9005 SCOPE OF PRACTICE OF REGISTERED DENTAL ASSISTANT

9005.1 Subject to the restrictions set forth in this section 9005, a dentist may delegate to a 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.

9005.2 Except as provided in subsection 9005.3 of this chapter, a dental assistant shall not place or expose dental x-ray film unless he or she has:

1. (a) Satisfactorily completed a radiation course or examination recognized by the American Dental Association Continuing Education Recognition Program (CERP);
2. (b) Been certified by the American Registry of Radiologic Technologists;
3. (c) Satisfactorily completed a radiation course and passed an examination given by the Dental Assisting National Board; or
4. (d) Been grandfathered in pursuant to the following section.

9005.3 A dentist may permit an assistant who does not meet the requirements of subsection 9005.2 to place or expose dental x-ray film if:

1. (a) The assistant has completed in-office training;
2. (b) The assistant has demonstrated competency to perform the task to the supervising dentist's satisfaction; and
3. (c) The assistant registers within twelve (12) months of the effective date of this chapter.

9005.4 Except as provided in subsection 9005.5 of this chapter, the following dental procedures shall only be delegated to a dental assistant who:

1. (a) Has satisfactorily completed a training program approved by CERP-approved program, a training program or course recognized by the American Dental Association Commission on Dental Accreditation (CODA); and
2. (b) Performs the tasks under direct supervision with the supervising dentist checking and approving the completed task prior to dismissal of the patient from the office:

(1) Placement of retraction cord;

(2) Placement or removal of matrices;

(3) The application of a medicinal agent to a tooth for a prophylactic purpose;

(4) Placement of periodontal dressings;

(5) Removal of temporary restorations without the use of a rotary instrument;

(6) Removal of sutures; and

(7) Whitening.

9005.5 A dentist may delegate performance of a task set forth in subsection 9005.4 of this chapter to a dental assistant who does not meet the training requirements in subsection 9005.4(1), if:

(a) The assistant had been performing the task on the effective date of these regulations;

(b) The assistant has demonstrated competency to perform the task to the supervising dentist's satisfaction; and

(c) The assistant registers within twelve (12) months of the effective date of these regulations.

9005.6 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 intraoral polishing of a tooth or a restoration;

(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) The application of pit and fissure sealants;

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

(i) Administration of local anesthesia with board identified criteria and certification;

(j) Administration of nitrous oxide with board identified criteria and certification;

(k) Placement of temporary restorations; or

(l) Taking final impressions.

SOURCE: Notice of Final Rulemaking published at 58 DCR 852, 5853 (July 15, 2011).