Current through Supplement No. 394, October, 2024
Duties are delegated to dental assistants under prescribed
levels of supervision as follows:
1. A
dental assistant who is not registered with the board and who is employed by a
dentist may:
a. Perform the following duties
under direct supervision:
(1) Take and record
pulse, blood pressure, and temperature.
(2) Take and record preliminary dental and
medical history for the interpretation by the dentist.
(3) Apply topical medications and drugs to
oral tissues, including topical anesthetic, topical fluoride, fluoride varnish,
and desensitizing agents, but not including caustic agents.
(4) Receive removable dental prosthesis for
cleaning or repair.
(5) Take
impressions for study casts.
(6)
Hold impression trays in the mouth (e.g., reversible hydrocolloids, rubber
base).
(7) Retract patient's cheek,
tongue, or other tissue parts during a dental procedure.
(8) 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.
(9) Isolate the operative field, not to
include rubber dams.
(10) Hold a
curing light for any dental procedure. Curing lights may not include a laser
capable of cutting, burning, or damaging hard or soft tissue or for
electrosurgery for tissue retraction.
(11) Produce on a patient of record, a final
scan by digital capture for review and inspection by the authorizing dentist
for a prescriptive fixed or removable appliance.
(12) Monitor a patient who has been induced
into nitrous oxide analgesia if the dentist has provided sufficient training to
the dental assistant completed after January 1, 2024. The dentist shall
maintain documentation of the training for the duration of the delegation and
shall provide documentation of the training to the board upon
request.
b. Perform the
following duties under general supervision:
(1) Provide oral hygiene instructions and
education.
(2) Remove periodontal
dressings.
2.
A qualified dental assistant may:
a. Perform
the following duties under the direct supervision of a dentist:
(1) Duties set forth in subsection
1.
(2) Acid etch enamel surfaces as
directed by the dentist.
(3) Dry
root canal with paper points.
(4)
Apply resin infiltration.
(5)
Orally transmit a prescription that has been authorized by the supervising
dentist.
(6) Remove band and
bracket adhesives with a slow-speed handpiece.
(7) Place and remove matrix bands and
wedges.
b. Perform the
following duties under the general supervision of a dentist:
(1) Produce on a patient of record, a final
scan by digital capture for review and inspection by the authorizing dentist
for a prescriptive fixed or removable appliance.
(2) Take and record pulse, blood pressure,
and temperature.
(3) Take and
record preliminary dental and medical history for the interpretation by the
dentist.
(4) Apply topical
medications and drugs to oral tissues, including topical anesthetic and
anticariogenic agents, and desensitizing agents.
(5) Place and remove arch wires or appliances
that have been activated by the dentist.
(6) Cut and remove arch wires or replace
loose bands, loose brackets, or other orthodontic appliances for palliative
care.
(7) Remove sutures.
(8) Place, tie, and remove ligature wires and
elastic ties, and select and place orthodontic separators.
(9) Preselect and prefit orthodontic
bands.
(10) Repack dry socket
medication and packing for palliative care.
(11) Take dental radiographs.
c. Perform the following duties
under the indirect supervision of a dentist:
(1) Polish coronal surfaces of teeth with a
rubber cup or brush after the dentist provides the dental assistant with
sufficient training. The dentist shall maintain documentation of the training
completion for the duration of the delegation and provide it to the board upon
request.
(2) Place orthodontic
brackets using an indirect bonding technique by seating the transfer tray
loaded with brackets previously positioned in the dental laboratory by a
licensed dentist.
3. A qualified dental assistant-limited
radiology registrant may perform the duties listed in subsection 1, and may
take dental radiographs under the general supervision of a dentist.
4. A registered dental assistant may perform
the duties set forth in subsection 2 and the following duties under the direct
supervision of a dentist:
a. Acid etch enamel
surfaces prior to direct bonding of orthodontic brackets or composite
restorations.
b. Take face bow
transfers.
c. Adjust permanent
crowns outside of the mouth.
d.
Administer emergency medications to a patient in order to assist the dentist in
an emergency.
e. Hold impression
trays in the mouth (e.g., reversible hydrocolloids, rubber base).
5. A registered dental assistant
may perform the following duties on a patient of record under the indirect
supervision of a dentist:
a. Place and remove
rubber dams.
b. Place retraction
cord in the gingival sulcus of a prepared tooth prior to the dentist taking an
impression of the tooth.
c. Remove
excess cement from inlays, crowns, bridges, and orthodontic appliances with
hand instruments or a slow-speed handpiece.
d. Place and remove periodontal
dressings.
e. Monitor a patient who
has been inducted by a dentist into nitrous oxide inhalation
analgesia.
f. Apply bleaching
solution, activate light source, and monitor and remove bleaching
materials.
g. Place orthodontic
brackets using an indirect bonding technique by seating the transfer tray
loaded with brackets previously positioned in the dental laboratory by a
licensed dentist.
6. A
registered dental assistant may perform the following duties under the general
supervision of a dentist:
a. Take and record
pulse, blood pressure, and temperature.
b. Take and record preliminary dental and
medical history for the interpretation by the dentist.
c. Apply topical medications and drugs to
oral tissues, including topical anesthetic, topical fluoride, fluoride varnish,
silver diamine fluoride, hemostatic agents, and desensitizing agents.
d. Receive removable dental prosthesis for
cleaning or repair.
e. Take
impressions or occlusal bite registrations for study casts.
f. Fabricate, adjust, place, recement, or
remove a temporary crown, bridge, or onlay or temporary restorative material.
This applies only to dentitions actively under treatment for which a permanent
restoration is being fabricated.
g.
Remove sutures.
h. Cut and remove
arch wires or replace loose bands, loose brackets, or other orthodontic
appliances for palliative treatment.
i. Place, tie, and remove ligature wires and
elastic ties, and place orthodontic separators.
j. Provide oral hygiene education and
instruction.
k. Provide an oral
assessment for interpretation by the dentist.
l. Repack dry socket medication and packing
for palliative treatment.
m. Apply
pit and fissure sealants if the registered dental assistant has provided
documentation of a board-approved sealant course or training that includes hand
skills, and has received an endorsement from the board. Adjust sealants with
slow-speed handpiece.
n. Polish the
coronal surfaces of the teeth with a rubber cup or brush.
o. Polish restorations with a slow-speed
handpiece.
p. Take dental
radiographs.
q. Take impressions
for fixed or removable orthodontic appliances, athletic mouth guards, bleaching
trays, bite splints, flippers, and removable prosthetic repairs.
r. Preselect and prefit orthodontic
bands.
s. Perform nonsurgical
clinical and laboratory diagnosis tests, including pulp testing, for
interpretation by the dentist.
t.
Place and remove arch wires or appliances that have been activated by a
dentist.
u. Provide screenings as
defined by subsection 44 of section 20-01-02-01.
v. Adjust a temporary denture or partial for
dentitions actively under treatment for which permanent dentures or partial
dentures are being fabricated.