Rule 4715-11-04.4 | Expanded function dental auxiliary; practice when the dentist is not physically present.
(A) Subject to the requirements set forth in paragraph (B) of this rule, an expanded function dental auxiliary may provide all of the following services to a patient when the supervising dentist is not physically present at the location where the services are provided:
(1) Application of pit and fissure sealants;
(2) Recementation of temporary crowns or recementation of crowns with temporary cement;
(3) Application of topical fluoride;
(4) Application of fluoride varnish;
(5) Application of disclosing solutions;
(6) Application of desensitizing agents;
(7) Caries susceptibility testing; and
(8) Instruction on oral hygiene home care, including the use of toothbrushes and dental floss.
(B) An expanded function dental auxiliary may provide the services in paragraph (A) of this rule for not more than fifteen consecutive business days to a patient when the supervising dentist is not physically present at the location at which the services are provided if all of the following requirements are met:
(1) The expanded function dental auxiliary has at least two years and a minimum of three thousand hours of experience practicing as an expanded function dental auxiliary. This experience shall be documented on a form supplied by the board, with any necessary supporting information attached, and the form shall be maintained in the facility(s) where the expanded function dental auxiliary is working.
(2) The expanded function dental auxiliary has successfully completed a course approved by the state dental board in the identification and prevention of potential medical emergencies. This board approved course shall be taken through a permanent sponsor, shall be at least four hours in duration, and shall include, at a minimum, the following topics:
(a) Medical history;
(b) Recognition of common medical emergency situations;
(c) Office emergency protocols;
(d) Basic airway management;
(e) Prevention of emergency situations during dental appointments; and
(f) Recognition of symptoms, first aid treatment and possible outcomes for patients who exhibit bleeding injuries, cardiovascular disease, insulin reaction, diabetic coma, shock, syncope, epileptic seizures and allergic reactions.
Completion of this course shall be documented on a form supplied by the board, with all necessary supporting information attached, and the form shall be maintained in the facility(s) where the expanded function dental auxiliary is working
(3) The supervising dentist has evaluated the expanded function dental auxiliary's skills and has made a determination that the expanded function dental auxiliary is competent to treat patients without the dentist being physically present. This determination shall be documented on a form supplied by the board, and the form shall be maintained at the facility(s) where the expanded function dental auxiliary is working.
(4) The supervising dentist examined the patient not more than one year prior to the date the expanded function dental auxiliary provides the services to the patient.
(5) The supervising dentist has established written protocols or written standing orders for the expanded function dental auxiliary to follow during and in the absence of an emergency.
(6) The supervising dentist completed and evaluated a medical and dental history of the patient not more than one year prior to the date the expanded function dental auxiliary provides services to the patient and the supervising dentist determines that the patient is in a medically stable condition.
(7) In advance of the appointment for dental services, the patient is notified that the supervising dentist will be absent from the location and that the expanded function dental auxiliary cannot diagnose the patient's dental health care status. This notification must be documented in the patient record.
(8) The expanded function dental auxiliary is employed by, or under contract with, one of the following:
(a) The supervising dentist;
(b) A dentist licensed under this chapter who is one of the following:
(i) The employer of the supervising dentist;
(ii) A shareholder in a professional association formed under Chapter 1785. of the Revised Code of which the supervising dentist is a shareholder;
(iii) A member or manager of a limited liability company formed under Chapter 1705. of the Revised Code of which the supervising dentist is a member or manager;
(iv) A shareholder in a corporation formed under division (B) of section 1701.03 of the Revised Code of which the supervising dentist is a shareholder;
(v) A partner or employee of a partnership or a limited liability partnership formed under Chapter 1775. or 1776. of the Revised Code of which the supervising dentist is a partner or employee.
(c) A government entity that employs the expanded function dental auxiliary to provide services in a public school or in connection with other programs the government entity administers.
(C) An expanded function dental auxiliary may apply pit and fissure sealants prior to a dentist examining the patient and rendering a diagnosis, and when a dentist is not physically present at the location where the service is provided, if all of the following are the case:
(1) All of the conditions specified in paragraph (B) of this rule have been satisfied, except for paragraphs (B)(4) and (B)(6) of this rule.
(2) The expanded function dental auxiliary is providing the service as part of a program operated through any of the following: a school district board of education or the governing board of an educational service center; the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code; a national, state, district, or local dental association; or any other public or private entity recognized by the state dental board.
(3) A supervising dentist for the program described in paragraph (C)(2) of this rule meets both of the following conditions:
(a) Is employed by or a volunteer for, and the patients are referred by, the entity through which the program is operated;
(b) Is available for consultation by telephone, videoconferencing, or other means of electronic communication.
(4) The application of pit and fissure sealants is limited to erupted permanent posterior teeth without suspicion of dentinal cavitation.
If the patient is a minor, a parent, guardian, or other person responsible for the patient has been notified that a dentist will not be present at the location and that the expanded function dental auxiliary is not trained to diagnose or treat other serious dental concerns that could exist.
Last updated September 8, 2023 at 2:27 PM
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