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
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