N.J. Admin. Code § 13:30-1A.3 - Scope of practice of licensed dental hygienist under direct supervision

(a) A licensed dental hygienist practicing under the direct supervision of a licensed dentist may:

1. Perform a complete prophylaxis including the removal of all hard and soft deposits from all surfaces of human natural and restored teeth to the epithelial attachments and the polishing of natural and restored teeth;

2. Perform root planing;

3. Provide prophylactic and preventive measures such as the application of fluorides and pit and fissure sealants and other recognized topical agents for the prevention of oral disease or discomfort;

4. Place intrasulcular therapeutic medications approved by the Food and Drug Administration, as directed by a dentist;

5. Assess soft and hard tissue of the head, neck and oral cavity and note deformities, defects, and abnormalities therein;

6. Fabricate mouth guard appliances;

7. Remove excess cement from crowns or other restorations and orthodontic appliances;

8. Remove sutures;

9. Place and remove periodontal dressings and other surgical dressings;

10. Trial size (pre-select) orthodontic bands, wires, stainless steel crowns and temporary crowns intra-orally or on diagnostic models;

11. Make radiographic exposures as permitted by the Department of Environmental Protection pursuant to N.J.S.A. 26:2D-24 et seq.;

12. Provide oral health education including dietary analysis and clinical instruction in order to promote dental health;

13. Apply topical anesthetic agents;

14. Take and record vital signs;

15. Retract patient's cheek, tongue or other tissue parts during a dental procedure;

16. Remove such debris as is normally created in the course of treatment during or after dental procedures by vacuum devices, compressed air, mouthwashes and water;

17. Take dental photographs including the use of intra-oral cameras;

18. Select shades of prosthetic appliances;

19. Apply hot or cold packs pursuant to the direction of a licensed dentist;

20. Assess whether there is carious activity by the use of detecting agents and carious detection instruments. Such instruments shall not include lasers that are capable of altering, cutting, burning, or damaging hard or soft tissue;

21. Etch teeth in preparation for bonding, sealants, and desensitizing agents;

22. Use a curing light for any dental procedure. Such curing light shall not include a laser capable of altering, cutting, burning, or damaging hard or soft tissue or electrosurgery for tissue retraction;

23. Isolate the operative field, including the placement and removal of rubber dams;

24. Take alginate impressions;

25. Place and remove matrices and wedges;

26. Place temporary restorations;

27. Perform hand removal of soft temporary restorations;

28. Fabricate and cement temporary crowns and bridges after preparation of tooth (teeth) by a dentist. This shall not include intra-oral occlusal adjustment;

29. Perform hand removal of crowns and bridges that have been temporarily cemented;

30. Place amalgam, composite or gold foil in a tooth for condensation by the dentist;

31. Place and remove retraction cords and medicated pellets. This shall not include electrosurgery or the use of lasers for tissue retraction;

32. Perform bite registration procedures;

33. Place and remove arch wires and ligature wires;

34. Demonstrate home-use bleaching systems and apply bleaching agents;

35. Use an in-office light activated bleaching system;

36. Assist a licensed dentist in the administration of nitrous oxide, provided the licensed dentist is physically present in the operatory at all times during the procedure.

i. In accordance with this subsection, a licensed dental hygienist who is monitoring a patient to whom the supervising dentist has administered nitrous oxide/oxygen inhalation analgesia may, while monitoring the patient, perform other functions within the dental hygienist scope of practice as delegated by the supervising dentist even if the dentist is not physically present in the operatory;

37. Administer local anesthesia provided he or she satisfies the requirements set forth in N.J.A.C. 13:30-1A.5;

38. Take impressions for orthodontic appliances;

39. Place orthodontic separators. The supervising licensed dentist shall review the placement to ensure proper placement of the orthodontic separators;

40. Remove bands and brackets without the use of rotary instruments;

41. Remove primary adhesive, without the use of rotary instruments, after debanding and/or debonding; and

42. Perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.

(b) In addition to the activities set forth in (a) above, a licensed dental hygienist practicing under the direct supervision of a licensed dentist pursuant to N.J.A.C. 13:30-8.20 may monitor a patient to whom the supervising dentist has administered nitrous oxide/oxygen inhalation analgesia, provided that:

1. The licensed dental hygienist has successfully completed a Board-approved course offered in a Commission on Dental Accreditation accredited college or university or in a hospital licensed by the Department of Health, which emphasizes the administration of nitrous oxide simultaneously with the administration of oxygen and safe and effective patient monitoring;

i. The course shall be submitted to the Board for review and approval of course outline, content and objectives, curriculum vitae of instructors and whether the training is visual, hands-on or lecture;

ii. The nitrous oxide/oxygen administration course shall be at least 14 hours in length, which shall include at least seven hours of didactic training and seven hours of clinical training; and

iii. The clinical training shall include, at a minimum, 10 monitored administrations of nitrous oxide/oxygen inhalation analgesia;

2. The licensed dental hygienist holds a current certification in Basic or Advanced Cardiac Life Support by the American Heart Association, the American Red Cross or an equivalent association approved by the Board;

3. The licensed dental hygienist completes a three-hour didactic or clinical course in nitrous oxide/oxygen inhalation analgesia in every other registration renewal period. Completion of the recertification course shall be in addition to the continuing education requirements set forth at N.J.A.C. 13:30-5.2;

4. The licensed dental hygienist monitors the patient and maintains the therapeutic level of nitrous oxide/oxygen inhalation analgesia as established by the dentist; and

5. Upon any untoward reaction of the patient, the licensed dental hygienist immediately turns off the flow of nitrous oxide, maintains the established oxygen level, and immediately summons the dentist.

(c) The monitoring of nitrous oxide/oxygen inhalation analgesia by a licensed dental hygienist without first having met the minimum standards of training and procedures pursuant to (b) above, shall constitute a deviation from normal standards of practice required of a licensee.

(d) A licensed dental hygienist who engages in the activities outlined in (a) and (b) above without direct supervision, except as provided in N.J.A.C. 13:30-1A.4, shall be deemed to be engaging in the unauthorized practice of dental hygiene and professional misconduct and shall be subject to the penalties set forth in N.J.S.A. 45:6-58, 45:1-22, and N.J.S.A. 45:1-25.

(e) A licensed dentist who permits a licensed dental hygienist to engage in the activities outlined in (a) and (b) above without direct supervision, except as provided in N.J.A.C. 13:30-1A.4, shall be subject to the penalties set forth in N.J.S.A. 45:1-21 and 45:1-25.

Notes

N.J. Admin. Code § 13:30-1A.3

Amended and recodified from 13:30-1A.2 by 48 N.J.R. 1462(b), effective 7/18/2016 Amended by 50 N.J.R. 1282(a), effective 5/21/2018