2018 Allowable and Prohibited Duties for Dental Assistants: Massachusetts. How to Use the Following Charts

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1 2017 Assisting National Board, Inc. All rights reserved Assisting National Board, Inc. All rights reserved Allowable and Prohibited Duties f s: How to Use the Following Charts View which job designations are used in your state. Be sure to follow the legal requirements to perfm dental radiographic. See which tasks are not permitted by state law. Review all the allowable tasks f each level of dental assisting as published in the state practice act. Arizona State-approved 1/4/17 Arizona State-approved 1/4/17 View the education/training/credential required f each level of dental assisting. Education/Training/ Credential Required To perfm specified restative functions in Arizona under the supervision of a licensed dentist, a dental assistant must hold an Arizona Restative Certificate. To qualify, one must: Hold the Arizona Conal Polishing certificate (see requirements below) and the Arizona Radiologic Proficiency certificate (see requirements to the right) Successfully complete an EFDA training course approved by the Arizona State Board of Examiners (ASBDE) at a Commission on Accreditation (CODA)- accredited program Pass DANB s AMP, TMP and RF exams Under the supervision of a licensed dentist, perfm restative required by the ASBDE (place, contour and finish 20 direct restations and place and cement five prefabricated crowns, following the preparation of the tooth by a licensed dentist) and document these on a Licensed Dentist Endsement fm Apply to DANB f the Arizona s Restative Certificate To perfm conal polishing in Arizona under the general supervision of a licensed dentist, a dental assistant must hold an Arizona Conal Polishing Certificate. To qualify, one must: Pass DANB s Conal Polish (CP) exam found in the Conal Polish Exam f Arizona Residents application packet Submit an Arizona Conal Polishing Clinical Skills Affidavit (completed by a licensed dentist a conal polishing educat/ course instruct) to DANB Receive the Arizona Conal Polishing Certificate, sent upon successful completion of the DANB CP exam and submission of the Arizona Conal Polishing Clinical Skills Affidavit to DANB A dental assistant in Arizona may perfm basic supptive dental specified by the state dental practice act (see opposite page) under the direct supervision of a licensed dentist. There are no education training requirements f this level of dental assisting. State of AZ qualified in conal polishing Proposed Standardized National Job Titles (see below) s DANB (CDA) Registered (RDA) Entry Level Radiography Requirements In der to legally operate dental x-ray equipment and perfm dental radiographic under the general supervision of a licensed dentist in Arizona, a dental assistant must hold a current Arizona boardapproved certificate in radiology. To obtain a certificate, one must: Pass the national DANB Radiation Health and Safety (RHS) exam Receive the Arizona Radiologic Proficiency Certificate, issued by DANB OR Be currently certified in another U.S. jurisdiction that requires successful completion of written and clinical dental radiography exam(s) Apply to the Arizona State Board of Examiners (ASBDE) f Radiography Certification by Credential and receive the Arizona Radiologic Proficiency Certificate, issued by the ASBDE Note: Arizona no longer requires dental assistants to take the Arizona Clinical Radiologic Proficiency Exam as a requirement f earning the Arizona Radiologic Proficiency Certificate, effective Jan. 1, s who passed the RHS exam pri to Jan. 1, 2011, but have not passed the clinical exam may call DANB at f infmation on how to obtain an Arizona Radiologic Proficiency Certificate. The ADAA/DANB Alliance developed a listing of standardized job titles (left) based on its national Ce Competencies Study conducted from The same study utilized a list of 70 job functions which were determined to be representative of a broad range of dental assisting ce competencies. s in this state that relate to the national DANB/ ADAA Ce Competencies Study are numbered to the right, using language directly from this state s dental practice act. (The numbers crespond to the study s task numbering system.) s listed with bullets are part of this state s practice act but are not specific matches to DANB/ADAA research. These state templates reflect the wk done by the ADAA/DANB Alliance to suppt a unifm national model f one set of dental assisting tasks, levels and requirements, which will serve as a viable career ladder f dental assistants. s NOT Permitted by s in AZ The following functions are not permitted by any level of dental assistant: 46. Taking final impressions f any activating thodontic appliance, fixed removable prosthesis 51. Intraal carvings of dental restations prostheses* A procedure which by law only licensed dentists, licensed dental hygienists, certified denturists can perfm Final jaw registrations Activating thodontic appliances An irreversible procedure * Under a new Arizona law passed in the 2015 legislative session, a dental assistant who has met the requirements f an listed in the first column on this page may perfm placement, contouring and finishing of direct restations. Allowable s (s with numbers relate specifically to Ce Competency designations; State of AZ functions with bullets are in this state s practice act but are not specific matches to DANB research) 18. Apply fluide varnish 40. Apply sealants Place interim therapeutic restations under the direction of a licensed dentist following a consultation conducted through teledentistry Level of Supervision Not Specified 12, 33, 51, 70. Perfm placement, contouring and finishing of direct restations the placement and cementation of prefabricated crowns following the preparation of the tooth by a licensed dentist; the restative materials used shall be determined by the dentist. qualified in conal 9. Perfm conal polishing polishing Under Direct Supervision* 61. Remove excess cement from inlays, Cleanse the supragingival surface of 18. Apply topical fluides crowns, bridges, and thodontic the tooth in preparation f: 27, 45. Place and remove dental dams appliances a. The placement of bands, crowns, and matrix bands 62. Remove periodontal dressings with and restations 40. Apply sealants hand instruments b. dam application 47, 50. Fabricate and place interim Prepare a patient f nitrous oxide and c. Acid etch restations with tempary cement oxygen administration upon d. Removal of dressings and packs 54, 55. Remove tempary cement the direct instruction and presence of a and interim restations with hand dentist instruments Place dental material into a patient s 59. Observe a patient during nitrous oxide mouth in response to a licensed and oxygen as instructed by dentist s instruction the dentist 2. Collect and recd infmation pertaining to extraal conditions 2. Collect and recd infmation pertaining to existing intraal conditions 24, 26. Train instruct patients in al hygiene techniques, preventive, dietary counseling f caries and plaque control, and provide pre- and post-operative instructions relative to specific office treatment *Direct supervision: "Direct Supervision" means, f purposes of Article 7 only, that a licensed dentist is present in the office and available to provide immediate treatment care to a patient and observe a dental assistant s wk. General supervision: "General Supervision" means, f purposes of Article 7 only, a licensed dentist is available f consultation, whether not the dentist is in the office, regarding treatment that the dentist authizes and f which the dentist remains responsible. The numbers next to each task crespond to the 70 numbered tasks that were identified and used in the DANB/ADAA Ce Competencies Study. Tasks that are not numbered do not directly match one of the 70 tasks, yet are identified by the state in the practice act. A full list of those tasks follow your state s chart. See Appendix A f me infmation about the task numbering system. Compare your state s job designations to those used as standardized job titles in the DANB/ADAA Ce Competencies Study. If your state s dental practice act specifically defines levels of supervision, the state-specific definition is noted below the chart. See Appendix B f me infmation about supervision. These data are presented f infmational 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 infmation. To verify, 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 Assisting National Board, Inc. (DANB). DANB, Assisting National Board, RHS, ICE, and Measuring Assisting Excellence are registered service marks of DANB. CERTIFIED DENTAL ASSISTANT is a certification mark of DANB. 201 Assisting National Board, Inc.

2 2018 Assisting National Board, Inc. All rights reserved. State-approved 11/7/17 Education/Training/ Credential Required To qualify as an, one must: Be 18 years of age and of good mal character Hold any of the following national DANB certifications: CDA, COA, CPFDA CRFDA; certification from another Board-approved certifying body at the time of registration Complete a fmal program in the delegable expanded functions at a CODAaccredited program Hold current certification in CPR/AED f the Professional Rescuer from the American Red Cross BLS from the American Heart Association Apply to the MA Board of Registration in Dentistry f registration. To qualify as a Fmally, one must: Be 18 years of age and of good mal character Complete a dental assisting program accredited by CODA authized, approved, accredited, licensed certified by the Department of Higher Education (DHE), the New England Association of Schools and Colleges (NEASC) both Hold current certification in CPR/AED f the Professional Rescuer from the American Red Cross BLS from the American Heart Association Apply to the MA Board of Registration in Dentistry f registration. To qualify as a (CA), one must: Be 18 years of age and of good mal character Hold any of the following national DANB certifications: CDA, COA, CPFDA CRFDA; certification from another Board-approved certifying body at the time of registration Hold current certification in CPR/AED f the Professional Rescuer from the American Red Cross BLS from the American Heart Association Apply to the MA Board of Registration in Dentistry f registration To qualify as a on the Job (OJT), one must: Be 18 years of age, of good mal character, and not licensed as a dentist dental hygienist Complete a course in infection control/cdc guidelines* Hold current certification in CPR/AED f the Professional Rescuer from the American Red Cross BLS from the American Heart Association Apply to the MA Board of Registration in Dentistry f registration. A person who is at least 18 years of age and who has not previously been licensed as a dental assistant, dental hygienist, dentist may undergo unlicensed on-the-job training f a one-time period of up to six consecutive months. Pri to commencing training, the prospective dental assistant must complete infection control education and must submit a notice of intent to the MA Board of Registration in Dentistry containing infmation required by the Board. State of MA (CA) Fmally on the Job (OJT) Proposed Standardized National Job Titles (see below) s DANB (CDA) Registered (RDA) Entry Level Radiography Requirements To take dental radiographs under the supervision of a dentist, a dental assistant must Be an on on-the-job trained (OJT) Complete a course in radiological techniques and safeguards Pass the DANB Radiation Health and Safety (RHS) exam other exam approved by the Board of Registration in Dentistry, within one year of the course completion OR Be a, (CA), Fmally Successfully complete a course with a curriculum that complies with Commission on Accreditation (CODA) standards f radiological techniques and safeguards in dentistry The ADAA/DANB Alliance developed a listing of standardized job titles (left) based on its national Ce Competencies Study conducted from The same study utilized a list of 70 job functions which were determined to be representative of a broad range of dental assisting ce competencies. s in this state that relate to the national DANB/ADAA Ce Competencies Study are numbered to the right, using language directly from this state s dental practice act. (The numbers crespond to the study s task numbering system.) s listed with bullets are part of this state s practice act but are not specific matches to DANB/ADAA research. These state templates reflect the wk done by the ADAA/ DANB Alliance to suppt a unifm national model f one set of dental assisting tasks, levels, and requirements, which will serve as a viable career ladder f dental assistants. s NOT Permitted by s in MA The following functions are not permitted by any level of dental assistant: 2. Perfm and recd charting of the al cavity and surrounding structures, including but not limited to existing dental restations, lesions, and periodontal probing depths 20. Perfm sub-gingival and supra-gingival scaling 29. Perfm final positioning and attachment of thodontic bonds and bands 46. Take final impressions f fixed and removable prosthetic restation of teeth al structures 49. Perfm pulp testing Perfm final diagnoses and treatment planning Perfm surgical cutting on hard soft tissue Prescribe parenterally administer drugs medicaments Prescribe dental lab wk ders f any appliance prosthetic device restation to be inserted into a patient s mouth Operate high speed rotary instruments in the mouth Perfm pulp-capping Perfm final cementation of Perfm preliminary evaluation to determine needed dental hygiene services Make referrals to dentist, physicians and other practitioners in consultation with a dentist Conduct dental screenings Evaluate radiographs f provision of dental hygiene services Perfm min emergency denture adjustments in nursing homes other residential long-term care facilities Perfm min emergency dental adjustments Administer local anesthesia Perfm gross debridement and/ scaling and root planing Perfm root planing and curettage Prepare and perfm al cytological smears studies Use diagnostic and periodontic non-cutting lasers Perfm polishing of amalgam restations Perfm micro disk identification applications Perfm periodontal charting Irrigate root canals 64

3 2018 Assisting National Board, Inc. All rights reserved. State-approved 11/7/17 State of MA Allowable s (s with numbers relate specifically to Ce Competency designations; functions with bullets are in this state s practice act but are not specific matches to DANB research) With Immediate Supervision* 12, 33. Place restative materials in tooth f condensation and finishing by the dentist 14 Dry root canals with paper points 34. Apply cavity varnish, liner(s) and bonding agents 43. Select and adapt stainless steel crowns other pre-fmed crown f insertion by dentist 58. Removal of implant healing caps/cover screws f restative 59. Assist monit nitrous oxide Under supervision of a dentist holding a deep sedation/general anesthesia permit Assist in anesthesia administration, including patient moniting (must be appropriately trained and hold current certification in BLS f the Healthcare Provider) With Direct Supervision* 6. Place and remove gingival retraction materials 12, 51 Place and condense amalgam restations 33. Place and finish composite restations 51. Carve, contour, adjust amalgam restations 9. Polish teeth, after dentist dental hygienist has determined that teeth are free of calculus, with slow-speed hand piece 15. Place and remove thodontic arch wires 18. Apply anti-cariogenic agents, including fluide varnish 22. Expose radiographs (see "Radiography Requirements" on previous page) 24. Provide al health instruction 27. Place and remove dental dams 29. Preliminary intraal fit of bands 35, 62. Place and remove periodontal dressings 37. Take and recd vital signs 40. Apply and adjust dental sealants 42. Place and remove thodontic separats 44. Take impressions f study casts and bite registrations, including f identification purposes, night guards and custom fluide and bleaching trays pursuant to a dentist s prescription der 70. Place stainless steel crowns Recd dental screenings Recd charting of the al cavity and surrounding structures, including but not limited to dental restations, lesions and periodontal probing depths 44. Take impressions f thodontic retainers 44,64. Take impressions f athletic mouth guards 47. Fabricate provisional restations intraally 47,54. Cement and remove tempary 48. Irrigate and aspirate the al cavity 48. Retract lips, cheek, tongue and other al tissue parts 50. Place tempary restations (not including tempization of inlays, onlays, ) to provide palliative treatment 50. Place cotton pellets and tempary restative materials into endodontic openings 50. Place tempary sedative restations/fillings 54, 55. Remove tempary restations 56. Apply topical anesthetic agents agents from bridges and appliances (including thodontic appliances) Apply bleaching agents and activate with non-laser non-curing device Obtain endodontic cultures Preliminarily fit crowns to check contacts, adjust occlusion on crowns inside the mouth Place tempary soft liners in a removable prosthesis 68. Perfm min emergency palliative thodontic adjustments to eliminate pain and discomft Re-cement and adjust intact tempary restations intraally Apply desensitizing agents Place and remove wedges Insert and/ perfm min adjustment of night mouth guards, athletic mouth guards and custom fluide trays Preliminary al fit of arch wire Select size of headgear Etch appropriate enamel surfaces befe bonding of thodontic appliances by a dentist Place elastics and ligature wires Remove fixed thodontic appliances Take intra-al photographs Review medical and dental histy Perfm dietary screening f dental disease prevention and control Adjust dentures on the tissue side to eliminate tissue irritation (CA) Fmally With Immediate Supervision* 12, 33. Place restative materials in tooth f condensation and finishing by the dentist 34. Apply cavity varnish, liner(s) and bonding agents 43. Select and adapt stainless steel crowns other pre-fmed crown f insertion by dentist 50. Place tempary sedative restations/ fillings (CA only; FTDA is not allowed to perfm this function) With Direct Supervision* 6. Place and remove gingival retraction materials 40. Apply and adjust dental sealants 47. Fabricate provisional restations intraally 50. Place cotton pellets and tempary restative materials into endodontic openings agents from bridges and appliances 54, 55. Remove tempary restations 58. Removal of implant healing caps/cover screws f restative 59. Assist monit nitrous oxide 70. Place stainless steel crowns Place tempary soft liners in a removable prosthesis (FTDA; CA may perfm under immediate supervision) Obtain endodontic cultures (FTDA; CA may perfm under direct supervision) (including thodontic appliances) Recd dental screenings Recd charting of the al cavity and surrounding structures, including but not limited to dental restations, lesions and periodontal probing depths Apply desensitizing agents Place and remove wedges Apply bleaching agents and activate with non-laser non-curing device Under supervision of a dentist holding a deep sedation/general anesthesia permit Assist in anesthesia administration, including patient moniting (must be appropriately trained and hold current certification in BLS f the Healthcare Provider) Preliminarily fit crowns to check contacts, adjust occlusion on crowns inside the mouth (CA only; FTDA is not allowed to perfm this function) Place tempary soft liners in a removable prosthesis (CA; FTDA may perfm under immediate supervision) Obtain endodontic cultures (CA; FTDA may perfm under immediate supervision) Continued *Immediate Supervision: Direct Supervision: General Supervision: Supervision of dental by a licensed dentist, who remains in the dental facility, personally diagnoses the condition to be treated, personally authizes the, and befe dismissal of the patient, evaluates the treatment rendered. Supervision of dental based on instructions given by a licensed dentist who remains in the dental facility while the are being perfmed by the auxiliary Supervision of dental based on instructions given by a licensed dentist but not requiring the physical presence of a supervising dentist during the perfmance of those. 65

4 2018 Assisting National Board, Inc. All rights reserved. -Continued State-approved 11/7/17 State of MA Allowable s (s with numbers relate specifically to Ce Competency designations; functions with bullets are in this state s practice act but are not specific matches to DANB research) (CA) Fmally 9. Polish teeth, after dentist dental hygienist has determined that teeth are free of calculus, with slow-speed hand piece 15. Place and remove thodontic arch wires 18. Apply anti-cariogenic agents, including fluide varnish 22. Expose radiographs (See "Radiography Requirements" on p. 64 ) 24. Provide al health instruction 27. Place and remove dental dams 29. Preliminary intraal fit of bands 35, 62. Place and remove periodontal dressings 37. Take and recd vital signs 48. Irrigate and aspirate the al cavity 42. Place and remove thodontic separats 44, 64. Take impressions f study casts and bite registrations, including f identification purposes, night guards, and custom fluide and bleaching trays pursuant to a dentist s prescription der 44. Take impressions f thodontic retainers 44, 64. Take impressions f athletic mouth guards 47, 54. Cement and remove tempary 48. Retract lips, cheek, tongue and other al tissue parts 50. Place tempary restations (not including tempization of inlays, onlays, ) to provide palliative treatment 56. Apply topical anesthetic agents 68. Perfm min emergency palliative thodontic adjustments to eliminate pain and discomft Insert and/ perfm min adjustment of night mouth guards, athletic mouth guards and custom fluide trays Preliminary al fit of archwire Select size of headgear Etch appropriate enamel surfaces befe bonding of thodontic appliances by a dentist Place elastics and ligature wires Remove fixed thodontic appliances Remove excess cement and bonding agents from thodontic appliances Re-cement and adjust intact tempary restations intraally Review medical and dental histy and consult when necessary with medical practitioner Take intraal photographs Perfm dietary screening f dental disease prevention and control on the Job (OJT) With Immediate Supervision* 12, 33. Place restative materials in tooth f condensation and finishing by the dentist 34. Apply cavity varnish, liner(s) and bonding agents 43. Select and adapt stainless steel crowns other pre-fmed crown f insertion by dentist 44, 64. Take impressions f study casts and bite registrations, including f identification purposes, night guards and custom fluide and bleaching trays pursuant to a dentist s prescription der 44, 64. Take impressions f athletic mouth guards 47. Fabricate provisional restations intraally 47, 54. Cement and remove tempary 50. Place tempary restations (not including tempization of inlays, onlays, ) to provide palliative treatment 58. Removal of implant healing caps/cover screws f restative 59. Assist monit nitrous oxide agents from bridges and appliances 68. Perfm min emergency palliative thodontic adjustments to eliminate pain and discomft Place and remove wedges Insert and/ perfm min adjustment of night mouth guards, athletic mouth guards and custom fluide trays Apply bleaching agents and activate with a non-laser non-curing device Under supervision of a dentist holding a deep sedation/general anesthesia permit Assist in anesthesia administration, including patient moniting (must be appropriately trained and hold current certification in BLS f the Healthcare Provider) With Direct Supervision* 6. Place and remove gingival retraction materials 15. Place and remove thodontic arch wires 18. Apply anti-cariogenic agents, including fluide varnish 24. Provide al health instruction 27. Place and remove dental dams 29. Preliminary intraal fit of bands 42. Place and remove thodontic separats 44. Take impressions f thodontic retainers 50. Place cotton pellets and tempary restative materials into endodontic openings 56. Apply topical anesthetic agents agents from thodontic appliances Recd dental screenings Recd charting of the al cavity and surrounding structures, including but not limited to dental restations, lesions and periodontal probing depths Preliminary al fit of arch wire Apply desensitizing agents Select size of headgear Etch appropriate enamel surfaces befe bonding of thodontic appliances by a dentist Place elastics and ligature wires Remove fixed thodontic appliances 22. Expose radiographs (see "Radiography Requirements" on p. 64) 37. Take and recd vital signs 48. Retract lips, cheek, tongue and other al tissue parts 48. Irrigate and aspirate the al cavity Review medical and dental histy and consult when necessary with medical practitioner Take intraal photographs *Immediate Supervision: Direct Supervision: General Supervision: Supervision of dental by a licensed dentist, who remains in the dental facility, personally diagnoses the condition to be treated, personally authizes the, and befe dismissal of the patient, evaluates the treatment rendered. Supervision of dental based on instructions given by a licensed dentist who remains in the dental facility while the are being perfmed by the auxiliary. Supervision of dental based on instructions given by a licensed dentist but not requiring the physical presence of a supervising dentist during the perfmance of those. 66

5 Appendix A: Numbering System f Assisting s The following list of 70 dental assisting tasks was developed by the ADAA/DANB Alliance as part of a study of dental assisting ce competencies conducted between 2002 and These selected tasks were determined to be representative of a broad range of dental assisting ce competencies. The numbered functions listed in the preceding state charts crespond to functions that were included in the DANB/ ADAA ce competencies study and use language directly from the state s dental practice act. The numbers are provided to facilitate comparison between and among states. s listed with bullets in the preceding charts are part of the state s practice act but are not specific matches to the functions that were included in the study. 1. Perfm mouth mirr inspection of the al cavity 2. Chart existing restations conditions 3. Phone in prescriptions at the direction of the dentist 4. Receive and prepare patients f treatment, including seating, positioning chair, and placing napkin 5. Complete labaty authization fms 6. Place and remove retraction cd 7. Perfm routine maintenance of dental equipment 8. Monit and respond to postsurgical bleeding 9. Perfm conal polishing 10. Apply effective communication techniques with a variety of patients 11. Transfer dental instruments 12. Place amalgam f condensation by the dentist 14. Dry canals 15. Tie in archwires 16. Demonstrate knowledge of ethics/ jurisprudence/patient confidentiality 17. Identify features of rotary instruments 18. Apply topical fluide 19. Select and manipulate gypsums and waxes 20. Perfm supragingival scaling 21. Mix dental materials 22. Expose radiographs 23. Evaluate radiographs f diagnostic quality 24. Provide patient preventive education and al hygiene instruction 25. Perfm sterilization and disinfection 26. Provide pre- and post-operative instructions 27. Place and remove dental dam 28. Pour, trim, and evaluate the quality of diagnostic casts 29. Size and place thodontic bands and brackets 30. Using the concepts of fourhanded dentistry, assist with basic restative, including prosthodontics and restative dentistry 31. Identify intraal anatomy 32. Demonstrate understanding of the OSHA Hazard Communication Standard 33. Place, cure and finish composite resin restations 34. Place liners and bases 35. Place periodontal dressings 36. Demonstrate understanding of the OSHA Bloodbne Pathogens Standard 37. Take and recd vital signs 38. Monit vital signs 39. Clean and polish removable appliances and prostheses 40. Apply pit and fissure sealants 41. Prepare procedural trays/ armamentaria set-ups 42. Place thodontic separats 43. Size and fit stainless steel crowns 44. Take preliminary impressions 46. Take final impressions 47. Fabricate and place tempary crowns 48. Maintain field of operation during dental through the use of retraction, suction, irrigation, drying, placing and removing cotton rolls, etc. 49. Perfm vitality tests 50. Place tempary fillings 51. Carve amalgams 52. Process dental radiographs 53. Mount and label dental radiographs 54. Remove tempary crowns and cements 55. Remove tempary fillings 56. Apply topical anesthetic to the injection site 57. Demonstrate understanding of the Centers f Disease Control and Prevention Guidelines 58. Using the concepts of fourhanded dentistry, assist with basic intraal surgical, including extractions, periodontics, endodontics, and implants 59. Monit nitrous oxide/oxygen 60. Maintain emergency kit 61. Remove permanent cement from supragingival surfaces 62. Remove periodontal dressings 63. Place post-extraction dressings 64. Fabricate custom trays, to include impression and bleaching trays, and athletic mouthguards 65. Recognize basic medical 66. Recognize basic dental 67. Respond to basic medical 68. Respond to basic dental 69. Remove post-extraction dressings 70. Place stainless steel crown 2018 Assisting National Board, Inc.

6 Appendix B: Levels of Supervision An imptant consideration in the discussion of the delegation of tasks to dental assistants is that of supervision of dental assistants by their dentist-employers. The American Association (ADA) has identified five levels of supervision f dental auxiliaries, including dental assistants, which it defines in its Comprehensive Policy Statement on Allied Personnel, (2010: 505) which is part of its Current Policies, last updated in Note that allied dental personnel refers to dental assistants, dental hygienists, community dental health codinats and dental labaty technicians. The five levels of supervision defined by the ADA are as follows: Personal supervision: A type of supervision in which the dentist is personally operating on a patient and authizes the allied dental personnel to aid treatment by concurrently perfming a supptive procedure. Direct supervision: A type of supervision in which a dentist is in the dental office treatment facility, personally diagnoses and treatment plans the condition to be treated, personally authizes the and remains in the dental office treatment facility while the are being perfmed by the allied dental personnel and evaluates their perfmance befe dismissal of the patient. Indirect supervision: A type of supervision in which a dentist is in the dental office treatment facility, has personally diagnosed and treatment planned the condition to be treated, authizes the, and remains in the dental office treatment facility while the are being perfmed by the allied dental personnel, and will evaluate the perfmance of the allied dental personnel. General supervision: A type of supervision in which a dentist is not required to be in the dental office treatment facility when are provided, but has personally diagnosed and treatment planned the condition to be treated, has personally authized the, and will evaluate the perfmance of the allied dental personnel. Public Health Supervision: A type of supervision in which a licensed dental hygienist may provide dental hygiene services, as specified by state law regulations, when such services are provided as part of an ganized community program in various public health settings, as designated by state law, and with general oversight of such programs by a licensed dentist designated by the state. Furtherme, the ADA s Comprehensive Policy Statement on Allied Personnel stipulates that intraal expanded functions should be perfmed by allied dental personnel under the supervision of a dentist. Because the study of dental assisting ce competencies undertaken by the ADAA/DANB Alliance did not address the question of supervision, the ADAA/DANB Alliance does not make any recommendations as to the levels of supervision that should be necessary f the delegation of the tasks included in the study to dental assistants. However, the ADAA/DANB Alliance believes it is imptant to call attention to the fact that, while the ADA has defined supervision levels in the afementioned policy statement, which governs the ADA s own activities and the activities of its members, these definitions have not been unifmly adopted by the dental boards of every U.S. state district. F the purposes of the attached charts, if a state s dental practice act specifically defines levels of supervision, the state-specific definition is noted in the footer of the second page of the state chart. Measuring Assisting Excellence Assisting National Board, Inc. (DANB) 444 N. Michigan Ave., Suite 900, Chicago, IL Fax: danbmail@danb.g Assisting National Board, Inc.