02 department of professional and financial regulation 313 state board of dental examiners chapter 3: rules relating to dental assistants summary



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02 DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
313 STATE BOARD OF DENTAL EXAMINERS
Chapter 3: RULES RELATING TO DENTAL ASSISTANTS

Summary: This Chapter establishes the duties a dentist may delegate to dental assistants, certified dental assistants, and expanded function dental assistants. A dentist may not permit a dental assistant, certified dental assistant or expanded function dental assistant to perform any act not specifically provided for in this chapter.


I. GENERAL SUPERVISION OF DENTAL ASSISTANTS
A dental assistant may perform the following duties under the general supervision of a dentist:
A. Change/replace dry socket packets after diagnosed and treatment planned by a dentist;
B. Expose dental radiographs, but only if licensed as a Dental Radiographer pursuant to Title 32 M.R.S.A. §1100-I through §1100-R;
C. For instruction purposes, a dental assistant may demonstrate to a patient how the patient should place and remove removable prostheses, appliances, or retainers;
D. For the purpose of eliminating pain or discomfort, remove loose, broken, or irritating orthodontic appliances;
E. Give oral health instructions;
F. Irrigate and aspirate the oral cavity;
G. Perform dietary analyses for dental disease control;
H. Place and recement with temporary cement an existing crown that has fallen out provided that the dental assistant promptly notifies the dentist this procedure was performed so that appropriate follow-up can occur;
I. Place and remove periodontal dressing;
J. Pour and trim dental models;
K. Remove sutures with a follow-up appointment with the dentist within 7-10 days of suture removal;
L. Retract lips, cheek, tongue and other tissue parts;
M. Take and pour impressions for study casts;
N. Take and record the vital signs of blood pressure, pulse, and temperature;
O. Take dental plaque smears for microscopic inspection and patient education; and
P. Take intra-oral photographs.

II. DIRECT SUPERVISION OF DENTAL ASSISTANTS
A dental assistant may perform the following intra-oral procedures only under the direct supervision of a dentist:
A. Apply cavity varnish;
B. Apply liquids, pastes and gel topical anesthetics;
C. Assist an orthodontist in preparation of teeth for attaching, bonding, cementing fixed appliances in a manner appropriate, and according to manufacturer’s directions for the product(s) being used;
D. Deliver, but not condense or pack, amalgam or composite restoration material;
E. Fabricate temporary crowns and bridges, limiting handpiece rotary instrumentation used in the fabrication only to extraoral use, so long as the dentist checks the occlusion and fit prior to releasing the patient;
F. Irrigate and dry root canals;
G. Isolate the operative field;
H. Perform cold vitality testing with confirmation by the dentist;
I. Perform electronic vitality scanning with confirmation by the dentist;
J. Perform preliminary selection and fitting of orthodontic bands, but final placement and cementing in the patient's mouth shall be done by the dentist;
K. Place and cement temporary crowns with temporary cement;
L. Place and remove matrix bands;
M. Place and remove rubber dams;
N. Place and remove wedges;
O. Place elastics and/or instruct in their use;
P. Place, hold, or remove celluloid and other plastic strips prior to or subsequent to the placement of a filling by the dentist;
Q. Place or remove temporary separating devices;
R. Place wires, pins, and elastic ligatures to tie in orthodontic arch wires that have been fitted and approved by the dentist at the time of insertion;
S. Prepare tooth sites and surfaces with a rubber cup and pumice for banding or bonding of orthodontic brackets. This procedure shall not be intended or interpreted as an oral prophylaxis, which is a procedure specifically reserved to be performed by dental hygienists or dentists. This procedure also shall not be intended or interpreted as a preparation for restorative material. A dentist or dental hygienist shall check and approve the procedure;
T. Reapply, on an emergency basis only, orthodontic brackets;
U. Record readings with a digital caries detector and report them to the dentist for interpretation and evaluation;
V. Remove composite material using slow speed instrumentation for de-bonding brackets, as long as the dentist conducts a final check prior to release of the patient;
W. Remove excess cement from the supragingival surfaces of teeth;
X. Remove gingival retraction cord;
Y. Remove orthodontic arch wires and tension devices and any loose bands or bonds, but only as directed by the dentist;
Z. Select and try in stainless steel or other preformed crowns for insertion by the dentist;
AA. Take impressions for opposing models and retainers;
BB. Take impressions for single-arch athletic mouth guards, bleaching trays; custom trays and fluoride trays; and
CC. Take intra-oral measurements and make preliminary selection of arch wires and intra and extra-oral appliances, including head gear.

III. GENERAL SUPERVISION OF CERTIFIED DENTAL ASSISTANTS
In addition to the duties permitted under Chapter 3, Section I of these Rules, a certified dental assistant may perform the following duties under general supervision of a dentist:
A. Place temporary fillings on an emergency basis, provided that the patient is informed of the temporary nature of the fillings; and
B. Remove excess cement from the supragingival surfaces of teeth.

IV. DIRECT SUPERVISION OF EXPANDED FUNCTION DENTAL ASSISTANT
In addition to the duties permitted under Chapter 3, section II of these rules, an EFDA may perform the following duties under direct supervision of a dentist.


  1. Apply cavity liners and bases so long as: 1) the dentist has ordered the cavity liner or base; 2) the dentist has checked the cavity liner or base prior to the placement of the restoration; and 3) the dentist has checked the final restoration prior to patient dismissal;

B. Apply pit and fissure sealants after an evaluation of the teeth by the dentist at the time of sealant placement;


C. Apply supragingival desensitizing agents to an exposed root surface and/or dentinal surface of teeth;
D. Apply topical fluorides recognized for the prevention of dental caries;
E. Cement provisional/temporary crowns and bridges and remove excess cement;
F. Perform tooth vitality tests;
G. Place and contour amalgam, composite and other restorative materials prior to the final setting and/or curing of the material;
H. Place and remove periodontal dressing;
I. Place and remove retraction cord;
J. Record readings with a digital caries detector and report them to the dentist for interpretation and evaluation;
K. Size, place, and cement/bond orthodontic bands and brackets with final inspection by the dentist;
L. Supragingival polishing: A Maine licensed dentist (DDS/DMD) or a Maine licensed hygienist (RDH) must first determine that the teeth to be polished are free of calculus or other extraneous material prior to polishing. Dentists may only permit an EFDA to perform supragingival polishing using a slow speed rotary instrument and rubber cup. Dentists may allow an EFDA to use high-speed, power-driven handpieces/instruments to contour or finish newly-placed composite materials; and
M. Take and pour impressions for study casts, bleaching trays, athletic mouth guards, provisional/temporary crowns, and bridges, and custom fluoride trays.

V. CERTIFICATION REQUIREMENTS FOR EFDAs
To qualify for certification to practice expanded function dental assisting, an applicant shall meet the following requirements:
A. Be at least 18 years of age;
B. Have a high school diploma or its equivalent;
C. Hold a current CDA certificate or a registered dental hygiene license and have successfully completed a formal program in EFDA approved by the Board at a CODA accredited program or an equivalent program as determined by the Board, or is credentialed to perform as an EFDA by another state or Canadian province, except that the professional education and experience may not be less than is required in this State as set out in section VI;
D. Have successfully completed with a passing grade of 90 percent, the jurisprudence examination given by the Board; and
E. Provide documentary proof to the Board of current certification in CPR.

VI. CERTIFICATION BY ENDORSEMENT FOR EFDA’S
The Board may at its discretion, without examination, issue a certificate to an applicant to practice EFDA who furnishes proof satisfactory to the Board that the EFDA applicant has been duly licensed or certified as an EFDA to practice in another state or Canadian province after full compliance with the requirements of its dental laws, except that the professional education may not be less than is required in this State and the applicant must: (a) have successfully completed with a passing grade of 90 percent, the jurisprudence examination given by the Board; and (b) provide documentary proof to the Board of current certification in CPR. In addition, the applicant must have been at least three (3) years in actual practice in the state or Canadian province in which the EFDA license or certification was granted.
The Board may require letters of reference as to ability. Applicants for certification by endorsement who meet the requirements of this section must be interviewed in person by the Board or members of the Board prior to being issued a certificate. Every certification so given must state upon its face that it was granted on the basis of endorsement.

STATUTORY AUTHORITY: 32 M.R.S.A. §§ 1073(2), 1094-D, 1094-E, 1094-F, 1094-G, 1094-H, 1100-A, 1100 I – 1100 R.


EFFECTIVE DATE:

May 22, 2007 – filing 2007-194


AMENDED:

February 11, 2009 – filing 2009-56

June 27, 2010 – filing 2010-256
REPEALED AND REPLACED:

September 9, 2012 – 2012-247





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