1. The Board shall, upon application by a dental hygienist who is licensed pursuant to this chapter and has such qualifications as the Board specifies by regulation, issue a special endorsement of the license allowing the dental hygienist to practice public health dental hygiene. The special endorsement may be renewed biennially upon the renewal of the license of the dental hygienist. 2. Except as otherwise provided in subsections 4 and 5, a dental hygienist who holds a special endorsement issued pursuant to subsection 1 may provide services without the authorization or supervision of a dentist only as specified by regulations adopted by the Board. 3. As part of a program for the provision of public health dental hygiene approved by the Board, a dental hygienist with a special endorsement to practice public health dental hygiene may authorize a dental assistant or expanded function dental assistant under his or her direct supervision to: (a) Apply dental sealants; (b) Apply topical fluoride; (c) Perform coronal polishing; (d) Take radiographs; and (e) Provide oral health education. 4. Except as otherwise provided in subsection 6, a dental hygienist who holds a special endorsement issued pursuant to subsection 1 may perform the services set forth in subsection 5 without supervision by a dentist and without authorization from the licensed dentist of the patient on whom the services are to be performed, if: (a) The services are performed at a health facility, a school or a place in this State approved by the Board; and (b) The Board approves the treatment protocol submitted by the dental hygienist which includes an explanation of the methods that the dental hygienist will use to: (1) Treat patients; and (2) Refer patients to a dentist for: (I) Follow-up care; (II) Diagnostic services; and (III) Any service that the dental hygienist is not authorized to perform. 5. In compliance with the requirements of subsection 4, a dental hygienist described in subsection 4 may: (a) Expose radiographs. (b) Conduct an assessment of the oral health of the patient through medical and dental histories, radiographs, indices, risk assessments and intraoral and extraoral procedures that analyze and identify the oral health needs and problems of the patient. (c) After conducting an assessment pursuant to paragraph (b), develop a dental hygiene care plan to address the oral health needs and problems of the patient described in paragraph (b). (d) Provide dental hygiene care that includes: (1) Implementation of a dental hygiene care plan described in paragraph (c). (2) Evaluation of oral and periodontal health after the implementation of the dental hygiene care plan as described in subparagraph (1) in order to identify the subsequent treatment, continued care and referral needs of the patient. (e) Remove stains, deposits and accretions, including dental calculus. (f) Smooth the natural and restored surface of a tooth by using the procedures and instruments commonly used in oral prophylaxis, except that an abrasive stone, disc or bur may be used only to polish a restoration. (g) Take the following type of impressions: (1) Those used for the preparation of diagnostic models; (2) Those used for the fabrication of temporary crowns or bridges; and (3) Those used for the fabrication of temporary removable appliances, provided no missing teeth are replaced by those appliances. (h) Perform subgingival curettage. (i) Remove sutures. (j) Place and remove a periodontal pack. (k) Remove excess cement from cemented restorations and orthodontic appliances. A dental hygienist may not use a rotary cutting instrument to remove excess cement from restorations or orthodontic appliances. (l) Train and instruct persons in the techniques of oral hygiene and preventative procedures. (m) Recement and repair temporary crowns and bridges. (n) Recement permanent crowns and bridges with nonpermanent material as a palliative treatment. (o) Place a temporary restoration with nonpermanent material as a palliative treatment. (p) Administer local intraoral chemotherapeutic agents in any form except aerosol, including, but not limited to: (1) Antimicrobial agents; (2) Fluoride preparations; (3) Topical antibiotics; and (4) Topical desensitizing agents. (q) Apply pit and fissure sealant to the dentition for the prevention of decay. 6. The Board may suspend or revoke the authorization described in subsection 4 if the: (a) Dental hygienist fails to renew his or her license or it is canceled, suspended or revoked; (b) Board receives a complaint filed against the dental hygienist; (c) Dental hygienist commits an act which constitutes a cause for disciplinary action; or (d) Dental hygienist violates any provision of this chapter or the regulations adopted pursuant thereto. Nothing in this subsection prohibits a dental hygienist from applying for reinstatement of the authorization to perform the services described in subsection 4 if the Board suspends or revokes the authorization pursuant to this subsection. 7. As used in this section: (a) Health care facility has the meaning ascribed to it in NRS 162A.740 . (b) Health facility has the meaning ascribed to it in NRS 449.260 . (c) Oral prophylaxis means the preventive dental procedure of scaling and polishing which includes the removal of calculus, soft deposits, plaques and stains and the smoothing of unattached tooth surfaces in order to create an environment in which hard and soft tissues can be maintained in good health by the patient. (d) School means an elementary, secondary or postsecondary educational facility, public or private, in this State.
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