N.J. Admin. Code § 13:30-2.4

Current through Register Vol. 56, No. 24, December 18, 2024

Section 13:30-2.4 - Scope of practice of registered dental assistant

(a) A registered dental assistant may perform the following duties under the direct supervision of a licensed dentist:

1. Isolate the operative field, including the placement and removal of rubber dams;

2. Place and remove matrices and wedges;

3. Place temporary restorations;

4. Remove excess cement from crowns or other restorations and orthodontic appliances. Such removal shall not include any subgingival cement or debris;

5. Remove sutures;

6. Fabricate and cement temporary crowns and bridges after preparation of tooth (teeth) by a dentist. This does not include intra-oral occlusal adjustment;

7. Etch teeth in preparation for bonding, sealants and desensitizing agents;

8. Place caries detecting agents;

9. Use instruments for caries detection. Such instruments shall not include lasers that are capable of altering, cutting, burning or damaging hard or soft tissue;

10. Perform hand removal of soft temporary restorations;

11. Perform hand removal of crowns and bridges that have been temporarily cemented;

12. Prepare coronal surfaces for bonding and restoration, with pumice and water only, not to include a prophylaxis;

13. Take alginate impressions;

14. Place amalgam, composite or gold foil in a tooth for condensation by the dentist;

15. Place and remove retraction cords and medicated pellets. This shall not include electrosurgery or the use of lasers for tissue retraction;

16. Perform bite registration procedures;

17. Place and remove periodontal dressings and other surgical dressings;

18. Trial size (pre-select) orthodontic bands, wires, stainless steel crowns and temporary crowns intra-orally or on diagnostic models;

19. Place and remove arch wires and ligature wires;

20. Take impressions for and perform laboratory fabrication of mouth guards. This shall not include insertion of the appliance;

21. Make radiographic exposures as permitted by the Department of Environmental Protection pursuant to N.J.S.A. 26:2D-24 et seq.;

22. Provide oral health education including dietary analysis and clinical instruction in order to promote dental health;

23. Apply topical anesthetic agents;

24. Take and record vital signs;

25. Retract patient's cheek, tongue or other tissue parts during a dental procedure;

26. Remove such debris as is normally created in the course of treatment during or after dental procedures by vacuum devices, compressed air, mouthwashes and water;

27. Use a curing light for any dental procedure. Such curing light shall not include a laser capable of altering, cutting, burning, or damaging hard or soft tissue or for electrosurgery for tissue retraction;

28. Take dental photographs including the use of intra-oral cameras;

29. Select shades of prosthetic appliances;

30. Demonstrate home-use bleaching systems and apply bleaching agents;

31. Apply hot or cold packs pursuant to the direction of a licensed dentist;

32. Administer a topical treatment on a patient after a licensed dentist or licensed dental hygienist has performed a prophylaxis;

33. Assist a licensed dentist in the administration of nitrous oxide, provided the licensed dentist is physically present in the operatory at all times during the procedure;

34. Provide prophylactic and preventive measures, such as the application of fluorides and pit and fissure sealants and other recognized topical agents for the prevention of oral disease or discomfort. This shall not include prophylaxis;

35. Take impressions for orthodontic appliances. The supervising licensed dentist shall review and evaluate the impression prior to its use for fabrication;

36. Place orthodontic separators. The supervising licensed dentist shall ensure proper placement;

37. Remove bands and brackets without the use of rotary instruments; and

38. Perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.

(b) A registered dental assistant practicing under the direct supervision of a licensed dentist pursuant to N.J.A.C. 13:30-8.20 may monitor a patient to whom the supervising dentist has administered nitrous oxide/oxygen inhalation analgesia provided the registered dental assistant does not perform any other function while monitoring the patient, and provided that:

1. The registered dental assistant has successfully completed a Board-approved course offered in a CODA (Commission on Dental Accreditation of the American Dental Association) approved college or university clinical setting or hospital setting which emphasizes the administration of nitrous oxide simultaneous with the administration of oxygen and safe and effective patient monitor:

i. The course shall be submitted to the Board for review and approval of course outline, content and objectives, curriculum vitae of instructors and whether the training is visual, hands-on or lecture;

ii. The nitrous oxide/oxygen administration course shall be at least 14 hours in length, which shall include at least seven hours of didactic training and seven hours of clinical training; and

iii. The clinical training shall include, at a minimum, 10 monitored administrations of nitrous oxide/oxygen inhalation analgesia.

2. The registered dental assistant holds a current certification in Basic or Advanced Cardiac Life Support by the American Heart Association, the American Red Cross or an equivalent association approved by the Board;

3. The registered dental assistant completes a three-hour didactic or clinical course in nitrous oxide/oxygen inhalation analgesia in every other registration renewal period. Completion of the recertification course shall be in addition to the continuing education requirements set forth at N.J.A.C. 13:30-5.3.

4. The registered dental assistant monitors the patient and maintains the therapeutic level of the nitrous oxide/oxygen inhalation analgesia as established by the dentist; and

5. Upon any untoward reaction of the patient, the registered dental assistant immediately turns off the flow of nitrous oxide, maintains the established oxygen level, and immediately summons the dentist.

(c) The monitoring of nitrous oxide/oxygen inhalation analgesia by a registered dental assistant without first having met the minimum standards of training and procedures as contained in this section shall constitute a deviation from normal standards of practice required of a licensee.

(d) A registered dental assistant who engages in the activities outlined in (a), (b), and (c) above without direct supervision shall be deemed to be engaging in the unauthorized practice of dental assisting and professional misconduct, and shall be subject to the penalties set forth in N.J.S.A. 45:1-22 and 45:1-25.

(e) A dental assistant may provide a written work authorization for emergency repair of a dental prosthesis provided that the prosthesis shall not require any intra-oral procedure and shall be thereafter inserted by a licensed dentist.

N.J. Admin. Code § 13:30-2.4

Amended by 50 N.J.R. 1282(a), effective 5/21/2018