Current through April 3, 2024
(1) A lawfully
licensed and duly registered dentist may delegate to dental assistants those
procedures for which they have received adequate training and for which the
dentist exercises direct supervision and full responsibility, except as
follows:
(a) Those procedures which require
professional judgment and skill of a dentist as defined in the Dental Practice
Act or rules of the Board.
(b)
Those clinical procedures which are primarily concerned with the practice of
dentistry or dental hygiene and which are allocated by the Dental Practice Act
or Rules of the Tennessee Board of Dentistry specifically and solely to
licensed dentists and/or licensed dental hygienists.
(2) Registered dental assistants, with
additional Board-approved training, may, under the direct supervision of a
licensed dentist perform the following procedures:
(a) Coronal polishing, pursuant to Rule
0460-04-.04; and
(b) Monitoring
nitrous oxide, pursuant to Rule 0460-04-.05; and
(c) Application of sealants, pursuant to Rule
0460-04-.09.
(d) Performance of
expanded restorative functions, pursuant to Rule 0460-04-.10.
(e) Performance of expanded prosthetic
functions, pursuant to Rule 0460-04-.10.
(f) Exposure of dental radiographs, pursuant
to Rule 0460-04-.11.
(3)
Delegable or Assignable Procedures - In addition to those duties of the
practical dental assistant or registered dental assistant which are commonly
recognizable by the dental profession for safe performance, pursuant to T.C.A.
§
63-5-108, a practical dental
assistant or registered dental assistant may perform the following duties which
are assigned or delegated by the employer/supervising dentist:
(a) The processing of radiographs, including
digital, of the mouth, gums, jaws, teeth or any portion thereof for dental
diagnosis.
(b) The application of
topical fluorides.
(c) The
instruction of patients in dietary principles.
(d) The taking and recording of a patient's
blood pressure, pulse, temperature, and medical history, and charting of oral
conditions.
(e) The maintenance of
instrument and operatory infection control
(f) The preparation of instrument
trays
(g) The placement and removal
of matrices for restoration.
(h)
The removal of cement from restorations and bands.
(i) The removal of sutures and
staples.
(j) The fabrication,
placement and removal of temporary restorations.
(k) The placement and removal of rubber
dam.
(l) The placement and removal
of socket dressings.
(m) The
placement and removal of periodontal dressings.
(n) The taking of dental plaque
smears.
(o) The taking of alginate
impressions for any purpose other than permanent restorations.
(p) The removal of ligature and arch
wires.
(q) Bending, selecting and
pre-sizing arch wires and placing arch wires after final adjustment and
approval by the dentist.
(r) The
selection, prefitting, cementation, curing, and removing of orthodontic bands
or brackets.
(s) Placement and
removal of pre-treatment separators.
(t) Removal of loose or broken bands or
brackets.
(u) Placement of springs
on wires.
(v) Placement of hooks on
brackets.
(w) Placement of chain
elastics on brackets.
(x) Ligation
of arch wires to brackets.
(y)
Packing and removing retraction cord, with or without vasoactive chemicals, for
restorative dental procedures.
(z)
Removal of cement excess from supragingival surface of teeth by hand
instruments only.
(aa) The
placement of amalgam in prepared cavities for condensation by the
dentist.
(bb) The application of
topical anesthetics.
(cc) The
application of desensitizing agents.
(dd) Placement of cavity bases and
liners.
(ee) Application of tooth
conditioners for bonding.
(ff)
Selecting and pre-fitting of stainless steel crowns or other pre-formed crowns
for insertion by the dentist.
(gg)
The taking of oral cytologic smears.
(hh) Performing pulp testing.
(ii) Packing of pulpotomy paste.
(jj) Drying canals with absorbent paper
points.
(kk) Demonstration of oral
hygiene procedures and oral health care regimen
(ll) Calling in prescriptions to the
pharmacist as instructed by the employer/dentist.
(mm) Fitting, adjusting and cementation of
correctional appliances.
(nn) Wound
care as directed.
(oo) Irrigating
extraction site.
(pp) Placement of
exposure chains and attachments.
(qq) Other duties specifically approved by
the Board at a regularly scheduled meeting of the Board.
(4) Prohibited Procedures-In addition to the
duties defined as the practice of dentistry or dental hygiene by T.C.A. §
63-5-108, dental assistants are
not permitted to perform the following:
(a)
Examination, diagnosis and treatment planning;
(b) Surgical or cutting procedures on hard or
soft tissue, including laser, air abrasion or micro-abrasion procedures,
including curettage or root planing;
(c) Fitting, adjusting, and placement of
prosthodontics appliances;
(d)
Issuance of prescription medications or medications not authorized by T.C.A.
§
63-5-108(c) or
Rule 0460-04-.08 (3), or work authorizations;
(e) Performance of direct pulp capping,
pulpotomy, and other endodontic procedures not authorized by T.C.A. §
63-5-108(c) or
Rule 0460-04-.08 (3);
(f) Approving
the final occlusion;
(g) Placement
of sutures;
(h) Administration of
local anesthesia, nitrous oxide, conscious sedation, or general
anesthesia;
(i) Monitoring of
nitrous oxide without certification as provided in Rule 0460-04-.05 and
0460-04-.08 (2);
(j) Coronal
polishing without certification as provided in Rule 0460-04-.04 and 0460-04-.08
(2);
(k) Application of sealants
without certification as provided by Rule 0460-04-.09 and 0460-04-.08
(2);
(l) Use of a high-speed
handpiece intraorally;
(m)
Utilization of laser equipment and technology in the course of the performance
of their duties unless specifically authorized by T.C.A. §
63-5-108(c) or
Rule 0460-04-.08 (3). Only dentists licensed by the Tennessee Board of
Dentistry shall be authorized to perform procedures involving laser
technology.
(n) The exposure of
radiographs without certification as provided by Rule 0460-04-.11 and Rule
0460-04-.08 (2).
(o) Expanded
restorative or prosthetic functions without certification as provided by Rule
0460-04-.10 and Rule 0460-04-.08 (2).
(5) Dental assistants who perform procedures
not delegable pursuant to this rule, or who perform procedures specifically
prohibited by T.C.A. §
63-5-108, or who perform
procedures without the direct supervision of a dentist, or who perform coronal
polishing, application of sealants or nitrous oxide monitoring without the
applicable certification or in violation of the rules governing those
procedures, may be subject to disciplinary action pursuant to T.C.A. §
63-5-116(b).
Authority: T.C.A. §§
4-5-202,
4-5-204,
63-5-105,
63-5-108,
63-5-115, and
63-5-116.
