9004. SCOPE OF PRACTICE

9004 SCOPE OF PRACTICE 9004.1 Subject to the restrictions set forth in this section, a dentist may delegate to a registered dental assistant only those procedures which are: (a) Appropriate to the training and experience of the dental assistant and the practice of the supervising dentist; (b) Reversible; and (c) To be performed under the direct supervision of the dentist. 9004.2 Level I Dental Assistant may perform the following functions under direct supervision of a dentist: Placing retraction cord; Placing matrices; Applying fluoride (rinse, foam tray, and fluoride varnish); Placing periodontal dressings; Removing temporary restorations without the use of a rotary instrument; Removing sutures; Taking impression for study models or diagnostic casts; Rinsing and aspirating the oral cavity; Retracting the lips, cheek, tongue, and flaps; Placing or removing materials for the isolation of the dentition, provided that the material is not retained by the dentition; Applying topical anesthesia; Constructing athletic mouth guards and night guards on models; Performing intraoral photography; Curing by the use of halogen light; Checking for loose bands; Whitening or bleaching using trays; Take and record vital signs; and Other functions as approved by the Board. 9004.3 Level II Dental Assistant may perform the following functions under direct supervision of a dentist: All functions permitted to Level I Dental Assistant, as enumerated in § 9004.2; Performing vitality tests; Taking alginate impressions for intraoral appliances; [Repealed]; Applying desensitizing agents; Placing or removing a rubber dam; Etching; Fabricating indirect restorations in a dental office; Placing or removing a matrix band; Drying a root canal; Preparing and fitting stainless steel crowns; Preparing temporary crowns; Removing excess cement; and Removing or placing a periodontal dressing (except placing the original periodontal dressing). 9004.4 Level III Dental Assistant may perform the following functions under direct supervision of a dentist: (a) All functions permitted to Level I Dental Assistant or Level II Dental Assistant, as enumerated in §§ 9004.2 and 9004.3; (b) The application of pit and fissure sealants; (c) Coronal polishing to remove stain and biofilm; and (d) Glucose testing. 9004.5 Level I, II, or III Dental Assistant working under the direct supervision of an orthodontist may also perform the following functions: Preparing and fitting orthodontic bands; Removing excess cement from around orthodontic bands; Placing and removing arch wires; Cementing orthodontic bands, placing bonded attachments, or removing cemented or bonded orthodontic bands and attachments; Placing elastics and ligatures; and Selecting headgear. 9004.6 A dentist shall not delegate to a dental assistant any of the following procedures: (a) Those procedures excluded by 17 DCMR § 4215.1; (b) A preliminary dental examination; (c) A complete prophylaxis, including the removal of any deposits, diseased crevicular tissue, accretion, or stain from the surface of a tooth or a restoration; (d) The restoration of a tooth; (e) The charting of cavities during preliminary examination, prophylaxis, or polishing; however, a dentist may permit an assistant to record the charting of cavities as dictated by the dentist or dental hygienist during the course of a preliminary examination or dental procedure; (f) The instruction of individuals or groups of individuals in oral health care, unless it is in the dental office and done as instructed by the dentist; (g) [Repealed]; (h) Diagnostic screening to identify indications of oral abnormalities; (i) Administration of local anesthesia; (j) Administration of nitrous oxide; (k) Placement of temporary restorations; (l) Taking final impressions; (m) Adjusting occlusion of natural teeth, restorations, or appliances; (n) Registration of jaw relations; (o) Cementing permanent crowns or restorations; (p) Applying silver diamine fluoride; (q) Glucose monitoring; (r) Whitening or bleaching (internal, laser, or high-intensity light); (s) Using a high speed handpiece intraorally; (t) Oral cancer screenings; (u) Oral cancer tissue biopsy; (v) Placing initial periodontal dressing; (w) Placement of liquid dam; (x) Applying and removing a socket dressing; (y) Placement of subgingival medicaments; (z) Removing intracoronal temporary restorations; or (aa) Placing sutures. SOURCE: Notice of Final Rulemaking published at 58 DCR 5852, 5853 (July 15, 2011); as amended by Final Rulemaking published at 60 DCR 10055 (July 12, 2013); as amended by Final Rulemaking published at 67 DCR 2217 (February 28, 2020): as amended by Final Rulemaking published at 71 DCR 002153 (March 1, 2024). District of Columbia Municipal Regulations Business, Occupations, and Professionals 17 DCMR § 9004