N.Y. Comp. Codes R. & Regs. tit. 8 § 61.9

Current through Register Vol. 46, No. 45, November 2, 2024

Section 61.9 - Practice of dental hygiene

The practice of dental hygiene, in accordance with section 6606 of the Education Law, shall be performed either under the supervision of a licensed dentist or pursuant to a collaborative arrangement as defined in subdivision (f) of this section.

(a) The degrees of supervision by the dentist as defined are follows:

(1) General supervision shall mean that a supervising dentist is available for consultation, diagnosis and evaluation, has authorized the dental hygienist to perform the services, and exercises that degree of supervision appropriate to the circumstances.

(2) Personal supervision shall mean that the dentist in the dental office or facility, personally diagnoses the condition to be treated, personally authorizes the procedure and, before dismissal of the patient, personally examines the condition after treatment is completed.

(b) The following services may be performed under the general supervision of a licensed dentist:

(1) removing calcareous deposits, accretions and stains, including scaling and planing of exposed root surfaces indicated for a complete prophylaxis;

(2) applying topical agents indicated for a complete dental prophylaxis;

(3) removing excess cement from surfaces of the teeth;

(4) providing patient education and counseling relating to the improvement of oral health;

(5) taking and exposing dental radiographs;

(6) performing topical anticariogenic agent applications, including but not limited to topical fluoride applications, and performing topical anesthetic applications;

(7) polishing teeth, including existing restorations;

(8) taking and assessing medical history including the measuring and recording of vital signs as an aid to diagnosis by the dentist and to assist the dental hygienist in providing dental hygiene services;

(9) performing dental and/or periodontal assessments as an aid to diagnosis by the dentist and to assist the dental hygienist in providing dental hygiene services;

(10) applying pit and fissure sealants;

(11) applying desensitizing agents to the teeth;

(12) placing and removing temporary restorations;

(13) making assessments of the oral and maxillofacial area as an aid to diagnosis by the dentist;

(14) taking impressions for study casts. Study casts shall mean only such casts as will be used for purposes of diagnosis and treatment planning by the dentist and for the purposes of patient education; and

(15) providing dental health care case management and care coordination services, which shall include, but not be limited to:

(i) community outreach;

(ii) improving oral health outcomes;

(iii) improving access to dental care by assisting people in establishing an ongoing relationship with a dentist, in order to promote the comprehensive, continuous and coordinated delivery of all aspects of oral health care; and

(iv) assisting people to obtain dental health care.

(c) The following services may be performed only under the personal supervision of a licensed dentist:

(1) placing or removing rubber dam;

(2) removing sutures;

(3) placing or removing matrix bands;

(4) applying a topical medication not related to a complete dental prophylaxis;

(5) placing and removing periodontal dressings;

(6) selecting and prefitting provisional crowns;

(7) selecting and prefitting orthodontic bands;

(8) removing orthodontic arch wires and ligature ties;

(9) taking impressions for space maintainers, orthodontic appliances, and occlusal guards;

(10) placing and removing temporary separating devices; and

(11) placing orthodontic ligatures.

(d) The dental supportive services that a licensed dentist authorizes a registered dental assistant to perform under section 61.13(b)(18) of this Part, designated in such paragraph as other dental supportive services, may be performed by a licensed dental hygienist under the personal supervision of a licensed dentist who has delegated such function to the licensed dental hygienist, unless general supervision for such service is otherwise expressly prescribed in this section.

(e) In accordance with section 29.1(b)(9) and (10) of this Title, a licensed dental hygienist performing services under the supervision of a licensed dentist or pursuant to a collaborative arrangement as defined in subdivision (f) of this section is not permitted to provide dental services or dental supportive services that the licensed dental hygienist knows or has reason to know that he or she is not competent to perform, and a licensed dentist is not permitted to delegate to a licensed dental hygienist dental services or dental supportive services that the licensed dentist knows or has reason to know that the licensed dental hygienist is not qualified by training, experience or by licensure to perform.

(f) Collaborative arrangement.

(1) Definitions. As used in this subdivision:

(i) Collaborative arrangement shall mean an agreement between a registered dental hygienist working for a hospital and a licensed and registered dentist who has a formal relationship with the same hospital.

(ii) Hospital shall mean a hospital as defined by Public Health Law section 2801(1).

(2) Requirements. A registered dental hygienist providing services pursuant to a collaborative arrangement shall:

(i) only provide those services that may be provided under general supervision as specified in subdivision (b) of this section, provided that the physical presence of the collaborating dentist is not required for the provision of such services;

(ii) instruct individuals to visit a licensed dentist for comprehensive examination or treatment;

(iii) possess and maintain certification in cardiopulmonary resuscitation in accordance with the requirements for dentists set forth in section 61.19 of this Part and the following:

(a) At the time of his or her registration renewal, the dental hygienist shall attest to having met the cardiopulmonary resuscitation requirement or attest to meeting the requirements for exemption as defined in clause (b) of this subparagraph.

(b) A dental hygienist may be granted an exemption to the cardiopulmonary resuscitation requirement if he or she is physically incapable of complying with the requirements of this subparagraph. Documentation of such incapacity shall include a written statement by a licensed physician describing the dental hygienist's physical incapacity. The dental hygienist shall also submit an application to the department for exemption which verifies that another individual will maintain certification and be present at the location where the dental hygienist provides dental hygiene services, pursuant to a collaborative arrangement, while the dental hygienist is treating patients.

(c) Each dental hygienist shall maintain for review by the department records of compliance with the cardiopulmonary resuscitation certification requirement, including the dental hygienist's cardiopulmonary resuscitation certification card; and

(iv) provide collaborative services only pursuant to a written agreement that is maintained in the practice setting of the dental hygienist and collaborating dentist. Such written agreement shall include:

(a) provisions for:

(1) referral and consultation;

(2) coverage for emergency absences of either the dental hygienist or collaborating dentist;

(3) resolution of disagreements between the dental hygienist and collaborating dentist regarding matters of treatment, provided that, to the extent a disagreement cannot be resolved, the collaborating dentist's treatment shall prevail;

(4) the periodic review of patient records by the collaborating dentist; and

(5) such other provisions as may be determined by the dental hygienist and collaborating dentist to be appropriate; and

(b) protocols, which may be updated periodically, identifying the services to be performed by the dental hygienist in collaboration with the dentist and reflecting accepted standards of dental hygiene. Protocols shall include provisions for:

(1) case management and care coordination, including treatment;

(2) appropriate recordkeeping by the dental hygienist; and

(3) such other provisions as may be determined by the dental hygienist and collaborating dentist to be appropriate.

(3) Collaborative arrangements shall not supersede any law or regulation which requires identified services to be performed under the personal supervision of a dentist.

N.Y. Comp. Codes R. & Regs. Tit. 8 § 61.9

Amended, New York State Register December 31, 2014/Volume XXXVI, Issue 52, eff. 1/1/2015

Amended New York State Register February 26, 2020/Volume XLII, Issue 08, eff. 2/26/2020