N.D. Admin. Code 20-03-01-01

Current through Supplement No. 394, October, 2024

Section 20-03-01-01 - [Effective 10/1/2024] Duties

Duties are delegated to dental assistants under prescribed levels of supervision as follows:

1. A dental assistant who is not registered with the board and who is employed by a dentist may:

a. Perform the following duties under direct supervision:

(1) Take and record pulse, blood pressure, and temperature.

(2) Take and record preliminary dental and medical history for the interpretation by the dentist.

(3) Apply topical medications and drugs to oral tissues, including topical anesthetic, topical fluoride, fluoride varnish, and desensitizing agents, but not including caustic agents.

(4) Receive removable dental prosthesis for cleaning or repair.

(5) Take impressions for study casts.

(6) Hold impression trays in the mouth (e.g., reversible hydrocolloids, rubber base).

(7) Retract patient's cheek, tongue, or other tissue parts during a dental procedure.

(8) Remove such debris as is normally created in the course of treatment during or after dental procedures by vacuum devices, compressed air, mouthwashes, and water.

(9) Isolate the operative field, not to include rubber dams.

(10) Hold a curing light for any dental procedure. Curing lights may not include a laser capable of cutting, burning, or damaging hard or soft tissue or for electrosurgery for tissue retraction.

(11) Produce on a patient of record, a final scan by digital capture for review and inspection by the authorizing dentist for a prescriptive fixed or removable appliance.

(12) Monitor a patient who has been induced into nitrous oxide analgesia if the dentist has provided sufficient training to the dental assistant completed after January 1, 2024. The dentist shall maintain documentation of the training for the duration of the delegation and shall provide documentation of the training to the board upon request.

b. Perform the following duties under general supervision:

(1) Provide oral hygiene instructions and education.

(2) Remove periodontal dressings.

2. A qualified dental assistant may:

a. Perform the following duties under the direct supervision of a dentist:

(1) Duties set forth in subsection 1.

(2) Acid etch enamel surfaces as directed by the dentist.

(3) Dry root canal with paper points.

(4) Apply resin infiltration.

(5) Orally transmit a prescription that has been authorized by the supervising dentist.

(6) Remove band and bracket adhesives with a slow-speed handpiece.

(7) Place and remove matrix bands and wedges.

b. Perform the following duties under the general supervision of a dentist:

(1) Produce on a patient of record, a final scan by digital capture for review and inspection by the authorizing dentist for a prescriptive fixed or removable appliance.

(2) Take and record pulse, blood pressure, and temperature.

(3) Take and record preliminary dental and medical history for the interpretation by the dentist.

(4) Apply topical medications and drugs to oral tissues, including topical anesthetic and anticariogenic agents, and desensitizing agents.

(5) Place and remove arch wires or appliances that have been activated by the dentist.

(6) Cut and remove arch wires or replace loose bands, loose brackets, or other orthodontic appliances for palliative care.

(7) Remove sutures.

(8) Place, tie, and remove ligature wires and elastic ties, and select and place orthodontic separators.

(9) Preselect and prefit orthodontic bands.

(10) Repack dry socket medication and packing for palliative care.

(11) Take dental radiographs.

c. Perform the following duties under the indirect supervision of a dentist:

(1) Polish coronal surfaces of teeth with a rubber cup or brush after the dentist provides the dental assistant with sufficient training. The dentist shall maintain documentation of the training completion for the duration of the delegation and provide it to the board upon request.

(2) Place orthodontic brackets using an indirect bonding technique by seating the transfer tray loaded with brackets previously positioned in the dental laboratory by a licensed dentist.

3. A qualified dental assistant-limited radiology registrant may perform the duties listed in subsection 1, and may take dental radiographs under the general supervision of a dentist.

4. A registered dental assistant may perform the duties set forth in subsection 2 and the following duties under the direct supervision of a dentist:

a. Acid etch enamel surfaces prior to direct bonding of orthodontic brackets or composite restorations.

b. Take face bow transfers.

c. Adjust permanent crowns outside of the mouth.

d. Administer emergency medications to a patient in order to assist the dentist in an emergency.

e. Hold impression trays in the mouth (e.g., reversible hydrocolloids, rubber base).

5. A registered dental assistant may perform the following duties on a patient of record under the indirect supervision of a dentist:

a. Place and remove rubber dams.

b. Place retraction cord in the gingival sulcus of a prepared tooth prior to the dentist taking an impression of the tooth.

c. Remove excess cement from inlays, crowns, bridges, and orthodontic appliances with hand instruments or a slow-speed handpiece.

d. Place and remove periodontal dressings.

e. Monitor a patient who has been inducted by a dentist into nitrous oxide inhalation analgesia.

f. Apply bleaching solution, activate light source, and monitor and remove bleaching materials.

g. Place orthodontic brackets using an indirect bonding technique by seating the transfer tray loaded with brackets previously positioned in the dental laboratory by a licensed dentist.

6. A registered dental assistant may perform the following duties under the general supervision of a dentist:

a. Take and record pulse, blood pressure, and temperature.

b. Take and record preliminary dental and medical history for the interpretation by the dentist.

c. Apply topical medications and drugs to oral tissues, including topical anesthetic, topical fluoride, fluoride varnish, silver diamine fluoride, hemostatic agents, and desensitizing agents.

d. Receive removable dental prosthesis for cleaning or repair.

e. Take impressions or occlusal bite registrations for study casts.

f. Fabricate, adjust, place, recement, or remove a temporary crown, bridge, or onlay or temporary restorative material. This applies only to dentitions actively under treatment for which a permanent restoration is being fabricated.

g. Remove sutures.

h. Cut and remove arch wires or replace loose bands, loose brackets, or other orthodontic appliances for palliative treatment.

i. Place, tie, and remove ligature wires and elastic ties, and place orthodontic separators.

j. Provide oral hygiene education and instruction.

k. Provide an oral assessment for interpretation by the dentist.

l. Repack dry socket medication and packing for palliative treatment.

m. Apply pit and fissure sealants if the registered dental assistant has provided documentation of a board-approved sealant course or training that includes hand skills, and has received an endorsement from the board. Adjust sealants with slow-speed handpiece.

n. Polish the coronal surfaces of the teeth with a rubber cup or brush.

o. Polish restorations with a slow-speed handpiece.

p. Take dental radiographs.

q. Take impressions for fixed or removable orthodontic appliances, athletic mouth guards, bleaching trays, bite splints, flippers, and removable prosthetic repairs.

r. Preselect and prefit orthodontic bands.

s. Perform nonsurgical clinical and laboratory diagnosis tests, including pulp testing, for interpretation by the dentist.

t. Place and remove arch wires or appliances that have been activated by a dentist.

u. Provide screenings as defined by subsection 44 of section 20-01-02-01.

v. Adjust a temporary denture or partial for dentitions actively under treatment for which permanent dentures or partial dentures are being fabricated.

N.D. Admin Code 20-03-01-01

Effective September 1, 1980; amended effective February 1, 1992; October 1, 1993; May 1, 1996; August 1, 1998; April 1, 2000; June 1, 2002; July 1, 2004; April 1, 2006; January 1, 2011.

Amended by Administrative Rules Supplement 2015-355, January 2015, effective 1/1/2015.

Amended by Administrative Rules Supplement 2015-356, April 2015, effective 4/1/2015.

Amended by Administrative Rules Supplement 2017-365, July 2017, effective 7/1/2017.

Amended by Administrative Rules Supplement 2021-380, April 2021, effective 4/1/2021.

Amended by Administrative Rules Supplement 2022-385, July 2022, effective 7/1/2022.

Amended by Administrative Rules Supplement 2022-386, October 2022, effective 10/1/2022.

Amended by Administrative Rules Supplement 2024-394, October 2024, effective 10/1/2024.

General Authority: NDCC 43-20-10

Law Implemented: NDCC 43-20-01.1, 43-20-08, 43-20-10, 43-20-13