9004.1 Subject to the restrictions set forth in this section, a dentist may delegate to a registered dental assistant only those procedures which are:

1. (a) Appropriate to the training and experience of the dental assistant and the practice of the supervising dentist;
2. (b) Reversible; and
3. (c) To be performed under the direct supervision of the dentist.

9004.2 Level I Dental Assistant may perform the following functions under direct supervision of a dentist:

1. (a) Placing retraction cord;
2. (b) Placing matrices;
3. (c) Applying fluoride (rinse, foam tray, and fluoride varnish);
4. (d) Placing periodontal dressings;
5. (e) Removing temporary restorations without the use of a rotary instrument;
6. (f) Removing sutures;
7. (g) Taking impression for study models or diagnostic casts;
8. (h) Rinsing and aspirating the oral cavity;
9. (i) Retracting the lips, cheek, tongue, and flaps;
10. (j) Placing or removing materials for the isolation of the dentition, provided that the material is not retained by the dentition;

(k) Applying topical anesthesia;

(l) Constructing athletic mouth guards and night guards on models;

(m) Performing intraoral photography;

(n) Curing by the use of halogen light;

(o) Checking for loose bands;

(p) Whitening or bleaching using trays;

(q) Take and record vital signs; and

(r) Other functions as approved by the Board.

9004.3 Level II Dental Assistant may perform the following functions under direct supervision of a dentist:

(a) All functions permitted to Level I Dental Assistant, as enumerated in § 9004.2;

(b) Performing vitality tests;

(c) Taking alginate impressions for intraoral appliances;

(d) [Repealed];

(e) Applying desensitizing agents;

(f) Placing or removing a rubber dam;

(g) Etching;

(h) Fabricating indirect restorations in a dental office;

(i) Placing or removing a matrix band;

(j) Drying a root canal;

(k) Preparing and fitting stainless steel crowns;

(l) Preparing temporary crowns;

(m) Removing excess cement; and

(n) Removing or placing a periodontal dressing (except placing the original periodontal dressing).

9004.4 Level III Dental Assistant may perform the following functions under direct supervision of a dentist:

(a) All functions permitted to Level I Dental Assistant or Level II Dental Assistant, as enumerated in §§ 9004.2 and 9004.3;

(b) The application of pit and fissure sealants;

(c) Coronal polishing to remove stain and biofilm; and

(d) Glucose testing.

9004.5 Level I, II, or III Dental Assistant working under the direct supervision of an orthodontist may also perform the following functions:

(a) Preparing and fitting orthodontic bands;

(b) Removing excess cement from around orthodontic bands;

(c) Placing and removing arch wires;

(d) Cementing orthodontic bands, placing bonded attachments, or removing cemented or bonded orthodontic bands and attachments;

(e) Placing elastics and ligatures; and

(f) Selecting headgear.

9004.6 A dentist shall not delegate to a dental assistant any of the following procedures:

(a) Those procedures excluded by 17 DCMR § 4215.1;

(b) A preliminary dental examination;

(c) A complete prophylaxis, including the removal of any deposits, diseased crevicular tissue, accretion, or stain from the surface of a tooth or a restoration;

(d) The restoration of a tooth;

(e) The charting of cavities during preliminary examination, prophylaxis, or polishing; however, a dentist may permit an assistant to record the charting of cavities as dictated by the dentist or dental hygienist during the course of a preliminary examination or dental procedure;

(f) The instruction of individuals or groups of individuals in oral health care, unless it is in the dental office and done as instructed by the dentist;

(g) [Repealed];

(h) Diagnostic screening to identify indications of oral abnormalities;

(i) Administration of local anesthesia;

(j) Administration of nitrous oxide;

(k) Placement of temporary restorations;

(l) Taking final impressions;

1. (m) Adjusting occlusion of natural teeth, restorations, or appliances;
2. (n) Registration of jaw relations;
3. (o) Cementing permanent crowns or restorations;
4. (p) Applying silver diamine fluoride;
5. (q) Glucose monitoring;
6. (r) Whitening or bleaching (internal, laser, or high-intensity light);
7. (s) Using a high speed handpiece intraorally;
8. (t) Oral cancer screenings;
9. (u) Oral cancer tissue biopsy;
10. (v) Placing initial periodontal dressing;
11. (w) Placement of liquid dam;
12. (x) Applying and removing a socket dressing;
13. (y) Placement of subgingival medicaments;
14. (z) Removing intracoronal temporary restorations; or
15. (aa) Placing sutures.

SOURCE: Notice of Final Rulemaking published at 58 DCR 5852, 5853 (July 15, 2011); as amended by Final Rulemaking published at 60 DCR 10055 (July 12, 2013); as amended by Final Rulemaking published at 67 DCR 2217 (February 28, 2020); as amended by Final Rulemaking published at 71 DCR 002153 (March 1, 2024).