216-40-05 R.I. Code R. § 2.10

Current through June 20, 2024

Section 216-RICR-40-05-2.10 - Delegable Procedures/Duties to Dental Hygienists, Public Health Dental Hygienists, DANB-Certified Assistants, DAANCE-Certified Maxillofacial Surgery Assistants and Dental Assistants with Specific Type of Supervision

2.10.1General Requirements

A. Dental Hygienists. Pursuant to R.I. Gen. Laws § 5-31.1-33, any licensed dentist, public institution or school authority may employ any licensed dental hygienist whose activities shall be confined to those dental services, procedures/duties that licensed dental hygienist he/she has been educated to perform and which are authorized by the Board, and under the specific type of supervision as set forth in § 2.10.2 of this Part. Such dental procedures/duties may be delegated by the dentist and performed under the direction of the dentist, in accordance with the provisions of the Act and this Part.

1. Nothing in this section shall be construed to authorize a licensed dental hygienist or public health dental hygienist to perform any of the non-delegable (exclusionary) procedures/ duties as set forth in § 2.10.3 of this Part.

B. DANB-Certified Assistants, DAANCE-Certified Maxillofacial Surgery Assistants and Dental Assistants. A dentist may delegate to a DANB-certified assistant, DAANCE-certified maxillofacial surgery assistant or a dental assistant, based on the individual's competency and/or training, reversible intraoral dental services, procedures or duties which are to be performed under the supervision of the dentist as approved by the Board and set forth in § 2.10.2 of this Part. Provided, however, oral prophylaxis shall be performed only by a licensed dentist or a licensed dental hygienist.

1. Nothing in this section shall authorize a DANB- certified assistant or a dental assistant to perform any of the non-delegable (exclusionary) procedures/duties as set forth in § 2.10.3 of this Part.

C. All procedures/duties performed by dental auxiliaries shall be performed under the direct supervision of a dentist, unless otherwise specified in § 2.10.2 of this Part.

D. Any reversible intraoral procedure not specifically enumerated as delegable or non- delegable (exclusionary) pursuant to §§ 2.10.2 and 2.10.3 of this Part, may be delegated to any category of dental auxiliary, (dental hygienist, public health dental hygienist, DANB-certified assistant, DAANCE-certified maxillofacial surgery assistant and dental assistant) based on the discretion of the delegating dentist, the education and training and competency of the dental auxiliary.

E. The supervising dentist shall be accountable and fully responsible for all dental services, procedures and duties performed by any dental auxiliary under his or her supervision. However, a dental auxiliary is responsible for his/her own professional behavior and shall be guided by existing professional standards.

2.10.2 Delegable Procedures/Duties

A. A dentist may delegate to auxiliary personnel those procedures which the dentist may deem advisable, except for those procedures excluded in § 2.10.3 of this Part. Any delegated procedures shall be both the responsibility of and under the specified supervision of the dentist.

1. Dental Hygienist and Public Health Dental Hygienist. A dental hygienist or a public health dental hygienist, may remove calculus, accretions and stains from both supragingival and subgingival tooth surfaces by scaling and root planing, as well as any duties performed by a DANB-certified assistant or a dental assistant. These procedures may be accomplished under general supervision, in a dental office, and under general supervision of the dentist.

2. DANB-Certified Assistant

a. A DANB-certified assistant may perform reversible intraoral procedures under the direct supervision of the dentist.

b. Such procedures may include the application of pit and fissure sealants, coronal polishing, placing and/or removing retraction cord; fluoride treatments; and placement or removal of bonded orthodontic attachments and/or cementation or removal of orthodontic bands provided:

(1) Such procedures were incorporated into the academic training from which the DANB-certified assistant graduated; OR

(2) Provided he/she has completed academic clinical training to clinical competence.

3. The DANB- certified assistant may not perform any of the procedures specifically listed for a dental hygienist, nor any irreversible intraoral procedures.

4. Dental Assistant. A dental assistant may perform reversible intraoral procedures under the direct supervision of the dentist. He or she may not perform any of the procedures listed specifically for a licensed dental hygienist or DANB-certified assistant nor any irreversible intraoral procedures.

a. A dental assistant may perform a final digital scan with final inspection and approval of the dentist.

B. Dentists licensed pursuant to R.I. Gen. Laws § 5-31.1-6 may delegate to any dental hygienists licensed pursuant to R.I. Gen. Laws § 5-31.1-6 who are employed on a regular basis by such dentists any procedures which he or she may deem advisable; including those procedures specified under § 2.10.2 of this Part pertaining to dentists and dental hygienists and any such dental hygienists may engage in the practice of dental hygiene outside of such dentists' office in order to render to residents of nursing facilities licensed pursuant to R.I. Gen. L aws Chapter 23-17 without the on-site direct supervision of a dentist licensed pursuant to R.I. Gen. Laws § 5-31.1-6, those dental services, procedures and duties that he or she has been educated to perform and which are authorized by the Board or through R.I. Gen. Laws § 5-31.1-39.

C. Delegable procedures and duties for DAANCE-certified maxillofacial surgery assistants are set forth in R.I. Gen. Laws § 5-31.1-31.

2.10.3Non-Delegable (Exclusionary) Procedures/Duties

A. Notwithstanding the provisions of § 2.14 of this Part, nothing in this Part authorizes a dental hygienist, public health dental hygienist, DANB-certified assistant or dental assistant, to perform any of the following procedures or duties:

1. Diagnosis and treatment planning;

2. Surgical procedures on hard or soft tissue;

3. Prescribing medications;

4. Administering general anesthesia/deep sedation, moderate sedation and/or minimal sedation, or nitrous oxide plus medication;

5. Administering sedative inhalants;

6. Taking conventional/ physical impressions for models upon which full or partial dentures, or permanent crowns, bridges, inlays, onlays, posts and cores will be fabricated;

7. Adjusting occlusion of fixed and removable prosthodontic appliances;

8. Final cementation of permanent crowns, bridges, inlays, onlays and posts and cores; and insertion of final prosthesis.

9. Condensing and carving restorative materials in teeth, except temporary restoratives;

10. Placement of sutures;

11. Exposure of radiographs without successful completion of a course in dental radiography which is offered by an education institution with a program accredited by the Commission on Dental Accreditation and which fulfills institutional requirements as set forth in R.I. Gen. Laws § 40-20-1;

12. Perform direct pulp capping procedures;

13. Orthodontic arch wire detailing with the exception of minor adjustments to eliminate pain or discomfort;

14. Flush root canal;

15. Temporary wire ligation; and

16. Use of a rotary instrument in the oral cavity unless licensed or certified under the provisions of the Act and this Part. (See also § 2.10.2(A)(2)(b) of this Part).

216 R.I. Code R. § 216-RICR-40-05-2.10

Amended effective 4/4/2019