Administering Nitrous Oxide to a Patient (a Board-issued permit is required)

1. Which staff members may be delegated the duty of administering nitrous oxide to patients?
   1. Registered Dental Hygienists.
   2. Registered Dental Assistants.
   3. Before a dentist can delegate the duty of administering nitrous oxide to a patient, the RDH or RDA must first complete Board-approved training, submit a nitrous oxide permit application, and be granted a permit by the Board.  
   4. The application for a nitrous oxide administration permit may be found here: https://www.nddentalboard.org/www/download_resource.asp?id=540
2. Which staff members may not be delegated the duty of administering nitrous oxide to patients under any circumstance?
   1. Qualified Dental Assistants.
   2. Qualified Dental Assistant-Limited Radiology Registrants.
   3. Unregistered Dental Assistants.
   4. The law does not allow QDAs, QDA-LRRs, and UDAs to be granted a permit to administer nitrous oxide to patients.

Monitoring a Patient Who has been Induced into Nitrous Oxide

1. Which staff members may be delegated the duty of monitoring a patient who is induced into nitrous oxide?
   1. Registered Dental Hygienists and Registered Dental Assistants.
      1. RDHs and RDAs may monitor patients who are induced into nitrous oxide. They do not need any additional training beyond what they originally completed when they became RDHs and RDAs. They must be under a dentist’s indirect supervision and do not need to be issued a permit for this duty.
   2. Fully trained Qualified Dental Assistants, Qualified Dental Assistant-Limited Radiology Registrants and Unregistered Dental Assistants.
      1. Before monitoring a patient who a permit-holder has induced into nitrous oxide, a QDA, a QDA-LRR, or a UDA must be fully trained on the duty to the dentist’s satisfaction. The training can be in-house, can include outside resources, or a combination of education tools. Once the dentist is satisfied with the skill level of their assistant, the dentist may delegate this duty. The dentist must retain the training records.
      2. The assistant must be under a dentist’s direct supervision and does not need to be issued a permit for this duty.
2. Which staff members may not be delegated the duty of monitoring a patient who has been induced into nitrous oxide?
   1. A QDA, QDA-LRR, or UDA who has not been fully trained to the satisfaction of the supervising dentist.

In addition to understanding the above summary, it is important to review the laws relating to these (and all) duties. Please do so. The laws may be found here: Laws and Rules - ND Dental Board. Specific cites to the nitrous oxide duties referenced above are as follows:

1. A nitrous oxide permit is required: NDAC 20-02-01-05(1)(f)
2. An RDH who has been issued a nitrous oxide administration permit from the Board may administer nitrous oxide to a patient: NDAC 20-04-01-01(2)(g)
3. An RDH may monitor patients induced into nitrous oxide: NDAC 20-04-01-01(2)(d)
4. An RDA who has been issued a nitrous oxide administration permit from the Board may administer nitrous oxide to a patient: NDAC 20-03-01-01(4)
5. An RDA may monitor patients induced into nitrous oxide: NDAC 20-03-01-01(5)(e)
6. A QDA, QDA-LRR, and UDA who has been fully trained to the satisfaction of the dentist may monitor patients who have been induced into nitrous oxide: NDAC 20-03-01-01(a)(12).