Current through Register No. 40, October 3, 2024
(a) Any dental
hygienist shall be considered qualified in a specific area if he or she has
successfully completed an expanded duty course, or successfully challenged an
examination in same, or both, as stated in Den 302.05(a) through (q). Course
records, pursuant to
Den
403.06, and a certificate of course completion shall
be retained by the course participant and provided to the board upon request by
the board.
(b) Any dental hygienist
may petition the board for approval of an expanded duty course or equivalent
training course. The petition shall include all information that the petitioner
wishes the board to consider in evaluating the proposed course, such as the
entity giving the course, an outline of the topics to be covered, the number of
hours of lectures and hours of practical experience and the textbooks to be
used.
(c) No dental hygienist shall
be considered qualified prior to the date that he or she is officially informed
by the course or examination provider that he or she has successfully completed
an expanded duty course approved by the board.
(d) Any dental hygienist shall be considered
qualified in provisional crown and bridge restorations after successfully
completing an expanded duty course in provisional crown and bridge restorations
which:
(1) Is offered by a continuing
education provider as defined in
Den
403.07(a)(1);
(2) Is a minimum of 8 hours;
(3) Includes at least the following:
a. Provisional restoration anatomy;
b. Occlusal requirements; and
c. Cementation; and
(4) Provides to the dental hygienist written
evidence certifying that the course has been successfully completed and which
is signed by the course provider.
(e) If qualification in provisional crown and
bridge restorations is determined, the duty shall be performed with the
following conditions:
(1) A dental hygienist
qualified in provisional crown and bridge restorations shall perform this
service only under the direct supervision of a licensed dentist;
(2) The provisional restoration may be
fabricated intraorally, however all occlusal adjustments and modifications
shall be completed extraorally; and
(3) The completed provisional restoration
shall be examined by the dentist prior to cementation by a qualified dental
hygienist.
(f) Any dental
hygienist shall be considered qualified in orthodontic duties after
successfully completing an expanded duty course in orthodontic duties which:
(1) Is offered by a continuing education
provider as defined in
Den
403.07(a)(1);
(2) Is a minimum of 8 hours;
(3) Includes at least the following:
a. Placement and removal of orthodontic
separators;
b. Preparation of teeth
for bonding of brackets;
c. Removal
of orthodontic bands or brackets;
d. Trial fitting of orthodontic
bands;
e. Using hand instruments to
remove excess cement from bands on the coronal surfaces of the teeth;
f. Trial fitting of head gear;
g. Simple emergency adjustment of orthodontic
appliances to relieve pain;
h.
Taking impressions for orthodontic appliances;
i. Attachment or tying in and removal of
orthodontic wires; and
j. Bending
arch wires; and
(4)
Provides to the dental hygienist written evidence certifying that the course
has been successfully completed and which is signed by the course
provider.
(g) If
qualification in orthodontics is determined, the duty shall be performed with
the following conditions:
(1) A dental
hygienist qualified in orthodontic duties shall perform this service only under
the direct supervision of a licensed dentist.
(h) The duty of placing dental sealants shall
be performed under the general supervision or public health supervision of a
licensed dentist.
(i) Any dental
hygienist shall be considered qualified in local anesthesia only after
successfully completing an expanded duty course in local anesthesia which:
(1) Is offered by an institution accredited
by CODA;
(2) Is a minimum of 20
didactic hours and 12 clinical hours;
(3) Entails passing the local anesthesia
examination given by the CDCA;
(4)
Includes at least the following topics:
a.
Neurophysiology of pain and pain control;
b. Pharmacology of local anesthetic solutions
and drug interactions;
c. Potential
local and systemic complications;
d. Medical and dental indications and
contraindications;
e. Medical and
dental history assessment;
f.
Safely assembling and handling a syringe;
g. Locating anatomical landmarks associated
with local anesthesia;
h. Injection
techniques;
i. Hands-on experience
with maxillary and mandibular injections by administering at least 6
infiltration and 6 block injections; and
j. Legal issues associated with local
anesthesia administration by a dental hygienist; and
(5) Provides to the dental hygienist written
evidence certifying that the course has been successfully completed and which
is signed by the course provider.
(j) If qualification in local anesthesia is
determined, the duty shall be performed with the following conditions:
(1) A dental hygienist qualified in local
anesthesia shall:
a. Administer local
anesthesia only under the direct supervision of a dentist; and
b. Display at his or her place of practice
proof of anesthesia qualification approved by the board;
(2) Any hygienist graduating from a CODA
accredited school of dental hygiene shall comply with (i) above if a local
anesthesia course meeting the foregoing requirements was not part of the school
curriculum;
(3) A dental hygienist
who has qualified to administer local anesthesia in another jurisdiction may
qualify for endorsement by the board to perform that function by presenting
written documentation of training equivalent to (i) above and a letter from a
supervising dentist attesting to the hygienist's experience administering local
anesthesia within the previous 2 years; and
(4) Students enrolled in a CODA accredited
school of dental hygiene, who have passed a local anesthesia course as part of
the school curriculum, shall not be in violation of this rule if they
administer local anesthesia as part of a dental hygiene examination.
(k) To obtain a local anesthesia
permit, a dental hygienist qualified to administer local anesthesia shall
provide to the board:
(1) A written request
and a certified check or money order made payable to the "Treasurer, State of
New Hampshire" for the local anesthesia fee specified in
Den 301.08, or if
presented in person, the payment may be in cash;
(2) Proof of course completion. Applicants
whose course was taken out of state shall also provide a copy of the course
syllabus; and
(3) His or her CDCA
score.
(l) Any dental
hygienist shall be considered qualified to monitor the administration of
nitrous oxide (N2O) to patients after successfully
completing an expanded duty course in monitoring the administration of nitrous
oxide which:
(1) Is offered by a course
provider as defined in
Den
403.07(a)(1);
(2) Is a minimum of 6 hours;
(3) Includes at least the following:
a. Aspects of pain and anxiety;
b. Anatomy and physiology of
respiration;
c. Stages of drug
induced central nervous system depression;
d. Pharmacology and physiological effects of
nitrous oxide;
e. Advantages and
disadvantages of inhalation sedation using nitrous oxide;
f. Medical assessment of patient prior to
using nitrous oxide; and
g. Proper
administration of nitrous oxide to include:
1. Description and use of inhalation
equipment;
2. Patient
monitoring;
3. Possible reactions
of patients under nitrous oxide;
4.
Hazards of nitrous oxide for patients and operator; and
5. Management of
complications;
(4) Requires the passing of a written test
administered by the course provider; and
(5) Provides to the dental hygienist written
evidence certifying that the course has been successfully completed and which
is signed by the course provider.
(m) If qualification in monitoring the
administration of nitrous oxide (N2O) is determined, the
duty shall be performed with the following conditions:
(1) A dental hygienist qualified in the
monitoring of nitrous oxide shall monitor nitrous oxide only under the direct
supervision of a dentist;
(2) A
dental hygienist qualified to monitor the administration of nitrous oxide shall
monitor only after a dentist has initiated the administration and brought the
patient to the intended level of nitrous oxide inhalation sedation;
(3) A dental hygienist qualified to monitor
the administration of nitrous oxide shall be currently certified in BLS-HCP;
and
(4) A dental hygienist who has
qualified to monitor nitrous oxide in another jurisdiction may qualify for
endorsement by the board to perform that function by presenting written
documentation of training equivalent to (l) above and a letter from a
supervising dentist attesting to the hygienist's experience monitoring nitrous
oxide within the previous 2 years.
(n) Any dental hygienist shall be considered
qualified to administer nitrous oxide (N2O) for minimal
sedation of patients after successfully completing an expanded duty course in
the monitoring and administration of nitrous oxide which:
(1) Is offered by an institution accredited
by CODA;
(2) Is a minimum of 8
didactic hours and 6 clinical hours;
(3) Includes at least the following:
a. Physiological and psychological aspects of
pain and anxiety;
b. Stages of drug
induced central nervous system depression;
c. Anatomy and physiology as they relate to
inhalation sedation;
d. Indications
and contraindications of inhalation sedation;
e. Pharmacology and physiological effects of
nitrous oxide, including drug interactions;
f. Medical assessment of patient prior to
using nitrous oxide;
g. Description
and use of inhalation sedation equipment;
h. Monitoring of patient's vital
functions;
i. Preventing,
recognizing and managing possible complications of inhalation
sedation;
j. Health hazards and
techniques to limit occupational exposure;
k. Abuse potential of nitrous oxide;
and
l. Maintenance of proper
records;
(4) Requires the
passing of a written test administered by the course provider;
(5) Requires successfully completing a
clinical evaluation by the course provider; and
(6) Provides to the dental hygienist written
evidence certifying that the course has been successfully completed and which
is signed by the course provider.
(o) If qualification in the administration of
nitrous oxide (N2O) is determined, the duty shall be
performed with the following conditions:
(1) A
dental hygienist qualified in the administration of nitrous oxide shall:
a. Administer nitrous oxide only under the
direct supervision of a dentist; and
b. Display at his or her place of practice
proof of a nitrous oxide qualification course approved by the board;
(2) Any hygienist graduating from
CODA accredited school of dental hygiene shall comply with (l) above if a
nitrous oxide course meeting the foregoing requirements was not part of the
school curriculum;
(3) A dental
hygienist who has qualified to administer nitrous oxide in another jurisdiction
may qualify for endorsement by the board to perform that function by presenting
written documentation of training equivalent to (l) above and a letter from a
supervising dentist attesting to the hygienist's experience administering
nitrous oxide within the previous 2 years; and
(4) Students enrolled in a CODA accredited
school of dental hygiene, who have passed a nitrous oxide course as part of the
school curriculum, shall not be in violation of this rule if they administer
nitrous oxide as part of a dental hygiene examination.
(p) Those individuals who qualify in the
administration of nitrous oxide on or after January 1, 2018 shall be issued a
permit upon submission of the following:
(1)
Proof of course completion and, if the course was taken out of state, a copy of
the course syllabus;
(2) A written
request; and
(3) A check or money
order made payable to the "Treasurer, State of New Hampshire" for the
application fee specified in
Den 301.08, or if
presented in person, the payment may be in cash.
(q) In-office tooth whitening shall be
performed under general supervision.
#6909, eff 12-9-98; amd by #7270, eff 5-12-00; amd by
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