234 CMR, § 5.11

Current through Register 1538, January 3, 2025

Section 5.11 - Delegable Procedures

Registered Dental Hygienists (RDH), Public Health Dental Hygienist (PHDH), Expanded Function Dental Assistant (EFDA), Certified Assistant (CA), Formally-trained Dental Assistant (FTDA), and Dental Assistant Trained on the Job (OJT) and may perform the following dental procedures pursuant to the designated level of supervision or direction: General Supervision (G), Written Collaborative Agreement (WCA), Direct Supervision (D), Immediate Supervision (I) or Delegation Not Allowed (N/A).

DELEGATED DUTY	RDH	PHDH	EFDA	CA	FTDA	OJT
(1)	Review medical and dental history and consult when necessary with medical practitioner	G	WCA	G	G	G	G
(2)	Perform preliminary evaluation to determine needed dental hygiene services	G	WCA	N/A	N/A	N/A	N/A
(3)	Make referrals to dentists, physicians, and other practitioners in consultation with a dentist	G	WCA	N/A	N/A	N/A	N/A
(4)	Provide oral health instruction	G	WCA	G	G	G	D
(5)	Perform dietary screening for dental disease prevention and control	G	WCA	G	G	G	N/A
(6)	Conduct dental screenings	G	WCA	N/A	N/A	N/A	N/A
(7)	Record dental screenings	G	WCA	D	D	D	D
(8)	Expose radiographs	G	WCA	G	G	G	G
(9)	Evaluate radiographs for provision of dental hygiene services	G	WCA	N/A	N/A	N/A	N/A
(10)	Take intra-oral photographs	G	WCA	G	G	G	G
(11)	Perform and record charting of the oral cavity and surrounding structures, including but not limited to, existing dental restorations, lesions and periodontal probing depths	G	WCA	N/A	N/A	N/A	N/A
(12)	Record charting of the oral cavity and surrounding structures, including but not limited to, dental restorations, lesions and periodontal probing depths	G	WCA	D	D	D	D
(13)	Take and record vital signs	G	WCA	G	G	G	G
(14)	Perform minor emergency denture adjustments to eliminate pain and discomfort in nursing homes and other residential or long term care facilities	G	WCA	N/A	N/A	N/A	N/A
(15)	Perform pulp testing	D	N/A	N/A	N/A	N/A	N/A
(16)	Apply anti-cariogenic agents, including fluoride varnish	G	WCA	G	G	G	D
(17)	Apply topical anesthetic agents	G	WCA	G	G	G	D
(18)	Apply and adjust dental sealants	G	WCA	G	D	D	N/A
(19)	Take impressions for study casts, bite registrations, including for identification purposes, night guards, and custom fluoride and bleaching trays pursuant to a dentist's prescription or order	G	WCA	G	G	G	I
(20)	Take impressions for athletic mouth guards	G	WCA	G	G	G	I
(21)	Retract lips, cheek, tongue and other oral tissue parts	G	WCA	G	G	G	G
(22)	Irrigate and aspirate the oral cavity	G	WCA	G	G	G	G
(23)	Re-cement and adjust intact temporary restorations intra-orally	G	WCA	G	G	G	N/A
(24)	Place temporary restorations (not including temporization of inlays, on-lays, crowns, and bridges) to provide palliative treatment	G	WCA	G	G	G	I
(25)	Assist or monitor nitrous oxide analgesia	I	I	I	I	I	I
(26)	Place and remove gingival retraction materials	D	D	D	D	D	D
(27)	Apply cavity varnish, liner(s) and bonding agents	I	I	I	I	I	I
(28)	Apply desensitizing agents	G	WCA	G	D	D	D
(29)	Place restorative materials in tooth for condensation and finishing by the dentist	I	I	I	I	I	I
(30)	Remove temporary restorations with hand instruments	G	WCA	G	I	I	N/A
(31)	Place and remove wedges	G	WCA	G	D	D	I
(32)	Place and remove matrix bands	G	WCA	G	D	D	I
(33)	Place and remove dental dams	G	WCA	G	G	G	D
(34)	Place and remove periodontal dressings	G	WCA	G	G	G	N/A
(35)	Remove sutures	G	WCA	G	G	G	D
(36)	Removal of implant healing caps/cover screws for restorative procedures	I	I	I	I	I	I
(37)	Dry root canals with paper points	I	I	I	N/A	N/A	N/A
(38)	Place cotton pellets and temporary restorative materials into endodontic openings	G	WCA	G	D	D	D
(39)	Remove excess cement and bonding agents from bridges and appliances with hand instruments	G	WCA	G	D	D	I
(40)	Cement and remove temporary crowns and bridges	G	WCA	G	G	G	I
(41)	Insert and/or perform minor adjustment of night mouth guards, athletic mouth guards, and custom fluoride trays	G	WCA	G	G	G	I
(42)	Select and adapt stainless steel crowns or other preformed crown for insertion by dentist	I	I	I	I	I	I
(43)	Perform sub-gingival and supra-gingival scaling	G	WCA	N/A	N/A	N/A	N/A
(44)	Polish teeth, after dentist or dental hygienist has determined that teeth are free of calculus, with slow speed hand piece	G	WCA	G	G	G	N/A
(45)	Administer local anesthesia pursuant to 234 CMR 6.00	D	D	N/A	N/A	N/A	N/A
(46)	Perform gross debridement and/ or scaling and root planing	G	WCA	N/A	N/A	N/A	N/A
(47)	Prepare and perform oral cytological smears or studies	D	N/A	N/A	N/A	N/A	N/A
(48)	Use diagnostic and periodontic non-cutting lasers	D	N/A	N/A	N/A	N/A	N/A
(49)	Preliminarily fit crowns to check contacts, adjust occlusion on crowns inside the mouth	G	WCA	D	D	N/A	N/A
(50)	Place temporary soft liners in a removal prosthesis	G	WCA	D	D	I	N/A
(51)	Obtain endodontic cultures	D	N/A	D	D	I	N/A
(52)	Apply bleaching agents and activate with non-laser non-curing device	G	WCA	D	D	D	I
(53)	Fabricate provisional restorations intraorally	G	WCA	G	D	D	I
(54)	Place and condense amalgam restorations	D	N/A	D	N/A	N/A	N/A
(55)	Carve, contour, adjust amalgam restorations	D	N/A	D	N/A	N/A	N/A
(56)	Place and finish composite restorations	D	N/A	D	N/A	N/A	N/A
(57)	Adjust dentures on the tissue side to eliminate tissue irritation	G	WCA	G	N/A	N/A	N/A
(58)	Place temporary sedative restorations/fillings	G	WCA	G	I	N/A	N/A
(59)	Place Stainless Steel Crowns	D	D	D	I	I	N/A
(60)	Take impressions for orthodontic retainers	G	WCA	G	G	G	D
(61)	Preliminary intra-oral fit of bands	G	WCA	G	G	G	D
(62)	Preliminary oral fit of arch wire	G	WCA	G	G	G	D
(63)	Select size of headgear	G	WCA	G	G	G	D
(64)	Place and remove orthodontic separators	G	WCA	G	G	G	D
(65)	Place and remove orthodontic arch wires	G	WCA	G	G	G	D
(66)	Etch appropriate enamel surfaces before bonding of orthodontic appliances by a dentist	G	WCA	G	G	G	D
(67)	Place elastics and ligature wires	G	WCA	G	G	G	D
(68)	Remove fixed orthodontic appliances	G	WCA	G	G	G	D
(69)	Remove excess cement and bonding agents from orthodontic appliances with hand instruments	G	WCA	G	G	G	D
(70)	Perform minor emergency palliative orthodontic adjustments to eliminate pain and discomfort	G	WCA	G	G	G	I
(71)	Perform any other procedure approved by the Board

234 CMR, § 5.11

Amended by Mass Register Issue 1271, eff. 10/10/2014.