LOCAL ANESTHESIA | RESTORATIVE FUNCTIONS | ANESTHESIA ASSISTANT | NITROUS OXIDE INHALATION ANALGESIA | NEW TECHNOLOGY
A dental hygienist may be authorized by permit to provide anesthesia assistant duties and/or provide restorative functions. The permit must be renewed when the license is renewed including evidence of 2 hours of continuing education pertaining to the expanded duty. A dental hygienist is authorized by permit to provide local anesthesia; renewal of the local anesthesia permit is not required, continuing education for local anesthesia is not required.
A licensed dental hygienist may apply for a permit to administer local anesthesia to a patient who is at least eighteen years old, under the direct supervision of a licensed dentist. A license applicant must include the permit application to receive the local anesthesia endorsement.
To be considered for a permit, a hygienist must have successfully completed a didactic and clinical course in local anesthesia within the last twenty-four months sponsored by a dental or dental hygiene program accredited by the Commission on Dental Accreditation of the American Dental Association resulting in the dental hygienist becoming clinically competent in the administration of local anesthesia.
A licensed dental hygienist applying for a local anesthesia permit who has been permitted to administer local anesthesia in another state and who has continuously administered local anesthesia during the past three years must provide verification of the permit and continuous use to the North Dakota Board of Dental Examiners.
Verification may consist of:
A licensed dental hygienist requesting a permit to administer anesthesia who cannot provide verification must retake and successfully pass a didactic and clinical course in local anesthesia sponsored by a dental or dental hygiene program accredited by the Commission on Dental Accreditation of the American Dental Association.
Local Anesthesia Permit Application
The Board may issue a permit authorizing a dental hygienist to provide restorative duties if the applicant meets the requirements set forth in NDAC 20-04-01-03.1(3)(a).
RDH/RDA restorative procedures allowed under direct supervision of a dentist:
Restorative Functions Permit Application
The Board may issue a Class I permit allowing the permitholder to provide anesthesia assistance under the contiguous supervision of a dentist who is authorized to provide moderate sedation, deep sedation, or general anesthesia once the applicant successfully:
An individual authorized by a Class I permit may provide the following duties under contiguous supervision of a dentist who is authorized to provide moderate sedation, deep sedation, or general anesthesia:
The Board may issue a Class II permit authorizing the permitholder to provide anesthesia assistance under the direct visual supervision of a dentist who is authorized to provide moderate sedation, deep sedation, or general anesthesia once the applicant:
An individual authorized by a Class II permit may provide the following duties under direct visual supervision of a dentist who is authorized to provide moderate sedation, deep sedation, or general anesthesia::
Anesthesia Assistant Permit Application
Anesthesia Assistant Courses Accepted by the NDBDE
1. The following standards apply to the administration of nitrous oxide inhalation analgesia:
a. Inhalation equipment must have a fail-safe system that is appropriately checked and calibrated. The equipment also must have either a functioning device that prohibits the delivery of less than thirty percent oxygen or an appropriately calibrated and functioning in-line oxygen analyzer with audible alarm. A scavenging system must be available if gases other than oxygen or air are used.
b. Patient dental records must include the concentration administered and duration of administration.
c. A dentist may not delegate monitoring of nitrous oxide inhalation analgesia once the patient has ingested an enteral drug for the purpose of minimal sedation.
d. Before authorizing a dental hygienist or registered dental assistant to administer nitrous oxide inhalation analgesia, the dentist must have provided and documented training in the proper and safe operation of the nitrous oxide inhalation analgesia equipment.
e. A patient receiving nitrous oxide inhalation analgesia must be continually monitored by authorized dental staff. A dental hygienist or a registered dental assistant may terminate or reduce the amount of nitrous oxide previously administered by the authorized nitrous oxide inhalation analgesia provider.
f. The board may issue a permit authorizing the administration of nitrous oxide inhalation to a dentist or dental hygienist or registered dental assistant if the following requirements are met:
(1) Evidence of successful completion of a twelve-hour, board-approved course of training or course provided by a program accredited by an accrediting body recognized by the United States department of education, and either:
(a) Completed the course within thirteen months before application; or
(b) Completed the course more than thirteen months before application, has legally administered nitrous oxide inhalation analgesia for a period of time during the three years preceding application, and provides written documentation from a dentist that has employed or supervised the applicant, attesting to the current clinical proficiency of the applicant to administer nitrous oxide inhalation analgesia.
(2) Evidence of current certification in basic life support by the American heart association for the health care provider, or an equivalent program approved by the board.
Permit Application - Nitrous Oxide Inhalation Analgesia
Board-approved Courses
University of Minnesota School of Dentistry (umn.edu) (at this website, search “nitrous” for the most current course offering).
New technologies have enhanced the preventive and therapeutic duties hygienists may provide. Any services provided by a licensee, regardless of the devise used, must be within the scope of practice for each licensee. Whenever a new treatment modality is brought forward, it is the NDSBDE policy that the dentist must have adequate proficiency and training related to the technology. Licensees utilizing new technology must maintain documentation of satisfactory completion of Board approved continuing education or training. Neither the particular technology utilized nor amendments to scope of practice alter the fact that all licensees are responsible for their individual actions with the dentist ultimately responsible for all care provided in each dental office.
Contact the Board's Executive Director if you have questions regarding regulations governing the practice of dental hygiene in North Dakota.