Delegable Procedures

Registered Dental Hygienists (RDH), Public Health Dental Hygienist (PHDH), Expanded Function Dental Assistant (EFDA), Certified Assistant (CA), Formally-trained Dental Assistant (FTDA), and Dental Assistant Trained on the Job (OJT) and may perform the following dental procedures pursuant to the designated level of supervision or direction: General Supervision (G), Written Collaborative Agreement (WCA), Direct Supervision (D), Immediate Supervision (I) or Delegation Not Allowed (N/A). DELEGATED DUTY RDH PHDH EFDA CA FTDA OJT Review medical and dental history and consult when necessary with medical practitioner G WCA G G G G Perform preliminary evaluation to determine needed dental hygiene services G W CA N/A N/A N/A N/A Make referrals to dentists, physicians, and other practitioners in consultation with a dentist G WCA N/A N/A N/A N/A Provide oral health instruction G WCA G G G D Perform dietary screening for dental disease prevention and control G WCA G G G N/A Conduct dental screenings G WCA N/A N/A N/A N/A Record dental screenings G WCA D D D D Expose radiographs G WCA G G G G Evaluate radiographs for provision of dental hygiene services G WCA N/A N/A N/A N/A 5.11: continued DELEGATED DUTY RDH PHDH EFDA CA FTDA OJT Take intra-oral photographs G WCA G G G G Perform and record charting of the oral cavity and surrounding structures, including but not limited to, existing dental restorations, lesions and periodontal probing depths G WCA N/A N/A N/A N/A Record charting of the oral cavity and surrounding structures, including but not limited to, dental restorations, lesions and periodontal probing depths G WCA D D D D Take and record vital signs G WCA G G G G Perform minor emergency denture adjustments to eliminate pain and discomfort in nursing homes and other residential or long term care facilities G WCA N/A N/A N/A N/A Perform pulp testing D N/A N/A N/A N/A N/A Apply anti-cariogenic agents, including fluoride varnish G WCA G G G D Apply topical anesthetic agents G WCA G G G D Apply and adjust dental sealants G WCA G D D N/A Take impressions for study casts, bite registrations, including for identification purposes, night guards, and custom fluoride and bleaching trays pursuant to a dentist’s prescription or order G WCA G G G I Take impressions for athletic mouth guards G WCA G G G I Retract lips, cheek, tongue and other oral tissue parts G WCA G G G G Irrigate and aspirate the oral cavity G WCA G G G G Re-cement and adjust intact temporary restorations intra-orally G WCA G G G N/A Place temporary restorations (not including temporization of inlays, on-lays, crowns, and bridges) to provide palliative treatment G WCA G G G I Assist or monitor nitrous oxide analgesia I I I I I I Place and remove gingival retraction materials D D D D D D Apply cavity varnish, liner(s) and bonding agents I I I I I I Apply desensitizing agents G WCA G D D D Place restorative materials in tooth for condensation and finishing by the dentist I I I I I I Remove temporary restorations with hand instruments G WCA G I I N/A Place and remove wedges G WCA G D D I Place and remove matrix bands G WCA G D D I Place and remove dental dams G WCA G G G D Place and remove periodontal dressings G WCA G G G N/A Remove sutures G WCA G G G D Removal of implant healing caps/cover screws for restorative procedures I I I I I I Dry root canals with paper points I I I N/A N/A N/A Place cotton pellets and temporary restorative materials into endodontic openings G WCA G D D D (39) Remove excess cement and bonding agents G WCA G D D I from bridges and appliances with hand instruments Cement and remove temporary crowns and bridges G WCA G G G I Insert and/or perform minor adjustment of night mouth guards, athletic mouth guards, and custom fluoride trays G WCA G G G I Select and adapt stainless steel crowns or other pre­ formed crown for insertion by dentist I I I I I I Perform sub-gingival and supra-gingival scaling G WCA N/A N/A N/A N/A 5.11: continued DELEGATED DUTY RDH PHDH EFDA CA FTDA OJT Polish teeth, after dentist or dental hygienist has determined that teeth are free of calculus, with slow speed hand piece G WCA G G G N/A Administer local anesthesia pursuant to 234 CMR 6.00 D D N/A N/A N/A N/A Perform gross debridement and/ or scaling and root planing G WCA N/A N/A N/A N/A Prepare and perform oral cytological smears or studies D N/A N/A N/A N/A N/A Use diagnostic and periodontic non-cutting lasers D N/A N/A N/A N/A N/A Preliminarily fit crowns to check contacts, adjust occlusion on crowns inside the mouth G WCA D D N/A N/A Place temporary soft liners in a removal prosthesis G WCA D D I N/A Obtain endodontic cultures D N/A D D I N/A Apply bleaching agents and activate with non-laser non-curing device G WCA D D D I Fabricate provisional restorations intraorally G WCA G D D I Place and condense amalgam restorations D N/A D N/A N/A N/A Carve, contour, adjust amalgam restorations D N/A D N/A N/A N/A Place and finish composite restorations D N/A D N/A N/A N/A Adjust dentures on the tissue side to eliminate tissue irritation G WCA G N/A N/A N/A Place temporary sedative restorations/fillings G WCA G I N/A N/A Place Stainless Steel Crowns D D D I I N/A Take impressions for orthodontic retainers G WCA G G G D Preliminary intra-oral fit of bands G WCA G G G D Preliminary oral fit of arch wire G WCA G G G D Select size of headgear G WCA G G G D Place and remove orthodontic separators G WCA G G G D Place and remove orthodontic arch wires G WCA G G G D Etch appropriate enamel surfaces before bonding of orthodontic appliances by a dentist G WCA G G G D Place elastics and ligature wires G WCA G G G D Remove fixed orthodontic appliances G WCA G G G D Remove excess cement and bonding agents from orthodontic appliances with hand instruments G WCA G G G D Perform minor emergency palliative orthodontic adjustments to eliminate pain and discomfort G WCA G G G I Perform any other procedure approved by the Board