Dental auxiliaries There are different categories of dental assistants and dental hygienists, each with specific requirements regarding training and skills. Laws specifically define the duties that each category of auxiliary is allowed to perform, the level of dentist supervision required, and the settings in which the duties may be performed (California Dental Association, 2019). It is a criminal offense to perform illegal functions, as well as grounds for license discipline of both the person A dental assistant is an individual who, without a license, may perform basic supportive dental procedures, as authorized by law and by regulations adopted by the Board, under the supervision of a licensed dentist. “Basic supportive dental procedures” are defined in Section 1750 of the Dental Practice Act as procedures that have technically elementary characteristics, are completely reversible, and are unlikely to precipitate potentially hazardous conditions for the patient being treated. Since January 1, 2010, the scope of practice for dental assistants has included new and expanded duties and two new “add-on” specialty permits in orthodontics and dental sedation. All categories of dental assistants are eligible to obtain these specialty permits after completing the required instruction. In addition, licensure and license renewal requirements have changed for RDAs and RDAEFs. The Dental Board of California publishes a duty table available at https://www.dbc.ca.gov/formspubs/pub_permitted_duties. pdf, and it is shown in Appendix B. Levels of supervision For all categories of dental assistants, dentists retain the authority to determine which new duties their staff members can perform and on which patients these procedures are performed. The level of required supervision is determined Dental assistants Scope of practice by statute for the dental assistant and the RDAEF. For RDAs, the supervising dentist determines on an individual basis which allowable procedures may be completed under general supervision, and which must be completed under direct supervision. In addition to documenting the permitted and prohibited duties of all licensed dental auxiliaries and dental assistants, the table shown in Appendix B designates four basic levels of supervision, using the letters D, C, G, and DD. Direct supervision, designated in Appendix B by the letter D, refers to supervision of dental procedures based on instructions given by a licensed dentist who must be physically present in the treatment facility during the performance of those procedures. Another type of supervision (C) allows the assistant to perform in a designated setting under the supervision of a dentist, RDH, or registered dental hygienist in alternate practice (RDHAP). General supervision, designated by the letter G, means that a duty is permitted based on instructions given by a licensed dentist but does not require the physical presence of the supervising dentist during its performance. Finally, in the category designated DD, the dentist determines whether each procedure can be performed under general supervision, or whether direct supervision of the RDA is required. Exceptions to this category are found in Section 1777 of the Dental Practice Act, which states that direct supervision by the dentist or an RDH or RDHAP is necessary for an RDA or RDAEF engaging in (1) coronal polishing, (2) the application of topical fluoride, or (3) the application of sealants (after having completed a
performing the illegal function and any person who aids or abets such illegal activity. According to the Dental Practice Act, Section 1684.5(d): A dentist shall not concurrently supervise more than a total of five registered dental assistants in extended functions, registered dental hygienists, or registered dental hygienists in alternative practice providing services pursuant to Sections 1753.55, 1910.5, and 1926.05. (California Dental Practice Act, 2015) Board-approved course on the procedure) (California Dental Association, 2019). There is another level of supervision that is not defined but is specified in the description of the actual duty by statute. In those cases, the patient must be seen by the supervising dentist after the duty is performed and before the patient is dismissed. Proof of that compliance requires that the supervising dentist sign off the chart note made by the dental auxiliary. It is a requirement that all supervising dentists be familiar with the permitted and prohibited duties of dental auxiliaries. Therefore, it is essential that supervising dentists review the dental duty tables. Section 1753.7 of the Dental Practice Act also stipulates that a dentist may not simultaneously supervise more than three extended function dental assistants or extended function dental hygienists. Unlicensed dental assistants Although the dental assistant is an unlicensed dental professional, the employer of a dental assistant is responsible for ensuring that any dental assistant hired and in continuous employment for 120 days or more has already successfully completed, or successfully completes within a year of the date of employment, all of the following: ● A Board-approved two-hour course in the Dental Practice Act. ● A Board-approved eight-hour course in infection control. ● A course in basic life support (BLS) offered by an instructor approved by the American Red Cross (ARC) or the American Heart Association (AHA), or any other course approved by the Board as equivalent and that provides the student with the opportunity to engage in hands-on simulated clinical scenarios. Dental assistants must keep their BLS certifications current. (The DALE Foundation, 2021) Initial licensure: Registered dental assistants Section 1752.1 of the Dental Practice Act states that a registered dental assistant applying for initial licensure must submit written evidence to the Board of one of the following eligibility requirements: ● Graduation from an educational program in registered dental assisting approved by the Board, and satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the Board. ● Evidence of completion of at least 15 months of satisfactory work experience as a dental assistant in California or another state, and satisfactory performance on the Registered Dental Assistant Combined Written and Law and Ethics Examination administered by the Board. “Satisfactory work experience” means the performance of the duties of a dental assistant in a competent manner as determined by the employing dentist, who shall certify to such satisfactory work experience in the application. The Board shall give credit toward the work experience referred to in this section to persons who have graduated from a dental assisting
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