R156-69-808b. Expanded Functions of Dental Auxiliaries -- Certification for the Placement of Direct Restorations -- Parameters -- CPE

(1) Under Subsections 58-69-808(1)(b) and (2), the qualifications, training, and safety standards for a dental hygienist or dental assistant to obtain a certification for the placement of direct restorations are established in this section. (2) Under Subsection 58-69-808(2)(a), an applicant for a certification under this section shall: (a) meet one of the following requirements: (i) currently hold a dental hygienist license; or (ii) provide evidence that the applicant is a dental assistant: (A) with at least 3,500 hours of dental assisting in the last six years; and (B) who holds current CPR or BCLS-BLS certification; (b) complete and pass an approved education program of at least 172 hours that: (i) is: (A) CODA accredited; (B) recognized by DANB; or (C) approved by the Division in collaboration with the Board and is listed on the Division website at https://commerce.utah.gov/dopl/dentistry/; (ii) includes a hands-on component that requires obtaining written informed consent from each patient that meets the requirements of Subsection R156-69-808d(2); (iii) is taught by an instructor who: (A) has an active and current license as a dentist; (B) is qualified by education, training, and experience to provide instruction on the placement of direct restorations; (C) has at least 4,000 hours of clinical experience; (D) is teaching within the scope of practice for the instructor's license; (E) meets the CPE requirements of Section R156-69-304a; and (F) may be assisted by a licensed hygienist who is certified in direct restorations, when: (I) in a non-patient lab setting; and (II) under the direct supervision of the instructor dentist; and (iv) meets the requirements of Subsection (3); and (c) pass an examination that: (i) includes: (A) a written component; and (B) a clinical component; and (ii) is approved by the Division in collaboration with the Board as listed on the Division website at https://commerce.utah.gov/dopl/dentistry/. (3) Under Subsection 58-69-808(2)(a), a dental hygienist or dental assistant applying for a certification under this section shall complete an education program on the placement of direct restorations with a curriculum that meets the following requirements: TABLE 1 Curriculum for the Placement of Direct Restorations Certification Topics Subtopics Minimum didactic clock hours Minimum clinical patient care clock hours Foundational anatomy, physiology, morphology, and occlusion Including: morphology; interproximal contact of primary teeth and permanent teeth; occlusal concepts including malocclusion; centric contacts, excursions, and how they relate to restorative contours; marginal ridge form; embrasures; anatomical principles supporting restorative outcomes; and poor outcomes of restorations including incorrect restoration occlusal adjustment, poor interproximal contour, and improper placement or bonding techniques 6 hours 12 hours Restorative materials and armamentarium including: amalgam; hybrid or nano-hybrid composite including filler types, monomer composition, viscosity, and selection; flowable composite; packable composite; resin-modified glass ionomer (RMGI); conventional glass ionomers (GI); intermediate restorative material (IRM); bonding agents including etching and rinsing, self-etch technique, and different bonding generations; and selecting appropriate materials Restorative materials, armamentarium, and instrumentation Instrumentation including: hand instruments; handpiece ergonomics; 8 hours 20 hours dental bur selection; matrix systems including Tofflemire, sectional matrices, wedges selection, and correct size for proper contour; a slow-speed handpiece for restorative material; and dental or surgical magnification devices such as dental loupes or a microscope Adhesive dentistry and tooth isolation Including: adhesive systems; bonding strategies; curing protocols; rubber dam placement including clamp selection, punch patterns, and inversion techniques; moisture control and contamination including saliva, sulcular fluid management, and bonding inhibition; management of oxygen-inhibited layer and smear layer; and infection control 6 hours 16 hours Direct restoration placement and finishing for Class I through VI Including: contacts; occlusion; occlusal adjustment including marking and adjusting an occlusion post-placement; occlusal adjustment including interpretation and functional occlusal contact adjustments; shade matching including hue, chroma, value, metamerism, and layering; matrix band placement including Tofflemire retainer setup, band contouring, and wedge technique for proximal contact and seal; condensation technique for amalgam; managing condensation timing with setting characteristics; carving and finishing amalgam; smoothing margins and removing flash without ditching; amalgam safety and mercury hygiene; composite placement techniques including bonding, incremental fill, anatomical shaping, and light curing strategies; finishing and polishing including contouring, surface texture, margins, polishing, and retention; and identify potential restorative complications and mitigation of complications including patient factors and procedures 10 hours 40 hours Caries removal, liners, and bases Including: selective caries removal; liner placement; bases; interim therapeutic restorations (ITR) principles; and temporizations 4 hours 10 hours Law and rule 1 hour N/A Professional ethics Including consent 1 hour N/A Clinical integration and simulated patient care Including: comprehensive treatment sequencing; full treatment sequencing, time management, and patient positioning; case management including recognizing when isolation fails and managing complications; provider and patient ergonomics; one Class II posterior composite; one Class III anterior composite; and one Class II posterior amalgam 8 hours 30 hours Comprehensive knowledge-based written exam N/A N/A Competency examinations Summative evaluations on performance that is judged with calibrated rubrics N/A N/A (4)(a) Under Subsection 58-69-808(2)(b), a dental hygienist or dental assistant with a current certification under this section shall perform direct restoration services as follows: (i) provide one or more of the following services: (A) place, condense, carve, or polish restorative materials on a direct restoration; and (B) use a hand instrument or a slow-speed handpiece on the direct restoration under Subsection (4)(a)(i)(A); and (ii) under the following parameters: (A) after obtaining consent from the patient that meets the requirements of Subsection R156-69-808d(1); (B) have magnification tools available and use when necessary; (C) the supervising dentist obtains and maintains professional liability insurance covering the certification holder for work performed while engaging in the expanded function; (D) the supervising dentist completes a final evaluation of the direct restoration placement including fit, contact, finish, and occlusion before the patient leaves; and (E) the patient's record documents that the dental hygienist or dental assistant completed the direct restoration placement. (b) A dental hygienist or dental assistant with a current certification under this section may not use pulp capping materials. (5) Under Subsection 58-69-808(2)(b), a dental hygienist or dental assistant with certification under this section shall complete the CPE requirements for the placement of direct restorations under Subsection R156-69-304a(6)(b) or (7)(a)(i).