3 Colo. Code Regs. § 709-1.25

Current through Register Vol. 47, No. 22, November 25, 2024

Section 3 CCR 709-1.25 - Placement of Interim Therapeutic Restorations by Dental Hygienists

This Rule is promulgated pursuant to sections 12-20-204, 12-220-105(3), 12-220-106, 12-220-504(1)(d), 12-220-505, and 12-220-508(1)(c)(VIII) C.R.S.

A. Once issued a permit by the Board, a dental hygienist may place interim therapeutic restorations in a dental practice setting under "direct supervision" as defined in section 12-220-104(7), C.R.S or "indirect supervision" as defined in section 12-220-104(9), C.R.S., of a dentist with an active license in good standing issued by the Board, or through "telehealth supervision" as defined in section 12-220-104(15), C.R.S., for purposes of communication with the supervising dentist.

B. A dentist shall not supervise more than 5 full-time equivalent dental hygienists who place interim therapeutic restorations under telehealth supervision unless granted a waiver by the Board pursuant to section 12-220-505(6)(b), C.R.S.

1. Application Process

a. The applicant requesting a waiver must submit a written application on a form approved by the Board detailing the basis for the waiver request.

b. The written request should address why there is good cause to waive the supervision requirement as set forth in section 12-220-505(6)(a), C.R.S., and should include any documentation necessary to support the request.

c. Upon receipt of the waiver request and documentation, the matter will be considered at the next Board meeting. The applicant will receive the Board's decision in writing.

2. Waiver Requirements

a. Upon a showing of good cause, the Board may permit a waiver of the supervision requirement as set forth in section 12-220-505(6)(a), C.R.S.

b. Factors to be considered in granting such waivers include, but are not limited to:

(1) The quality of protocols setting out the responsibilities of the supervision of the dental hygienist with regard to placing interim therapeutic restorations; and

(2) Any disciplinary history on the part of the supervising dentist or dental hygienist.

c. All such waivers shall be in the sole discretion of the Board. All waivers shall be strictly limited to the terms provided by the Board. The Board reserves the right to withdraw or cancel the waiver upon a finding of disciplinary action. No waivers shall be granted if in conflict with State law.

d. The waiver shall be valid for up to two years, and the dentist must reapply for the waiver every license renewal cycle.

C. In order to be eligible for a permit to place an ITR, a dental hygienist must:

1. Hold a license in good standing to practice dental hygiene in Colorado;

2. Complete a course developed at the postsecondary education level offered under the direct supervision of a member of the faculty of a Colorado dental or dental hygiene school accredited by the Commission on Dental Accreditation (CODA) or its successor agency that complies with the following uniform training standards:

a. Four hours of didactic instruction, including but not limited to:

(1) Pulpal anatomy;

(2) Principles of adhesive restorative materials;

(3) Preparation of the tooth and placement techniques;

(4) Diagnostic criteria for interim therapeutic restorations;

(5) Evaluation of proper placement and technique; and

(6) Protocols for handling sensitivity, complications, or unsuccessful completion and follow-up;

b. Four hours of laboratory instruction that includes placement of interim therapeutic restorations on typodont teeth;

c. Criteria for evaluating competency through placement of interim therapeutic restorations on a minimum of four teeth under direct supervision of faculty; and

d. Clinical evaluations of students must be performed by a dentist with a faculty appointment at an accredited Colorado dental or dental hygiene school.

D. A dental hygienist shall not use local anesthesia for the purpose of placing interim therapeutic restorations.

E. A dental hygienist shall inform the patient or the patient's legal guardian that the interim therapeutic restorations (ITR) will require routine monitoring and follow up or maintenance with a dentist, as appropriate. This informed consent shall be documented in the patient's records.

F. Pursuant to 12-220-201(1)(nn), C.R.S., the Board may take disciplinary action against an applicant or licensee for failing to comply with the requirements regarding the placement of interim therapeutic restorations.

3 CCR 709-1.25

Adopted April 28, 2016, Effective June 30, 2016, Amended July 14, 2021, Effective September 14, 2021; Amended November 3, 2022; Effective December 30, 2022

38 CR 04, February 25, 2015, effective 3/30/2015

38 CR 11, June 10, 2015, effective 6/30/2015

39 CR 04, February 25, 2016, effective 3/16/2016

39 CR 10, May 25, 2016, effective 6/30/2016

39 CR 16, August 25, 2016, effective 9/14/2016

41 CR 04, February 25, 2018, effective 3/17/2018

41 CR 11, June 10, 2018, effective 7/3/2018

41 CR 14, July 25, 2018, effective 8/14/2018

42 CR 11, June 10, 2019, effective 6/30/2019

42 CR 23, December 10, 2019, effective 1/1/2020

44 CR 11, June 10, 2021, effective 6/30/2021

44 CR 16, August 25, 2021, effective 9/14/2021

44 CR 23, December 10, 2021, effective 12/30/2021

45 CR 21, November 10, 2022, effective 10/4/2022

45 CR 23, December 10, 2022, effective 12/10/2022

45 CR 23, December 10, 2022, effective 12/30/2022