A registered dental assistant shall apply for a permit to perform the following duties:

1. A restorative care permitholder under the direct supervision of a dentist may perform the following restorative functions: a. Place, contour, carve, adjust, and finish direct restorative dental materials including amalgam, glass ionomer, alloy, or composite restorations. All margins must be entirely within the enamel. Permitholders may use hand instruments or a slow-speed or high-speed handpiece; b. Adapt and cement stainless steel crowns; and c. Place a temporary sedative filling.

The restorative functions only may be performed after the patient has given informed consent for the placement of the restoration by a restorative care permitholder.

Before the patient is released, the final restorations must be checked and documented by the supervising dentist.

2. A dental anesthesia assistant authorized by a class I permit and under the contiguous supervision of a dentist authorized by permit to provide moderate sedation, deep sedation, or general anesthesia may: a. Initiate and discontinue an intravenous line for a patient being prepared to receive intravenous medications, sedation or general anesthesia; b. Adjust the rate of intravenous fluids infusion only to maintain or keep the line patent or open; c. Prepare and monitor anesthesia equipment; d. Perform patient monitoring including vital signs, adverse events, and patient positioning; and e. Assist with emergency treatment and protocols, including the use of suction, automated defibrillators, and crash cart equipment.

3. A dental anesthesia assistant authorized by a class II permit and under the direct visual supervision of a dentist authorized by permit to provide moderate sedation, deep sedation, or general anesthesia may carry out all duties of a class I permitholder and: a. Draw up, label, prepare, and waste medications; b. Follow instructions to deliver medication into an intravenous line upon verbal command of the supervising dentist; c. Adjust the rate of intravenous fluids infusion beyond a keep-open rate upon verbal command of the supervising dentist; and d. Adjust an electronic device to provide medications, such as an infusion pump upon verbal command of the supervising dentist.

4. A registered dental assistant or registered dental hygienist authorized by permit and under the indirect supervision of a dentist may administer nitrous oxide analgesia to a patient who has

not taken sedative medications before treatment in accordance with subsection 2 of section 20-02-01-05.

History: Effective April 1, 2015; amended effective July 1, 2017; July 1, 2022; October 1, 2024; April 1, 2026.

General Authority: NDCC 43-20-10