2018 Allowable and Prohibited Duties for Dental Assistants: New Mexico

How to Use the Following Charts

Be sure to follow the legal require- Review all the allow- ments to perform able tasks for each level View which job dental radio- See which tasks of dental assisting as designations are graphic are not permitted published in the state used in your state. procedures. by state law. practice act.

State-approved 1/4/17 State-approved 1/4/17 Arizona Arizona

Education/Training/ Job Title Proposed Radiography Functions NOT Permitted Job Title Allowable Functions Standardized Credential Required According to Requirements by Dental Assistants in AZ According to (Functions with numbers relate specifically to Core Competency designations; State of AZ National Job State of AZ Titles functions with bullets are in this state’s practice act but are not specific matches to DANB research) (see below) To perform specified restorative In order to legally operate dental

© 2017 Dental Assisting National Board, Inc. All rights reserved. functions in Arizona under the © 2017 Dental Assisting National Board, Inc. All rights reserved. x-ray equipment and perform dental The following functions are not supervision of a licensed dentist, radiographic procedures under the a dental assistant must hold an permitted by any level of dental general supervision of a licensed assistant: Arizona Expanded Function – dentist in Arizona, a dental assistant Restorative Certificate. To qualify, must hold a current Arizona board- Under General Supervision* View the educa- one must: 46. Taking final impressions for approved certificate in radiology. any activating orthodontic 18. Apply fluoride varnish ■ Hold the Arizona Coronal 40. Apply sealants Polishing certificate (see appliance, fixed or To obtain a certificate, one must: removable prosthesis • Place interim therapeutic requirements below) and the restorations under the direction tion/training/cre- Arizona Radiologic Proficiency 51. Intraoral carvings of dental  Pass the national DANB Radiation restorations or prostheses* of a licensed dentist following a The numbers next to certificate (see requirements to Health and Safety (RHS) exam consultation conducted through the right) • A procedure which by law AND only licensed dentists, teledentistry AND Receive the Arizona Radiologic licensed dental hygienists, dential required Proficiency Certificate, issued by Expanded ■ Successfully complete an EFDA Expanded or certified denturists can Function each task correspond to training course approved by Expanded DANB perform Function Functions Dental Level of Supervision Not Specified the Arizona State Board of Dental • Final jaw registrations Assistant Dental Examiners (ASBDE) Dental OR • Activating orthodontic 12, 33, 51, 70. Perform placement, for each level of Assistant Assistant  Be currently certified in another (EFDA) at a Commission on Dental (EFDA) appliances contouring and finishing of direct the 70 numbered tasks Accreditation (CODA)- (EFDA) U.S. jurisdiction that requires • An irreversible procedure restorations or the placement and accredited program successful completion of written cementation of prefabricated crowns dental assisting. and clinical dental radiography following the preparation of the tooth AND exam(s) * Under a new Arizona law by a licensed dentist; the restorative that were identified and ■ Pass DANB’s AMP, TMP and AND passed in the 2015 legislative materials used shall be determined by RF exams Apply to the Arizona State Board session, a dental assistant the dentist. of Dental Examiners (ASBDE) AND who has met the requirements ■ Under the supervision of a for Dental Assistant Radiography for an Expanded Function used in the DANB/ADAA licensed dentist, perform Certification by Credential and Dental Assistant listed in the restorative procedures required receive the Arizona Radiologic first column on this page may by the ASBDE (place, contour Proficiency Certificate, issued by perform placement, contouring and finish 20 direct restorations the ASBDE and finishing of direct Core Competencies restorations. and place and cement five Note: Arizona no longer requires dental prefabricated crowns, following assistants to take the Arizona Clinical the preparation of the tooth by a Radiologic Proficiency Exam as a Study. Tasks that are not licensed dentist) and document requirement for earning the Arizona these procedures on a Licensed Radiologic Proficiency Certificate, effective Dentist Endorsement form Jan. 1, 2011. Dental Assistants who passed the RHS exam prior to Jan. 1, 2011, but AND have not passed the clinical exam may call Dental numbered do not directly ■ Apply to DANB for the Arizona DANB at 1-800-367-3262 for information Expanded Functions – Assistant DANB on how to obtain an Arizona Radiologic qualified Under General Supervision*

Restorative Certificate Proficiency Certificate. Certified in coronal 9. Perform coronal polishing procedures

Dental polishing match one of the 70 Assistant procedures To perform coronal polishing (CDA)  procedures in Arizona under the or general supervision of a licensed Registered tasks, yet are identi- dentist, a dental assistant must Dental The ADAA/DANB Alliance hold an Arizona Coronal Polishing Assistant developed a listing of Certificate. (RDA) standardized job titles (left) based Dental on its national Core Competencies Under Direct Supervision* fied by the state in the To qualify, one must: Study conducted from 2002-2005. Assistant 13. Remove sutures 61. Remove excess cement from inlays, • Cleanse the supragingival surface of qualified  Pass DANB’s Coronal Polish 18. Apply topical fluorides crowns, bridges, and orthodontic the tooth in preparation for: in coronal 27, 45. Place and remove dental dams appliances with hand instruments a. The placement of bands, crowns, (CP) exam found in the “Coronal polishing The same study utilized a list of 70 practice act. A full list of Polish Exam for Arizona and matrix bands 62. Remove periodontal dressings with and restorations procedures job functions which were determined 40. Apply sealants Residents” application packet to be representative of a broad hand instruments b. Dental dam application 47, 50. Fabricate and place interim • Prepare a patient for nitrous oxide and c. Acid etch procedures range of dental assisting core restorations with temporary cement AND Dental competencies. oxygen analgesia administration upon d. Removal of dressings and packs those tasks follow your  Submit an Arizona Coronal Assistant 54, 55. Remove temporary cement the direct instruction and presence of a and interim restorations with hand Polishing Clinical Skills Affidavit Functions in this state that dentist (completed by a licensed dentist instruments • Place dental material into a patient’s relate to the national DANB/ 59. Observe a patient during nitrous oxide or a coronal polishing educator/ ADAA Core Competencies  mouth in response to a licensed state’s chart. course instructor) to DANB Dental and oxygen analgesia as instructed by dentist’s instruction Study are numbered to the right, the dentist using language directly from this Assistant AND state’s dental practice act. (The  Receive the Arizona Coronal numbers correspond to the study’s Polishing Certificate, sent upon task numbering system.) Under General Supervision* successful completion of the DANB CP exam and submission Functions listed with bullets are part 2. Collect and record information of the Arizona Coronal Polishing of this state’s practice act but are pertaining to extraoral conditions See Appendix A for more Clinical Skills Affidavit to DANB not specific matches to DANB/ADAA 2. Collect and record information research. pertaining to existing intraoral Entry conditions A dental assistant in Arizona may Level These state templates reflect the 24, 26. Train or instruct patients in oral perform basic supportive dental Dental work done by the ADAA/DANB hygiene techniques, preventive information about the procedures specified by the state Dental Assistant Alliance to support a uniform procedures, dietary counseling for dental practice act (see opposite Assistant national model for one set of caries and plaque control, and provide page) under the direct supervision of dental assisting tasks, levels pre- and post-operative instructions a licensed dentist. and requirements, which will relative to specific office treatment task numbering system. serve as a viable career ladder There are no education or training for dental assistants. requirements for this level of dental *Direct supervision: "Direct Supervision" means, for purposes of Article 7 only, that a licensed dentist is present in the office and available to provide immediate treatment or care to a patient and observe a dental assistant’s work. assisting. General supervision: "General Supervision" means, for purposes of Article 7 only, a licensed dentist is available for consultation, whether or not the dentist is in the office, regarding procedures or treatment that the dentist authorizes and for which the dentist remains responsible. 14 15

Compare your state’s job designations to those used If your state’s dental practice act specifically defines levels as standardized job titles in the DANB/ADAA Core of supervision, the state-specific definition is noted below the Competencies Study. chart. See Appendix B for more information about supervision.

These data are presented for informational purposes only and are not intended as a legal opinion regarding dental practice in any state. DANB confers with each state’s dental board at least annually regarding the accuracy and currency of this information. To verify, or if you have any questions, please contact your state’s dental board.

NELDA®, CDA®, COA®, CRFDA®, CPFDA®, and COMSA®, are registered certification marks of the Dental Assisting National Board, Inc. (DANB). DANB®, Dental Assisting National Board®, RHS®, ICE®, and Measuring Dental Assisting Excellence® are registered service marks of DANB. CERTIFIED DENTAL ASSISTANT™ is a certification mark of DANB.

Job Title Proposed Education/Training/ Radiography Functions NOT Permitted Credential Required According to Standardized by Dental Assistants in NM State of NM National Job Requirements Titles (see below) To earn NM certification as an expanded function To legally operate dental x-ray The following functions are not dental auxiliary (EFDA), one must: equipment and perform dental permitted by any level of dental ■■Complete an accepted EFDA course in a radiographic procedures in New assistant: © 2018 Dental Assisting National Board, Inc. All rights reserved. program approved by the board or accredited Mexico, a dental assistant must be by CODA, certified. To obtain this certification, 46. Final impressions, to OR one must: include physical and Have a minimum of five years, 1000 hours digital impressions, for per year, continuous employment as a ■■Study by independent preparation dental assistant or dental hygienist and earn restorations or prosthetic Expanded or in a training course on radiation appliances* state certification in radiography, rubber cup Function health and safety within the past 36 coronal polishing and application of topical months • Removal of, or addition to, fluoride and pit and fissure sealant expanded Dental the hard or soft tissue of Auxiliary functions and complete a course of study AND the oral cavity in subject areas prescribed by the board, (EFDA) ■■Have assisted with or observed five • Diagnosis and treatment including a post-test approved by the board cases of full mouth series intraoral planning and obtain a recommendation for EFDA Expanded radiographs (or five extraoral certification from a supervising dentist • Initial fitting and adaptation Functions radiographs, if applying for limited of prostheses ■■AND pass a clinical exam accepted by the certificate) board for EFDA certification Dental • Final fitting, adaptation, Assistant ■■AND Earn a 75% score on the NM AND seating and cementation jurisprudence exam (EFDA) ■■Pass the national DANB Radiation of any fixed or removable ■■AND Apply for an apprenticeship permit from Health and Safety (RHS) exam dental appliance or the NM Board of Dental Health Care restoration, including ■■AND Complete an apprenticeship within 180 AND days but not limited to inlays, ■■Apply to the NM Board of Dental crowns, space maintainers, ■■AND Return permit and signed affidavit to Health Care for a training permit, NM Board of Dental Health Care, which will valid for six months habit devices, anti-snoring then issue EFDA certificate or sleep apnea appliances, AND or splints Holders of state-certification in dental assisting expanded functions and ■■Pass a state radiography clinical • Irrigation and medication EFDAs must have formal training in infection control from a course ap- exam, within six months of passing of canals, cone try-in, proved in accordance with New Mexico Board of Dental Health Care rules the DANB RHS exam reaming, filing or filling of and regulations. root canals AND ■■Pass the New Mexico jurisprudence • Other services defined as the practice of dentistry or To perform expanded functions under the DANB exam (take-home) general supervision of a licensed dentist in New Certified dental hygiene Mexico, a dental assistant must earn state AND • Bleaching or whitening Dental ■Apply to the NM Board of Dental certification. To qualify, one must: Assistant ■ teeth without the direct or Health Care for certification to indirect supervision of a Rubber cup coronal polishing and application of (CDA) perform radiography topical fluoride: or dentist ■■Study by independent preparation or in a Registered • Laser-assisted non- training course in the functions and assist Dental surgical periodontal

with/observe five cases of rubber cup coronal Assistant treatment polishing on children and adults and five

applications of topical fluoride and ■Pass DANB’s national Coronal Polish (CP) ■  exam and DANB’s Topical Fluoride (TF) exam *This task is prohibited for and Dental dental assistants and dental ■■Apply to the NM Board of Dental Health Care assistants with state certifica- Assistant The ADAA/DANB Alliance for advanced certification in coronal polishing with state tion in expanded functions. and application of topical fluoride and developed a listing of EFDAs are permitted, under ■■Pass the state jurisprudence exam (take- certification standardized job titles in expanded direct supervision, to take home) and (left) based on its national Core impressions, including digital ■■Perform rubber cup coronal polishing on five functions Competencies Study conducted from impressions, for permanent adults and children and application of topical 2002-2005. fluoride on five children while being personally fixed or removable prosthetics observed by a dentist, dental hygienist, or a involving single teeth; EFDAs dental assistant certified in rubber cup coronal The same study utilized a list of 70 are prohibited from taking final polishing and topical fluoride. job functions which were determined impressions for multiple units to be representative of a broad of crowns, bridges, cast frame- Pit and Fissure Sealants: range of dental assisting core work, partial dentures, or full ■■Have 2,080 hours of dental assisting chairside dentures final impressions. experience in the two years prior to application competencies. and ■■Study by independent preparation or in a Functions in this state that relate training course in the function and to the national DANB/ADAA Core ■■Assist with/observe 12 pit and fissure sealant Competencies Study are applications and numbered to the right, using ■■Pass DANB’s national Sealants (SE) exam and language directly from this state’s dental practice act.  ■■Apply for advanced certification in pit and fissure sealants to the NM Board of Dental (The numbers correspond to the Health Care and study’s task numbering system.) ■■Pass the NM jurisprudence exam (take-home) and Functions listed with bullets are part ■■Apply pit and fissure sealants on five patients of this state’s practice act but are while being personally observed by a licensed dentist or dental hygienist not specific matches to DANB/ADAA research.

The DANB Certified Dental Assistant (CDA) certification automatically qualifies a dental assistant to apply for state certification for each of these expanded functions. A dental assistant who is certified to perform one or more expanded functions in another state with requirements not less stringent than those in New Mexico may apply for state certification Dental These state templates reflect the based on credentials. See DANB's 2018 State Fact Booklet or contact Assistant work done by the ADAA/DANB the New Mexico Board of Dental Health Care for requirements. Alliance to support a uniform national model for one set of A dental assistant in New Mexico is an individual dental assisting tasks, levels and who may perform basic supportive dental Dental Entry requirements, which will serve procedures under the direct supervision of a Assistant Level as a viable career ladder for licensed dentist (see notes on opposite page). Dental dental assistants. There are no education or training requirements for Assistant this level of dental assistant.

90 New Mexico State-approved 11/20/17

Job Title Allowable Functions According to (Functions with numbers relate specifically to Core Competency designations; State of NM functions with bullets are in this state’s practice act but are not specific matches to DANB research)

Under Direct Supervision*

12, 51. Place and shape direct restorative 47, 50. Cement permanent or provisional 50. Place temporary or sedative © 2018 Dental Assisting National Board, Inc. All rights reserved. materials into cavity preparations restorations with temporary or restorative material into unprepared completed by a dentist, using provisional cement, provided the tooth fractures as a palliative measure; instrumentation as necessary and permanent cementation will be the EFDA shall NOT use any proper for this purpose completed or monitored by the automated method to clean out the 43. Perform preliminary fitting and shaping dentist within six months fracture or prepare the tooth, including Expanded of stainless steel crowns which 50. Place temporary or sedative but not limited to high speed, slow Function shall undergo final evaluation and restorations in open carious lesions speed, air abrasion, ultrasonic, laser Dental cementation by a dentist after hand excavation of gross decay etc. Auxiliary 46. Take impressions for permanent fixed or and debris; if pain is perceived by 61. Remove residual orthodontic bracket (EFDA) removable prosthetics involving single the patient, dentist shall evaluate or band cement or resin from teeth teeth, to include digital impressions; lesion before completion by EFDA. after the brackets or bands have been these include single crowns or single The EFDA shall NOT use any removed by the dentist, or to prepare tooth replacement prosthetics; EFDAs automated method to clean out the the tooth or teeth for re-cementation shall not take final impressions for lesion or prepare the tooth, including of a debonded bracket or band, using multiple units of single crowns, bridges, but not limited to high speed, slow instrumentation as necessary and cast framework partial dentures or full speed, air abrasion, ultrasonic, laser proper for this purpose dentures final impressions etc.

Under General Supervision*

40. Place pit and fissure sealants (under Note: EFDA duties are allowed under direct supervision of a NM licensed dentist provid- supervision as certification or licensure ed the dentist has prepared the cavity or tooth for the restorative procedure; instructed allows) the EFDA on the particular elements of the individual case; fully examined and evalu- 47. In emergency situation, recement ated the procedure carried out by the EFDA, and corrected or replaced any deficiency temporary or permanent crowns or found in the EFDA work before allowing the patient to leave the treatment facility; the bridges using provisional cement when dentist is ultimately responsible for the quality of the final restorative procedure carried out by the EFDA; and not more than two EFDAs, performing expanded functions, per instructed to do so by the dentist, licensed dentist are present in office.) provided the permanent cementation will be completed or monitored by the dentist within six months Note: This state allows individuals certified as Community Dental Health Coordinators to perform a separate set of advanced restorative, palliative and educational functions. Please see the separate chart for New Mexico CDHC functions on the pages that follow.

Dental Assistant Under General Supervision* with state certification 9. Rubber cup coronal polishing in expanded 18. Application of topical fluoride functions 22. Place and expose dental radiographs 40. Pit and fissure sealants

Note: New Mexico rules indicate that collaborative practice dental hygienists may work with and supervise dental assistants, including dental assistants certified to perform these expanded functions.

Under Indirect Supervision* 9. Rubber cup coronal polishing 18. Application of topical fluoride 40. Pit and fissure sealant application 59. Administer nitrous oxide with the dentist's authorization Note: Rubber cup coronal polishing, • Any basic supportive dental application of topical fluoride and pit and procedure, not excluded elsewhere in fissure sealants must be approved by the rule or in statute dentist or dental hygienist upon completion.

Dental Assistant DANB’s Note on Allowable Dental Assisting Functions In the state of New Mexico, all dental assistants may: • Perform infection control and occupational safety procedures • Perform other duties not specified by this state’s dental practice act At this time, DANB cannot list all allowable dental assisting functions for each state because some states’ dental practice acts outline very specific allowable functions, while others outline only prohibited functions and some contain minimal or no regulation of dental assisting duties.

*General Supervision: Authorization by a dentist of the procedures to be used by a dental assistant or expanded functions dental auxiliary and the execution of the procedures in accordance with a dentist’s diagnosis and treatment plan at a time the dentist is not physically present and in facilities as designated by rule of the board Indirect Supervision: A dentist, or in certain settings a dental hygienist or dental assistant certified in expanded functions is present in the treatment facility while authorized treatments are being performed by a dental assistant Direct supervision: The process under which an act is performed when a dentist licensed pursuant to the Dental Health Care Act: (1) is physically present throughout the performance of the act; (2) orders, controls and accepts full professional responsibility for the act performed; and (3) evaluates and approves the procedure performed before the patient departs the care setting 91 New Mexico (Community Dental Health Coordinator) State-approved 11/20/17

Job Title Proposed Education/Training/ Radiography Functions NOT Permitted Credential Required According to Standardized by CDHCs in NM State of NM National Job Requirements Titles (see below) To legally operate dental x-ray equipment CDHC may not perform and perform dental radiographic procedures any other procedure, duty in New Mexico, a Community Dental Health or function under any level © 2018 Dental Assisting National Board, Inc. All rights reserved. Coordinator must be certified. To obtain this certification, one must: of supervision that is not expressly listed as allowable. Study by independent preparation or Community in a training course on radiation health Dental Health and safety within the past 36 months Coordinator (CDHC) AND ■■Have assisted with or observed five cases of full mouth series intraoral radiographs (or five extraoral radiographs, if applying for limited certificate)

AND ■■Pass the national DANB Radiation Health and Safety (RHS) exam

AND Expanded ■■Apply to the NM Board of Dental Health Functions Care for a training permit, valid for six Dental months To work as a Community Dental Assistant Health Coordinator (CDHC) in New (EFDA) AND Mexico, one must obtain certification ■■Pass a state radiography clinical exam, from the New Mexico Board of within six months of passing the DANB Dental Health Care. RHS exam AND To qualify, an applicant must: ■■Pass the New Mexico jurisprudence exam (take-home) ■■Have a high school diploma or equivalent, or a college-level AND degree ■■Apply to the NM Board of Dental Health Care for certification to perform radiography AND ■■Have New Mexico certification in Community DANB radiography, rubber cup coronal Dental Health Certified polishing, and application of Coordinator Dental topical fluoride and pit and fissure (CDHC) Assistant sealant expanded functions (see (CDA) p. 90 of this publication for or requirements) Registered The CDHC workforce model was Dental developed by the American Dental AND Assistant Association (ADA) to address access ■■Complete the New Mexico (RDA) to care issues among underserved jurisprudence exam with a score U.S. populations. Currently, New of at least 75% Mexico is the only state that has formally adopted the Community AND Dental Health Coordinator model. ■■Successfully complete a CDHC program approved by the NM The CDHC model contemplates

Board of Dental Health Care multiple career paths for those

desiring to work as Community Dental Health Coordinators. For dental CDHCs must have formal training assistants who may aspire to the in infection control from a course CDHC designation, the career approved in accordance with New ladder would contain these Mexico Board of Dental Health Care standardized job titles that rules and regulations. appear at left.

Some functions in the ADA/DANB Dental Alliance’s dental assisting Core Assistant Competencies Study are included in the scope of practice for CDHCs. The study utilized a list of 70 job functions which were determined to be representative of a broad range of dental assisting core competencies. Functions for this workforce member that relate to the national DANB/ ADAA Core Competencies Study are numbered to the right, using language directly from this state’s dental practice act. (The Entry numbers correspond to Level the study’s task numbering  Dental system.) Assistant Functions listed with bullets are part of this state’s practice act but are not specific matched to DANB/ADAA research.

92 New Mexico (Community Dental Health Coordinator) State-approved 11/20/17

General Supervision* 9. Rubber cup coronal polishing (not • Provide the following limited palliative to be represented as a prophylaxis)** procedures: 18. Topical application of fluorides** 24. Instruct the patient on brushing, 22, 52. Expose and develop necessary flossing, gingival massage or radiographs as ordered by the cleaning for gingival inflammation supervising dentist or as established in or infection protocol by a supervising dentist ◦ Application of hot/cold 40. Application of pit and fissure compresses to the face and mouth Community sealants** ◦ Instruct patient in the use Dental Health 50. Place temporary and sedative of various rinses containing Coordinator restorative materials in unexcavated salt, sodium bicarbonate, (CDHC) carious lesions and unprepared tooth chlorhexidine, etc. as ordered by fractures the dentist • Take a complete health and dental ◦ Place avulsed teeth in the proper history preservation solution for transport • Observe and transmit patient data to a dentist through teledentistry means to a ◦ Apply pressure compresses to dentist intraoral wounds • Transmit prescription or medication ◦ Perform any other palliative orders on the direct order of a dentist procedures as directly instructed • Act as an advocate for patients and by the supervising dentist, and the community in accessing dental within the scope of practice of the care CDHC

** when previously authorized by the supervising dentist or dental hygienist and cavitation of the enamel is not present

*General Supervision: Authorization by a dentist of the procedures to be used by a community dental health coordinator and the execution of the procedures in accordance with the dentist’s diagnosis and treatment plan at a time the dentist is not physically present and in the facility as designated by rules of the board