4715-9-01 Permissible practices of a dental hygienist.

(A) The dental hygienist may perform the following tasks and/or procedures under the direct supervision of a licensed dentist if the dental hygienist has completed the requirements set forth in sections 4715.23 , 4715.39 , and 4715.23 1 of the Revised Code and board rules. The dental hygienist must have completed a basic life-support training course certified by the American heart association, the American red cross or the American safety and health institute and remain current at all times when performing the following tasks and/or procedures:

(1) Administration of intraoral block and infiltration local anesthesia - Upon completion of the requirements set forth in sections 4715.23 and 4715.231 of the Revised Code and rule 4715-9-01.1 of the Administrative Code, a licensed dental hygienist may administer intraoral block and infiltration local anesthesia.

(2) Administration (initiate, adjust, monitor, and terminate) of nitrous oxide-oxygen (N 2 O-O 2 ) minimal sedation - Upon completion of the requirements set forth in section 4715.23 of the Revised Code and rule 4715-9-01.2 of the Administrative Code, a licensed dental hygienist may administer N 2 O-O 2 minimal sedation while providing treatment if the following requirements are met:

(a) The supervising dentist has evaluated the patient and prescribed the use of N 2 O-O 2 minimal sedation.

(b) The supervising dentist must approve the use of N 2 O-O 2 minimal sedation immediately prior to each instance of administration.

(c) The dental hygienist shall not administer N 2 O-O 2 minimal sedation to more than one patient at a time.

(d) The dental hygienist shall physically remain with the patient at all times.

(e) The supervising dentist approves the discharge of the patient.

(3) Monitoring nitrous oxide-oxygen (N 2 O-O 2 ) minimal sedation - Upon completion of the requirements set forth in sections 4715.23 and 4715.39 of the Revised Code and rule 4715-9-01.3 of the Administrative Code, a licensed dental hygienist may monitor N 2 O-O 2 minimal sedation while providing treatment if the following requirements are met:

(a) A satisfactory initiation phase has been administered by the dentist.

(b) The dental hygienist shall not monitor more than one patient at a time.

(c) The dental hygienist shall physically remain with the patient at all times.

(d) The dental hygienist must document the supervising dentist's approval for discharge of the patient.

(e) The dental hygienist, who is qualified to only monitor N 2 O-O 2 minimal sedation, shall not under any circumstances administer, adjust, or terminate N 2 O-O 2 minimal sedation.

The completion of all requirements for paragraphs (A)(1) to (A)(3) of this rule shall be documented on a form supplied by the board, with all supporting information attached. This form shall be maintained in the facility(s) where the dental hygienist is working.

(B) The dental hygienist may perform the following tasks and/or procedures which may be delegated only to a licensed dental hygienist under the supervision of a licensed dentist:

(1) Removal of calcareous deposits or accretions from the crowns and roots of teeth.

(2) Periodontal scaling, root planing, and soft tissue curettage.

(3) Sulcular placement of prescribed materials.

(4) Bleaching of teeth (excluding procedures that utilize light amplification by stimulated emission of radiation (LASER) technologies).

(C) The dental hygienist may also perform the following tasks and/or procedures under the supervision of a licensed dentist:

(1) Polishing of the clinical crown(s) of teeth, including restorations.

(2) Pit and fissure sealants.

(3) Standard, diagnostic, radiologic procedures for the purpose of contributing to the provision of dental services.

(D) In performing advanced remediable restorative intra-oral dental tasks and/or procedures, the licensed dental hygienist is subject to sections 4715.61 to 4715.66 of the Revised Code and agency level rules regulating expanded function dental auxiliaries.

(E) In performing basic remediable intra-oral and extra-oral dental tasks and/or procedures, the licensed dental hygienist is subject to those rules regulating basic qualified personnel. However, dental hygienists may engage in the following duties when the dentist is not physically present, subject to the limitations outlined in divisions (C) and (D) of section 4715.22 of the Revised Code, which must be adhered to when performing these duties:

(1) Aspiration and retraction, excluding placement of gingival retraction materials.

(2) Intra-oral instrument transfer.

(3) Preliminary charting of missing and filled teeth.

(4) Elastomeric impressions for diagnostic models and models to be used for opposing models in the construction of appliances and restorations.

(5) Taking impressions for the construction of custom athletic mouth protectors/mouthguards, and trays for application of medicaments.

(6) Application of disclosing solutions.

(7) Caries susceptibility testing.

(8) Demonstration of oral hygiene procedures, including, but not limited to, use of toothbrushes and dental floss.

(9) Application of topical anesthetics.

(10) Fluoride application.

(11) Topical applications of desensitizing agents to teeth.

(12) Application and removal of periodontal dressings.

(13) Intra-oral bite registrations for diagnostic model articulation.

(14) All supportive services necessary to the maintenance of a hygienic practice environment, including, but not limited to, all sterilizing procedures.

(15) All supportive services or procedures necessary to protect the physical well-being of the patient during routine treatment procedures and during periods of emergencies, including, but not limited to:

(a) Physical positioning of the patient;

(b) Monitoring of vital signs;

(c) Assistance during administration of life-support activities; and

(d) Any other non-invasive procedures deemed necessary by the supervising dentist to maintain the health and safety of the patient.

(16) All non-invasive supportive services and procedures necessary to the gathering and maintaining of accurate and complete medical and dental history of the patient, including but not limited to:

(a) Taking photographs;

(b) Recording patient treatment;

(c) Measurement of blood pressure and body temperature; and

(d) Other common tests deemed necessary by the supervising dentist.

(17) All extra-oral supportive laboratory procedures, including, but not limited to:

(a) Repair, construction and finishing of metallic and plastic prosthetic devises; and

(b) Compilation of radiographic data for interpretation by the dentist, i.e., tracings, etc.

(18) The preparation of impression materials.

(19) All patient education services, including, but not limited to:

(a) Progress reports;

(b) Consultations (oral or written);

(c) Oral hygiene instructions;

(d) Use of intra-oral hygiene devices;

(e) Normal nutrition information as it relates to dental health;

(f) Behavioral modification;

(g) Self adjustment of orthodontic appliances; and

(h) All other post-operative and post-insertion instructions, as deemed appropriate by the supervising dentist.

Replaces: 4715-9-01

Effective: 12/24/2010
R.C. 119.032 review dates: 12/01/2015
Promulgated Under: 119.03
Statutory Authority: 4715.03 , 4715.39
Rule Amplifies: 4715.22 , 4715.23 , 4715.231 , 4715.39
Prior Effective Dates: 04-05-77, 04-01-90, 02-05-93, 07-25-93, 03-03-95, 04-05-99, 06-17-99, 05-15-03, 06-21-04, 10-09-06