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DEPARTMENT OF HEALTH
NOTICE OF PROPOSED RULEMAKING
The Director of the Department of Health, pursuant to the authority set forth in section 302(14) of the District of Columbia Health Occupations Revision Act of 1985(Act), effective March 15, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1203.02(14)), and Mayor’s Order 98-140, dated August 20, 1998, hereby gives notice of his intent to take final rulemaking action to adopt the following amendments to Title 17, “Business, Occupations, and Professions,” of the District of Columbia Municipal Regulations (DCMR) in not less than thirty (30) days after the date of publication of this notice in the D.C. Register. The purpose of the amendment is to establish registration regulations for dental assistants, a licensing category which was newly established pursuant to the Practice of Dentistry Amendment Act of 2009, effective July 7, 2010 (D.C. Law 18-36; D.C. Official Code § 3-1209.05 ).
Title 17, BUSINESS, OCCUPATIONS, AND PROFESSIONS, of the DCMR is amended by adding a new Chapter 90 to read as follows:
CHAPTER 90 DENTAL ASSISTANTS
Secs.
9000 APPLICABILITY
9001 REGISTRATION REQUIRED
9002 EDUCATION REQUIREMENT
9003 TERM OF REGISTRATION
9004 RENEWAL OF REGISTRATION
9005 SCOPE OF PRACTICE OF REGISTRED DENTAL ASSISTANT
9006 RESPONSIBILITY OF SUPERVISING DENTIST
9099 DEFINITIONS
9000 APPLICABILITY
9000.1 This chapter applies to applicants for and holders of a registration to practice as a dental assistant.
9000.2 Sections 4001, 4004, 4005, 4006, 4012 and 4013 of Chapter 40 of Title 17 of the District of Columbia Municipal Regulations supplement this chapter.
9001 REGISTRATION REQUIRED
9001.1 No person shall perform or be permitted to perform any duties as a dental assistant without a registration issued by the Board.
9001.2 Notwithstanding subsection 9001.1, a person who is performing the duties of a dental assistant on the effective date of this chapter shall have twelve (12) months after the effective date of this chapter to obtain a registration.
9002 EDUCATION REQUIREMENT
9002.1 No person shall be registered as a dental assistant unless they have graduated from high school, or have a general equivalency diploma.
9003 TERM OF REGISTRATION
9003.1 Unless modified by the Director pursuant to subsection 4006.3 of this title, a registration issued pursuant to this chapter shall expire at 12:00 midnight of December 31 of each odd-numbered year.
9004 RENEWAL OF REGISTRATION
9004.1 An applicant for renewal of a registration shall comply with the requirements of Chapter 40 of the District of Columbia Municipal Regulations pertaining to renewal.
9005 SCOPE OF PRACTICE OF REGISTERED DENTAL ASSISTANT
9005.1 Subject to the restrictions set forth in this section 9005, a dentist may delegate to a dental assistant only those procedures which are:
(a) Appropriate to the training and experience of the dental assistant and the practice of the supervising dentist;
(b) Reversible; and
(c) To be performed under the direct supervision of the dentist.
9005.2 Except as provided in subsection 9005.3 of this chapter, a dental assistant shall not place or expose dental x-ray film unless he or she has:
(a) Satisfactorily completed a radiation course or examination recognized by the American Dental Association Continuing Education Recognition Program (CERP); or
(b) Been certified by the American Registry of Radiologic Technologists; or
(c) Satisfactorily completed a radiation course and passed an examination given by the Dental Assisting National Board; or
(f) Been grandfathered in pursuant to the following section.
9005.3 A dentist may permit an assistant who does not meet the requirements of subsection 9005.2 to place or expose dental x-ray film if:
(a) The assistant has completed in-office training;
(b) The assistant has demonstrated competency to perform the task to the supervising dentist’s satisfaction; and
(c) The assistant registers within twelve (12) months of the effective date of this chapter.
9005.4 Except as provided in subsection 9005.5 of this chapter, the following dental procedures shall only be delegated to a dental assistant who:
(a) Has satisfactorily completed a training program approved by CERP-approved program, a training program or course recognized by the American Dental Association Commission on Dental Accreditation (CODA); and
(b) Performs the tasks under direct supervision with the supervising dentist checking and approving the completed task prior to dismissal of the patient from the office:
(1) Placement of retraction cord;
(2) Placement or removal of matrices;
(3) The application of a medicinal agent to a tooth for a prophylactic purpose;
(4) Placement of periodontal dressings;
(5) Removal of temporary restorations without the use of a rotary instrument;
(6) Removal of sutures; and
(7) Whitening.
9005.5 A dentist may delegate performance of a task set forth in subsection 9005.4 of this
chapter to a dental assistant who does not meet the training requirements in subsection 9005.4(1), if:
(a) The assistant had been performing the task on the effective date of these regulations;
(b) The assistant has demonstrated competency to perform the task to the supervising dentist’s satisfaction; and
(c) The assistant registers within twelve (12) months of the effective date of these regulations.
9005.6 A dentist shall not delegate to a dental assistant any of the following procedures:
(a) Those procedures excluded by 17 DCMR § 4215.1;
(b) A preliminary dental examination;
(c) A complete prophylaxis, including the removal of any deposits, diseased crevicular tissue, accretion, or stain from the surface of a tooth or a restoration;
(d) The intraoral polishing of a tooth or a restoration;
(e) The charting of cavities during preliminary examination, prophylaxis, or
polishing, however a dentist may permit an assistant to record the charting of
cavities as dictated by the dentist or dental hygienist during the course of a preliminary examination or dental procedure;
(f) The instruction of individuals or groups of individuals in oral health care,
unless it is in the dental office and done as instructed by the dentist;
(g) The application of pit and fissure sealants;
(h) Diagnostic screening to identify indications of oral
abnormalities;
(i) Administration of local anesthesia with board identified criteria and
certification;
(j) Administration of nitrous oxide with board identified criteria and
certification;
(k) Placement of temporary restorations; or
(l) Taking final impressions.
9006 RESPONSIBILITY OF SUPERVISING DENTIST
9006.1 In all instances, the licensed dentist assumes ultimate responsibility for determining, on the basis of his or her diagnosis, the specific treatment the patient will receive and which aspects of treatment will be delegated to a dental assistant in accordance with this chapter and the Act.
9099 DEFINITIONS
9099.1 For the purposes of this chapter, the following terms shall have the meanings ascribed:
Act - the District of Columbia Health Occupation Revision Act, effective July 18, 2009 (D.C. Law 6-99; D.C. Official Code §§ 3-1203.01, et seq.).
Board - the Board of Dentistry.
Dental assistant - a person who is registered by the Board and is authorized to assist a licensed dentist in the performance of duties related to oral care under the direct supervision of a dentist.
Direct supervision - the dentist is in the dental office or treatment facility, personally diagnoses the condition to be treated, personally authorizes the procedures, remains in the dental office or dental treatment facility while the procedures are being performed by the dental assistant, and personally evaluates the performance of the dental assistant before dismissal of the patient.
All persons desiring to comment on the subject of this proposed rulemaking should file comments in writing not later than thirty (30) days after the date of the publication of this notice in the D.C. Register. Comments should be sent to the Department of Health, Office of the General Counsel, 825 North Capitol Street, N.E., 4th Floor, Washington, D.C. 20002. Copies of the proposed rules may be obtained from the Department at the same address during the hours of 9 a.m. to 5 p.m., Monday through Friday, excluding holidays.
