N.H. Code Admin. R. Den 302.05

Current through Register No. 17, April 25, 2024

Section Den 302.05 - Dental Hygienist Qualification in Specific Area

(a) Any dental hygienist shall be considered qualified in a specific area if he or she has successfully completed an expanded duty course, or successfully challenged an examination in same, or both, as stated in Den 302.05(a) through (q). Course records, pursuant to Den 403.06, and a certificate of course completion shall be retained by the course participant and provided to the board upon request by the board.

(b) Any dental hygienist may petition the board for approval of an expanded duty course or equivalent training course. The petition shall include all information that the petitioner wishes the board to consider in evaluating the proposed course, such as the entity giving the course, an outline of the topics to be covered, the number of hours of lectures and hours of practical experience and the textbooks to be used.

(c) No dental hygienist shall be considered qualified prior to the date that he or she is officially informed by the course or examination provider that he or she has successfully completed an expanded duty course approved by the board.

(d) Any dental hygienist shall be considered qualified in provisional crown and bridge restorations after successfully completing an expanded duty course in provisional crown and bridge restorations which:

(1) Is offered by a continuing education provider as defined in Den 403.07(a)(1);

(2) Is a minimum of 8 hours;

(3) Includes at least the following:

a. Provisional restoration anatomy;

b. Occlusal requirements; and

c. Cementation; and

(4) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

(e) If qualification in provisional crown and bridge restorations is determined, the duty shall be performed with the following conditions:

(1) A dental hygienist qualified in provisional crown and bridge restorations shall perform this service only under the direct supervision of a licensed dentist;

(2) The provisional restoration may be fabricated intraorally, however all occlusal adjustments and modifications shall be completed extraorally; and

(3) The completed provisional restoration shall be examined by the dentist prior to cementation by a qualified dental hygienist.

(f) Any dental hygienist shall be considered qualified in orthodontic duties after successfully completing an expanded duty course in orthodontic duties which:

(1) Is offered by a continuing education provider as defined in Den 403.07(a)(1);

(2) Is a minimum of 8 hours;

(3) Includes at least the following:

a. Placement and removal of orthodontic separators;

b. Preparation of teeth for bonding of brackets;

c. Removal of orthodontic bands or brackets;

d. Trial fitting of orthodontic bands;

e. Using hand instruments to remove excess cement from bands on the coronal surfaces of the teeth;

f. Trial fitting of head gear;

g. Simple emergency adjustment of orthodontic appliances to relieve pain;

h. Taking impressions for orthodontic appliances;

i. Attachment or tying in and removal of orthodontic wires; and

j. Bending arch wires; and

(4) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

(g) If qualification in orthodontics is determined, the duty shall be performed with the following conditions:

(1) A dental hygienist qualified in orthodontic duties shall perform this service only under the direct supervision of a licensed dentist.

(h) The duty of placing dental sealants shall be performed under the general supervision or public health supervision of a licensed dentist.

(i) Any dental hygienist shall be considered qualified in local anesthesia only after successfully completing an expanded duty course in local anesthesia which:

(1) Is offered by an institution accredited by CODA;

(2) Is a minimum of 20 didactic hours and 12 clinical hours;

(3) Entails passing the local anesthesia examination given by the CDCA;

(4) Includes at least the following topics:

a. Neurophysiology of pain and pain control;

b. Pharmacology of local anesthetic solutions and drug interactions;

c. Potential local and systemic complications;

d. Medical and dental indications and contraindications;

e. Medical and dental history assessment;

f. Safely assembling and handling a syringe;

g. Locating anatomical landmarks associated with local anesthesia;

h. Injection techniques;

i. Hands-on experience with maxillary and mandibular injections by administering at least 6 infiltration and 6 block injections; and

j. Legal issues associated with local anesthesia administration by a dental hygienist; and

(5) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

(j) If qualification in local anesthesia is determined, the duty shall be performed with the following conditions:

(1) A dental hygienist qualified in local anesthesia shall:

a. Administer local anesthesia only under the direct supervision of a dentist; and

b. Display at his or her place of practice proof of anesthesia qualification approved by the board;

(2) Any hygienist graduating from a CODA accredited school of dental hygiene shall comply with (i) above if a local anesthesia course meeting the foregoing requirements was not part of the school curriculum;

(3) A dental hygienist who has qualified to administer local anesthesia in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (i) above and a letter from a supervising dentist attesting to the hygienist's experience administering local anesthesia within the previous 2 years; and

(4) Students enrolled in a CODA accredited school of dental hygiene, who have passed a local anesthesia course as part of the school curriculum, shall not be in violation of this rule if they administer local anesthesia as part of a dental hygiene examination.

(k) To obtain a local anesthesia permit, a dental hygienist qualified to administer local anesthesia shall provide to the board:

(1) A written request and a certified check or money order made payable to the "Treasurer, State of New Hampshire" for the local anesthesia fee specified in Den 301.08, or if presented in person, the payment may be in cash;

(2) Proof of course completion. Applicants whose course was taken out of state shall also provide a copy of the course syllabus; and

(3) His or her CDCA score.

(l) Any dental hygienist shall be considered qualified to monitor the administration of nitrous oxide (N₂O) to patients after successfully completing an expanded duty course in monitoring the administration of nitrous oxide which:

(1) Is offered by a course provider as defined in Den 403.07(a)(1);

(2) Is a minimum of 6 hours;

(3) Includes at least the following:

a. Aspects of pain and anxiety;

b. Anatomy and physiology of respiration;

c. Stages of drug induced central nervous system depression;

d. Pharmacology and physiological effects of nitrous oxide;

e. Advantages and disadvantages of inhalation sedation using nitrous oxide;

f. Medical assessment of patient prior to using nitrous oxide; and

g. Proper administration of nitrous oxide to include:

1. Description and use of inhalation equipment;

2. Patient monitoring;

3. Possible reactions of patients under nitrous oxide;

4. Hazards of nitrous oxide for patients and operator; and

5. Management of complications;

(4) Requires the passing of a written test administered by the course provider; and

(5) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

(m) If qualification in monitoring the administration of nitrous oxide (N₂O) is determined, the duty shall be performed with the following conditions:

(1) A dental hygienist qualified in the monitoring of nitrous oxide shall monitor nitrous oxide only under the direct supervision of a dentist;

(2) A dental hygienist qualified to monitor the administration of nitrous oxide shall monitor only after a dentist has initiated the administration and brought the patient to the intended level of nitrous oxide inhalation sedation;

(3) A dental hygienist qualified to monitor the administration of nitrous oxide shall be currently certified in BLS-HCP; and

(4) A dental hygienist who has qualified to monitor nitrous oxide in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (l) above and a letter from a supervising dentist attesting to the hygienist's experience monitoring nitrous oxide within the previous 2 years.

(n) Any dental hygienist shall be considered qualified to administer nitrous oxide (N₂O) for minimal sedation of patients after successfully completing an expanded duty course in the monitoring and administration of nitrous oxide which:

(1) Is offered by an institution accredited by CODA;

(2) Is a minimum of 8 didactic hours and 6 clinical hours;

(3) Includes at least the following:

a. Physiological and psychological aspects of pain and anxiety;

b. Stages of drug induced central nervous system depression;

c. Anatomy and physiology as they relate to inhalation sedation;

d. Indications and contraindications of inhalation sedation;

e. Pharmacology and physiological effects of nitrous oxide, including drug interactions;

f. Medical assessment of patient prior to using nitrous oxide;

g. Description and use of inhalation sedation equipment;

h. Monitoring of patient's vital functions;

i. Preventing, recognizing and managing possible complications of inhalation sedation;

j. Health hazards and techniques to limit occupational exposure;

k. Abuse potential of nitrous oxide; and

l. Maintenance of proper records;

(4) Requires the passing of a written test administered by the course provider;

(5) Requires successfully completing a clinical evaluation by the course provider; and

(6) Provides to the dental hygienist written evidence certifying that the course has been successfully completed and which is signed by the course provider.

(o) If qualification in the administration of nitrous oxide (N₂O) is determined, the duty shall be performed with the following conditions:

(1) A dental hygienist qualified in the administration of nitrous oxide shall:

a. Administer nitrous oxide only under the direct supervision of a dentist; and

b. Display at his or her place of practice proof of a nitrous oxide qualification course approved by the board;

(2) Any hygienist graduating from CODA accredited school of dental hygiene shall comply with (l) above if a nitrous oxide course meeting the foregoing requirements was not part of the school curriculum;

(3) A dental hygienist who has qualified to administer nitrous oxide in another jurisdiction may qualify for endorsement by the board to perform that function by presenting written documentation of training equivalent to (l) above and a letter from a supervising dentist attesting to the hygienist's experience administering nitrous oxide within the previous 2 years; and

(4) Students enrolled in a CODA accredited school of dental hygiene, who have passed a nitrous oxide course as part of the school curriculum, shall not be in violation of this rule if they administer nitrous oxide as part of a dental hygiene examination.

(p) Those individuals who qualify in the administration of nitrous oxide on or after January 1, 2018 shall be issued a permit upon submission of the following:

(1) Proof of course completion and, if the course was taken out of state, a copy of the course syllabus;

(2) A written request; and

(3) A check or money order made payable to the "Treasurer, State of New Hampshire" for the application fee specified in Den 301.08, or if presented in person, the payment may be in cash.

(q) In-office tooth whitening shall be performed under general supervision.

N.H. Code Admin. R. Den 302.05

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Amended byVolume XXXIV Number 46, Filed November 13, 2014, Proposed by #10689, Effective 10/7/2014, Expires10/7/2024.

Amended by Volume XXXVI Number 01, Filed January 7, 2016, Proposed by #10991, Effective 12/9/2015, Expires 12/9/2025.

Amended by Volume XXXVII Number 50, Filed December 14, 2017, Proposed by #12428, Effective 12/6/2017, Expires 12/6/2027.