4447564 This rulemaking creates two (2) levels of registered dental assistants and clarifies the required education and training as well as the scope of authorized practice by dental assistants.

DEPARTMENT OF HEALTH

 

NOTICE OF FINAL 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, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1203.02(14) (2007 Repl.)), and Mayor’s Order 98-140, dated August 20, 1998, hereby gives notice of the intent to amend  Chapter 90 (Dental Assistants) of Title 17 (Business, Occupations, and Professions) of the District of Columbia Municipal Regulations (DCMR).

 

The purpose of this rulemaking is to create two (2) levels of registered dental assistants and clarify the required education and training as well as the scope of authorized practice by dental assistants.

 

These rules were previously published in the D.C. Register as a proposed rulemaking on April 12, 2013, at 60 DCR 5653.  No written comments were received from the public in connection with this publication during the thirty (30)-day comment period, and no changes have been made to the rulemaking. 

 

Final action to adopt the rules took place on May 15, 2013.  These rules will be effective upon publication of the notice in the D.C. Register.

 

Chapter 90 (DENTAL ASSISTANTS) of Title 17 (BUSINESS, OCCUPATIONS, AND PROFESSIONS) is amended as follows:

 

Section 9000 (APPLICABILITY) is amended to read as follows:

 

9000                GENERAL PROVISIONS

 

9000.1             This chapter applies to applicants for and holders of a registration to practice as a dental assistant.

 

9000.2             Chapters 40 (Health Occupations: General Rules) and 41 (Health Occupations Administrative Procedures) of Title 17 of the District of Columbia Municipal Regulations supplement this chapter.

 

 

Section 9001 (REGISTRATION REQUIRED) is amended to read as follows:

 

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 obtain a registration no later than September 17, 2012.

 

 

Section 9002 (EDUCATION REQUIREMENT) is amended to read as follows:

 

9002                TERM OF REGISTRATION

 

9002.1             Subject to § 9002.2, a registration issued pursuant to this chapter shall expire at 12:00 midnight of December 31 of each odd-numbered year.

 

9002.2             If the Director changes the renewal system pursuant to § 4006.3 of Chapter 40 of this title, a registration issued pursuant to this chapter shall expire at 12:00 midnight of the last day of the month of the birth date of the holder of the registration or other date established by the Director.

 

 

Section 9003 (TERM OF REGISTRATION) is amended to read as follows:

 

9003                EDUCATION REQUIREMENT

 

9003.1             No person shall be registered as a Level I Dental Assistant or Level II Dental Assistant unless he or she has graduated from high school or has a general equivalency diploma.

 

9003.2             Except as provided in § 9003.3, an applicant for a registration as a Level II Dental Assistant shall provide satisfactory evidence to the Board of the following:

 

(a)        That the applicant has successfully completed and graduated from an educational program for dental assistants approved by the Board or the American Dental Association’s (ADA) Commission on Dental Accreditation (CODA);

 

(b)        That the applicant possesses a current and valid certification as a Certified Dental Assistant from the Dental Assisting National Board (DANB); or

 

(c)        That the applicant has completed a dental assisting program approved by the Board.

 

9003.3             Notwithstanding the requirements of § 9003.2, an applicant for a registration as a Level II Dental Assistant may be granted a registration if the applicant registers no later than September 17, 2012 and provides satisfactory evidence of the following:

 

(a)                That the applicant has been performing the duties of a dental assistant on the effective date of this chapter; and

 

(b)               That the applicant has demonstrated competency to perform the duties of a dental assistant to the satisfaction of the supervising dentist.

 

9003.4             As a prerequisite to registration, a dental assistant shall present proof to the Board that he or she has completed a course in dental radiography training that the Board deems satisfactory.

 

 

Section 9004 (RENEWAL OF REGISTRATION) is amended to read as follows:

 

9004                SCOPE OF PRACTICE

 

9004.1             Subject to the restrictions set forth in this section, a dentist may delegate to a registered 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.

 

9004.2             Level I Dental Assistant may perform the following functions under direct supervision of a dentist:

 

(a)                Placing retraction cord;

 

(b)               Placing matrices;

 

(c)                Applying  a medicinal agent to a tooth for a prophylactic purpose;

 

(d)               Placing periodontal dressings;

 

(e)                Removing temporary restorations without the use of a rotary instrument;

 

(f)                Removing sutures;

 

(g)               Taking impression for study models or diagnostic casts;

 

(h)               Rinsing and aspirating the oral cavity;

 

(i)                 Retracting the lips, cheek, tongue, and flaps;

 

(j)                 Placing or removing materials for the isolation of the dentition, provided that the material is not retained by the dentition;

 

(k)               Applying  topical anesthesia;

 

(l)                 Constructing athletic mouth guards in models;

 

(m)             Performing intraoral photography;

 

(n)               Curing by the use of halogen light;

 

(o)               Checking for loose bands;

 

(p)               Whitening; and

 

(q)               Other functions as approved by the Board.

 

9004.3             Level II Dental Assistant may perform the following functions under direct supervision of a dentist:

 

(a)                All functions permitted to Level I Dental Assistant, as enumerated in § 9004.2;

 

(b)               Performing vitality tests;

 

(c)                Taking alginate impressions for intraoral appliances;

 

(d)               Applying topical fluoride;

 

(e)                Applying desensitizing agents;

 

(f)                Placing or removing a rubber dam;

 

(g)               Etching;

 

(h)               Fabricating indirect restorations in a dental office;

 

(i)                 Placing or removing a matrix band;

 

(j)                 Drying a root canal;

 

(k)               Preparing and fitting stainless steel crowns;

 

(l)                 Preparing temporary crowns;

 

(m)             Removing excess cement;

 

(n)               Removing or placing a periodontal dressing (except placing the original periodontal dressing); and

 

(o)               Constructing athletic mouth guards on models.

 

9004.4             Level I or II Dental Assistant working under the direct supervision of an orthodontist may also perform the following functions:

 

(a)                Preparing and fitting orthodontic bands;

 

(b)               Removing excess cement from around orthodontic bands;

 

(c)                Placing and removing arch wires;

 

(d)               Cementing orthodontic bands, placing bonded attachments, or removing cemented or bonded orthodontic bands and attachments;

 

(e)                Placing elastics and ligatures; and

 

(f)                Selecting headgear.

 

9004.5             A dentist shall not delegate to a dental assistant any of the following procedures:

 

(a)        Those procedures excluded by 17 DCMR § 4215.1;

 

(a)        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.

 

 

Section 9005 (SCOPE OF PRACTICE OF REGISTERED DENTAL ASSISTANT) is amended to read as follows:

 

9005                RADIOGRAPHY REQUIREMENTS

 

9005.1             Except as provided in § 9005.2, a dental assistant shall not place or expose dental x-ray film unless he or she has:

 

(a)                Successfully passed the Dental Assisting National Board’s (DANB) Radiation Health and Safety (RHS) examination or Certified Dental Assistant (CDA) examination; or

 

(b)               Successfully completed a dental radiography training program approved by the Board.

 

9005.2             Notwithstanding § 9005.1, a dentist may permit an assistant 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 no later than September 17, 2012.

 

 

Section 9099 (DEFINITIONS) is amended as follows:

 

Add a new definition as follows:

 

Director – the Director of the Department of Health or the Director’s designee.