§ 59-328.34. Practice of dental hygiene under supervision of dentist – Delegation of duties to dental hygienist – Authorization of advanced procedures.

A.  A dental hygienist may practice dental hygiene under the supervision of a dentist in a dental office or treatment facility.  A dentist may employ not more than the equivalent of three full-time dental hygienists for each dentist actively practicing in the same dental office.

B.  1.  A dentist may delegate to a dental hygienist the following procedures:

a.the duties and expanded duties authorized for dental assistants by the State Dental Act or the rules of the Board of Dentistry,

b.health history assessment pertaining to dental hygiene,

c.dental hygiene examination and the charting of intra-oral and extra-oral conditions, which include periodontal charting, dental charting and classifying occlusion,

d.dental hygiene assessment and treatment planning for procedures authorized by the supervisory dentist,

e.prophylaxis, which means the removal of any and all calcareous deposits, stains, accretions, or concretions from the supragingival and subgingival surfaces of human teeth, utilizing instrumentation by scaler or periodontal curette on the crown and root surfaces of human teeth, including rotary or power driven instruments.  This paragraph shall not be construed to prohibit the use of a rubber cap or brush on the crowns of human teeth by a dental assistant who holds a current expanded duty permit for Coronal Polishing/Topical Fluoride issued by the Board,

f.periodontal scaling and root planing,

g.dental hygiene nutritional and dietary evaluation,

h.placement of subgingival prescription drugs for prevention and treatment of periodontal disease,

i.soft tissue curettage,

j.placement of temporary fillings,

k.removal of overhanging margins,

l.dental implant maintenance,

m.removal of periodontal packs,

n.polishing of amalgam restorations, and

o.other procedures authorized by the Board.

2.  The procedures specified in subparagraphs b through o of paragraph 1 of this subsection may be performed only by a dentist or a dental hygienist.

3.  Except as provided in subsections C and D of this section, the procedures specified in paragraph 1 of this subsection may be performed by a dental hygienist only on a patient of record and only under the supervision of a dentist.  The level of supervision, whether direct, indirect or general, shall be at the discretion of the supervisory dentist.  Authorization for general supervision shall be limited to a maximum of thirteen (13) months following an examination by the supervisory dentist of a patient of record.

C.  1.  A dentist may authorize procedures to be performed by a dental hygienist, without complying with the provisions of paragraph 3 of subsection B of this section, if:

a.the dental hygienist has at least two (2) years experience in the practice of dental hygiene,

b.the authorization to perform the procedures is in writing and signed by the dentist, and

c.the procedures are performed during an initial visit to a person in a treatment facility.

2.  The person upon whom the procedures are performed must be referred to the authorizing dentist after completion of the procedures performed pursuant to paragraph 1 of this subsection.

3.  A dental hygienist shall not perform a second set of procedures on a person pursuant to this subsection until the person has been examined and accepted for dental care by the authorizing dentist.

4.  The treatment facility in which any procedure is performed by a dental hygienist pursuant to this subsection shall note each such procedure in the medical records of the person upon whom the procedure was performed.

D.  A treatment facility may employ dental hygienists whose services shall be limited to the examination of teeth and the teaching of dental hygiene or as otherwise authorized by the Board.

E.  The Board is authorized to:

1.  Prescribe, by rule, advanced procedures that may be performed by a dental hygienist who has satisfactorily completed a course of study regarding the performance of such procedures.  The advance procedures shall include the administration of local anesthesia and the administration of nitrous oxide analgesia;

2.  Establish guidelines for courses of study necessary for a dental hygienist to perform advanced procedures;

3.  Issue authorization to perform advanced procedures to those dental hygienists who meet the eligibility requirements; and

4.  Establish the level of supervision, whether direct, indirect or general, under which the advanced procedures may be performed.

F.  A dental hygienist shall not own or operate an independent practice of dental hygiene.

G.  Nothing in the State Dental Act shall be construed to prohibit a dentist from performing any of the procedures that may be performed by a dental hygienist.

Added by Laws 1970, c. 173, § 34, eff. July 1, 1970.  Amended by Laws 2003, c. 171, § 3, emerg. eff. May 5, 2003; Laws 2013, c. 405, § 14, eff. July 1, 2013.