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Regulations - Chapter 3, Article 5

TITLE 16. PROFESSIONAL AND VOCATIONAL REGULATIONS
DIVISION 10. DENTAL BOARD OF CALIFORNIA
CHAPTER 3. DENTAL AUXILIARIES
ARTICLE 5. DUTIES AND SETTINGS

Section 1085. Dental Assistant Duties and Settings.
Section 1086. RDA Duties and Settings.
Section 1087. RDAEF Duties and Settings.
Section 1088. RDH Duties and Settings.
Section 1089. RDHEF Duties and Settings.
Section 1090. RDHAP Duties and Settings.
Section 1090.1. RDHAP Documentation of Dentist Relationship.

Section 1085. Dental Assistant Duties and Settings.
(a) Unless specifically so provided by regulation, a dental assistant may not perform the following functions or any other activity which represents the practice of dentistry or requires the knowledge, skill and training of a licensed dentist:
  1. (1) Diagnosis and treatment planning;
  2. (2) Surgical or cutting procedures on hard or soft tissue;
  3. (3) Fitting and adjusting of correctional and prosthodontic appliances;
  4. (4) Prescription of medicines;
  5. (5) Placement, condensation, carving or removal of permanent restorations, including final cementation procedures;
  6. (6) Irrigation and medication of canals, try-in cones, reaming, filing or filling of root canals;
  7. (7) Taking of impressions for prosthodontic appliances, bridges or any other structures which may be worn in the mouth;
  8. (8) Administration of injectable and/or general anesthesia;
  9. (9) Oral prophylaxis procedures.
(b) A dental assistant may perform such basic supportive dental procedures as the following under the general supervision of a licensed dentist:
  1. (1) Extra-oral duties or functions specified by the supervising dentist;
  2. (2) Operation of dental radiographic equipment for the purpose of oral radiography if the dental assistant has complied with the requirements of section 1656 of the Code.
  3. (3) Examine orthodontic appliances.
(c) A dental assistant may perform such basic supportive dental procedures as the following under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist.
  1. (1) Take impressions for diagnostic and opposing models, bleaching trays, temporary crowns and bridges, and sports guards;
  2. (2) Apply non-aerosol and non-caustic topical agents;
  3. (3) Remove post-extraction and periodontal dressings;
  4. (4) Placement of elastic orthodontic separators;
  5. (5) Remove orthodontic separators;
  6. (6) Assist in the administration of nitrous oxide analgesia or sedation; however, a dental assistant shall not start the administration of the gases and shall not adjust the flow of the gases unless instructed to do so by the dentist who shall be present at the patient's chairside at the implementation of these instructions. This regulation shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency.
  7. (7) Hold anterior matrices;
  8. (8) Remove sutures;
  9. (9) Take intra-oral measurements for orthodontic procedures;
  10. (10) Seat adjusted retainers or headgears, including appropriate instructions;
  11. (11) Check for loose bands;
  12. (12) Remove arch wires;
  13. (13) Remove ligature ties;
  14. (14) Apply topical fluoride, after scaling and polishing by the supervising dentist or a registered dental hygienist;
  15. (15) Place and remove rubber dams;
  16. (16) Place, wedge and remove matrices.
  17. (17) Cure restorative or orthodontic materials in operative site with light-curing device.
  18. For the purpose of this section a supervising licensed dentist is defined as a dentist whose patient is receiving the services of a dental assistant in the treatment facility and is under the direct control of said licensed dentist.
Note: Authority cited: Section 1614, Business and Professions Code. Reference: Section 1751, Business and Professions Code.
HISTORY
  1. Editorial correction of subsection (c)(6) filed 7-17-85; effective thirtieth day thereafter (Register 85, No. 29).
  2. Editorial correction of subsection (a) (Register 91, No. 30).
  3. Amendment of subsections (c)(1) and (c)(6) filed 2-23-98; operative 3-25-98 (Register 98, No. 9).
  4. Change without regulatory effect amending subsection (c)(1) filed 7-15-98 pursuant to section 100, title 1, California Code of Regulations (Register 98, No. 29).
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Section 1086. RDA Duties and Settings.
(a) Unless specifically so provided by regulation, the prohibitions contained in section 1085 of these regulations apply to registered dental assistants.
(b) A registered dental assistant may perform all functions which may be performed by a dental assistant.
(c) Under general supervision, a registered dental assistant may perform the following duties:
  1. (1) Mouth-mirror inspection of the oral cavity, to include charting of obvious lesions, existing restorations and missing teeth;
  2. (2) Placement and removal of temporary sedative dressings.
(d) A registered dental assistant may perform the following procedures under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist.
  1. (1) Obtain endodontic cultures;
  2. (2) Dry canals, previously opened by the supervising dentist, with absorbent points;
  3. (3) Test pulp vitality;
  4. (4) Place bases and liners on sound dentin;
  5. (5) Remove excess cement from supragingival surfaces of teeth with a hand instrument or floss;
  6. (6) Size stainless steel crowns, temporary crowns and bands;
  7. (7) Fabrication of temporary crowns intra-orally;
  8. (8) Temporary cementation and removal of temporary crowns and removal of orthodontic bands;
  9. (9) Placement of orthodontic separators;
  10. (10) Placement and ligation of arch wires;
  11. (11) Placement of post-extraction and periodontal dressings;
  12. (12) Apply bleaching agents;
  13. (13) Activate bleaching agents with non-laser light-curing device;
  14. (14) Take bite registrations for diagnostic models for case study only;
  15. (15) Coronal polishing (Evidence of satisfactory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof). The processing times for coronal polishing course approval are set forth in section 1069.
  16. This procedure shall not be intended or interpreted as a complete oral prophylaxis (a procedure which can be performed only by a licensed dentist or registered dental hygienist). A licensed dentist or registered dental hygienist shall determine that the teeth to be polished are free of calculus or other extraneous material prior to coronal polishing.
  17. (16) Removal of excess cement from coronal surfaces of teeth under orthodontic treatment by means of an ultrasonic scaler. (Evidence of satisfactory completion of a board-approved course of instruction or equivalent instruction in an approved RDA program in this function must be submitted to the board prior to any performance thereof.) The processing times for ultrasonic scaler course approval are set forth in section 1069.
(e) Settings. Registered dental assistants may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or in an equivalent facility approved by the board.
Note: Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1614 and 1754, Business and Professions Code; and Section 15376, Government Code.
HISTORY
  1. Amendment of subsection (d) filed 2-22-88; operative 3-23-88 (Register 88, No. 10).
  2. Change without regulatory effect amending subsection (d)(11) filed 9-11-89 pursuant to section 100, title 1, California Code of Regulations (Register 89, No. 37).
  3. Amendment of subsection (d)(11) filed 10-29-90; operative 11-28-90 (Register 90, No. 48).
  4. New subsection (d)(11) and subsection renumbering filed 5-9-96; operative 6-8-96 (Register 96, No. 19).
  5. New subsections (d)(7), (d)(12) and (d)(13) and subsection renumbering filed 1-24-2000; operative 2-23-2000 (Register 2000, No. 4).
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Section 1087. RDAEF Duties and Settings.
(a) Unless specifically so provided by regulation, the prohibitions contained in Section 1085 apply to RDAEFs.
(b) An RDAEF may perform all duties assigned to dental assistants and registered dental assistants.
(c) An RDAEF may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist.
  1. (1) Cord retraction of gingivae for impression procedures;
  2. (2) Take impressions for cast restorations;
  3. (3) Take impressions for space maintainers, orthodontic appliances and occlusal guards.
  4. (4) Prepare enamel by etching for bonding;
  5. (5) Formulate indirect patterns for endodontic post and core castings;
  6. (6) Fit trial endodontic filling points;
  7. (7) Apply pit and fissure sealants;
  8. (8) Remove excess cement from subgingival tooth surfaces with a hand instrument;
  9. (9) Apply etchant for bonding restorative materials.
(d) Settings. Registered dental assistants in extended functions may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or in an equivalent facility approved by the board.
Note: Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1614, 1756 and 1757, Business and Professions Code.
HISTORY
  1. Amendment of subsection (c)(7) and new subsections (c)(8)-(9) filed 4-27-2000; operative 5-27-2000 (Register 2000, No. 17).
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Section 1088. RDH Duties and Settings.
(a) Unless specifically so provided by regulation, the prohibition contained in Section 1085(a), subsections (1) through (8) of these regulations shall apply to duties performed by a registered dental hygienist.
(b) A registered dental hygienist may perform all duties assigned to dental assistants and registered dental assistants, under the supervision of a licensed dentist as specified in these regulations.
(c) Under general supervision, a registered dental hygienist may perform the following duties in addition to those provided by Section 1760(b) of the Code:
  1. (1) Root planing;
  2. (2) Polish and contour restorations;
  3. (3) Oral exfoliative cytology;
  4. (4) Apply pit and fissure sealants;
  5. (5) Preliminary examination, including but not limited to:
  6. (A) Periodontal charting;
  7. (B) Intra and extra-oral examination of soft tissue;
  8. (C) Charting of lesions, existing restorations and missing teeth;
  9. (D) Classifying occlusion;
  10. (E) Myofunctional evaluation;
  11. (6) Irrigate sub-gingivally with an antimicrobial and/or antibiotic liquid solution(s).
  12. (7) The following direct supervision duties of dental assistants and registered dental assistants:
  13. (A) Dental Assistant.
  14. (1) Taking impressions for diagnostic and opposing models;
  15. (2) Applying non-aerosol and non-caustic topical agents;
  16. (3) Removing post-extraction and periodontal dressings;
  17. (4) Removing sutures;
  18. (5) Taking intra-oral measurements for orthodontic procedures;
  19. (6) Checking for loose bands;
  20. (7) Removing ligature ties;
  21. (8) Applying topical fluoride;
  22. (9) Placing elastic separators.
  23. (B) Registered Dental Assistant
  24. (1) Test pulp vitality;
  25. (2) Removing excess cement from supragingival surfaces of teeth;
  26. (3) Sizing stainless steel crowns, temporary crowns and bands;
  27. (4) Temporary cementation and removal of temporary crowns and removal of orthodontic bands.
  28. (5) Placing post-extraction and periodontal dressings.
(d) A registered dental hygienist may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist.
  1. (1) Placement of Antimicrobial or Antibiotic Medicaments which do not later have to be removed.
  2. (2) All duties so assigned to a dental assistant or a registered dental assistant, unless otherwise indicated;
  3. (3) Periodontal soft tissue curettage (Evidence of satisfactory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof);
  4. (4) Administration of local anesthetic agents, infiltration and conductive, limited to the oral cavity (Evidence of satisfactory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof);
  5. (5) Administration of nitrous oxide and oxygen when used as an analgesic, utilizing fail-safe type machines containing no other general anesthetic agents. (Evidence of satisfactory completion of a board-approved course of instruction in this function must be submitted to the board prior to any performance thereof.)
(e) A registered dental hygienist may undertake the duties authorized by this section in the following settings, provided the appropriate supervision requirements are met:
  1. (1) The treatment facility of a licensed dentist;
  2. (2) Licensed health facilities as defined in Section 1250 of the Health and Safety Code,
  3. (3) Licensed clinics as defined in Section 1203 of the Health and Safety Code,
  4. (4) Licensed community care facilities as defined in Section 1502 of the Health and Safety Code,
  5. (5) Schools of any grade level whether public or private,
  6. (6) Public institutions, including but not limited to federal, state and local penal and correctional facilities.
  7. (7) Mobile units operated by a public or governmental agency or a nonprofit and charitable organization approved by the board; provided, however, that the mobile unit meets the statutory and regulatory requirements for mobile units,
  8. (8) Home of a non-ambulatory patient, provided there is a written note from a physician or registered nurse stating that the patient is unable to visit a dental office.
  9. (9) Health fairs or similar non-profit community activities. Each such fair or activity shall be approved by the board.
  10. Any other facility must be approved by the board.

Note: Authority cited: Section 1614, Business and Professions Code. Reference: Section 1614 and 1759, Business and Professions Code.

HISTORY
  1. New subsection (c)(6) and subsection renumbering filed 4-25-2000; operative 5-25-2000 (Register 2000, No. 17).
  2. New subsection (d)(1) and subsection renumbering filed 12-17-2001; operative 1-16-2002 (Register 2001, No. 51).

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Section 1089. RDHEF Duties and Settings.
(a) Unless specifically provided by regulation, the prohibitions contained in Section 1085(a) (1) through (8) shall apply to RDHEFs.
(b) An RDHEF may perform all duties assigned to dental assistants, registered dental assistants and registered dental hygienists.
(c) An RDHEF may perform the procedures set forth below under the direct supervision of a licensed dentist when done so pursuant to the order, control and full professional responsibility of the supervising dentist. Such procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient from the office of said dentist.
  1. (1) Cord retraction of gingivae for impression procedures;
  2. (2) Take impressions for cast restorations;
  3. (3) Take impressions for space maintainers, orthodontic appliances and guards;
  4. (4) Prepare enamel by etching for bonding;
  5. (5) Formulate indirect patterns for endodontic post and core castings;
  6. (6) Fit trial endodontic filling points;
  7. (7) Apply etchant for bonding restorative materials.
(d) Settings. Registered dental hygienists in extended functions may undertake the duties authorized by this section in a treatment facility under the jurisdiction and control of the supervising licensed dentist, or an equivalent facility approved by the Board.
Note: Authority cited: Sections 1614 and 1762, Business and Professions Code. Reference: Sections 1614 and 1762, Business and Professions Code.
HISTORY
  1. Amendment of subsection (c) filed 6-20-85; effective thirtieth day thereafter (Register 85, No. 25).
  2. Repealer and new subsections (c) and (d) and amendment of NOTE filed 2-28-92; operative 3-30-92 (Register 92, No. 12).
  3. Amendment of subsection (c)(6) and new subsection (c)(7) filed 4-27-2000; operative 5-27-2000 (Register 2000, No. 17).

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Section 1090. RDHAP Duties and Settings.
(a) Unless specifically so provided by regulation, an RDHAP may not perform the following functions or any activity which represents the practice of dentistry or requires knowledge, skill and training of a licensed dentist:
  1. (1) Diagnosing and treatment planning;
  2. (2) Surgical or cutting procedures on hard or soft tissue;
  3. (3) Fitting and adjusting of correctional and prosthodontic appliances;
  4. (4) Prescribing medication;
  5. (5) Placing, condensing, carving or removal of permanent restorations, including final cementation procedures;
  6. (6) Irrigating and medicating canals, try-in cones, reaming, filing or filling of root canals;
  7. (7) Taking of impressions for prosthodontic appliances, bridges, or any other devices which may be worn in the mouth;
  8. (8) Administering local or general anesthesia, oral or parental conscious sedation.
(b) Under the supervision of a licensed dentist, an RDHAP may perform the duties assigned to registered dental hygienists by Section 1088, under the same levels of supervision and in the same settings as specified in that section, in addition to those duties permitted by Section 1768(b)(3).
(c) Independently and without the supervision of a licensed dentist, an RDHAP may, upon the prescription of a dentist or a physician and surgeon licensed in California, perform the duties assigned to a registered dental hygienist by Section 1088(c).
  1. (1) All prescriptions shall contain the following information:
  2. (A) The pre-printed name, address, license number, and signature of the prescribing dentist or physician and surgeon.
  3. (B) The name, address and phone number of the patient.
  4. (C) The date the services are prescribed and the expiration date of the prescription. The prescription shall be for dental hygiene services and, if necessary, include special instructions for the care of that patient.

Note: Authority cited: Section 1614, Business and Professions Code. Reference: Sections 1614 and 1768, Business and Professions Code.

HISTORY
  1. New section filed 5-31-2000; operative 6-30-2000 (Register 2000, No. 22).
  2. New subsections (c)(1)-(c)(1)(C) filed 8-15-2000; operative 9-14-2000 (Register 2000, No. 33).
Section 1090.1. RDHAP Documentation of Dentist Relationship.
Prior to the establishment of an independent practice, an RDHAP shall provide to the board documentation of an existing relationship with at least one dentist for referral, consultation, and emergency services, on the form entitled: Documentation of RDHAP Relationship with Dentist, (rev. 5/99), which is hereby incorporated by reference. The dentist's license shall be current, active and not under discipline by the board. Any change shall be reported to the Board in writing, within 30 days following such change.

Note: Authority cited: Section 1614, Business and Professions Code. Reference: Section 1770, Business and Professions Code.

HISTORY
  1. New section filed 5-31-2000; operative 6-30-2000 (Register 2000, No. 22).