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DANB Indiana Assisting New Regulations Guide Flow Chart 2011
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  • 1. These data are presented for informational 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 information. To verify, or if you have any questions, please contact your state’s dental board. Measuring Dental Assisting Excellence® How To Use The Following Charts Be sure to follow the legal View requirements which job to perform designations dental are used in radiographic See which tasks are not Chart 1 your state. procedures. permitted by state law.    Review all the allowable tasks for each level of dental assisting as published in the state practice act. Chart 2 View the education/training/credentialrequired foreach levelof dentalassisting. The numbers next to each task correspond to the 70 numbered tasks that were identified and used in the DANB/ADAA  Core Competency 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. Compare your state’s job designations to those used as standardized job titles in the DANB/ADAA Core Competency Study.  If your state’s dental practice act specifically defines levels of supervision, the state-specific definition is noted in the template. © 2011 Dental Assisting National Board, Inc.
  • 2. Dental Assisting Functions ListThe following is a list of 70 dental assisting tasks developed by the ADAA/DANB Alliancein the course of its research. These selected tasks were determined to be representativeof a broad range of dental assisting core competencies.Functions in each state that correspond to the national Core Competencies Study functionsare numbered in the Career Ladder Template, using language directly from the state’s dentalpractice act. Functions listed with bullets in the Career Ladder Template are part of the state’spractice act but are not specific matches to DANB research.1. Perform mouth mirror inspection 27. Place and remove dental dam 54. Remove temporary crowns and of the oral cavity 28. Pour, trim, and evaluate the cements2. Chart existing restorations or quality of diagnostic casts 55. Remove temporary fillings conditions 29. Size and place orthodontic bands 56. Apply topical anesthetic to the3. Phone in prescriptions at the and brackets injection site direction of the dentist 30. Using the concepts of four- 57. Demonstrate understanding of4. Receive and prepare patients for handed dentistry, assist with the Centers for Disease Control treatment, including seating, basic restorative procedures, and Prevention Guidelines positioning chair, and placing including prosthodontics and 58. Using the concepts of four- napkin restorative dentistry handed dentistry, assist with5. Complete laboratory 31. Identify intraoral anatomy basic intraoral surgical authorization forms 32. Demonstrate understanding of procedures, including6. Place and remove retraction cord the OSHA Hazard extractions, periodontics,7. Perform routine maintenance of Communication Standard endodontics, and implants dental equipment 33. Place, cure and finish composite 59. Monitor nitrous oxide/oxygen8. Monitor and respond to post- resin restorations analgesia surgical bleeding 34. Place liners and bases 60. Maintain emergency kit9. Perform coronal polishing 35. Place periodontal dressings 61. Remove permanent cement procedures 36. Demonstrate understanding of from supragingival surfaces10. Apply effective communication the OSHA Bloodborne Pathogens 62. Remove periodontal dressings techniques with a variety of Standard 63. Place post-extraction dressings patients 37. Take and record vital signs 64. Fabricate custom trays, to11. Transfer dental instruments 38. Monitor vital signs include impression and12. Place amalgam for condensation 39. Clean and polish removable bleaching trays, and athletic by the dentist appliances and prostheses mouthguards13. Remove sutures 40. Apply pit and fissure sealants 65. Recognize basic medical14. Dry canals 41. Prepare procedural trays/ emergencies15. Tie in archwires armamentaria set-ups 66. Recognize basic dental16. Demonstrate knowledge of ethics/ 42. Place orthodontic separators emergencies jurisprudence/patient confidentiality 43. Size and fit stainless steel crowns 67. Respond to basic medical17. Identify features of rotary 44. Take preliminary impressions emergencies instruments 45. Place and remove matrix bands 68. Respond to basic dental18. Apply topical fluoride 46. Take final impressions emergencies19. Select and manipulate gypsums 47. Fabricate and place temporary 69. Remove post-extraction and waxes crowns dressings20. Perform supragingival scaling 48. Maintain field of operation 70. Place stainless steel crown21. Mix dental materials during dental procedures through22. Expose radiographs the use of retraction, suction,23. Evaluate radiographs for irrigation, drying, placing and diagnostic quality removing cotton rolls, etc.24. Provide patient preventive 49. Perform vitality tests education and oral hygiene 50. Place temporary fillings instruction 51. Carve amalgams25. Perform sterilization and 52. Process dental radiographs disinfection procedures 53. Mount and label dental26. Provide pre- and post-operative radiographs instructions
  • 3. Levels of Supervision An important 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 Dental Association (ADA) has identified four levels of supervision for dental auxiliaries, including dental assistants, which it defines in its “Comprehensive Policy Statement on Allied Dental Personnel,” (2006: 307) which is part of its Current Policies, last updated in 2007. Note that “allied dental personnel” refers to dental assistants, dental hygienists and dental laboratory technicians. The four levels of supervision defined by the ADA are as follows: Personal supervision: A dentist is personally operating on a patient and authorizes the allied dental personnel to aid treatment by concurrently performing a supportive procedure. Direct supervision: A dentist is in the dental office or treatment facility, personally diagnoses the condition to be treated, personally authorizes the procedures, and remains in the dental office or treatment facility while the procedures are being performed by the allied dental personnel and, before dismissal of the patient, evaluates the performance of the allied dental personnel. Indirect supervision: A dentist is in the dental office or treatment facility, has personally diagnosed the condition to be treated, authorizes the procedures, and remains in the dental office or treatment facility while the procedures are being performed by the allied dental personnel, and will evaluate the performance of the allied dental personnel. General supervision: A dentist is not required to be in the dental office or treatment facility when procedures are being performed by the allied dental personnel, but has personally diagnosed the condition to be treated, has personally authorized the procedures and will evaluate the performance of the allied dental personnel. Furthermore, the ADA’s Comprehensive Policy Statement on Allied Dental Personnel stipulates that intraoral expanded functions should be performed by allied dental personnel “only under the direct supervision of a dentist.” Because the study of dental assisting core 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 for the delegation of the tasks included in the study to dental assistants. However, the ADAA/DANB Alliance believes it is important to call attention to the fact that, while the ADA has defined supervision levels in the aforementioned policy statement, which governs the ADA’s own activities and the activities of its members, these definitions have not been uniformly adopted by the dental boards of every U.S. state or district. For the purposes of this volume, if a state’s dental practice act specifically defines levels of supervision, the state-specific definition is noted in the template. Dental Assisting National Board, Inc. (DANB) 444 N. Michigan Ave., Suite 900 Chicago, IL 60611 1-800-367-3262 or 312-642-3368 Measuring Dental Fax: 312-642-1475 Assisting Excellence® www.danb.org • danbmail@danb.org© 2011 Dental Assisting National Board, Inc.
  • 4. Indiana State-approved 1/1/11 Reviewed by DANB 1/1/11 Job Title Proposed Education/Training/ Standardized Radiography Functions NOT Permitted Credential Required According to by Dental Assistants in IN State of IN National Job Requirements Titles (see below) To legally operate dental x-ray Note: The legislature of Indiana equipment and perform dental passed a law in 2008, House radiographic procedures in the state The following functions are not © 2011 Dental Assisting National Board, Inc. Bill 1172, that recognizes dental of Indiana, a dental assistant must permitted by any level of dental assistants. The Indiana State obtain a limited dental radiographic assistant: Board of Dentistry is currently license from the Indiana State drafting the Indiana Administra- Expanded Functions Department of Health/Division of • Diagnosis and treatment tive Code rules to implement changes to the Dental Practice Dental Medical Radiology Services. planning Act. Assistant • Cutting of hard or soft tissues (EFDA) To obtain this license, one must: • Any intraoral impression which would lead to the Dental fabrication of a final prosthetic Assistant  Successfully complete aPreliminarily: CODA-accredited program appliance qualified • Removing calcific deposits or in coronal in radiographyTo perform coronal polishing OR accretions from the surfaces polishing/ of human teeth or cleaningprocedures in the state of Indiana Dental Successfully complete an Indianaunder the direct supervision of a Board-approved program in or polishing such teeth Assistant (except coronal polishing,licensed dentist, a dental assistant qualified in radiographymust: AND THEN as permitted by meeting the fluoride requirements) administra-  Be certified by a licensed  Successfully complete a practitioner or licensed dental • Applying and using within tion DANB the patient’s mouth such board-approved curriculum for hygienist in an approved Certified educational program as proficient antiseptic sprays, washes or polishing the coronal surface Dental of teeth in performing the procedures medicaments for the control Assistant included in the limited dental or prevention of dental (CDA) curriculum caries (except for applyingTo administer fluoride in the orstate of Indiana under the direct AND THEN medicaments, as permitted by Registered  Pass one (1) or more of the meeting the requirements)supervision of a licensed dentist, a Dentaldental assistant must: following examinations: • Treating gum disease Assistant (a) The national DANB Certified • Using impressions and x-ray (RDA) Dental Assistant (CDA) exam photographs for treatment Successfully complete a board-approved curriculum for (b) The national DANB Radiation purposes applying medicaments for the Health and Safety (RHS) exam • Administering local dental control or prevention of dental (c) An exam approved by the IN anesthetics caries State Department of Health/ Division of Medical Radiology Services AND THEN  Apply to the IN State Department of Health/Division of Medical Radiology Services for a limited dental radiographic license Note: The IN State Department of Health also issues student dental radiography permits and provisional Dental radiography permits. Assistant  The ADAA/DANB Alliance developed a listing of standardized job titles (left) based on its national Core Competencies Study conducted from 2002-2005.A dental assistant in the state ofIndiana may perform basic sup- The same study utilized a list of 70portive dental procedures specified job functions which were determinedby the state dental practice act Dental to be representative of a broad(see opposite page) under the Assistant range of dental assisting core supervision of a licensed dentist. competencies.There are no education or training Functions in this staterequirements for this level of dental that relate to the nationalassisting, except for radiography DANB/ADAA Core Competenciesrequirements. Study are numbered to the right, using language directly from this state’s dental practice act. (The numbers correspond to the study’s task numbering system.) Entry Level Functions listed with bullets are part Dental of this state’s practice act but are Assistant not specific matches to DANB/ADAA research. These state templates reflect the work being done by the ADAA/ DANB Alliance to support a uniform national model for one set of dental assisting tasks, levels and requirements, which will serve as a viable career ladder for dental assistants. 34
  • 5. Indiana State-approved 1/1/11 Reviewed by DANB 1/1/11 Job Title Allowable Functions According to (Functions with numbers relate specifically to Core Competency designations; State of IN functions with bullets are in this state’s practice act but are not specific matches to DANB research) © 2011 Dental Assisting National Board, Inc. Dental Assistant qualified in coronal Under Direct Supervision* polishing/ Dental 9. Polish the coronal surface of teeth Assistant 18. Apply medicaments for the control or prevention of dental caries qualified in fluoride administra- tion DANB’s Note on Allowable Dental Assisting Functions Dental In the state of Indiana, all dental assistants may: Assistant • Perform infection control and occupational safety procedures • Perform other duties not specified by this state’s dental practice act At this time, DANB cannot list all allowable dental assisting functions for each state because some states’ dental practice acts outline very specific allowable functions, while others outline only prohibited functions and some contain minimal or no regulation of dental assisting duties.*Direct Supervision: A licensed dentist is physically present in the facility when patient care is provided by the dental assistant 35