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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 195. Board of Dentistry |
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Chapter 15. Duties for Dental Assistants and the Rules Regulating the Practice of Dental Hygiene |
SECTION 195:15-1-4. Expanded duty permits for dental assistants; fees
Latest version.
- (a) It is the determination of the Board that certain duties may be performed by a dental assistant who has satisfactorily completed a course of study regarding the performance of such duties. Applicants who successfully complete recognized expanded duty training at a formal dental assisting program approved by the Board and the Commission on Dental Accreditation of the American Dental Association shall be eligible for permits. Pursuant to paragraph 9 of subsection B of 59 O.S., Section 328.15, the Board hereby establishes four (4) expanded duty permits for dental assistants with definitions, requirements, and course guidelines as follows:(1) Radiation Safety.(A) Definition: A dental assistant holding this expanded duty permit may expose intra-oral and extraoral radiographs.(B) Requirement: Satisfactory completion of a course of study in radiation safety and protection, consisting of a minimum of seven (7) hours, approved by the Board. After satisfactory completion of the course of study, each applicant shall submit written verification from the applicant's current employing dentist attesting to competent clinical experience. All applications shall contain both signatures of the employing dentist and the student.(C) Course Guidelines:(i) Minimum standards for courses to train dental assistants to expose intra-oral and extraoral radiographs are as follows:(I) The instruction level shall meet level 4 of the Board's Guide to Curriculum Development for Expanded Duties.(II) Courses shall be taught by licensed dentists, licensed dental hygienists or dental assistants who have been issued expanded duty permits in radiation safety by the Board. Further, instructors shall have a minimum of one year of experience exposing radiographs.(III) The course shall be a minimum of seven (7) hours in length for the instructional portion.(IV) Expanded duty permits will require a clinical portion in which each student shall complete 200 radiographs, no more than five can be panoramic, as certified by employing dentist.(ii) The course shall be designed and conducted to provide each student with a thorough knowledge about the exposure of radiographs. Upon completion of the course, students shall be able to apply this knowledge to expose radiographs safely as instructed.(iii) The instruction portion of the course shall include instruction in:(I) Radiation physics;(II) Radiation biology;(III) Radiation health, safety and protection;(IV) Radiographic films and film quality;(V) Principles of radiographic techniques;(VI) Darkroom and processing techniques;(VII) Film mounting.(iv) Students shall be provided a course outline setting forth materials to be presented in the course and evaluation criteria established by the course provider for the course.(v) At one point during the course and upon completion of the class, students shall be evaluated by the course presenters by written examination. The examination shall cover the didactic portion of the course. Each student's written examinations shall be maintained by the course provider for a minimum period of one (1) year following completion of the examination. Each course provider shall, prior to beginning a course, allow a member of the Board or its designee to review the examination. The passing grade is set at 70%.(vi) Each course provider shall, within thirty (30) days after completion of a course, submit to the Board a list of the names of each of the students at the course and each student's final grade in the course.(vii) The course provider shall create and maintain records on each student, including test score for a one (1) year period. The director of the educational portion of the program shall sign a statement in the scholastic record attesting to the student's proficiency in the expanded duty.(viii) Courses offered pursuant to this rule are subject to unannounced audits by the Board. Any Board member or designee of the Board shall be provided full access to course materials or the classroom or clinic during instruction. Failure to provide access pursuant to this provision may subject the provider to invalidation of course results.(2) Coronal Polishing/Topical Fluoride.(A) Definition: A dental assistant holding this expanded duty permit may:(i) polish coronal surfaces of teeth, or prepare teeth for band cementation or bonding of brackets utilizing a slow speed rotary hand piece and rubber cup or brush (examination for calculus and scaling must be done by a dentist or dental hygienist), and(ii) apply topical fluoride and desensitizing agents.(B) Requirement: Satisfactory completion of a course of study, including a clinical component, in coronal polishing and the application of topical fluoride and desensitizing agents, consisting of a minimum of fourteen (14) hours, approved by the Board.(C) Course Guidelines:(i) For the purposes of this section, training necessary to prepare teeth for band cementation is accomplished by proper training in coronal polishing, as set forth in this section. Training for coronal polishing and applying topical fluoride and desensitizing agents shall be undertaken only in a single course which complies with all provisions of this section. Minimum standards for courses to train dental assistants to perform coronal polishing or to apply topical fluoride or desensitizing agents are as follows:(I) The course shall be open only to applicants with a minimum of one year of active chair side experience as a dental assistant, of which no less than six (6) months shall be in any one practice.(II) The instruction level shall meet level 4 of the Board's Guide to Curriculum Development.(III) The course shall be taught by licensed dentists, licensed dental hygienists or dental assistants who have been issued expanded duty permits in coronal polishing/topical fluoride or preparing teeth for band cementation by the Board. Dental assistants shall not conduct didactic portions of the class, but may undertake clinical training or evaluation.(IV) The course shall be a minimum of fourteen (14) hours in length for the instructional portion.(ii) The course shall be designed and conducted to provide each student the ability to manipulate polishing instruments correctly and remove all plaque and extrinsic stains that do not require scaling from the exposed surfaces of teeth without trauma to the teeth or gingiva. The course shall further provide each student with necessary knowledge about currently accepted topical fluoride and desensitizing agents and the ability to apply such fluoride agents to accomplish caries prevention.(iii) The didactic portion of the course shall include instruction in:(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 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;(XIII) Principles of application techniques, including the selection and care of armamentarium, the isolation of teeth, adaptation of trays, techniques and precautions.(iv) The clinical portion of the course shall include hands on experience in:(I) Identifying calculus, plaque, and intrinsic and extrinsic stains;(II) Polishing exposed surfaces of teeth;(III) Applying disclosing agents to the exposed surface 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;(VIII) Applying various desensitizing agents.(v) Students shall be provided a course outline setting forth materials to be presented in the course and evaluation criteria by the course provider for the course.(vi) The course shall include jurisprudence aspects, as follow:(I) Legal limitations of dental assistants;(II) Limitations on assistant services;(III) Penalties for violation of the State Dental Act or rules of the Board;(IV) Mechanisms by which a person can report violations of the State Dental Act or rules of the Board to the Board.(vii) The course provider shall conduct clinical experience of at least two (2) hours, including at least a one-half hour demonstration by an instructor. The clinical experience shall include all significant portions of the didactic instruction. Student/Faculty ratio shall be no greater than 1-6 on all clinical requirements.(viii) Upon completion of the course, students shall be evaluated by written examination. The examination shall cover the didactic portion of the course. The passing grade is set at 70%. A student who fails the examination may retake the examination no more than two (2) times. In the event a student takes the examination three (3) times and fails each time, the student shall not sit for the examination for a period of one (1) year. At that time, the student may retake the course and retake the examination pursuant to this rule. Results of the examination shall be retained by the course provider for a minimum period of one (1) year following successful completion of the examination. Each course provider shall, prior to beginning a course, allow a member of the Board or its designee to review the examinations.(ix) Each course provider shall, within thirty (30) days after completion of a course, submit to the Board a list of the names of each of the students at the course and each student's final grade in the course.(x) The course provider shall create and maintain records on each student, including test score of clinical testing, in the clinical test for a one (1) year period. The director of the educational portion of the program shall sign a statement in the scholastic record attesting to the student's proficiency in the expanded duty.(xi) Courses offered pursuant to this section are subject to unannounced audits by the Board. Any Board member or designee shall be provided full access to course materials or the classroom or clinic during instruction. Failure to provide access may subject the course provider to invalidation of course results.(3) Sealants.(A) Definition: A dental assistant holding this expanded duty permit may place pit and fissure sealants.(B) Requirement: Satisfactory completion of a course of study in the placement of pit and fissure sealants, consisting of a minimum of twelve (12) hours, approved by the Board. A dental assistant must hold a current expanded duty permit in Coronal Polishing/Topical Fluoride prior to enrolling in a course of study in the placement of pit and fissure sealants.(C) Course Guidelines:(i) Minimum standards to train dental assistants in the placement of pit and fissures sealants are as follows(I) The instruction level shall meet level 4 of the Board's Guide to Curriculum Development for Expanded Duties.(II) Courses shall be taught by licensed dentists or dental hygienists. Instructors shall have a minimum of one year clinical experience in the placement of pit and fissure sealants.(III) The course shall be a minimum of twelve (12) hours in length.(IV) Expanded duty permits will require a clinical portion in which each student shall complete pit and fissure sealants on at least four teeth on at least one patient.(V) Each applicant who completes the clinical portion will be required to submit verification from employing dentist that he/she has completed eight additional sealants on patients under the direct supervision in a dental office. Verification shall be submitted within one year of completion of the course.(VI) Applicants shall have a minimum of one year clinical experience as a dental assistant.(ii) The Course shall be designed to provide the student with a thorough knowledge of placement of pit and fissure sealants.(iii) The didactic portion of the course shall include instruction in(I) Indication/contraindications for sealants;(II) Preparation of teeth for sealants;(III) Proper isolation of teeth for sealants;(IV) Education of patient and/or parent regarding sealants;(V) Dental materials;(VI) Infection control;(VII) Tooth anatomy; and(VIII) Armamentarium;(iv) The clinical portion of the course shall include:(I) Patient assessment;(II) Proper tooth isolation and preparation for sealants;(III) Infection control;(IV) Evaluation of proper technique in the placement of sealants;(V) Evaluation by instructors of completed sealants; and(VI) Patient education;(v) The clinical experience shall be at least five (5) hours, including a one (1) hour demonstration by an instructor. The clinical experience shall include all applicable portions of the didactic instruction. Each student shall complete eight sealants on eight additional teeth. Student/faculty ratio shall be no greater than 1-6 on all clinical requirements.(vi) Upon completion of the course, students shall be evaluated by written examination. The passing grade is set at 70%. A student who fails the examination may retake the examination no more than two (2) times. In the event a student takes the examination three (3) times and fails, the student shall not sit for the examination again for at least one (1) year. At that time the student may retake the course and retake the examination pursuant to this rule.(vii) Each course provider shall, within thirty (30) days after completion of a course, submit to the Board a list of the names of each student attending the course and each student's final grades.(viii) The course provider shall create and maintain records on each student, including all test scores for one (1) year. The director of the educational program shall sign a statement in the scholastic record attesting to the student's proficiency in the expanded duty.(ix) Courses offered pursuant to this section are subject to unannounced audits by the Board. Any Board member or designee shall be provided full access to course materials or the classroom or clinic during instruction. Failure to provide access may subject the course provider to invalidation of course results.(4) Nitrous Oxide.(A) Definition: A dental assistant holding this expanded duty permit may assist a dentist or a dental hygienist who holds an advanced procedure permit in the administration of nitrous oxide.(B) Requirement: Satisfactory completion of a course of study in nitrous oxide administration, consisting of a minimum of twelve (12) hours, approved by the Board.(C) Course Guidelines:(i) The courses shall be open only to applicants with a minimum of one (1) year of active experience as a dental assistant.(ii) The instruction shall meet level 3 of the Board's Guide to Curriculum Development.(iii) The course shall be taught by licensed dentists or licensed dental hygienists with a minimum of one (1) year experience in teaching advanced education in comprehensive pain and anxiety control and with one (1) year of clinical experience in nitrous oxide administration.(iv) The minimum course length shall be twelve (12) hours.(v) The ratio of faculty to student shall be no greater than 1 to 10.(vi) The course shall be designed and conducted to provide the student with detailed knowledge of nitrous oxide oxygen inhalation sedation and its use in dentistry. Upon successful completion of the course, the student shall be trained to assist in the administration of nitrous oxide in an office setting safely and as needed.(vii) The didactic portion of the course shall include:(I) The history, philosophy and psychology of nitrous oxide-oxygen inhalation sedation;(II) Definition and descriptions of the physiological and psychological aspects of pain and anxiety;(III) A description of the stages of drug induced central nervous system depression through all levels of consciousness and unconsciousness, with special emphasis on the distinction between the conscious and unconscious state;(IV) The anatomy and physiology of respiration;(V) The pharmacological and physiological effects of nitrous oxide for analgesia and sedation, including physical properties, action, side effects, absorption, excretion and toxicity;(VI) The advantages and disadvantages of inhalation sedation with nitrous oxide;(VII) The management of reaction to, or complications of nitrous oxide;(VIII) Matters regarding patient status assessment, including:a. Taking and reviewing a thorough health history, including vital signs;b. Implications of health history problems related to sedation;c. Indications and contra-indications of conscious sedation;(IX) The description and use of inhalation sedation equipment;(X) Introduction of nitrous oxide to the patient;(XI) Precautions for the successful introduction of nitrous oxide to the patient;(XII) Dosages and needs of the patient;(XIII) Patient monitoring, specifically to include vital signs and reflexes related to consciousness;(XIV) Possible reaction to nitrous oxide;(XV) Return of the patient to pre-sedation status and instructions for post-operative care;(XVI) Hazards of nitrous oxide to the patient and operator;(XVII) The recognition, prevention and management of complications and life threatening situations related to nitrous oxide;(XVIII) Legal considerations of nitrous oxide; and(XIX) The introduction to potential health hazards of trace anesthetics and proposed techniques for the elimination thereof.(viii) The clinical portion of the course shall include:(I) Patient status assessment;(II) Use of various nitrous oxide machines;(III) Introduction of nitrous oxide to the patient;(IV) Monitoring of the patient;(V) Return of the patient to pre-sedation status;(VI) Post-operative care of the patient and provision of instructions to the patient; and(VII) C.P.R.(ix) The clinical experience shall be at least two (2) hours, including at least a one-half hour demonstration by an instructor. The clinical experience shall include all significant portions of the didactic instruction. When not medically inappropriate, each student shall be afforded the opportunity to experience the effects of nitrous oxide. Student/faculty ratio shall be no greater than 1-10 on all clinical requirements.(x) Upon completion of the course, students shall be evaluated by written examination. The examination shall cover the didactic portion of the course. The passing grade is set at 70%. A student who fails the examination may retake the examination no more than two (2) times. In the event a student takes the examination three (3) times and fails each time, the student shall not sit for the examination for a period of one (1) year. At that time, the student may retake the course and retake the examination pursuant to this rule. Results of the examination shall be retained by the course provider for a minimum period of one (1) year following successful completion of the examination. Each course provider shall, prior to beginning a class, allow a member of the Board or its designee to review the examinations.(xi) Each course provider shall, within thirty (30) days after completion of a course, submit to the Board a list of the names of each of the students at the course and each student's final grade in the course.(xii) The course provider shall create and maintain records on each student, including test score of clinical testing, in the clinical test for a one (1) year period. The director of the educational portion of the program shall sign a statement in the scholastic record attesting to the student's proficiency in the expanded duty.(b) An application by a dental assistant for an expanded duty permit shall be made on a form prescribed by the Board, which shall be accompanied by the fee set forth in 195: 2-1-7.(c) Except as provided in (e), an expanded duty permit shall be automatically revoked if the holder thereof fails to secure an annual renewal of the permit within three (3) months from the 31st day of December of each year.(d) The expanded duties specified in (a) may be performed by a dental assistant only on a patient of record and only under the direct supervision of a dentist.(e) Expanded duty permits for Radiation Safety need not be renewed.(f) Dental assistants performing expanded duties shall prominently display the expanded duty permit at their place of employment.(g) All students who successfully complete expanded duty courses shall have one (1) year to secure a permit. Failure to submit an application within one (1) year from the date of the course shall result in the student being denied a permit and required to retake the approved expanded duty course.(h) All expanded duty permit holders shall provide proof of current CPR provided by the American Heart Association/Health Care Provider Level or the American Red Cross/Professional Rescuer.