Tenn. Comp. R. & Regs. 0460-05-.03

Current through October 22, 2024

Section 0460-05-.03 - SCHOOLS, PROGRAMS AND COURSES FOR THE REGISTERED DENTAL ASSISTANT

(1) Registered Dental Assisting Programs.

(a) Approval and Re-approval of Program.

1. The owner and/or director of a dental assistant program seeking board approval shall make application for approval to operate a program on forms provided by the Tennessee Board of Dentistry Administrative Office. The completed application along with program information required by this rule must be received by the Board office at least thirty days (30) days prior to the next regularly scheduled meeting in order for the Board to review the application. The owner and/or director of the program will be notified in writing of the Board's action(s).

2. The program shall be subject to on-site inspections by representatives of the Board and/or required to complete paper surveys, as requested.

3. The Board shall be notified immediately of any changes made in the operation of the program, such as changes of location, directorship, and/or instructors.

4. Approval granted by the Board of Dentistry is only valid for two (2) years from the date the approval is granted (ratified) by the Board.

5. Should approval be removed by the Board or not renewed after the expiration of the two (2) year time period, the program shall cease using the language 'board approved' on all materials and advertisements.

6. Resumes must be submitted on each instructor.

7. The application must also include a detailed curriculum which lists the outline of the subjects covered in the program and the learning objectives for each subject.

8. The program must inform the Board if the program will be taught in person or online. If any portion of the program is taught online, the subjects and number of hours taught online must be included with the application.

9. In order to obtain and/or retain Board approval, the program shall maintain compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum that are in effect upon application or re-application for approval.

(b) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment and Curriculum.

1. The curriculum must be structured on the basis of a minimum of 116 hours instructional hours and must include at least 14 hours in the subject of dental radiology.

2. Instructional hours should include didactic and laboratory instruction.

3. Students should generally be at least 18 years old before admittance to the program; however students must be 18 years old before any exposure to x-rays begins. Students must have high school diploma or equivalent.

4. The program must demonstrate that student enrollment numbers are proportionate to the number of faculty, and to the availability of appropriate classroom, laboratory, and clinical facilities, equipment, instruments, and supplies. Student to instructor ratio should not exceed 10/1.

5. A program must have access to dental operatories, sterilization equipment, x-ray machines (processing and/or digital equipment), and dental laboratory equipment.

6. The students must be provided a program syllabus at the beginning of each program. The syllabus must include a program outline, learning objectives for each topic and the amount of time to be spent on each topic. A sample dental assistant registration applicant form must be included when applying for board approval.

7. Program grading policies must be included in the information provided to each student.

8. Skills assessments where needed must be performed.

9. Students need to be informed that any conviction must be explained to the Board of Dentistry with their application for registration and that all court documents regarding any conviction must be submitted. The Board of Dentistry reviews all court documents required to be submitted with the application for registration and they may deny registration or require an appearance before the Board before deciding to issue or deny the registration.

10. Suggested materials to be utilized in the course include but are not limited to, the most recent editions of the following:

(i) Modern Dental Assisting; Doni L. Bird, CDA, RDA, RDH, MA and Debbie S. Robinson, CDA, MS

(ii) Tennessee Dental Practice Act - available at http://tn.gov/health/article/Dentistry-statutes;

(iii) Review of Dental Assisting; Betty Ladley Finkbeiner CDA Emeritus RDA BS MS

(iv) The Dental Assisting Workbook; Doni L. Bird, CDA, RDA, RDH, MA and Debbie S. Robinson, CDA, MS

11. The minimum of 14 hours in the subject of dental radiology required to be covered in the curriculum for the dental assistant registration must include, at a minimum, the same subjects as required for the dental radiology certification courses. (see Rule 0460-05-.03(7)(d) 4.)

12. The program syllabus must be approved by the Board and shall include instruction in all of the following subject matters:

(i) The dental health team;

(ii) The dental office, including a review of equipment commonly found in treatment areas;

(iii) Ethics and jurisprudence;

(iv) Applied psychology and communication skills;

(v) A review of the teeth and supporting tissues;

(vi) Assisting with soft tissue oral examination;

(vii) Dental charting;

(viii) Microbiology and oral pathology;

(ix) Dental materials;

(x) Preventive dentistry;

(xi) Disease transmission and infection control;

(xii) Special and disabled patients;

(xiii) Medical emergencies;

(xiv) Pharmacology and pain control;

(xv) Dental instruments;

(xvi) Delivering dental care and moisture control;

(xvii) The dental dam;

(xviii) Oral diagnosis and treatment planning;

(xix) General dentistry and restorations;

(xx) Pediatric dentistry;

(xxi) Orthodontics;

(xxii) Periodontics;

(xxiii) Endodontics;

(xxiv) Fixed prosthodontics;

(xxv) Removable prosthodontics; and

(xxvi) Oral surgery.

13. The curriculum content must include instruction in the following dental assisting skills and functions:

(i) Maintaining patient treatment records;

(ii) Reviewing and recording medical and dental histories;

(iii) Taking and recording vital signs;

(iv) Seating and dismissing patients;

(v) Preparing tray set-ups for operative procedures;

(vi) Managing infection and hazard control protocols consistent with current guidelines;

(vii) Operating oral evacuation systems and air/water syringes;

(viii) Maintaining a clear field of vision including various isolation techniques;

(ix) Performing a variety of instrument transfers;

(x) Utilizing appropriate chairside assistant ergonomics;

(xi) Providing patient preventive education and oral hygiene instruction;

(xii) Identifying and responding to medical and dental emergencies;

(xiii) Providing pre and post-operative instructions prescribed by a dentist;

(xiv) Applying topical anesthetic and desensitizing agents;

(xv) Placing and removing a rubber dental dam;

(xvi) Applying fluoride agents;

(xvii) Applying bases, liners, and bonding agents;

(xviii) Fabricating, placing and removing provisional restorations;

(xix) Placing and selecting matrix retainers, matrix bands, and wedges;

(xx) Removing of excess cement;

(xxi) Fabricating bleaching trays, mouth guards, and custom trays;

(xxii) Taking preliminary impressions (alginate impressions);

(xxiii) Placing and removing retraction materials;

(xxiv) Removing sutures;

(xxv) Performing pulp vitality tests;

(xxvi) Placing and removing periodontal dressing; and

(xxvii) Performing orthodontic functions as stated in Rule 0460-04-.08.

14. Time and attendance records must be kept on each student. The student must make up any missed hours. Usually, each program has extra hours added to the 116 total hours to facilitate makeup lessons.

15. Each program must have at least two (2) examinations during the program; one mid-term examination and a final examination.

16. Examinations must have a passing score of at least 75%.

17. Within thirty (30) days of program completion, the program director must certify in writing to the Board office that the student has completed all program requirements, including the requirements for the dental radiology certification.

18. Within thirty (30) days of program completion, a list of students must be submitted to the Board office along with the program completion letter for each student.

(2) Certification Course in Coronal Polishing

(a) Application for Board Approval - The owner and/or director of a certification course in coronal polishing shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received by the Board's office at least thirty (30) days prior to the next regularly scheduled meeting of the Board in order for the Board to review the application. The owner and/or director of the certification course will be notified in writing of the Board's action(s). This section shall also apply to ADA accredited dental assisting programs.

(b) Retention of Approval.

1. In order to obtain and/or retain Board approval, the certification course shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum as set forth in the Board's rules.

2. The certification course shall be subject to on-site inspections by representatives of the Board and required to complete such paper surveys as requested.

3. The Board shall be notified immediately of any changes made in the operation of the certification course, such as change of location, directorship, and/or instructors. A new certificate of approval will be issued in the event of change in either ownership or directorship of the course.

4. Certificates of approval shall be issued for two (2) years and shall expire on December 31st.

5. At least thirty (30) days prior to the commencement of the course, the approved course shall submit the name(s) of the Tennessee dentist(s) who will be directing the course, the date of the course, and the location of the course to the Board's Administrative Office.

(c) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment, and Curriculum.

1. The course shall be taught at an educational institution, defined as a school of dentistry, dental hygiene, or dental assisting, or a clinical facility approved by the Board which provides for proper patient care, including access to medication and equipment for the management of emergencies.

2. The course shall be directed in its entirety by a dentist who is licensed in good standing by the Tennessee Board of Dentistry. The dentist/clinical instructor may employ and/or utilize licensed dental hygienists or registered and certified dental assistants with a coronal polishing certification to teach and/or assist during the clinical portion of the course.

3. The clinical instructor-to-student ratio must be no less than one instructor to six students (1:6) for the clinical portion of the course.

4. The certification course shall consist of fourteen (14) hours of study over a two (2) day period. The course syllabus must be approved by the Board and meet the following requirements:

(i) Didactic - The didactic portion of the course shall include instruction in all of the following subject matters:

(I) Principles of plaque and stain formation;

(II) The clinical appearance of plaque, intrinsic and extrinsic stains and calculus (removal of calculus and scaleable stains shall be accomplished only by a dentist or licensed dental hygienist);

(III) The clinical appearance of clean and polished teeth;

(IV) Tooth morphology and the anatomy of the oral cavity as they relate to the retention of plaque, stain and polishing techniques;

(V) Principles of selecting abrasives and polishing agents and their effect on tooth structure and restorative materials;

(VI) Principles of polishing, including the selection and care of the armamentarium, instrumentation techniques and precautions, including the care of the mouth with fixed or removable prostheses and/or orthodontic appliances;

(VII) Principles of aseptic technique, including the sterilization of instruments, sanitation of equipment, and control of disease transmission;

(VIII) Principles of selecting and applying disclosing agents, including armamentarium, technique and precautions;

(IX) Principles of the preparation of teeth and the oral cavity for fluoride application;

(X) The reaction of fluorides with tooth structure;

(XI) Available fluoride agents;

(XII) Principles of the preparation and storage of fluoride agents; and

(XIII) Principles of application techniques, including the selection and care of armamentarium, the isolation of teeth, adaptation of trays, techniques and precautions.

(ii) Clinical - The course provider shall conduct clinical experience of at least two (2) hours duration, which shall include at least a one-half (1/2) hour demonstration by an instructor. The clinical portion shall include all significant parts of the didactic portion and hands-on experience in the following:

(I) Identifying calculus, plaque, and intrinsic and extrinsic stains;

(II) Polishing exposed surfaces of teeth;

(III) Applying disclosing agents to the exposed surfaces of teeth;

(IV) Evaluating the extent of plaque and stain removal;

(V) Maintaining the polishing armamentarium;

(VI) Maintaining aseptic techniques;

(VII) Applying various fluoride agents; and

(VIII) Applying various desensitizing agents.

(iii) The course shall include jurisprudence aspects, as follows:

(I) Limitations of the practice of dental assisting in accordance with the statutes and rules of the Board;

(II) Limitations on dental assistant services;

(III) Penalties for violation of the Dental Practice Act or Rules of the Board of Dentistry; and

(IV) Mechanisms by which a person can report violations of statutes and/or rules of the Board of Dentistry.

(d) The clinical instructor shall provide a copy of the syllabus to the student before or at the beginning of each course. The syllabus shall set forth the materials to be presented in the course and the evaluation criteria to be utilized by the clinical instructor to determine successful completion of the certification course.

(e) Upon completion of the course, students shall be evaluated by both a written and a clinical examination. The written examination shall cover the didactic portion of the course. The clinical examination shall cover the clinical portion of the course. The passing grade for each examination is set at seventy-five percent (75%). A student who fails either examination may retake the examination two (2) additional times before having to repeat the course in order to retake the examination(s). The written and clinical examinations required in this subparagraph of the rule meet the examination requirement of T.C.A. § 63-5-108(d).

(f) A letter, attesting to successful completion of the course and test score(s) for each student, must be sent to the Board's Administrative Office within thirty (30) days of completion of the certification course.

(g) The school offering the coronal polishing certification course will issue continuing education credit hours for the course.

(h) Failure to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.03(2) (b), may subject the course provider and students to invalidation of course results and withdrawal of course approval by the Board.

(3) Certification Course for Sealant Application

(a) Application of Rules - This section shall apply to both ADA accredited and board-approved dental assistant programs, as well as any other individual or entity which desires to establish such a certification course to admit and educate students who are currently registered as dental assistants. ADA accredited and board approved programs who are teaching students that are not currently registered as dental assistants must also comply with these rules but the students are not required to be a registered dental assistant until they have completed the program.

(b) All courses/entities (with the exception of dental assisting programs whose certification course is a part of their standard curriculum) shall have a procedure in place to ensure that the eligibility (current registration) of applicants is verified and documented, prior to allowing the applicant to attend the certification course.

(c) Application for Board Approval - The owner and/or director of a certification course in sealant application shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received by the Board's Office at least thirty (30) days prior the next regularly scheduled Board meeting in order for the Board to review the application. The course provider will be notified in writing of the Board's action(s). This section shall also apply to all dental assisting programs which choose to offer the certification course as a part of their curriculum.

(d) Retention of Approval.

1. The certification course shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment and curriculum, as set forth in these rules and as they may from time to time be amended, in order to obtain and/or retain Board approval.

2. The certification course shall be subject to on-site inspections by representatives of the Board and/or required to complete such paper surveys, as requested.

4. Certificates of approval shall be issued for one (1) year and shall expire on December 31^st of any given year.

5. At least thirty (30) days prior to the commencement of the course, the approved course shall submit the name(s) of the Tennessee dentist(s) who will be teaching the course, the date of the course, and the location of the course to the Board's Administrative Office.

(e) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment, and Curriculum.

1. The certification course shall admit only those students who have been verified by the course as having a current registration issued by the Tennessee Board of Dentistry. Students in Board approved programs which have been approved by the Board to teach sealant application are not required to be registered before admittance to the dental assisting program/course but are required to be registered before the temporary sealant application certification will be issued.

2. The course shall be taught at an educational institution, defined as a school of dentistry, dental hygiene, or dental assisting, or a clinical facility approved by the Board which provides for proper patient care, including access to medication and equipment for the management of emergencies. The course shall be directed by a dentist who is licensed in good standing by the Tennessee Board of Dentistry. The dentist/clinical instructor may employ and/or utilize licensed dental hygienists or registered dental assistants with sealant certification, either of which has two (2) or more years of full-time experience in sealant application, to assist during the course.

3. The class size shall be limited to forty (40) students, and the instructor-to student ratio must be one (1) instructor to ten (10) students (1:10) for the clinical portion of the course.

4. The certification course shall consist of a minimum of six (6) hours of study of which at least four (4) hours must be clinical exercises. The course syllabus must be approved by the Board and meet the following requirements:

(i) Didactic - The didactic portion of the course shall include instruction in all of the following subject matters:

(I) Indication/contraindications for sealants;

(II) Preparation of teeth for sealants;

(III) Proper isolation and moisture control of teeth for sealants, including rubber dam, dri-angles, cotton rolls, and retractors;

(IV) Education of patient and/or parent regarding sealants;

(V) Sealant materials, including light curing, self curing, and coloring;

(VI) Acid etching, including proper use and negative aspects;

(VII) Infection control;

(VIII) Tooth anatomy, including fossa, pit, fissure, groove, and occlusion; and

(IX) Armamentarium.

(ii) Clinical - The course provider/instructor shall conduct clinical exercises for a minimum of four (4) hours or until the clinical instructor determines clinical competency has been met. The clinical portion of the course shall include instruction in each of the following areas:

(I) Proper tooth isolation and preparation for sealants;

(II) Evaluation of proper technique in the placement of sealants;

(III) Evaluation by instructors of completed sealants; and

(IV) Infection control.

(f) Each student must pass a competency examination on the material covered in the didactic section before continuing to the clinical exercises. The passing grade is set at seventy-five percent (75%). Students who do not pass the competency examination may be offered remediation before the start of the clinical exercises and attempt to pass the examination an additional two (2) times. In the event a student takes and fails the examination a total of three (3) times, the student shall be required to retake the course and retake the examination at a future date.

(g) During the clinical portion of the course, each student shall complete pit and fissure sealants on at least ten (10) sterile extracted and sealable teeth or until competency is determined by the instructor. Laboratory tooth models specifically designed for sealant placement may be substituted for some of the extracted teeth. Acceptance of teeth other than extracted teeth is to be determined by the dentist directing the course. All necessary materials and instruments shall be provided by the student. In working with the extracted teeth all OSHA personal protective equipment shall be utilized and the teeth disposed of in accordance with standard practices.

(h) Upon successful completion of the course, the certification application and fee must be submitted by the student.

(i) The director/instructor of the certification course shall, within thirty (30) days after course completion or upon graduation from a dental assisting program submit a letter for each student which attests to the student's successful completion of the course and the student's examination grades. The completed forms shall be submitted directly to the Board's Administrative Office by the director/instructor.

(j) The student will be issued a temporary sealant application certification to complete a ninety (90) day externship in the office of the employer/supervising dentist(s). During the externship the following sealants must be successfully placed:

1. A minimum of four (4) maxillary permanent molars;

2. A minimum of four (4) mandibular permanent molars; and

3. A minimum of two (2) premolars.

(k) The employer/supervising dentist(s) must submit, on a form provided by the Board, proof of successful completion of the sealants required by subparagraph (3) (j) of this rule.

(l) Upon receipt of proof of successful completion of the sealants, the certification for sealant application will be issued.

(m) Extensions of the ninety (90) day temporary sealant application certification will be considered on a case-by-case basis upon receipt of written documentation stating the reason an extension is requested. The Board consultant has the authority to grant or deny the request.

(n) The school offering the sealant application certification course will issue continuing education credit hours for the course.

(o) ADA accredited dental assisting programs who include sealant application in their curriculum shall adhere to these rules but their students shall be exempt from the externship requirements detailed in 3 (j) above. These students shall show full competency as determined by the program director. Within thirty (30) days of graduation from the ADA accredited dental assisting program, the students' certification applications and fees shall be forwarded to the Board along with a letter from the director/instructor of the program attesting to each student's successful completion of the course and the student's examination grades. Upon receipt of this information, the certification for sealant application will be issued.

(p) Failure by the certification course to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.03(3) (d), may subject the course provider and students to invalidation of course results and withdrawal of course approval by the Board.

(4) Certification Course in Monitoring Nitrous Oxide

(a) Application of Rules - This section shall apply to both Tennessee ADA accredited and Board-approved dental assistant programs, as well as any other individual or entity which desires to establish such a certification course to admit and educate students who are currently registered dental assistants.

(b) Application for Board Approval - The owner and/or director of a certification course in monitoring nitrous oxide shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received in the Board's Office at least thirty (30) days prior to the next regularly scheduled Board meeting in order for the Board to review the application. The owner and/or director of the certification course will be notified in writing of the Board's action. This section shall also apply to all ADA-accredited and board-approved dental assisting programs.

(c) Retention of Approval.

1. The certification course, whether offered independently or as a part of the curriculum taught by a dental assisting program, shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum as set forth in this rule, as amended/may be amended, in order to obtain and/or retain Board approval.

2. The certification course shall be subject to on-site inspections by representatives of the Board and/or required to complete such paper surveys, as requested.

4. Certificates of approval shall be issued for one (1) year and shall expire on December 31^st of any given year.

(d) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment, and Curriculum.

1. The certification course shall admit only those registered dental assistants who are currently registered, pursuant to Rule 0460-04-.01(2), or are currently enrolled in an ADA-accredited or board approved program which offers this course as a part of their curriculum. It is the responsibility of the course owner/director to ensure that only currently registered dental assistants are admitted to the course.

2. The certification course shall be taught by a Tennessee licensed dentist or a licensed dental hygienist with nitrous oxide administration certification and a minimum of three (3) years clinical experience in utilizing administration of nitrous oxide and education in comprehensive pain and anxiety control. The instructor/dentist may employ and/or utilize anesthesiologists, pharmacologists, internists, and/or cardiologists who are licensed in Tennessee as instructors to assist the instructor/dentist in the teaching of the course.

3. The certification course shall consist of a minimum of five (5) hours of study. The course syllabus must be approved by the Board and this didactic course shall be designed and conducted to provide the student with detailed knowledge of nitrous oxide - oxygen inhalation sedation, its use in dentistry, and the health hazards and abuse potential of nitrous oxide. This didactic course shall include instruction in all of the following subject matters:

(i) The history, philosophy, psychology of nitrous oxide-oxygen inhalation sedation;

(ii) Definitions and descriptions of the physiological and psychological aspects of pain and anxiety;

(iii) Description of the stages of drug induced central nervous system depression, through all levels of consciousness and unconsciousness, with special emphasis on the difference between the conscious and unconscious state;

(iv) Anatomy and physiology of respiration;

(v) Pharmacological and physiological effects of nitrous oxide, including physical properties, action, side effects, absorption, excretion, and toxicity;

(vi) Advantages and disadvantages of inhalation sedation with nitrous oxide;

(vii) Management of reaction to, or complications with nitrous oxide;

(viii) Patient status assessment including:

(I) Taking and reviewing vital signs;

(II) Reflexes related to consciousness;

(III) Possible reactions to nitrous oxide;

(ix) Instruction for post-operative care;

(x) Recognition, prevention and management of complications and life-threatening situations related to nitrous oxide;

(xi) Demonstration and use of inhalation sedation equipment;

(xii) Legal considerations of nitrous oxide use;

(xiii) Discussion of sexual phenomena and hallucinatory effects reported with nitrous oxide;

(xiv) Discussion of the potential for abuse of nitrous oxide;

(xv) Recommended techniques for reducing occupational exposure to nitrous oxide; and

(xvi) Introduction of potential health hazards of trace anesthetics and proposed techniques for elimination thereof, including, but not limited to, recommendations and guidelines from the Centers for Disease Control (CDC) or the Occupational, Health, and Safety Administration (OSHA).

(e) Upon completion of the course, students shall be evaluated by written examination. The passing grade shall be seventy-five percent (75%). If the student initially fails the written examination, the exam may be taken no more than two (2) additional times before the course must be retaken and the exam retaken. The examination shall be developed and administered by the course director/instructor in such a manner as to determine competency for the monitoring of nitrous oxide.

(f) The certification course, or dental assisting school, will issue continuing education credit hours for the course.

(g) The director/instructor of the certification course or dental assisting program shall, within thirty (30) days after course completion or upon completion of the monitoring nitrous oxide portion of the ADA accredited or Board-approved dental assisting program, complete a form, provided by the Board, for each student to attest to the student's successful completion of the course or monitoring nitrous oxide portion and the student's examination grade. The completed forms shall be submitted directly to the Board's Office by the director/instructor.

(h) Failure to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.03(4) (c), may subject the course provider and students to invalidation of the course results and withdrawal of course approval issued by the Board.

(5) Certification Course in Expanded Restorative Functions

(a) Application for Board Approval - The director of a certification course in expanded restorative functions shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received in the Board's administrative office at least thirty (30) days prior to the next regularly scheduled Board meeting in order for the Board to review the application. The director of the certification course will be notified in writing of the Board's action(s).

(b) Retention of Approval.

1. The certification course must be taught at an educational institution as defined in part (5) (c) 2. of this rule and shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum as set forth in this rule, as amended/may be amended, in order to obtain and/or retain Board approval.

2. The certification course shall be subject to on-site inspections by representatives of the Board and/or required to complete such paper surveys, as requested.

4. Certificates of approval shall be issued for two (2) years and shall expire on December 31st every two (2) years.

(c) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment, and Curriculum.

1. The certification course shall admit only those registered dental assistants who are currently registered, pursuant to Rule 0460-04-.02, and who submit proof of a minimum of two (2) years continuous full-time employment within the past three (3) years in a dental practice as a registered dental assistant.

2. The certification course shall be taught at an educational institution, defined as a school of dentistry or a school which offers a specialty program in a recognized specialty branch of dentistry. The course director must be a licensed dentist who is a faculty member of an accredited school of dentistry. The certification course shall be taught by a course director and one (1) or more Tennessee licensed dentists and /or RDH/EFDA auxiliaries who are employed at an accredited school of dentistry.

3. The certification course shall be taught by one (1) or more Tennessee licensed dentists who are faculty members at an accredited school of dentistry.

4. The clinical instructor-to-student ratio must be one (1) instructor to eight (8) students (1:8).

5. The certification course shall consist of a minimum of ninety-six (96) hours of study over a three (3) week period.

6. The course syllabus shall be approved by the Board and the course shall be designed and conducted to provide the student with detailed knowledge of restorative functions. The clinical experience must be provided under the supervision of qualified faculty, and the students must be evaluated for competency. The didactic and clinical portion of the course shall include instruction in all of the following subject matters:

(i) First Week - The first (1st) week of the course must be a minimum of thirty-two (32) hours in length and a written and/or clinical competency examination is to be administered at the end of the week regarding:

(I) Dental morphology and occulusion;

(II) Dental materials, hazardous materials and product safety;

I. Amalgam;

II. Composite;

III. Glass Ionomer; and

IV. Mercury.

(III) Principles of cavity preparation on anterior and posterior class I, II, III, IV, and V teeth;

(IV) Instrumentation for all restorations;

(V) Liners and bases, types and placement;

(ii) Second Week - The second (2nd) week of the course must be a minimum of thirty-two (32) hours in length and a written and/or clinical competency examination regarding items (I) through (V) is to be administered at the end of the week. No high-speed handpiece is to be used in the course, only a slow-speed handpiece:

(I) Isolation and rubber dam placement;

(II) Caries;

(III) Selection and placement of matrix retainers;

(IV) Laboratory on insertion, packing and carving (finishing) of amalgam;

(V) Insertion, packing and carving (finishing) of amalgam;

(iii) Third Week - The third (3rd) week of the course must be a minimum of thirty-two (32) hours in length and a written and/or clinical competency examination regarding items (I) through (III) is to be administered at the end of the week. No high-speed handpiece is to be used in the course, only a slow-speed handpiece:

(I) Insertion, packing and carving (finishing) of amalgam;

(II) Laboratory on insertion, packing and carving (finishing) of composite and glass ionomers;

(III) Insertion, packing and carving (finishing) of composite and glass ionomers;

(iv) In addition to the weekly competency examinations required by subparts (i), (ii) and (iii), each student must pass a clinical examination regarding insertion, packing and carving (finishing) of amalgam prior to taking the comprehensive competency examination required by subpart (vi).

(v) Each student must pass the competency examination on the material covered each week before continuing to the material for the next week. Students who do not pass the competency examination may be offered remediation before the start of the next week.

(vi) Passage of a comprehensive competency examination on all material covered in the course is required at the end of the course. This examination shall be both written and clinical.

(d) The instructor shall provide a copy of the syllabus to the student before or at the beginning of each course, setting forth the materials to be presented in the course and the evaluation criteria to be utilized by the clinical instructor to determine successful completion of the certification course.

(e) The passing grade on each competency examination is set at seventy-five percent (75%). If the student initially fails any competency examination, the exam may be taken no more than one (1) additional time before the entire course must be retaken and the exam retaken. The examination shall be developed and administered by the course instructors in such a manner as to determine competency for the restorative functions.

(f) The director/instructor of the certification course shall, within thirty (30) days after course completion, complete a form, provided by the Board, for each student to attest to the student's successful completion of the course and the student's examination grade. The completed forms shall be submitted directly to the Board's Office by the director/instructor.

(g) The certification course will issue continuing education credit hours for the course.

(h) Failure to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.02(5) (b), may subject the course provider and students to invalidation of the course results and withdrawal of course approval issued by the Board.

(6) Certification Course in Expanded Prosthetic Functions

(a) Application for Board Approval - The director of a certification course in expanded prosthetic functions shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received in the Board's administrative office at least thirty (30) days prior to the next regularly scheduled Board meeting in order for the Board to review the application. The director of the certification course will be notified in writing of the Board's action(s).

(b) Retention of Approval.

1. The certification course must be taught at an educational institution as defined in part (6) (c) 2. of this rule and shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum as set forth in this rule, as amended/may be amended, in order to obtain and/or retain Board approval.

2. The certification course shall be subject to on-site inspections by representatives of the Board and/or required to complete such paper surveys, as requested.

4. Certificates of approval shall be issued for two (2) years and shall expire on December 31st every two (2) years.

(c) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment, and Curriculum.

3. The clinical instructor-to-student ratio must be one (1) instructor to eight (8) students (1:8).

4. The certification course shall consist of a minimum of sixty-four (64) hours of study over a two (2) week period.

5. The course syllabus shall be approved by the Board and the course shall be designed and conducted to provide the student with detailed knowledge of prosthetic functions. The clinical experience must be provided under the supervision of qualified faculty, and the students must be evaluated for competency. The didactic and clinical portion of the course shall include instruction in all of the following subject matters:

(i) First Week - The first (1st) week of the course must be a minimum of thirty-two (32) hours in length and a competency examination is to be administered at the end of the week regarding:

(I) Anatomy and physiology;

(II) Dentulous soft tissue including the gingival sulcus and its management;

(III) Edentulous soft tissue;

(IV) Physiologic function of these tissues and the principles of soft tissue management;

(V) Occlusion for fixed and removable appliances;

(VI) Tray selection and impression materials of models;

(VII) Border molding and master impressions, including a live patient experience;

(VIII) Tray selection;

I. Custom;

II. Stock;

III. Triple tray; and

IV. Construction and fitting.

(IX) Fixed prosthodontic impressions;

I. Full mouth;

II. Quadrant; and

III. Individual.

(ii) Second Week - The second (2nd) week of the course must be a minimum of thirty-two (32) hours in length and a competency examination is to be administered at the end of the week regarding:

(I) Gingival retraction;

(II) Mechanisms of gingival retraction;

(III) Types and size of cord;

(IV) Pharmacology of medicaments used and the techniques for placement;

(V) Practice placement;

(VI) Techniques of making impressions;

(VII) Laboratory practice for fixed impressions including infection control;

(VIII) Temporary restorations and laboratory technique for each;

I. Aluminum;

II. Polycarbonate; and

III. Custom.

(IX) Fabrication, polishing and placement of temporary restorations;

I. Anterior; and

II. Posterior.

(iii) Each student must pass the competency examination on the material covered before continuing to the material for the next week. Students who do not pass the competency examination may be offered remediation; and

(iv) Passage of a comprehensive competency examination on all material covered in the course is required at the end of the course.

(g) The certification course will issue continuing education credit hours for the course.

(h) Failure to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.03(6) (b), may subject the course provider and students to invalidation of the course results and withdrawal of course approval issued by the Board.

(7) Certification Course in Dental Radiology

(b) Application for Board Approval - The owner and/or director of a certification course in dental radiology shall make application for approval to operate that course of study on forms to be provided by the Board. The completed application must be received in the Board's Office at least thirty (30) days prior to the next regularly scheduled Board meeting in order for the Board to review the application. The owner and/or director of the certification course will be notified in writing of the Board's action. This section shall not apply to ADA accredited and Board-approved dental assisting programs who provide dental radiology instruction in accordance with ADA accreditation standards or the Board-approved 116 hour dental assistant curriculum, with the exception of (e), (f) and (g) of this section.

(c) Retention of Approval.

1. The certification course shall maintain strict compliance with all minimum standards for admissions, facilities, instructor(s), equipment, and curriculum as set forth in this rule, as amended/may be amended, in order to obtain and/or retain Board approval.

2. The certification course shall be subject to on-site inspections by representatives of the Board and/or required to complete such paper surveys, as requested.

4. Certificates of approval shall be issued for one (1) year and shall expire on December 31st of any given year.

(d) Minimum Standards for Admissions, Facilities, Instructor(s), Equipment and Curriculum.

1. The certification course shall admit only those registered dental assistants who are currently registered pursuant to Rule 0460-04-.01(2). It is the responsibility of the course owner/director to ensure that only currently registered dental assistants are admitted to the course.

2. The certification course shall be taught by a dentist who is licensed in good standing by the Tennessee Board of Dentistry. The dentist/clinical instructor may employ and/or utilize licensed dental hygienists or registered dental assistants certified in dental radiology to assist during the clinical portion of the course.

3. The class shall be limited to forty (40) students and the clinical instructor-to-student ratio must be no less than one (1) instructor to eight (8) students (1:8) for the clinical portion of the course.

4. The certification course shall consist of a minimum of fourteen (14) hours of study. The course syllabus must be approved by the Board and this didactic course shall be designed and conducted to provide the student with detailed knowledge of dental radiology including radiation health and safety and its application to dentistry. The course shall include instruction in all of the following subject matters:

(i) Expose and evaluate

(I) Select appropriate radiographic technique.

(II) Select appropriate radiographic film to examine, view, or survey conditions, teeth or landmarks.

(III) Select appropriate equipment for radiographic techniques.

(IV) Select patient management techniques before, during and after radiographic exposures.

(ii) Radiation Safety

(I) Patient.

(II) Operator.

(iii) Quality Assurance

(I) Identify exposure errors and ways to avoid these errors in future exposures.

(II) Identify processing errors and ways to avoid these errors.

(III) Correctly mount and label radiographs for diagnostic assessment.

(e) Upon completion of the course, students shall be evaluated by written examination. The passing grade shall be seventy percent (70%). If the student initially fails the written examination, the exam may be taken no more than two (2) additional times before the course must be retaken and the exam retaken. The examination shall be developed and administered by the course director/instructor in such a manner as to determine competency in dental radiology. This also applies to ADA accredited and Board approved dental assisting programs that provide dental radiology instruction in accordance with ADA accreditation standards or the Board-approved 116 hour dental assistant curriculum.

(f) The certification course, or dental assisting school, will issue continuing education credit hours for the course.

(g) The director/instructor of the certification course or dental assisting program shall, within thirty (30) days after course completion or upon completion of the dental radiology portion of the ADA accredited or Board-approved dental assisting program , complete a form, provided by the Board, for each student to attest to the student's successful completion of the course or dental radiology portion and the student's examination grade. The completed forms shall be submitted directly to the Board's office by the director/instructor.

(h) Failure to adhere to the rules governing the certification course or to provide access to inspection, pursuant to Rule 0460-05-.03(7) (c), may subject the course provider and students to invalidation of the course results and withdrawal of course approval issued by the Board.

Tenn. Comp. R. & Regs. 0460-05-.03

Original rule certified June 7, 1974. Amendment filed August 26, 1980; effective December 1, 1980. Repeal and new rule filed December 11, 1991; effective January 25, 1992. Repeal filed February 12, 1996; effective April 27, 1996. New rule filed September 17, 2003; effective December 1, 2003. Amendment filed August 3, 2005; effective October 17, 2005. Amendment filed October 12, 2007; effective December 26, 2007. Amendment filed September 25, 2008; effective December 9, 2008. Amendment filed October 22, 2010; effective January 20, 2011. Amendment filed December 20, 2011; effective March 19, 2012. Amendments filed September 30, 2014; effective December 29, 2014. Amendments filed January 31, 2017; effective 5/1/2017.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-107, 63-5-108, 63-5-111, 63-5-115, and 63-5-116.