Component 10 Northwest

Component Activities/ Regulation and Practice

2016 VDHA House of Delegates Weekend

Northwest Delegation and members with LFCC and VWCC students!

• DAII Regulations went into effect on March 2, 2011 and allow a dentist to utilize up to a total of four dental hygienists or dental assistants II in any combination practicing under direction at one and the same time!  Under the definition of “General Supervision”, the current regulations also read- “a dentist completes a periodic comprehensive examination of the patient and issues a written order for hygiene treatment that states the specific services to be provided by a dental hygienist during one or more subsequent appointments when the dentist may or may not be present.” Under duties delegated to a dental hygienist under general supervision it still states that the services noted on the written order shall be rendered within a specific time period, not to exceed 10 months from the date the dentist last examined the patient. Dental Assistants -  Guidance Document: 60-7  December 3, 2010
  

           Virginia Board of Dentistry  
 
DUTIES THAT MAY BE DELEGATED TO DENTAL ASSISTANTS I AND II UNDER INDIRECT SUPERVISION OF A DENTIST
GENERAL SERVICES

• Prepare patients for treatment/seating/positioning chair/placing napkin
  
• Perform health assessment
  
• Preventive education and oral hygiene instruction
  
• Perform mouth mirror inspection of the oral cavity
  
• Chart existing restorations and conditions as instructed by the dentist
  
• Take, record and monitor vital signs
  
• Transfer dental instruments
  
• Prepare procedural trays/armamentaria set-ups
  
• Maintain emergency kit
  
• Sterilization and disinfection procedures
  
• Compliance with OSHA Regulations and Centers for Disease Control Guidelines
  
• Prep lab forms for signature by the dentist
  
• Maintenance of dental equipment

RADIOLOGY and IMAGING

• Mount and label images
  
• Place x-ray film and expose radiographs ONLY WITH REQUIRED TRAINING
  
• Use intraoral camera or scanner to take images for tooth preparation and CAD CAM restorations 

RESTORATIVE SERVICE

• Provide pre- and post operative instructions
  
• Place and remove dental dam
  
• Maintain field of operation through use of retraction, suction, irrigation, drying
  
• Acid Etch - Apply/wash/dry remove only when reversible
  
• Amalgam:  Place only
  
• Amalgam:  Polish only with slow-speed handpiece and prophy cup
  
• Apply pit and fissure sealants
  
• Apply and cure primer and bonding agents
  
• Fabricate, cement, and remove temporary crowns/restorations
  
• Make impressions and pour and trim study/diagnostic models and opposing models
  
• Make impressions for athletic/night/occlusal/snore mouthguards and fluoride/bleaching trays
  
• Matrices - place and remove
  
• Measure instrument length
  
• Remove excess cement from coronal surfaces of teeth
  
• Remove sutures
  
• Dry canals with paper points
  
• Mix dental materials
  
• Place and remove post-extraction dressings/monitor bleeding
  
• Rubber Dams: Place and remove
  
• Sterilization and disinfection procedures
  

HYGIENE 

• Apply dentin desensitizing solutions
  
• Apply fluoride varnish, gels, foams and agents
  
• Apply pit and fissure sealant
  
• Address risks of tobacco use
  
• Give oral hygiene instruction
  
• Polish coronal portion of teeth with rotary hand piece and rubber prophy cup or brush
  
• Place and remove periodontal dressings
  
• Clean and polish removable appliances and prostheses

ORTHODONTICS

• Place and remove elastic separators
  
• Check for loose bands and brackets
  
• Remove arch wires and ligature ties
  
• Place ligatures to tie in archwire
  
• Select and fit bands and brackets for cementation by dentist
  
• Instruct patients in placement and removal of retainers and appliances after dentist has fitted and  made adjustments in the mouth
  
• Take impressions and make study models for orthodontic treatment and retainers
  

BLEACHING

• Take impressions and fabricate bleaching trays
  
• Apply bleach/whitener
  
• Bleach with light but not laser
  
• Instruct pt on bleaching procedures
  

SEDATION AND ANESTHESIA SERVICES

• Apply topical Schedule VI anesthetic
  
• Monitor patient under nitrous oxide
  
• Monitor patient under minimal sedation/anxiolysis 
  
• Monitor patient under moderate/conscious sedation ONLY WITH REQUIRED TRAINING
  
•  Monitor patient under deep sedation/general anesthesia ONLY WITH REQUIRED TRAINING
  
• Take blood pressure, pulse and temperature
  

DUTIES THAT MAY BE DELEGATED TO DENTAL ASSISTANTS I AND II UNDER INDIRECT SUPERVISION OF A DENTAL HYGIENIST

• Prepare patients for treatment/seating/positioning chair/placing napkin
  
• Perform health assessment
  
• Preventive education and oral hygiene instruction
  
• Transfer dental instruments
  
• Prepare procedural trays/armamentaria set-ups
  
• Maintain emergency kit
  
• Sterilization and disinfection procedures
  
• Compliance with OSHA Regulations and Centers for Disease Control Guidelines
  
• Maintenance of dental equipment
  
• Polish coronal portion of teeth with rotary hand piece and rubber prophy cup or brush
  
• Place and remove periodontal dressings
  
• Clean and polish removable appliances and prostheses
  
• Mount and label images
  
• Place x-ray film and expose radiographs ONLY WITH REQUIRED TRAINING
  

DUTIES THAT MAY ONLY BE DELEGATED TO DENTAL ASSISTANTS II UNDER DIRECT SUPERVISION OF A DENTIST

• Condense/pack and carve amalgam 
  
• Place, cure and finish composite resin restorations only with slow-speed handpiece
  
• Apply base and cavity liners/perform pulp capping procedures
  
• Final cementation of crowns and bridges after adjustment and fitting by the dentist
  
• Select and manipulate gypsums and waxes
  
• Make final impressions and fabricate master casts
  
• Place and remove non-epinephrine retraction cord