4311 ADMINISTRATION OF LOCAL ANESTHESIA AND NITROUS OXIDE BY DENTAL HYGIENISTS

4311.1 A licensed dental hygienist authorized by the District of Columbia Board of Dentistry ('Board') to administer local anesthesia or nitrous oxide pursuant to this section may administer local anesthesia or nitrous oxide in the District of Columbia.

4311.2 A licensed dental hygienist authorized by the Board to administer local anesthesia and nitrous oxide shall administer local anesthesia and nitrous oxide only under direct supervision of a dentist licensed under the Act.

4311.3 A licensed dental hygienist authorized by the Board to administer local anesthesia and nitrous oxide shall maintain current CPR certification for healthcare providers at the basic level. This training shall include use of either an automated external defibrillator or a defibrillator and electrocardiograph.

4311.4 An applicant for authorization to administer local anesthesia and nitrous oxide shall do the following:

(a) Submit a completed application and pay the required fee;

(b) Submit a copy of a valid CPR certification for healthcare providers at the basic level; and

(c) Demonstrate to the satisfaction of the Board that he or she has:

(1) Applied for licensure under this chapter as a dental hygienist, or has been issued a license under this chapter as a dental hygienist;

(2) Satisfactorily completed a training program or course of study in a formal program in the administration of local anesthesia and nitrous oxide meeting the requirements set forth in § 4311.6; and

(3) Satisfactorily completed a written examination(s) in the administration of local anesthesia and nitrous oxide administered by the Northeast Regional Board of Dental Examiners (NERB), other regional board, state board, or any agency approved by the Board.

4311.5 An applicant who is authorized to administer local anesthesia and nitrous oxide in another state may apply for authorization to administer in the District by submitting the following:

(a) A completed application and payment of the required fee;

(b) A copy of a valid CPR certification for healthcare providers at the basic level;

(c) Verification of his or her authorization to administer local anesthesia and nitrous oxide in the other state or jurisdiction; and

(d) Demonstrate to the satisfaction of the Board that he or she has:

(1) Applied for licensure under this chapter as a dental hygienist, or has been issued a license under this chapter as a dental hygienist;

(2) Satisfactorily completed a training program or course of study in a formal program in the administration of local anesthesia and nitrous oxide which

is substantially similar to the training program requirements set forth in § 4311.7; and

(3) Satisfactorily completed a written examination(s), not more than ten (10) years prior to the date of the application, in the administration of local anesthesia and nitrous oxide administered by the Northeast Regional Board of Dental Examiners (NERB), other regional board, state board, or any agency recognized by the Board.

4311.6 The training program or course of study required in § 4311.4 shall meet the following requirements:

1. (a) Be provided by a dental or dental hygiene program accredited by the Commission on Dental Accreditation of the American Dental Association; or an entity certified by the American Dental Association Continuing Education Recognition Program (CERP) which;
2. (b) Consists of a minimum of twenty (20) didactic hours and twelve (12) clinical hours; and
3. (c) Has a curriculum that includes but is not limited to the following topics:
4. (1) Anatomy of head, neck and oral cavity;
5. (2) Nitrous oxide administration;
6. (3) Recordkeeping;
7. (4) Armamentarium exercise;
8. (5) Local anesthesia and nitrous oxide;
9. (6) Neurophysiology;
10. (7) Pharmacology of local anesthetics and nitrous oxide;
11. (8) Pharmacology of vasoconstrictors;
12. (9) Potential local and systematic complications;
13. (10) Recognition and management of post-injection complications and reactions to injections;
14. (11) Contraindications;
15. (12) Medical and dental history evaluation procedures including psychological evaluation;
16. (13) Proper infection control techniques and proper disposal of sharps; and
17. (14) Hands-on practice, under direct supervision, including at least three clinical experiences in each of the following:
    1. (A) Basic injection techniques;
    2. (B) Basic placement techniques;

(C) Techniques of maxillary anesthesia;

(D) Techniques of mandibular injections; and

(E) Partner injections and partner administration of nitrous oxide;

SOURCE: Final Rulemaking published at 51 DCR 8847(September 10, 2004); as amended by Final Rulemaking published at 54 DCR 9545, 9548 (October 5, 2007).