2018 Allowable and Prohibited Duties for Dental Assistants: Texas How To

2018 Allowable and Prohibited Duties for Dental Assistants: Texas

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 TX State of TX National Job Requirements Titles (see below) To perform expanded functions under the general or direct supervision of a licensed dentist in Texas, a dental assistant must To legally operate dental x-ray The following functions are © 2018 Dental Assisting National Board, Inc. All rights reserved. complete the following: Note: Effective September equipment and perform dental not permitted by any level of 1, 2017, the pit and fissure radiographic procedures in the dental assistant: Monitor the administration of nitrous oxide: sealants certificate and state of Texas, one must be a  Completed a minimum of 8 hours coronal polishing certificate, Registered Dental Assistant (see 20. The removal of calculus, of didactic education and testing formerly required for dental requirements to the left). deposits or accretions in monitoring the administration of assistants to qualify to from the natural and nitrous oxide taken through a CODA- perform these functions in A dental assistant will not be restored surfaces of accredited dental, dental hygiene or Texas, have been discon- considered to be positioning, exposed human teeth and dental assisting program, approved tinued. Effective March 18, exposing, or otherwise making restorations in the human by the TSBDE 2018, the Texas Board has dental x-rays if the dental assistant mouth AND passed new requirements only performs radiological 33. The placement of any final  Complete a current course in Basic for dental assistants to be procedures in the course of training restoration Life Support eligible to perform these (or for other educational purposes) 46. The taking of an AND functions. and is at all times under the direct impression for a final  Apply to the TSBDE for a nitrous supervision of the employer dentist. restoration, appliance or oxide monitoring certificate A dental assistant performing prosthesis radiological procedures in the • Root planing or the Perform coronal polishing procedures: course of on-the-job training may smoothing and polishing of  Work at least two years as a dental Dental Expanded only do so for a period of one year. roughened root surfaces or assistant Assistant exposed human teeth  Functions Complete a minimum of eight hours qualified Dental • Comprehensive clinical and didactic education in to perform Assistant examination or diagnosis coronal polishing taken through expanded (EFDA) and treatment planning a dental school, dental hygiene functions • Surgical or cutting school or dental assisting program procedure on hard or soft accredited by CODA and approved by tissue the TSBDE • The prescription of a OR drug, medication or work Earn DANB's Coronal Polish (CP) authorization certificate of knowledge-based • The making of an intraoral competence occlusal adjustment OR • Direct pulp capping, Graduate from a CODA-accredited pulpotomy or any other dental assisting program approved by endodontic procedure the TSBDE that includes clinical and • The final placement and didactic education in coronal polishing intraoral adjustment of

a fixed or removable Perform pit and fissure sealant appliance procedures: • The authority to an  Work at least two years as a dental  individual to administer assistant a local anesthetic agent, AND inhalation sedative agent,  Complete a current course in Basic The ADAA/DANB Alliance parenteral sedative agent Life Support developed a listing of or general anesthetic agent AND standardized job titles • Diagnosis, treatment  Complete a minimum of eight hours (left) based on its national Core planning, prescription of clinical and didactic education in pit Competencies Study conducted from therapeutic measures and and fissure sealants taken through 2002-2005. reevaluation a CODA-accredited dental, dental • Placement of site-specific hygiene, or dental assistant program subgingival medicaments and approved by the TSBDE The same study utilized a list of 70 • Any other act the job functions which were determined delegation of which is A dental assistant in Texas can earn to be representative of a broad prohibited by board rule status as a Registered Dental Assistant DANB range of dental assisting core (RDA) by formally registering with the Certified competencies. TSBDE. To qualify, one must: Registered Dental Dental Assistant Functions in this state that relate to  Complete a current course in basic Assistant (CDA) the national DANB/ADAA life support (RDA) or Core Competencies Study AND Registered are numbered to the right, using language directly from   Complete a mandatory course of Dental training specified by the TSBDE that Assistant this state’s dental practice act. (The includes procedures for positioning (RDA) numbers correspond to the study’s and exposing dental x-rays, task numbering system.) jurisprudence and infection control OR Functions listed with bullets are part Earn the national DANB CDA of this state’s practice act but are certification and successfully not specific matches to DANB/ADAA complete the TSBDE jurisprudence research. assessment. AND  Apply to the TSBDE for registration Dental These state templates reflect the Assistant work done by the ADAA/DANB A dental assistant in the state of Texas Alliance to support a uniform may perform basic supportive dental national model for one set of procedures specified by the state dental Dental Assistant dental assisting tasks, levels practice act under the direct supervision of a Entry and requirements, which will licensed dentist (see opposite page). Level serve as a viable career ladder Dental for dental assistants. There are no education or training require- Assistant ments for this level of dental assisting.

132 State-approved 11/27/17 Texas Updated by DANB 5/4/18

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

Under Direct Supervision*

9. Coronal polishing (see requirements on previous page) Dental 40. Apply pit and fissure sealants, to Assistant include the use of a rubber qualified prophylaxis cup and appropriate to perform polishing materials to cleanse the expanded occlusal and smooth surfaces of functions teeth that will be sealed or to prepare teeth for application of orthodontic bonding resins (see requirements on previous page) 59. Monitor nitrous oxide (see requirements on previous page)

Under General Supervision*

22. Expose radiographs (see Registered “Radiography Requirements” on Dental previous page Assistant (RDA)

Under General Supervision* Under Direct Supervision* • The provision of interim treatment of 18. Apply fluoride varnish a minor emergency dental condition • Reversible acts and procedures to an existing patient of the treating dentist; the treating dentist must delegate the procedure orally or in writing before the dental assistant Dental performs the procedure, must retain Assistant responsibility for the procedure, and must schedule a follow-up appointment with the patient within a reasonable time

DANB’s Note on Allowable Dental Assisting Functions In the state of Texas, 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.

*Direct Supervision: The dentist who employs the dental assistant or is in charge of the dental assistant must be physically present in the dental office when the dental assistant performs a delegated dental act. General Supervision: The dentist who employs or is in charge of the dental assistant is responsible for supervising the services to be performed by the dental assistant. The dentist may or may not be present on the premises when the dental assistant performs the procedures. 133