0460-04-.01 Levels Of Practice

It is the intent of the Board to authorize two distinct levels of practice for dental assistants in dental offices in Tennessee. (1) Practical Dental Assistants (a) Definition - A practical dental assistant is an auxiliary employee of a licensed dentist(s) who is receiving practical chair side dental assisting training from a licensed dentist(s) or is a dental assistant student in an educational institution accredited by the Commission on Dental Accreditation of the American Dental Association. (b) Scope of Practice 1. A practical dental assistant must be under the direct supervision of a licensed dentist. 2. It is the intent of this rule that practical dental assistants not invade the practice procedures only allowed to be assigned or delegated to registered dental assistants or licensed dental hygienists. (2) Registered Dental Assistant (a) Definition - A dental assistant who has received a registration from the Board pursuant to rule 0460-04-.02. (b) Scope of Practice - A registered dental assistant may perform those additional procedures for which they have received Board certification as provided by Rule 0460- 04-.08 under the direct supervision of a dentist. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-105(4), 63-5-105(7), 63-5-108, 63-5-108(c), 63-5- 115, 63-5-116, 63-5-117, and 63-5-124. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. Repeal and new rule filed December 11, 1991; effective January 25, 1992. Amendment filed June 29, 1994; effective September 12, 1994. Amendment filed October 9, 1997; effective December 23, 1997. Amendment filed February 9, 2000; effective April 24, 2000. Amendment filed October 12, 2007; effective December 26, 2007. 0460-04-.02 REGISTRATION PROCESS. To practice as a dental assistant beyond the scope of a practical dental assistant a person must possess a lawfully issued registration from the Board. The process for obtaining a registration is as follows: RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (1) An applicant shall obtain a Board application form from the Board Administrative Office, respond truthfully and completely to every question or request for information contained in the form and submit it along with all documentation and fees required by the form and this rule to the Board Administrative Office. It is the intent of this rule that all activities necessary to accomplish the filing of the required documentation be completed prior to filing a registration application and that all documentation be filed simultaneously. (2) An applicant shall submit: (a) proof of having graduated from a high school or submit proof of possession of a general educational development (g.e.d.) certificate; and (b) proof of having attained at least eighteen (18) years of age; and (c) a signed “passport” style photograph taken within the preceding twelve (12) months. (3) An applicant shall submit evidence of good moral character. Such evidence shall include at least two (2) letters attesting to the applicant’s character from dental professionals on the signator’s letterhead. (4) An applicant shall submit proof of United States or Canadian citizenship or evidence of being legally entitled to live in the United States. Such evidence may include copies of birth certificates, naturalization papers, or current visa status. (5) An applicant shall submit the registration application fee and state regulatory fee provided in rule 0460-01-.02 (3). (6) An applicant shall disclose the circumstances surrounding any of the following: (a) Conviction of any criminal law violation of any country, state, or municipality, except minor traffic violations. (b) The denial of registration application by any other state or the discipline of registration in any state. (c) Failure of any professional licensure examinations. (7) An applicant shall cause to be submitted to the Board’s administrative office directly from the vendor identified in the Board’s registration application materials, the result of a criminal background check. (8) If an applicant has ever held a registration of any kind to practice dental assistance in any other state or Canada, the applicant shall submit or cause to be submitted the equivalent of the Tennessee Certificate of Endorsement from each such licensing board which indicates the applicant either holds a current active registration which is in good standing, or holds a registration which is currently inactive and whether it was in good standing at the time it became inactive. (9) An applicant shall submit evidence of current training in cardiopulmonary resuscitation (CPR) which is defined as successful completion of a BLS for Healthcare Providers, or CPR/AED for Professional Rescuers, or an equivalent course, which provides training for healthcare professionals in CPR and the use of an AED by a Board approved training organization. The course must be conducted in person and include a skills examination on a manikin with a certified instructor. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (10) An applicant must successfully complete the Tennessee Board of Dentistry Ethics and Jurisprudence examination. (11) Application review and registration decisions required by this rule shall be governed by rule 0460-01-.04. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-107, 63-5-108, 63-5-111, 63-5-115, and 63-5-124. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. New rule filed December 11, 1991; effective January 25, 1992. Amendment filed June 29, 1994; effective September 12, 1994. Amendment filed December 5, 1994; effective February 18, 1995. Amendment filed May 15, 1996; effective September 27, 1996. Amendment filed February 9, 2000; effective April 24, 2000. Amendment filed March 14, 2001; effective May 28, 2001. Amendment filed April 10, 2002; effective June 24, 2002. Amendments filed March 17, 2006; effective May 31, 2006. Amendment filed October 12, 2007; effective December 26, 2007. Amendment filed September 30, 2014; effective December 29, 2014. Amendments filed October 25, 2017; effective January 23, 2018. 0460-04-.03 REPEALED. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-108, 63-5-111, and 63-5-115. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. New rule filed December 11, 1991; effective January 25, 1992. Amendment filed March 20, 1996; effective June 3, 1996. Amendment filed May 15, 1996; effective September 27, 1996. Amendment filed April 10, 2002; effective June 24, 2002. Amendment filed December 16, 2005; effective March 1, 2006. Repeal filed October 12, 2007; effective December 26, 2007. 0460-04-.04 CORONAL POLISHING CERTIFICATION. Dental assistants who, pursuant to this rule and T.C.A. § 63-5-108 (d), receive certification to perform coronal polishing may only do so under the restrictions contained in this rule. (1) Definition - Coronal Polishing shall mean the polishing of the enamel and restorations on the clinical crown of human teeth by utilizing a combination of a polishing agent and a slow speed handpiece, a prophy angle, a rubber cup, or any home care cleaning device. (2) Qualifications – An applicant for a coronal polishing certification must be registered as a dental assistant in Tennessee prior to applying for admission to an education course in coronal polishing. The sequence of the certification process is as follows: (a) An applicant must apply for and successfully complete an educational course, as provided in this rule, as a prerequisite for certification; or (b) An applicant who has successfully completed a coronal polishing course in another state which was approved by the board in the other state, which the Board consultant has determined as equivalent to the Board-approved course in Tennessee, is eligible to apply directly to the Board for certification. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from that state. The information regarding content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office; or (c) Applicants who have successfully completed an ADA accredited dental assisting program which included coronal polishing in the curriculum are eligible to apply for the certification upon completion of the program. Within thirty (30) days of an applicant’s completion of the program, the program director/instructor must submit a letter to the Board administrator verifying that coronal polishing was included in the curriculum and a written and clinical examination was passed by the applicant. Upon receipt of the letter from the program director/instructor and the application and fees, the certification for coronal polishing will be issued. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (3) Retention of Certification - Certification for coronal polishing is only valid as long as the registered dental assistant has a current registration. If the registration expires or is retired, the certification is also considered expired or retired, and the dental assistant may not engage in coronal polishing until the registration is reinstated or reactivated. (4) Examination - The certification course must contain both a written and a clinical examination that covers the curriculum in Rule 0460-05-.03(2)(c)4(i) and (ii). The passing grade for each examination is set at seventy-five percent (75%). A student who fails either examination may retake the examination two (2) additional times before having to repeat the course in order to retake the examination. (5) Supervision (a) Any time a dental assistant is allowed to perform coronal polishing after receiving certification, the employer dentist must be physically on the office premises at all times during the polishing and must also: 1. Examine each patient immediately prior to the polishing to determine health, calculus and scalable stain free and to certify the need for coronal polishing; and 2. Examine each patient immediately after the polishing is completed to evaluate the results. (b) A dental assistant may not perform coronal polishing for patients who have not been examined immediately prior to being assigned for polishing. (6) Application review and decisions required by this rule shall be governed by Rule 0460-01-.04. Authority: T.C.A §§ 4-3-1011, 4-5-202, 4-5-204, 63-5-105, 63-5-107, 63-5-108, 63-5-111, and 63-5-115. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. New rule filed December 11, 1991; effective January 25, 1992. Amendment filed December 5, 1994; effective February 18, 1995. Amendment filed October 17, 1995; effective December 31, 1995. Amendment filed March 20, 1996; effective June 3, 1996. Amendment filed May 15, 1996; effective September 27, 1996. Amendment filed June 18, 2003; effective September 1, 2003. Amendment filed September 17, 2003; effective December 1, 2003. Amendment filed October 12, 2007; effective December 26, 2007. Amendment filed September 25, 2008; effective December 9, 2008. Amendment filed October 22, 2010; effective January 20, 2011. Amendments filed December 20, 2011; effective March 19, 2012. 0460-04-.05 NITROUS OXIDE CERTIFICATION. Dental assistants may not administer nitrous oxide to patients but may monitor nitrous oxide sedation (as defined in rule 0460-02-.07) upon becoming certified pursuant to the following process: (1) A dental assistant must be currently registered, pursuant to Rule 0460-04-.02, by the Board in order to be eligible to attend a certification course in monitoring nitrous oxide and/or qualify for certification. (2) To be eligible for certification, the registered dental assistant must successfully complete a Board-approved nitrous oxide monitoring certification course, or have successfully completed a comparable training course in another state, or be currently enrolled in an ADA-accredited or Board-approved program which offers this course as part of their curriculum. Once eligible for certification, the registered dental assistant shall not monitor nitrous oxide until certification has been issued by the Board. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (3) If the registered dental assistant completed a nitrous oxide monitoring course in another state which was approved by the board in the other state, the Board consultant must determine the course to be equivalent to the Board-approved course in Tennessee. The information regarding content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from the other board. Once eligible for certification, the registered dental assistant shall not monitor nitrous oxide until certification has been issued by the Board. (4) Nitrous oxide monitoring certification shall be added to the registration of the registered dental assistant, if the registered dental assistant has successfully completed a Board-approved certification course and notification of completion has been submitted to the Board’s Administrative Office by the course director on a form provided by the Board. (5) Registered dental assistants with nitrous oxide monitoring certification shall only monitor patients under the direct supervision of a licensed Tennessee dentist. This assistant shall not monitor more than one (1) patient at a time and shall physically remain with the patient at all times. (6) Registered dental assistants with nitrous oxide monitoring certification are not permitted to administer nitrous oxide. This assistant is only permitted to adjust the dosage or terminate the nitrous oxide at the specific direction and under the protocol of the supervising dentist or in cases of patient distress. (7) Registered dental assistants with nitrous oxide monitoring certification shall prominently display their current registration certificate, which is received upon registration and renewal, at their place of employment. (8) Certification in monitoring nitrous oxide is only valid as long as the registered dental assistant has a current registration. If the registration expires or is retired, the certification is also considered expired or retired and the dental assistant may not monitor nitrous oxide until the registration is reinstated or reactivated. (9) Application review and decisions required by this Rule shall be governed by 0460-01-.04. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-105(3), 63-5-105(4), 63-5-105(7), 63-5-108, 63-5- 108(b) through 63-5-108(d), and 63-5-115. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. Amendment filed October 13, 1983; effective November 14, 1983. Repeal and new rule filed December 11, 1991; effective January 25, 1992. Amendment filed February 18, 2003; effective May 4, 2003. Amendment filed September 17, 2003; effective December 1, 2003. Amendment filed October 12, 2007; effective December 26, 2007. 0460-04-.06 REGISTRATION RENEWAL. All dental assistants issued registrations by the Board must renew those registrations to be able to legally continue in practice. Registration renewal is governed by the following: (1) Renewal application (a) The due date for registration renewal is the last day of the month in which a registrant’s birthday falls pursuant to the Division of Health Related Boards “birthdate renewal system” contained on the renewal certificate as the expiration date. (b) Methods of Renewal 1. Internet Renewals - Individuals may apply for renewal and pay the necessary fees via the Internet. The application to renew can be accessed at: RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 https://apps.tn.gov/hlrs/ 2. Paper Renewals - For individuals who have not renewed their registration online via the Internet, a renewal application form will be mailed to each individual registered by the Board to the last address provided to the Board. Failure to receive such notification does not relieve the registrant from the responsibility of meeting all requirements for renewal. (c) A registration issued pursuant to these rules is renewable by the expiration date. To be eligible for renewal an individual must submit to the Division of Health Related Boards on or before the expiration date the following: 1. A completed renewal application form. 2. The renewal and state regulatory fees as provided in Rule 0460-01-.02. 3. Proof of successful completion of the Tennessee Board of Dentistry Ethics and Jurisprudence examination. (d) Registrants who fail to comply with the renewal rules or notification received by them concerning failure to timely renew shall have their registrations processed pursuant to rule 1200-10-01-.10. (2) Reinstatement of an Expired Registration - Reinstatement of a registration that has expired may be accomplished upon meeting the following conditions: (a) Payment of all past due renewal fees, state regulatory fees and the reinstatement fee as established in rule 0460-01-.02; and (b) Provide documentation of successfully completing continuing education requirements for the entire time the registration was expired, pursuant to Rule 0460-01-.05; and (c) Submit proof of successful completion of the Tennessee Board of Dentistry Ethics and Jurisprudence examination. (d) Any registrant who fails to renew registration prior to the expiration of the second (2nd) year after which renewal is due may be required to meet other conditions as the Board may deem necessary to protect the public. (3) Anyone submitting a renewal form, reinstatement/reactivation application, or letter which is found to be untrue may be subject to disciplinary action as provided in T.C.A. § 63-5-124. (4) Renewal issuance decisions pursuant to this rule may be made administratively, upon review by the Board. (5) Application review and decisions required by this rule shall be governed by rule 0460-01-.04. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-107, 63-1-108, 63-5-105, 63-5-105(7), 63-5-107, 63-5-108, 63-5-111, 63-5-115, 63-5-117, 63-5-124, and 63-5-129. Administrative History: Original rule certified June 7, 1974. Repeal filed August 26, 1980; effective December 1, 1980. New rule filed December 11, 1991; effective January 25, 1992. Amendment filed February 12, 1996; effective April 27, 1996. Amendment filed April 10, 2001; effective June 24, 2001. Amendment filed August 21, 2002; effective November 4, 2002. Amendment filed August 18, 2003; effective November 1, 2003. Amendments filed October 25, 2017; effective January 23, 2018. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 0460-04-.07 REGISTRATION RETIREMENT AND REACTIVATION. (1) Registrants who wish to retain their registration but not actively practice may avoid compliance with the registration renewal process, continuing education and CPR requirements by doing the following: (a) Obtain from, complete and submit to the Board Administrative Office an affidavit of retirement form. (b) Submit any documentation which may be required by the form to the Board Administrative Office. (2) Any registrant whose registration has been retired may reenter active practice by doing the following: (a) Submit a written request for reactivation to the Board Administrative Office; and (b) Pay the registration renewal fee and state regulatory fee as provided in rule 0460-01- .02 (3). If retirement was pursuant to rule 0460-04-.06 (5) and reactivation was requested prior to the expiration of one (1) year from the date of retirement, the Board may require payment of the late renewal fee and past due renewal and state regulatory fees as provided in rule 0460-01-.02 (3). (c) If requested, after review by the Board, a designated Board member, or the Board consultant, appear before the Board, a designated Board member, or the Board consultant, for an interview regarding continued competence in the event of retirement in excess of two (2) years. (d) Comply with the continuing education provisions of rule 0460-01-.05 (6) applicable to reactivation of retired registrations. (e) Submit proof of successful completion of the Tennessee Board of Dentistry Ethics and Jurisprudence examination. (3) Application review and decisions required by this rule shall be governed by rule 0460-01-.04. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-107, 63-5-108, 63-5-111, 63-5-115, 63-5-117, 63- 5-124, and 63-5-129. Administrative History: Original rule certified June 7, 1974. Repeal and new rule filed December 11, 1991; effective January 25, 1992. Amendment filed March 20, 1996; effective June 3, 1996. Amendment filed August 21, 2002; effective November 4, 2002. Amendment filed August 4, 2009; effective November 2, 2009. Amendments filed October 25, 2017; effective January 23, 2018. 0460-04-.08 SCOPE OF PRACTICE. (1) A lawfully licensed and duly registered dentist may delegate to dental assistants those procedures for which they have received adequate training and for which the dentist exercises direct supervision and full responsibility, except as follows: (a) Those procedures which require professional judgment and skill of a dentist as defined in the Dental Practice Act or rules of the Board. (b) Those clinical procedures which are primarily concerned with the practice of dentistry or dental hygiene and which are allocated by the Dental Practice Act or Rules of the Tennessee Board of Dentistry specifically and solely to licensed dentists and/or licensed dental hygienists. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (2) Registered dental assistants, with additional Board-approved training, may, under the direct supervision of a licensed dentist perform the following procedures: (a) Coronal polishing, pursuant to Rule 0460-04-.04; and (b) Monitoring nitrous oxide, pursuant to Rule 0460-04-.05; and (c) Application of sealants, pursuant to Rule 0460-04-.09. (d) Performance of expanded restorative functions, pursuant to Rule 0460-04-.10. (e) Performance of expanded prosthetic functions, pursuant to Rule 0460-04-.10. (f) Exposure of dental radiographs, pursuant to Rule 0460-04-.11. (3) Delegable or Assignable Procedures - In addition to those duties of the practical dental assistant or registered dental assistant which are commonly recognizable by the dental profession for safe performance, pursuant to T.C.A. § 63-5-108, a practical dental assistant or registered dental assistant may perform the following duties which are assigned or delegated by the employer/supervising dentist: (a) The processing of radiographs, including digital, of the mouth, gums, jaws, teeth or any portion thereof for dental diagnosis. (b) The application of topical fluorides. (c) The instruction of patients in dietary principles. (d) The taking and recording of a patient’s blood pressure, pulse, temperature, and medical history, and charting of oral conditions. (e) The maintenance of instrument and operatory infection control (f) The preparation of instrument trays (g) The placement and removal of matrices for restoration. (h) The removal of cement from restorations and bands. (i) The removal of sutures and staples. (j) The fabrication, placement and removal of temporary restorations. (k) The placement and removal of rubber dam. (l) The placement and removal of socket dressings. (m) The placement and removal of periodontal dressings. (n) The taking of dental plaque smears. (o) The taking of alginate impressions for any purpose other than permanent restorations. (p) The removal of ligature and arch wires. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (q) Bending, selecting and pre-sizing arch wires and placing arch wires after final adjustment and approval by the dentist. (r) The selection, prefitting, cementation, curing, and removing of orthodontic bands or brackets. (s) Placement and removal of pre-treatment separators. (t) Removal of loose or broken bands or brackets. (u) Placement of springs on wires. (v) Placement of hooks on brackets. (w) Placement of chain elastics on brackets. (x) Ligation of arch wires to brackets. (y) Packing and removing retraction cord, with or without vasoactive chemicals, for restorative dental procedures. (z) Removal of cement excess from supragingival surface of teeth by hand instruments only. (aa) The placement of amalgam in prepared cavities for condensation by the dentist. (bb) The application of topical anesthetics. (cc) The application of desensitizing agents. (dd) Placement of cavity bases and liners. (ee) Application of tooth conditioners for bonding. (ff) Selecting and pre-fitting of stainless steel crowns or other pre-formed crowns for insertion by the dentist. (gg) The taking of oral cytologic smears. (hh) Performing pulp testing. (ii) Packing of pulpotomy paste. (jj) Drying canals with absorbent paper points. (kk) Demonstration of oral hygiene procedures and oral health care regimen (ll) Calling in prescriptions to the pharmacist as instructed by the employer/dentist. (mm) Fitting, adjusting and cementation of correctional appliances. (nn) Wound care as directed. (oo) Irrigating extraction site. (pp) Placement of exposure chains and attachments. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (qq) Other duties specifically approved by the Board at a regularly scheduled meeting of the Board. (4) Prohibited Procedures—In addition to the duties defined as the practice of dentistry or dental hygiene by T.C.A. § 63-5-108, dental assistants are not permitted to perform the following: (a) Examination, diagnosis and treatment planning; (b) Surgical or cutting procedures on hard or soft tissue, including laser, air abrasion or micro-abrasion procedures, including curettage or root planing; (c) Fitting, adjusting, and placement of prosthodontics appliances; (d) Issuance of prescription medications or medications not authorized by T.C.A. § 63-5- 108 (c) or Rule 0460-04-.08 (3), or work authorizations; (e) Performance of direct pulp capping, pulpotomy, and other endodontic procedures not authorized by T.C.A. § 63-5-108(c) or Rule 0460-04-.08 (3); (f) Approving the final occlusion; (g) Placement of sutures; (h) Administration of local anesthesia, nitrous oxide, conscious sedation, or general anesthesia; (i) Monitoring of nitrous oxide without certification as provided in Rule 0460-04-.05 and 0460-04-.08 (2); (j) Coronal polishing without certification as provided in Rule 0460-04-.04 and 0460-04-.08 (2); (k) Application of sealants without certification as provided by Rule 0460-04-.09 and 0460- 04-.08 (2); (l) Use of a high-speed handpiece intraorally; (m) Utilization of laser equipment and technology in the course of the performance of their duties unless specifically authorized by T.C.A. § 63-5-108 (c) or Rule 0460-04-.08 (3). Only dentists licensed by the Tennessee Board of Dentistry shall be authorized to perform procedures involving laser technology. (n) The exposure of radiographs without certification as provided by Rule 0460-04-.11 and Rule 0460-04-.08 (2). (o) Expanded restorative or prosthetic functions without certification as provided by Rule 0460-04-.10 and Rule 0460-04-.08 (2). (5) Dental assistants who perform procedures not delegable pursuant to this rule, or who perform procedures specifically prohibited by T.C.A. § 63-5-108, or who perform procedures without the direct supervision of a dentist, or who perform coronal polishing, application of sealants or nitrous oxide monitoring without the applicable certification or in violation of the rules governing those procedures, may be subject to disciplinary action pursuant to T.C.A. § 63-5- 116 (b). RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-108, 63-5-115, and 63-5-116. Administrative History: Original rule certified June 7, 1974. Amendment filed August 26, 1980; effective December 1, 1980. Repeal and new rule filed December 11, 1991; effective January 25, 1992. Amendment filed May 15, 1996; effective September 27, 1996. Amendment filed September 17, 2003; effective December 1, 2003. Amendment filed August 3, 2005; effective October 17, 2005. Amendment filed October 12, 2007; effective December 26, 2007. Amendment filed September 25, 2008; effective December 9, 2008. Amendment filed September 30, 2014; effective December 29, 2014. 0460-04-.09 SEALANT APPLICATION CERTIFICATION. A registered dental assistant with this certification may only practice sealant application under the direct supervision of a licensed dentist. (1) Definition - Sealant application shall mean the application of an organic polymer to the enamel surfaces of teeth. (2) Qualifications for Certification (a) Registered dental assistants in good standing with the Tennessee Board of Dentistry, pursuant to Rule 0460-04-.02, are eligible to take a Board-approved sealant application certification course. (b) Individuals enrolled in either an ADA-accredited or Board-approved dental assisting program, which has elected to include in its curriculum the Board-approved sealant application certification course, will be qualified to perform the application of sealants upon issuance of the certification. All such programs shall adhere to the requirements of Rule 0460-05-.03 (3). (c) Registered dental assistants who have successfully completed a comparable assistant training program in another state in the application of sealants are eligible to apply directly to the Board of Dentistry for a sealant application certificate without additional training, provided the course is determined by the Board consultant to be equivalent to the Board-approved course in Tennessee. The information regarding content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from the other board. (d) After successful completion of a Board-approved certification course, if required, and receipt of proper notification from the course/instructor, an applicant will be issued an initial approval letter. The applicant’s certification will be ratified at the next scheduled meeting of the Board. (3) Supervision (a) Sealant application may only be performed under the direct supervision of a Tennessee licensed dentist. (b) The dentist must examine the patient immediately before and after sealant application to determine the need for, and evaluate the results of, sealant application. (4) Retention of Certification - Certification in sealant application is only valid as long as the registered dental assistant has a current registration to practice registered dental assisting. If the registration expires or is retired, the certification is also considered expired or retired, and the dental assistant may not apply sealants until the registration is reinstated or reactivated. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-108, 63-5-115, and 63-5-116. Administrative History: Original rule certified June 7, 1974. Amendment filed August 26, 1980; effective December 1, RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 1980. Repeal filed December 11, 1991; effective January 25, 1992. New rule filed September 17, 2003; effective December 1, 2003. Amendment filed October 12, 2007; effective December 26, 2007. 0460-04-.10 RESTORATIVE AND PROSTHETIC CERTIFICATIONS. (1) Dental assistants who have a minimum of two (2) years continuous full-time employment within the past three (3) years in a dental practice as a dental assistant are eligible for admission to a Board-approved certification course in restorative and/or prosthetic functions. A registered dental assistant must apply for and complete a Board-approved certification course in restorative or prosthetic functions and obtain the appropriate certification, issued by the Board, before he/she can perform expanded restorative or prosthetic functions on any patient. (2) Certification in restorative or prosthetic functions is only valid as long as the registered dental assistant has a current authorization to practice as a registered dental assistant. If the authorization expires or is retired, the certification is also considered expired or retired and the dental assistant may not perform restorative or prosthetic functions until the authorization to practice is reinstated or reactivated. (3) Registered dental assistants who possess a certification in restorative or prosthetic functions shall prominently display their current renewal certificate at their place of employment. (4) Registered dental assistants with certification in restorative or prosthetic functions may perform restorations or prosthetic functions only under the direct supervision and full responsibility of a licensed dentist. (5) Prohibited Procedures – The following procedures are prohibited for all dental assistants, including those who have certification in restorative or prosthetic functions: (a) Restorative Functions 1. Diagnosing of need for restorations; 2. Preparation/Cutting of the tooth or soft tissue; 3. Modifying existing structure; 4. Removal of caries, bases and liners; and 5. Use of high-speed handpieces intraorally. (b) Prosthetic Functions 1. Diagnosing need for any prosthetic appliance; 2. Establishing vertical dimension of occlusion and interocclusal records; 3. Delivering and/or adjusting appliance; and 4. Use of high-speed handpieces intraorally. (6) Registered dental assistants, who have successfully completed a comparable assistant training program in another state in expanded restorative or prosthetic functions, are eligible to apply directly to the Board for an expanded functions certificate without additional training, provided the course is determined by the Board consultant to be equivalent to the Board- approved course in Tennessee. The information regarding content of the course and proof of RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from the other board. If it is determined that the course is not equivalent, the registered dental assistant will be required to comply with the provisions of paragraph (1) before certification can be issued. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-108, and 63-5-115. Administrative History: Original rule certified June 7, 1974. Repeal filed December 11, 1991; effective January 25, 1992. Original rule filed August 3, 2005; effective October 17, 2005. Amendment filed October 12, 2007; effective December 26, 2007. Amendment filed September 30, 2014; effective December 29, 2014. 0460-04-.11 DENTAL RADIOLOGY CERTIFICATION. Registered dental assistants with this certification may expose dental radiographs under the direct supervision of a licensed dentist. (1) A dental assistant must be currently registered, pursuant to Rule 0460-04-.02, by the Board before attending a certification course in dental radiology and/or qualifying for certification, except as follows: (a) Dental assistants who are registered, pursuant to Rule 0460-04-.02, before the original effective date of this rule shall be issued dental radiology certification without having to complete the course required in paragraph (2). (b) Registered dental assistants, who have successfully completed a comparable assistant training program in another state in dental radiology, are eligible to apply directly to the Board for dental radiology certification without having to complete the requirements of paragraph (2), provided the course is determined by the Board consultant to be equivalent to the Board-approved course in Tennessee. The information regarding content of the course and proof of completion must be sent directly from the course provider to the Board’s administrative office. If a certification or permit was issued by the other state, verification of the certificate or permit must be received directly from the other board. If it is determined that the course is not equivalent, the registered dental assistant will be required to comply with the provisions of paragraph (2) before certification can be issued. (c) Assistants who have passed the radiology portion of the certified dental assistant examination given by the Dental Assisting National Boards, Inc. (DANB) or hold a current certification from DANB as a certified dental assistant are eligible to apply directly to the Board for dental radiology certification without having to complete the course required in paragraph (2). Proof of passage of the radiology portion of the DANB exam or proof of current DANB certification must be sent directly from the DANB to the Board’s administrative office. (2) To be eligible for certification, the registered dental assistant must successfully complete a Board-approved dental radiology training course or be currently enrolled in an ADA-accredited or Board-approved program which offers this course as part of their curriculum. Once eligible for certification, the registered dental assistant shall not expose dental radiographs until certification has been issued by the Board. (3) Dental radiology certification shall be added to the registration of the registered dental assistant, if the registered dental assistant has successfully completed a Board-approved certification course and notification of completion has been submitted to the Board's Administrative Office by the course director on a form provided by the Board. (4) Registered dental assistants with radiology certification shall prominently display their current registration certification, which is received upon registration and renewal, at their place of employment. RULES GOVERNING THE PRACTICE OF DENTAL ASSISTANTS CHAPTER 0460-04 (5) Certification in dental radiology is only valid as long as the registered dental assistant has a current registration. If the registration expires or is retired, the certification is also considered expired or retired and the dental assistant may not expose dental radiographs until the registration is reinstated or reactivated. (6) Application review and decisions required by this rule shall be governed by 0460-01-.04. Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-5-105, 63-5-108, and 63-5-115. Administrative History: Original rule certified June 7, 1974. Repeal filed December 11, 1991; effective January 25, 1992. Original rule filed October 12, 2007; effective December 26, 2007. Amendments filed September 30, 2014; effective December 29, 2014. 0460-04-.12 THROUGH 0460-04-.14 REPEALED.