Current through Register Vol. 41, No. 3, September 23, 2024
A. The
following duties of a dentist shall not be delegated to a dental hygienist:
1. Final diagnosis and treatment
planning;
2. Performing surgical or
cutting procedures on hard or soft tissue, except as may be permitted by
subdivisions C 1 and D 1 of this section;
3. Prescribing or parenterally administering
drugs or medicaments, except a dental hygienist who meets the requirements of
18VAC60-25-100 C may parenterally
administer Schedule VI local anesthesia to patients 18 years of age or
older;
4. Authorization of work
orders for any appliance or prosthetic device or restoration that is to be
inserted into a patient's mouth;
5.
Operation of high-speed rotary instruments in the mouth;
6. Administration of deep sedation or general
anesthesia and moderate sedation;
7. Condensing, contouring, or adjusting any
final, fixed, or removable prosthodontic appliance or restoration in the mouth
with the exception of packing and carving amalgam and placing and shaping
composite resins by dental assistants II with advanced training as specified in
18VAC60-30-120;
8. Final positioning and attachment of
orthodontic bonds and bands; and
9.
Final adjustment and fitting of crowns and bridges in preparation for final
cementation.
B. The
following duties shall only be delegated to dental hygienists under direction
and may only be performed under indirect supervision:
1. Scaling, root planing, or gingival
curettage of natural and restored teeth using hand instruments, slow-speed
rotary instruments, ultrasonic devices, and nonsurgical lasers with any
sedation or anesthesia administered.
2. Performing an initial examination of teeth
and surrounding tissues, including the charting of carious lesions, periodontal
pockets, or other abnormal conditions, for assisting the dentist in the
diagnosis.
3. Administering nitrous
oxide or local anesthesia by dental hygienists qualified in accordance with the
requirements of
18VAC60-25-100.
C. The following duties shall only be
delegated to dental hygienists and may be performed under indirect supervision
or may be delegated by written order in accordance with §
54.1-2722D of
the Code of Virginia to be performed under general supervision:
1. Scaling, root planning, or gingival
curettage of natural and restored teeth using hand instruments, slow-speed
rotary instruments, ultrasonic devices, and nonsurgical lasers with or without
topical oral anesthetics.
2.
Polishing of natural and restored teeth using air polishers.
3. Performing a clinical examination of teeth
and surrounding tissues, including the charting of carious lesions, periodontal
pockets, or other abnormal conditions, for further evaluation and diagnosis by
the dentist.
4. Subgingival
irrigation or subgingival and gingival application of topical Schedule VI
medicinal agents pursuant to §
54.1-3408J of
the Code of Virginia.
5. Duties
appropriate to the education and experience of the dental hygienist and the
practice of the supervising dentist, with the exception of those listed as
nondelegable in subsection B of this section and those restricted to indirect
supervision in subsection C of this section.
D. The following duties may only be delegated
under the direction and direct supervision of a dentist to a dental assistant
II:
1. Performing pulp capping
procedures;
2. Packing and carving
of amalgam restorations;
3. Placing
and shaping composite resin restorations with a slow-speed handpiece;
4. Taking final impressions;
5. Use of a non-epinephrine retraction cord;
and
6. Final cementation of crowns
and bridges after adjustment and fitting by the dentist.
E. A dental hygienist employed by the
Virginia Department of Health may provide educational and preventative dental
care under remote supervision, as defined in §
54.1-2722E of
the Code of Virginia, of a dentist employed by the Virginia Department of
Health and in accordance with the Protocol adopted by Virginia Department of
Health (VDH) for Dental Hygienists to Practice in an Expanded Capacity under
Remote Supervision by Public Health Dentists, May 2019, which is hereby
incorporated by reference.
F. A
dental hygienist employed by the Virginia Department of Behavioral Health and
Developmental Services (DBHDS) may provide educational and preventative dental
care under remote supervision, as defined in §
54.1-2722E of
the Code of Virginia, of a dentist employed by DBHDS and in accordance with the
Protocol for Virginia Department of Behavioral Health and Developmental
Services (DBHDS) Dental Hygienists to Practice in an Expanded Capacity under
Remote Supervision by DBHDS Dentists, May 2019, which is hereby incorporated by
reference.
Statutory Authority: §
54.1-2400 of the Code of
Virginia.
