By Leslie Canham, CDA, RDA
In California, 2010 marked a big year for dental assistants, registered dental assistants, and registered dental assistants in extended functions. As the government relations chairperson for the California Dental Assistants Association, I’ve been involved with the regulatory process by attending dental board meetings and providing testimony on issues related to dental assisting and infection control. There are new duties that are allowed in all dental assisting categories, and there is the addition of two new dental assistant permits. The new permits are the orthodontic assistant permit and the dental sedation assistant permit. Listed here are the additional duties for dental assistants and permit holders.
New dental assistant duties:
- Perform intraoral and extraoral photography
- Take facebow transfers and bite registrations
- Take intraoral impressions for all nonprosthodontic appliances
- Read and transmit information from a monitor display to the dentist during oral surgery procedures
New registered dental assistants duties:
- Use of automated caries detection devices and materials to gather information for diagnosis by the dentist
- Obtain intraoral images for computer-aided design (CAD) milled restorations
- Chemically prepare teeth for bonding
- Adjust dentures extraorally
New registered dental assistants in extended functions duties:
(Some of these duties are allowed only if a registered dental assistant in extended functions is licensed after Jan. 1, 2010.)
- Conduct preliminary evaluation of the patient's oral health, including — but not limited to — charting, intraoral and extraoral evaluation of soft tissue, classifying occlusion, and myofunctional evaluation
- Perform oral health assessments in school-based, community health project settings under the direction of a dentist, registered dental hygienist, or registered dental hygienist in alternative practice
- Size, fit, and cement endodontic master points and accessory points
- Take final impressions for toothborne removable prosthesis
- Place, contour, finish, and adjust all direct restorations
- Adjust and cement permanent indirect restorations
Permits for the orthodontic assistant and dental sedation assistant may be obtained by a dental assistant, registered dental assistant, or registered dental assistant in extended functions after meeting minimum work experience requirements, taking certain board-approved courses, and successfully completing a written examination.
Orthodontic assistant permit duties:
- All duties that a dental assistant is allowed to perform
- Prepare teeth for bonding, and select, preposition, and cure orthodontic brackets after a licensed dentist approves the bracket position
- Remove only orthodontic brackets and attachments with removal of the bonding material by the supervising licensed dentist
- Size, fit, and cement orthodontic bands
- Remove orthodontic bands and remove excess cement from supragingival surfaces of teeth with a hand instrument
- Place and ligate archwires
- Remove excess cement with an ultrasonic scaler from supragingival surfaces of teeth undergoing orthodontic treatment
Dental sedation assistant permit duties:
- All duties that a dental assistant is allowed to perform
- Monitor patients undergoing conscious sedation or general anesthesia by using data from noninvasive instrumentation such as pulse oximeters, electrocardiograms, capnography, and blood pressure, pulse, and respiration rate monitoring devices. Evaluating the condition of a sedated patient shall remain the responsibility of the dentist or other licensed health-care professional authorized to administer conscious sedation or general anesthesia, who shall be at the patient's chairside while conscious sedation or general anesthesia is being administered.
- Drug identification, limited to identification of appropriate medications, ampule and vial preparation, and withdrawing drugs of correct amount as verified by the supervising licensed dentist
- Add drugs, medications, and fluids to intravenous lines using a syringe, provided that a supervising licensed dentist is present at the patient's chairside, limited to determining patency of intravenous line, selection of injection port, syringe insertion into injection port, occlusion of intravenous line and blood aspiration, line release, and injection of drugs for appropriate time interval. The exception to this duty is that the initial dose of a medication should be administered by the supervising licensed dentist.
- Removal of intravenous lines
There are new training requirements for unlicensed dental assistants. All unlicensed dental assistants hired after Jan. 1, 2010, must successfully complete an eight-hour infection-control course and meet other training requirements. The infection-control course has a mandatory four-hour requirement to be hands-on training and live in a clinical setting. The supervising licensed dentist is responsible for ensuring that each unlicensed dental assistant, who is in his or her continuous employ for 120 days or more, has successfully completed board-approved courses in the Dental Practice Act, basic life support, and the eight-hour course in infection control within one year. The infection-control training will help to ensure that unlicensed dental assistants with or without formal training have the necessary skills for proper infection control.
These new and exciting changes will help to advance the productivity of dental assistants, make the dental office safer for everyone, and provide greater value to dentists. What’s happening in your state regarding dental assisting regulations? One of the best ways to stay informed is to be a member of your local, state, and national dental assisting associations.
Leslie Canham is a dental speaker and consultant specializing in infection control and OSHA compliance. She has more than 36 years of experience in dentistry. Canham is the founder of Leslie Canham Seminars, providing in-office training, mock inspections, consulting, and online seminars and webinars to help the dental team navigate state and federal regulations. Reach Canham at (888) 853-7543 or Leslie Canham.