Dental Examiners, Board of

Dental Examiners, Board of

Chapter 7: Dental Auxiliaries

Effective Date: 05/29/2024 to Current

Rule Type: Current Rules & Regulations

Reference Number: 034.0001.7.05292024

CHAPTER 7

DENTAL AUXILIARIES

Section 1. Authority. The Board is authorized under Wyoming Statute 33-15-119, 33-15-129(a), 33-15-123, and the WAPA to promulgate rules and regulations related to the application and licensure procedures to practice of dental hygiene and dental auxiliaries in Wyoming.

Section 2. Statement of Purpose. These Board Rules are adopted to implement the Board's authority to regulate the practice of dental hygiene and other dental auxiliaries.

Section 3. Dental Auxiliary Personnel. Except as otherwise provided, dental auxiliary personnel shall not perform irreversible procedures.

Section 4. Practice of Dental Hygiene.

(a) The dental hygienist shall:

(i) Work under the supervision of a Wyoming licensed dentist; and

(ii) Be responsible for maintaining a high degree of proficiency in the practice of dental hygiene that is consistent with current educational standards of the profession.

(b) Dental hygienists may work in the private office of a licensed dentist, in the Armed Forces of the United States, in federal or state institutions, in public health settings, and nursing or retirement facilities.

(c) Dental hygienists are encouraged to promote oral health. They may accomplish this through presentations to schools, institutions, groups, or individuals. In no event should these presentations be used for the purpose of advertising or soliciting patients for himself/herself or a dentist.

Section 5. Supervision of Procedures Performed by the Dental Hygienist.

(a) General Supervision. The following procedures require general supervision:

(i) Community dental health activities which includes public health services at federally funded health centers and clinics; nursing homes; extended care facilities; home health agencies; group homes for the elderly, disabled and youth; public health offices; Women, Infants, and Children; Head Start programs; child development programs; early intervention programs; migrant work facilities; free clinics; health fairs; public and private schools; state and county correctional institutions; community school-based prevention programs; and public health vans.

(A) Public health services solely consist of prophylaxis, topical fluoride applications, oral health education, and dental screenings. These services can be provided by the hygienist without prior authorization of the dentist. All patients seen shall be referred to a dentist annually.

(B) The hygienist shall maintain a Collaboration Agreement with a Wyoming licensed dentist. The hygienist must have a current Wyoming dental hygienist license with a minimum of two (2) years clinical experience.

1. (ii) Duties authorized for dental assistants set forth in the Board Rules;
2. (iii) Root plane, scale and polish teeth;
3. (iv) Polish amalgams and composites;
4. (v) Screen the oral cavity for disease;
5. (vi) Place temporary fillings that require no removal of tooth structure;
6. (vii) Place, expose, and process radiographic images;
7. (viii) Place pit and fissure sealants and silver diamine fluoride; and
8. (ix) Apply subgingival topical anesthetic (i.e. Oraqix).(b) Direct Supervision. The following procedures require direct supervision:- (i) Prepare, place, and remove periodontal packs;
9. (ii) Remove overhanging margins;
10. (iii) Treat diagnosed dry sockets;
11. (iv) Treat diagnosed pericoronitis;
12. (v) Perform whitening procedures; and
13. (vi) Perform expanded dental duties.

Section 6. Expanded Duties Permits.

(a) Permit. To obtain an expanded duties permit, a dental hygienist shall meet educational standards, or pass an examination approved by the Board, or both. Applicant shall submit a completed application for each duty.

(b) Training Course Approval.

(i) Training programs shall be approved in advance in writing by the Board. All expanded duty courses must contain an examination or competency assessment. Due to the varied programs, individual courses shall require individual approval after course content is reviewed by the Board.

(ii) Applicant shall provide evidence of satisfactory completion of each expanded duties course.

(iii) An applicant for soft tissue laser shall complete and provide proof of training that covers a minimum of twelve (12) hours of laser physics, safety, and appropriate use, to include a hands-on component, didactic testing component and laser (hands on) assessment component, prior to applying for a permit. The training shall meet the following requirements:

(A) The course shall be provided or recognized by any of the following organizations (or successor organization):

(I) CODA accredited institution:

(II) ADA Continuing Education Recognition Program (CERP);

(III) The Academy of General Dentistry (AGD) Program Approval for Continuing Education (PACE); or

(IV) The Academy of Laser Dentistry.

(B) The course must have a hands-on component and may not be online only.

(C) The course must also require the applicant to have completed a live and interactive training that addressed operations of the specific laser(s) utilized in the practice.

(iv) An in-person evaluation for an expanded duties permit may be required by the Board to ascertain the applicant’s knowledge of the expanded duties that the applicant wishes to be permitted to perform.

(c) Expanded Duties. The following may be performed by a dental hygienist with an appropriate expanded duties permit:

(i) Administer local anesthetics via injection;

(ii) Administer and monitor nitrous oxide/oxygen; or

(iii) Use soft tissue lasers to provide tissue therapy within the dental hygienists scope of practice.

(A) All lasers must be used in accordance with accepted safety guidelines.

(B) When utilizing a laser, the dental hygienist shall document the following, at a minimum:

(I) Type of Laser, including wavelength;

(II) Settings used (pulse or continuous wavelength, power setting); and

(III) Procedure performed with details including size and location (Herpetic lesions, Aphthous Ulcers, Perio debridement).

Section 7. Dental Assistants. The following applies to all dental assistants:

(a) Dental Assistant. A dentist holding a current Wyoming license may employ persons designated as “Dental Assistants.” They may be trained by their employer or by an accredited or Board approved program for dental assistants.

(b) General Supervision. The following procedures require general supervision:

(i) Take vital statistics and health histories;

(ii) Instruct patients in proper dental health care;

(iii) Process radiographs;

(iv) Fabricate and cement temporary crowns;

(v) Replace ligature wires and/or place elastic ties;

(vi) Remove ligature wire and/or elastic ties;

(vii) Place and remove orthodontic separators;

(viii) Remove broken bands, brackets, wires and appliances in emergency situations or as needed for operative or prophylactic purposes; and

(ix) Place and expose x-ray image receptors (either film or digital) with a dentist’s order, either verbal or written.

(c) Indirect Supervision. The following procedures require indirect supervision:

(i) Take impressions other than final or master impressions and/or digital scan impressions;

1. (ii) Apply topical medications, excluding pit and fissure sealants and silver diamine fluoride;
2. (iii) Mix dental materials to be used by the dentist; and
3. (iv) Insert arch wires that have been adjusted by the dentist into the brackets or attachments and secured in place.(d) Direct Supervision. The following procedures require direct supervision:- (i) Remove sutures;
4. (ii) Assist the dentist in all operative and surgical procedures;
5. (iii) Place and remove rubber dams;
6. (iv) Place and remove matrices;
7. (v) Remove excess cement from the coronal surfaces of the teeth;
8. (vi) Prepare and remove periodontal packs;
9. (vii) Polish the coronal surfaces of the teeth, rubber cup only, but not for the purpose of prophylaxis.
10. (viii) Perform whitening procedures;
11. (ix) Place and remove orthodontic wires and/or appliances that have been activated by the dentist;
12. (x) Take impressions for orthodontic procedures, i.e. retainers and removable appliances;
13. (xi) Remove direct bond attachments and bands;
14. (xii) Place pit and fissure sealants; and
15. (xiii) Treat diagnosed dry socket.(e) Prohibitions. The following procedures may not be performed by dental assistants:- (i) Remove tooth structure;
16. (ii) Diagnose for treatment;

(iii) Take final impressions either digital or conventional or deliver a permanent prosthesis of any type; (iv) Any procedure billed as a dental prophylaxis; (v) Use high speed handpiece intraorally; or (vi) Use low speed handpiece intraorally, except for coronal polishing.

Section 8. Exposure of Radiographic Images by Dental Assistants.

(a) Eligibility. An applicant may seek a permit to expose dental radiographs under the general supervision of a dentist, if the applicant demonstrates competency.

(b) Application Requirements. Applicant shall:

(i) Submit a completed application and payment of fee; and (ii) Demonstrate competency by submitting evidence the applicant has:

(A) Completed a course or examination in dental radiography within one (1) year immediately prior to the date of application that meets one of the following:

(I) A radiograph course from a CODA accredited program; (II) The DANB RHS Examination; (III) A radiograph training course administered by a state dental association; or

(IV) A curriculum of at least eight hours, which includes a competency assessment or examination and cover the following subjects:

(1.) Dental nomenclature; (2.) Machine operation exposure factors; (3.) Operator and patient safety; (4.) Practical or clinical experience in: a. Appropriate film handling, storage, and processing procedures when it applies.

b. Appropriate patient record documentation for radiographic images; or

(B) Been authorized to expose dental radiographs in another jurisdiction within the last five (5) years.

(c) Renewal. A permit to expose radiographs shall expire December 31 every second year, unless renewed.

(d) Late Renewal. A permit to expose radiographs that was not timely renewed may be renewed within five (5) years of the date the permit expired by submitting a late renewal application and the late fee. After five (5) years, the assistant must reapply and document completion of a new radiography course that meets the requirements in Section 8(a)(ii)(A) within one (1) year immediately prior to the date of application.

Section 9. Placement of Pit and Fissure Sealants by Dental Assistants.

(a) Eligibility. An applicant may apply for a pit and fissure sealant permit if the applicant has successfully completed a Board approved course which may include:

(i) Board approved course meeting the requirements identified in subsection (c); or

(ii) CODA accredited dental hygiene program or a dental assisting program.

(b) Application Requirements. Applicant shall submit:

(i) Completed application and payment of fee; and

(ii) Completed checklist demonstrating competency and completion of course within one (1) year immediately prior to the date of application.

(c) Education. The education program shall include:

(i) Didactic Education including:

(A) Infection Control;

(B) Microbiology;

(C) Chemistry;

(D) Dental anatomy;

(E) Ethics related to pit and fissure sealant application;

(F) Jurisprudence related to pit and fissure sealant application; and

(ii) Clinical Instruction including supervised application of sealants.

(d) Renewal. A permit to place pit and fissure sealants shall expire December 31 every second year, unless renewed.

(e) Late Renewal. A permit to place pit and fissure sealants that was not timely renewed may be renewed within five (5) years of the date the permit expired by submitting a late renewal application and the late fee. After five (5) years, the assistant must reapply and document completion of a new pit and fissure training course within one (1) year immediately prior to the date of application.

Section 10. Code of Ethics for Dental Hygienists and Dental Assistants. Each dental hygienist and dental assistant practicing in the state of Wyoming shall:

(a) Provide oral health care utilizing highest professional knowledge, judgment, and ability;

(b) Serve all patients without discrimination;

(c) Hold professional patient relationships in confidence;

(d) Utilize every opportunity to increase public understanding of oral health practices;

(e) Generate public confidence in members of the dental health profession;

(f) Cooperate with all health professions in meeting the health needs of the public;

(g) Recognize and uphold the laws and regulations governing this profession;

(h) Maintain professional competence through continuing education;

(i) Exchange professional knowledge with other health professions;

(j) Represent dental hygiene and/or dental assisting with high standards of personal conduct; and

(k) Comply with the provisions of ADHA’s Code of Ethics or Dental Assisting National Board’s Code of Professional Conduct as referenced in Chapter 1.