– Delegation of duties to dental hygienist – Authorization of advanced procedures. A. A dental hygienist may practice dental hygiene under the supervision of a dentist in a dental office or treatment facility. A dentist may employ not more than the equivalent of three full-time dental hygienists for each dentist actively practicing in the same dental office. Employing the equivalent of three dental hygienists shall mean the employment or any combination of full- or part-time dental hygienists not to exceed one hundred twenty (120) hours per week per dentist. B. 1. A dentist may delegate to a dental hygienist the following procedures: a. the duties and expanded duties authorized for dental assistants by the State Dental Act or the rules of the Board of Dentistry, b. health history assessment pertaining to dental hygiene, c. dental hygiene examination and the charting of intra- oral and extra-oral conditions, which include periodontal charting, dental charting and classifying occlusion, d. dental hygiene assessment and treatment planning for procedures authorized by the supervisory dentist, e. prophylaxis, which means the removal of any and all calcareous deposits, stains, accretions, or concretions from the supragingival and subgingival surfaces of human teeth, utilizing instrumentation by scaler or periodontal curette on the crown and root surfaces of human teeth, including rotary or power- driven instruments. This paragraph shall not be construed to prohibit the use of a prophy/polishing cup or brush on the crowns of human teeth by a dental assistant who holds a current expanded duty permit for coronal polishing and topical fluoride issued by the Board, f. periodontal scaling and root planing, g. dental hygiene nutritional and dietary evaluation, h. placement of subgingival prescription drugs for prevention and treatment of periodontal disease, i. soft tissue curettage, j. placement of temporary fillings, k. removal of overhanging margins, l. dental implant maintenance, m. removal of periodontal packs, n. polishing of amalgam restorations, and o. other procedures authorized by the Board. 2. The procedures specified in subparagraphs b through o of paragraph 1 of this subsection may be performed only by a dentist or a dental hygienist. 3. Except as provided in subsections C and D of this section, the procedures specified in paragraph 1 of this subsection may be performed by a dental hygienist only on a patient of record and only under the supervision of a dentist. The advanced procedures of administration of nitrous oxide, administration of local anesthesia, neuromodulator administration, therapeutic use of lasers, and phlebotomy and venipuncture shall be performed only under the direct or indirect supervision of a dentist. The level of supervision, whether direct, indirect, or general, for the advanced procedure of elder care and public health pursuant to Section 7 of this act shall be at the discretion of the supervisory dentist. Authorization for general supervision shall be limited to a maximum of thirteen (13) months following an examination by the supervisory dentist of a patient of record. C. 1. A dentist may authorize procedures to be performed by a dental hygienist, without complying with the provisions of paragraph 3 of subsection B of this section, if: a. the dental hygienist has at least two (2) years’ experience in the practice of dental hygiene, b. the authorization to perform the procedures is in writing and signed by the dentist, and c. the procedures are performed during an initial visit to a person in a treatment facility, or pursuant to Section 7 of this act. 2. The person upon whom the procedures are performed must be referred to a dentist after completion of the procedures performed pursuant to paragraph 1 of this subsection. 3. A dental hygienist shall not perform a second set of procedures on a person pursuant to this subsection until the person has been examined and accepted for dental care by a dentist. 4. The treatment facility in which any procedure is performed by a dental hygienist pursuant to this subsection shall note each such procedure in the medical records of the person upon whom the procedure was performed and list the dentist that authorized the hygienist to perform the procedures signed by the hygienist. D. A treatment facility may employ dental hygienists whose services shall be limited to the examination of teeth and the teaching of dental hygiene or as otherwise authorized by the Board. E. The Board is authorized to prescribe, by rule, the educational requirements for advanced procedures that may be performed by a dental hygienist upon receipt of the advanced procedures designated on his or her license. The advanced procedures shall include the administration of local anesthesia, the administration of nitrous oxide analgesia, neuromodulator administration, therapeutic use of lasers, phlebotomy and venipuncture, and elder care and public health pursuant to Section 7 of this act. F. A dental hygienist shall not own or operate an independent practice of dental hygiene. G. Nothing in the State Dental Act shall be construed to prohibit a dentist from performing any of the procedures that may be performed by a dental hygienist. H. Nothing in the State Dental Act shall be construed to allow a dental assistant to work under the supervision of a dental hygienist while acting under direct, indirect or general supervision, except as provided by Section 7 of this act.
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