D.C. Mun. Regs. tit. 17, r. 17-9004

Current through Register Vol. 71, No. 50, December 13, 2024

Rule 17-9004 - SCOPE OF PRACTICE

9004.1

Subject to the restrictions set forth in this section, a dentist may delegate to a registered dental assistant only those procedures which are:

(a) Appropriate to the training and experience of the dental assistant and the practice of the supervising dentist;

(b) Reversible; and

(c) To be performed under the direct supervision of the dentist.

9004.2

Level I Dental Assistant may perform the following functions under direct supervision of a dentist:

(a) Placing retraction cord;

(b) Placing matrices;

(c) Applying fluoride (rinse, foam tray, and fluoride varnish);

(d) Placing periodontal dressings;

(e) Removing temporary restorations without the use of a rotary instrument;

(f) Removing sutures;

(g) Taking impression for study models or diagnostic casts;

(h) Rinsing and aspirating the oral cavity;

(i) Retracting the lips, cheek, tongue, and flaps;

(j) Placing or removing materials for the isolation of the dentition, provided that the material is not retained by the dentition;

(k) Applying topical anesthesia;

(l) Constructing athletic mouth guards and night guards on models;

(m) Performing intraoral photography;

(n) Curing by the use of halogen light;

(o) Checking for loose bands;

(p) Whitening or bleaching using trays;

(q) Take and record vital signs; and

(r) Other functions as approved by the Board.

9004.3

Level II Dental Assistant may perform the following functions under direct supervision of a dentist:

(a) All functions permitted to Level I Dental Assistant, as enumerated in §§ 9004.2;

(b) Performing vitality tests;

(c) Taking alginate impressions for intraoral appliances;

(d) [Repealed];

(e) Applying desensitizing agents;

(f) Placing or removing a rubber dam;

(g) Etching;

(h) Fabricating indirect restorations in a dental office;

(i) Placing or removing a matrix band;

(j) Drying a root canal;

(k) Preparing and fitting stainless steel crowns;

(l) Preparing temporary crowns;

(m) Removing excess cement; and

(n) Removing or placing a periodontal dressing (except placing the original periodontal dressing).

(o) [Repealed].

9004.4

Level III Dental Assistant may perform the following functions under direct supervision of a dentist:

(a) All functions permitted to Level I Dental Assistant or Level II Dental Assistant, as enumerated in §§9004.2 and 9004.3;

(b) The application of pit and fissure sealants;

(c) Coronal polishing to remove stain and biofilm; and

(d) Glucose testing.

9004.5

Level I, II, or III Dental Assistant working under the direct supervision of an orthodontist may also perform the following functions:

(a) Preparing and fitting orthodontic bands;

(b) Removing excess cement from around orthodontic bands;

(c) Placing and removing arch wires;

(d) Cementing orthodontic bands, placing bonded attachments, or removing cemented or bonded orthodontic bands and attachments;

(e) Placing elastics and ligatures; and

(f) Selecting headgear.

9004.6

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 restoration of a tooth;

(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) [Repealed];

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

(i) Administration of local anesthesia;

(j) Administration of nitrous oxide;

(k) Placement of temporary restorations;

(l) Taking final impressions;

(m) Adjusting occlusion of natural teeth, restorations, or appliances;

(n) Registration of jaw relations;

(o) Cementing permanent crowns or restorations;

(p) Applying silver diamine fluoride;

(q) Glucose monitoring;

(r) Whitening or bleaching (internal, laser, or high-intensity light);

(s) Using a high speed handpiece intraorally;

(t) Oral cancer screenings;

(u) Oral cancer tissue biopsy;

(v) Placing initial periodontal dressing;

(w) Placement of liquid dam;

(x) Applying and removing a socket dressing;

(y) Placement of subgingival medicaments;

(z) Removing intracoronal temporary restorations; or

(aa) Placing sutures.

D.C. Mun. Regs. tit. 17, r. 17-9004

Notice of Final Rulemaking published at 58 DCR 5852, 5853 (July 15, 2011); as amended by Final Rulemaking published at 60 DCR 10055 (July 12, 2013); amended by Final Rulemaking published at 67 DCR 2217 (2/28/2020); amended by Final Rulemaking published at 71 DCR 2153 (3/1/2024)

Authority: Section 302(14) of the District of Columbia Health Occupations Revision Act of 1985, effective March 25, 1986 (D.C. Law 6-99; D.C. Official Code § 3-1203.02(14) (2007 Repl.)), and Mayor's Order 98-140, dated August 20, 1998.