4715-9-01 Permissible practices of a dental hygienist.

 

 

 

4715-9-01                    Permissible practices of a dental hygienist.

 

 

 

(A)   The dental hygienist may perform the following tasks and/or procedures under the direct supervision of a licensed dentist if the dental hygienist has completed the requirements set forth in sections 4715.23, 4715.39, and 4715.231 of the Revised Code and board rules. The dental hygienist must have completed a basic life-support training course certified by the American heart association, the American red cross or the American safety and health institute and remain current at all times when performing the following tasks and/or procedures:

 

(1)     Administration of intraoral block and infiltration local anesthesia - Upon completion of the requirements set forth in sections 4715.23 and 4715.231 of the Revised Code and rule 4715-9-01.1 of the Administrative Code, a licensed dental hygienist may administer intraoral block and infiltration local anesthesia.

 

(2)   Administration (initiate, adjust, monitor, and terminate) of nitrous oxide-oxygen (N O-O ) minimal sedation - Upon completion of the requirements set forth

2         2

in  section  4715.23  of  the  Revised  Code  and  rule  4715-9-01.2  of  the

Administrative Code, a licensed dental hygienist may administer N O-O

2         2

minimal sedation while providing treatment if the following requirements are

met:

 

(a)   The supervising dentist has evaluated the patient and prescribed the use of

N O-O

minimal sedation.

2         2

(b)   The supervising dentist must approve the use of N O-O

minimal sedation

2         2

immediately prior to each instance of administration.

(c)    The dental hygienist shall not administer N O-O

minimal sedation to

2         2

more than one patient at a time.

(d)  The dental hygienist shall physically remain with the patient at all times.

(e)   The supervising dentist approves the discharge of the patient.

(3)       Monitoring   nitrous   oxide-oxygen   (N O-O )   minimal   sedation   -   Upon

2         2

completion of the requirements set forth in sections 4715.23 and 4715.39 of

the  Revised  Code  and  rule  4715-9-01.3  of  the  Administrative  Code,  a

licensed  dental  hygienist  may  monitor  N O-O

minimal  sedation  while

2         2

providing treatment if the following requirements are met:

(a)  A satisfactory initiation phase has been administered by the dentist.

(b)   The dental hygienist shall not monitor more than one patient at a time.

(c)   The dental hygienist shall physically remain with the patient at all times.

(d)  The dental hygienist must document the supervising dentist's approval for discharge of the patient.

(e)    The dental hygienist, who is qualified to only monitor N O-O

minimal

2         2

sedation,  shall  not  under  any  circumstances  administer,  adjust,  or

terminate N O-O

minimal sedation.

2         2

The completion of all requirements for paragraphs (A)(1) to (A)(3) of this rule shall be documented on a form supplied by the board, with all supporting information attached. This form shall be maintained in the facility(s) where the dental hygienist is working.

(B)   The dental hygienist may perform the following tasks and/or procedures which may be delegated only to a licensed dental hygienist under the supervision of a licensed dentist:

(1)    Removal of calcareous deposits or accretions from the crowns and roots of teeth.

(2)   Periodontal scaling, root planing, and soft tissue curettage.

(3)   Sulcular placement of prescribed materials.

(4)     Bleaching of teeth (excluding procedures that utilize light amplification by stimulated emission of radiation (LASER) technologies).

(C)    The dental hygienist may also perform the following tasks and/or procedures under the supervision of a licensed dentist:

(1)   Polishing of the clinical crown(s) of teeth, including restorations.

(2)   Pit and fissure sealants.

(3)    Standard, diagnostic, radiologic procedures for the purpose of contributing to the provision of dental services.

(D)      In performing advanced remediable restorative intra-oral dental tasks and/or procedures, the licensed dental hygienist is subject to sections 4715.61 to 4715.66 of the Revised Code and agency level rules regulating expanded function dental auxiliaries.

(E)      In performing basic remediable intra-oral and extra-oral dental tasks and/or procedures, the licensed dental hygienist is subject to those rules regulating basic qualified personnel. However, dental hygienists may engage in the following duties when the dentist is not physically present, subject to the limitations outlined in divisions (C) and (D) of section 4715.22 of the Revised Code, which must be adhered to when performing these duties:

(1)   Aspiration and retraction, excluding placement of gingival retraction materials.

(2)   Intra-oral instrument transfer.

(3)   Preliminary charting of missing and filled teeth.

(4)     Elastomeric  impressions  for  diagnostic  models  and  models  to  be  used  for opposing models in the construction of appliances and restorations.

(5)        Taking    impressions    for    the    construction    of    custom     athletic     mouth protectors/mouthguards, and trays for application of medicaments.

(6)   Application of disclosing solutions.

(7)   Caries susceptibility testing.

(8)   Demonstration of oral hygiene procedures, including, but not limited to, use of toothbrushes and dental floss.

(9)   Application of topical anesthetics.

(10)   Fluoride application.

(11) Application of fluoride varnish.

(11)(12) Topical applications of desensitizing agents to teeth.

(12)(13) Application and removal of periodontal dressings.

(13)(14) Intra-oral bite registrations for diagnostic model articulation.

(15) Recementation of temporary crowns or the recementation of crowns with temporary cement.

(14)(16) All supportive services necessary to the maintenance of a hygienic practice environment, including, but not limited to, all sterilizing procedures.

(15)(17) All supportive services or procedures necessary to protect the physical well-being of the patient during routine treatment procedures and during periods of emergencies, including, but not limited to:

(a)   Physical positioning of the patient;

(b)   Monitoring of vital signs;

(c)   Assistance during administration of life-support activities; and

(d)   Any other non-invasive procedures deemed necessary by the supervising dentist to maintain the health and safety of the patient.

(16)(18) All non-invasive supportive services and procedures necessary to the gathering and maintaining of accurate and complete medical and dental history of the patient, including but not limited to:

(a)   Taking photographs;

(b)   Recording patient treatment;

(c)   Measurement of blood pressure and body temperature; and

(d)  Other common tests deemed necessary by the supervising dentist.

(17)(19) All extra-oral supportive laboratory procedures, including, but not limited to:

(a)     Repair,  construction  and  finishing  of  metallic  and  plastic  prosthetic devises; and

(b)    Compilation of radiographic data for interpretation by the dentist, i.e., tracings, etc.

(18)(20) The preparation of impression materials.

(19)(21) All patient education services, including, but not limited to:

(a)   Progress reports;

(b)   Consultations (oral or written);

(c)   Oral hygiene instructions;

(d)  Use of intra-oral hygiene devices;

(e)   Normal nutrition information as it relates to dental health;

(f)  Behavioral modification;

(g)   Self adjustment of orthodontic appliances; and

(h) "General nonmedical nutrition information" which is defined as nutrition information for the purpose of maintaining good oral health, including but not limited to:

(i) Principles of good nutrition and food preparation;

(ii) Food to be included in the normal daily diet;

(iii) Essential nutrients needed by the body;

(iv) Recommended amounts of the essential nutrients;

(v) Actions of nutrients on the body;

(vi) Effects of deficiencies of excesses of nutrients;or

(vii) Food and supplements that are good sources of essential nutrients.

(h)(i)  All  other  post-operative  and  post-insertion  instructions,  as  deemed appropriate by the supervising dentist.

Effective:                                                             09/12/2016

Five Year Review (FYR) Dates:                         06/24/2016 and 08/01/2021

CERTIFIED ELECTRONICALLY

Certification

08/31/2016

Date

Promulgated Under:                           119.03

Statutory Authority:                           4715.03, 4715.39

Rule Amplifies:                                  4715.22, 4715.23, 4715.231, 4715.39

Prior Effective Dates:                         04-05-77, 04-01-90, 02-05-93, 07-25-93, 03-03-95,

04-05-99, 06-17-99, 05-15-03, 06-21-04, 10-09-06