
b. A registered dental assistant providing services under public health supervision may perform all extraoral duties, take dental radiographs, assist with intraoral suctioning, use a curing light and take images using an intraoral camera.
c. Each patient shall sign a consent form that clarifies that dental public health services do not take the place of regular dental checkups at a dental office and are meant for people who otherwise would not have access to dental services.
d. After receiving dental public health services, the dental hygienist or dental assistant will provide to the patient, parent or guardian a written plan for referral to a dentist and assessment of further dental treatment needs.
(4) Reporting requirements. Each dental hygienist or dental assistant who rendered services under public health supervision at any time during the calendar year is obligated to complete a summary report at least annually or at the completion of a program. The dental hygienist or dental assistant will file the report with the dental and oral health program of the department of health and human services to assess the impact of the program.
a. The report filed by each dental hygienist should include, at a minimum, information related to the number of patients seen and services provided.
b. The report filed by each dental assistant should include, at a minimum, information related to the number of patients seen, the services provided to patients and the infection control protocols followed at each public health location. The department will provide summary reports to the board on an annual basis.
c. The dental and oral health program should provide summary reports to the board annually or upon request.

This rule is intended to implement Iowa Code chapter 153.

Notes

Iowa Admin. Code r. 481-574.11
Adopted by IAB March 5, 2025/Volume XLVII, Number 18, effective 4/9/2025

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