Current through Reg. 50, No. 187; September 24, 2024
(1) By virtue of their training and
licensure, dental hygienists are authorized to perform the following remediable
tasks without additional training as defined in Chapter 64B5-16, F.A.C. under
Direct supervision:
Gingival curettage.
(2) The following remediable tasks may be
performed by a dental hygienist who has received training in these procedures
in pre-licensure education or who has received formal training as defined by
Rule 64B5-16.002, F.A.C., and who performs the tasks under Direct supervision:
(a) Fabricating temporary crowns or bridges
intra-orally which shall not include any adjustment of occlusion to the
appliance or existing dentition;
(b) Selecting and pre-sizing orthodontic
bands, including the selection of the proper size band for a tooth to be banded
which does not include or involve any adapting, contouring, trimming or
cementing or otherwise modifying the band material such that it would
constitute fitting the band;
(c)
Selecting and pre-sizing archwires prescribed by the patient's dentist so long
as the dentist makes all final adjustments to bend, arch form determination,
and symmetry prior to final placement;
(d) Selecting prescribed extra-oral
appliances by pre-selection or pre-measurement which does not include final fit
adjustment;
(e) Preparing a tooth
surface by applying conditioning agents for orthodontic appliances by
conditioning or placing of sealant materials which does not include placing
brackets;
(f) Packing and removing
retraction cord, so long as it does not contain vasoactive chemicals and is
used solely for restorative dental procedures;
(g) Removing and re-cementing properly
contoured and fitting loose bands that are not permanently attached to any
appliance;
(h) Inserting or
removing dressings from alveolar sockets in post-operative osteitis when the
patient is uncomfortable due to the loss of a dressing from an alveolar socket
in diagnosed cases of post-operative osteitis; and,
(i) Assist the dentist in the initiation of
nitrous-oxide inhalation analgesia to a special needs or American Society of
Anesthesiologists (ASA) Category IV dental patients provided the patient has
not been previously sedated and the Dental Hygienist is in full compliance with
the requirements of paragraph 64B5-14.003(4)(a), F.A.C.
(3) The following remediable task may be
performed by a dental hygienist who has received on-the-job training and who
performs the task under Direct supervision: Changing of bleach pellets in the
internal bleaching process of non-vital, endodontically treated teeth after the
placement of a rubber dam. A dental hygienist may not make initial access
preparations.
(4) Administration of
Local Anesthesia:
(a) Notwithstanding Section
466.003(11), F.S., the administration of local anesthesia becomes a remediable
and delegable task if a Florida licensed dental hygienist has been
appropriately certified by the Board and has received a certificate from the
Florida Department of Health authorizing the dental hygienist to administer
local anesthesia in compliance with and pursuant to Section 466.017(5), F.S.
Upon the issuance of the certificate, the hygienist will be referred to as a
Certified Registered Dental Hygienist.
(b) Under Direct supervision, a CRDH may
administer local anesthesia in accordance with the following:
1. The patient must be eighteen years of age
or older,
2. The patient must not
be sedated; and,
3. The CRDH may
administer intraoral block and soft tissue infiltration anesthesia.
(c) A Registered Dental Hygienist
may apply for certification as a Certified Registered Dental Hygienist after
completion of the required education mandated by Section 466.017(5), F.S., and
in accordance with Rule 64B5-14.003, F.A.C.
(5) By virtue of their training and
licensure, dental hygienists are authorized to perform the following remediable
tasks without additional training as defined in Chapter 64B5-16, F.A.C., under
Indirect supervision:
Removal of excess remaining bonding adhesive or cement
following orthodontic appliance removal with slow-speed rotary instrument, hand
instrument or ultrasonic scalers.
(6) The following remediable tasks may be
performed by a dental hygienist who has received training in these procedures
in pre-licensure education or who has received formal training as defined by
Rule 64B5-16.002, F.A.C., and who performs the tasks under Indirect
supervision:
(a) Placing or removing rubber
dams;
(b) Placing or removing
matrices;
(c) Applying cavity
liners, varnishes or bases;
(d)
Securing or unsecuring an archwire by attaching or removing the fastening
device;
(e) Marginating
restorations with finishing burs, green stones, and/or burlew wheels with
slow-speed rotary instruments which are not for the purpose of changing
existing contours or occlusion;
(f)
Cementing temporary crowns and bridges with temporary cement;
(g) Assist the dentist in the initiation of
nitrous-oxide inhalation analgesia to American Society of Anesthesiologists
(ASA) Category I - III dental patients provided the Dental Hygienist is in full
compliance with the requirements of paragraph 64B5-14.003(4)(a), F.A.C.;
and,
(h) Using adjunctive oral
cancer screening medical devices approved by the U.S. Food and Drug
Administration.
(7) By
virtue of their training and licensure, dental hygienists are authorized to
perform the following remediable tasks without additional training as defined
in Chapter 64B5-16, F.A.C. under General supervison:
(a) Removing calculus deposits, accretions
and stains from exposed surfaces of the teeth and from the tooth surfaces
within the gingival sulcus (prophylaxis);
(b) Placing and exposing dental and carpal
radiographic film and sensors;
(c)
Root Planing.
(8) The
following remediable tasks may be performed by a dental hygienist who has
received training in these procedures in pre-licensure education or who has
received formal training as defined by Rule 64B5-16.002, F.A.C., and who
performs the tasks under General supervision:
(a) Polishing restorations which is not for
the purpose of changing the existing contour of the tooth and only with the
following instruments used with appropriate polishing materials - burnishers,
slow-speed hand pieces, rubber cups, and bristle brushes;
(b) Polishing clinical crowns of the teeth
which is not for the purpose of changing the existing contour of the teeth and
only with the following instruments used with appropriate polishing materials -
slow-speed hand pieces, bristle brushes, rubber cups, porte polishers and
air-abrasive polishers;
(c)
Applying of topical fluorides that are approved by the American Dental
Association or the Food and Drug Administration, including the use of fluoride
varnishes and silver diamine fluoride. These procedures may also be performed
as provided in subsection (10) of this rule.
(d) Removing excess cement from dental
restorations and appliances with non-mechanical hand instruments or ultrasonic
scalers only;
(e) Placing
periodontal or surgical dressings;
(f) Removing periodontal or surgical
dressings;
(g) Removing
sutures;
(h) Using appropriate
implements to assess and chart suspected findings of the oral cavity;
(i) Applying sealants;
(j) Placing or removing prescribed
pre-treatment separators; and,
(k)
Insert and/or perform minor adjustments to sports mouth guards and custom
fluoride trays.
(l) Placing
subgingival resorbable chlorhexidine, doxycycline hyclate, or minocycline
hydrochloride.
(m) Apply bleaching
solution, activate light source, monitor and remove in-office bleaching
materials.
(n) Taking impressions
for study casts which are not being made for the purpose of fabricating any
intra-oral appliances, restorations or orthodontic appliances;
(o) Taking impressions to be used for
creating opposing models or the fabrication of bleaching stents and surgical
stents to be used for the purpose of providing palatal coverage as well as
impressions used for fabrication of topical fluoride trays for home
application;
(p) Taking of
impressions for and delivery of at-home bleaching trays;
(q) Taking impressions for passive
appliances, occlusal guards, space maintainers and protective mouth
guards;
(9) The
following remediable tasks may be performed by a dental hygienist who has
received training in these procedures in pre-licensure education or on-the-job
training and who performs the tasks under General supervision:
(a) Fabricating temporary crowns and bridges
in a laboratory;
(b) Applying
topical anesthetics and anti-inflammatory agents which are not applied by
aerosol or jet spray;
(c) Taking or
recording patients' blood pressure rate, pulse rate, respiration rate, case
history and oral temperature;
(d)
Retracting lips, cheeks and tongue;
(e) Irrigating and evacuating debris not to
include endodontic irrigation;
(f)
Placing and removing cotton rolls;
(g) Placing or removing temporary
restorations with non-mechanical hand instruments only; and,
(h) Obtaining bacteriological cytological
(plaque) specimens, which do not involve cutting of the tissue and which do not
include taking endodontic cultures, to be examined under a microscope for
educational purposes.
(10) By virtue of their training and
licensure, dental hygienists are authorized to perform the following remediable
tasks without additional training as defined in Chapter 64B5-16, F.A.C.,
without supervision:
(a) Provide educational
programs, faculty or staff training programs, and authorized fluoride rinse
programs;
(b) Apply fluoride
varnishes, and silver diamine fluoride, instruct patients in oral hygiene care
and supervising patient oral hygiene care and other services which do not
involve diagnosis or treatment of dental conditions.
(c) Perform the remediable tasks specified in
Sections 466.023(3), 466.0235, and 466.024(2), F.S., as long as all provisions
of the respective statute are met.
(d) Follow a standing order for medical
clearance determined by a dentist licensed under chapter 466, F.S., or a
physician licensed under chapter 458 or chapter 459 when performing remediable
tasks specified in section 466.024(2)(f), F.S., as long as all provisions of
the respective statute are met.
(11) The following remediable tasks may be
performed by a dental hygienists who has received training in these procedures
in pre-licensure education or who has received formal training as defined by
Rule 64B5-16.002, F.A.C., and who performs the tasks without supervision:
(a) Perform the remediable tasks specified in
Sections 466.023(3), 466.0235, and 466.024(2), F.S., as long as all provisions
of the respective statute are met;
(b) Screening of a patient, including state
or federally mandated screenings, to determine an individual's need to be seen
by a dentist for a diagnosis;
(c)
Assessment of a patient, a limited clinical inspection that is performed to
identify possible signs of oral or systemic disease, malformation, or injury,
and the potential need for referral for diagnosis and treatment to a licensed
practitioner.
(d) All CRDH must
follow the procedure for reporting adverse incidents outlined in subsection
64B5-14.006(4), F.A.C.
(12) This rule shall be reviewed, and if
necessary, repealed, modified, or renewed through the rulemaking process five
years from the effective date.
Rulemaking Authority
466.004(4),
466.017(6),
466.023,
466.024 FS. Law Implemented
466.017(6),
466.023,
466.024
FS.
New 1-18-89, Amended 11-16-89, 3-25-90, 9-5-91, 2-1-93,
Formerly 21G-16.006, Amended 3-30-94, Formerly 61F5-16.006, Amended 1-9-95,
6-12-97, Formerly 59Q-16.006, Amended 1-25-98, 9-9-98, 3-25-99, 4-24-00,
9-27-01, 7-13-05, 2-14-06, 3-24-08, 7-20-09, 10-17-10, 8-5-12, 6-28-17,
8-29-17, 2-27-18, 12-9-18, 3-25-20, 3-30-21,
9-12-22.
