Dental Examiners, Board of

Dental Examiners, Board of

Chapter 7: Dental Auxiliaries

Effective Date: 11/03/2015 to 09/26/2017

Rule Type: Superceded Rules & Regulations

Reference Number: 034.0001.7.11032015

CHAPTER 7

DENTAL AUXILIARIES

Section 1. 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 2. Dental Auxiliary Personnel. Except as otherwise provided, dental auxiliary personnel shall not perform irreversible procedures.

Section 3. Practice of Dental Hygiene.

(a) The dental hygienist shall: (i) Work under the supervision of a qualified, Wyoming licensed dentist; and (ii) Be responsible for maintaining a high degree of proficiency in the practice of dental hygiene which 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, 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 4. Supervision of Procedures Performed by the Dental Hygienist.

(a) General Supervision. The following procedures require general supervision: (i) Community dental health activities; (ii) Functions authorized for dental assistants set forth in the Board Rules ; (iii) Root plane, scale and polish teeth; (iv) Polish amalgams and composites; (v) Screen the oral cavity for disease; (vi) Place temporary fillings which require no removal of tooth structure; (vii) Place, expose and process radiographic images; (viii) Place pit and fissure sealants; and (ix) Apply subgingival anesthetic (i.e. Oraqix) if the dental hygienist holds a local anesthetic expanded functions permit.

(b) Direct Supervision. The following procedures require direct supervision:

1. (i) Prepare, place and remove periodontal packs;
2. (ii) Remove overhanging margins;
3. (iii) Treat diagnosed dry sockets;
4. (iv) Treat diagnosed pericoronitis;
5. (v) Perform whitening procedures; and
6. (vi) Perform expanded dental functions.

Section 5. Expanded Functions Permit.

(a) Permit. To obtain an expanded functions permit, a dental hygienist shall meet educational standards and pass an examination approved by the Board. Applicant shall submit a completed application.

(b) Training Course Approval.

(i) Training programs shall be approved in advance in writing by the Board. 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 the expanded functions course.

(iii) In the case of use of lasers, the applicant shall provide proof of certification from the Academy of Laser Dentistry or other Board approved program. Programs will be continually evaluated by the Board. Applicants for laser permit shall receive approval from the Board for their proposed course/program PRIOR to taking the course/program.

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

(c) Expanded Functions. The following may be performed by a dental hygienist with an expanded functions permit:

1. (i) Administer local anesthetics;
2. (ii) Administer and monitor nitrous oxide/oxygen; and/or

(iii) Use lasers to provide soft tissue therapy within the dental hygienists scope of practice. Dental hygienists shall NOT use lasers at settings intended to cut/remove hard tissue or tooth structure.

Section 6. 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:

1. (i) Take vital statistics and health histories;
2. (ii) Instruct patients in proper dental health care;
3. (iii) Process radiographs;
4. (iv) Fabricate and cement temporary crowns;
5. (v) Replace ligature wires and/or place elastic ties;
6. (vi) Remove ligature wire and/or elastic ties;
7. (vii) Place and remove orthodontic separators; and

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

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

1. (i) Take impressions other than final or master impressions and/or digital scan impressions;
2. (ii) Apply topical medications, excluding pit and fissure sealants;
3. (iii) Mix dental materials to be used by the dentist;
4. (iv) Place and expose x-ray image receptors (either film or digital); and
5. (v) 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:

1. (i) Remove sutures;
2. (ii) Assist the dentist in all operative and surgical procedures;

(iii) Place and remove rubber dams; (iv) Place and remove matrices; (v) Remove excess cement from the coronal surfaces of the teeth; (vi) Prepare and remove periodontal packs; (vii) Polish the surfaces of the teeth, rubber cup only. A procedure performed by a dental assistant under this subsection may not be billed as a prophylaxis; (viii) Perform whitening procedures; (ix) Place and remove orthodontic wires and/or appliances that have been activated by the dentist; (x) Take impressions for retainers and removable appliances; (xi) Remove direct bond attachments and bands; (xii) Place pit and fissure sealants. (e) Prohibitions. The following procedures may not be performed by dental assistants: (i) Remove tooth structure; (ii) Diagnose for treatment; (iii) Remove chemically bonded attachments; (iv) May not take final impressions either digital or conventional or deliver a permanent prosthesis of any type; or (v) Any procedure billed as a prophylaxis.

Section 7. Exposure of Radiographic Images by Dental Assistants

(a) Eligibility. An applicant may seek a permit to expose dental radiographs under the indirect 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 completion of a course or examination in dental radiography approved by the Board.

Section 8. Placement of Pit and Fissure Sealants by Dental Assistants.

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

1. (i) Board approved course meeting the requirements identified in subsection (c); or
2. (ii) CODA accredited dental hygiene program or a dental assisting program.

(b) Application Requirements. Applicant shall submit:

1. (i) Completed application and payment of fee; and
2. (ii) Completed checklist demonstrating competency and completion of course.

(c) Education. The education program shall include:

1. (i) Didactic Education including:
2. (A) Infection Control;
3. (B) Microbiology;
4. (C) Chemistry;
5. (D) Dental anatomy;
6. (E) Ethics related to pit and fissure sealant application;
7. (F) Jurisprudence related to pit and fissure sealant application; and
8. (ii) Clinical Instruction including supervised application of sealants.

Section 9. Code of Ethics for Dental Hygienists and Dental Assistants. Each dental hygienist and dental assistant practicing in the state of Wyoming shall subscribe to the following:

1. (a) To provide oral health care utilizing highest professional knowledge, judgment, and ability;
2. (b) To serve all patients without discrimination;
3. (c) To hold professional patient relationships in confidence;
4. (d) To utilize every opportunity to increase public understanding of oral health practices;
5. (e) To generate public confidence in members of the dental health profession;
6. (f) To cooperate with all health professions in meeting the health needs of the public;

(g) To recognize and uphold the laws and regulations governing this profession; (h) To maintain professional competence through continuing education; (j) To exchange professional knowledge with other health professions; (k) To represent dental hygiene and/or dental assisting with high standards of personal conduct; and (l) To 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.