The New Jersey Board of Dentistry (Board) recently expanded the scope of practice of licensed dental hygienists, limited registered dental assistants in orthodontics and registered dental assistants. Effected providers should become familiar with these expanded parameters.
The amended rule now allows a licensed dental hygienist practicing under the direct supervision of a licensed dentist to take impressions for orthodontic appliances; place orthodontic separators (provided that the supervising licensed dentist reviews the placement to ensure proper placement of the orthodontic separators); remove bands and brackets without the use of rotary instruments; remove primary adhesive, without the use of rotary instruments, after debanding and/or debonding; and perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.
The rule was also amended to permit a licensed dental hygienist practicing under the general supervision of a licensed dentist in a dental office or a dental clinic to perform the same functions. Similarly, the expanded rule also permits a licensed dental hygienist practicing under the general supervision of a New Jersey licensed dentist in an institution to perform all of the above new functions except for the placement of orthodontic separators.
The amended rule further clarified that a licensed dental hygienist who engages in conduct without the appropriate supervision or administers local anesthesia without a permit and without direct supervision can be liable for engaging in the unauthorized practice of dental hygiene which will be considered professional misconduct.
Additionally, the amended rule provides for the expanded scope of a registered dental assistant who may perform the following duties under the direct supervision of a licensed dentist: take impressions for orthodontic appliances (provided that the supervising licensed dentist reviews and evaluates the impression prior to its use for fabrication); place orthodontic separators (provided that the supervising licensed dentist ensures proper placement); remove bands and brackets without the use of rotary instruments; and perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.
The rule further expanded the role of limited registered dental assistant in orthodontics whose can now perform all the new functions permitted to a registered dental assistant (mentioned in the preceding paragraph) under the direct supervision of an orthodontist as well as the following: with limitations, use a curing light for any dental procedure; apply topical anesthetic agents; apply topical fluoride; etch teeth in preparation for bonding, sealants, and desensitizing agents; place and ligate arch wires (provided that the supervising licensed dentist verifies the fit). The amended rule clarifies that only the supervising licensed dentist is permitted to customize the arch wire for the patient.
The Board further clarified that while both registered dental assistants and limited registered dental assistants in orthodontics can remove excess cement from crowns or other restorations and orthodontic appliances, such removal may not include any subgingival cement or debris.
Performing these newly expanded functions by dental assistants or limited registered dental assistant in orthodontics without the direct supervision of a licensed dentist/orthodontist would be considered unauthorized practice and professional misconduct subject to penalties and further Board action.
If you have any additional questions regarding the expanded scope of dental hygienists or dental assistants or have other health law related questions please contact our office.