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5. Expanded Function Permits

Expanded Function Permits

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. 

Local Anesthesia

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: 

1. A letter from the accredited school with the school seal affixed. Photocopies will not be accepted.
2. A notarized copy of the certification of the local anesthesia course completed.
3. A notarized letter stating that the licensed dental hygienist has administered local anesthesia within the last three years.
4. A notarized copy of the dental hygiene transcript with the local anesthesia course recorded.

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

Restorative Duties

The Board may issue a permit authorizing a dental hygienist to provide restorative duties if the applicant successfully completes the following:

• Completes a board approved course;
• Passes the Western Regional Examining Board’s restorative examination or other equivalent examination approved by the Board;
• Completes the restorative function component of the Dental Assisting National Board’s certified restorative functions dental assistant examination.

RDH/RDA restorative procedures allowed under direct supervision of a dentist:

• Place, carve, and adjust Class I, II and Class V supragingival amalgam or glass ionomer restorations with hand instruments or a slow-speed handpiece;
• Adapt and cement stainless steel crowns;
• Place, contour, and adjust Class I, II and Class V supragingival composite restorations where the margins are entirely within the enamel with hand instruments or a slow-speed handpiece.

 

Restorative Functions Permit Application

Anesthesia Assistant Duties

A dental hygienist may provide anesthesia assistance under the supervision of a dentist authorized by the Board to provide moderate sedation, once the applicant successfully completes the following:

1. Board-approved dental anesthesia assistant education and training course;
2. Board-approved competency examination;
3. Completion of a training in intravenous access or phlebotomy;
4. Has proof of current BLS or ACLS or PALS;
5. Provides proof of a general anesthesia permit issued to the OMFS who will be supervising the anesthesia assistant’s services.

A dental hygienist may provide the following duties under contiguous supervision of a dentist authorized by the Board to provide moderate sedation:

1. Initiate and discontinue an IV line for a patient being prepared to receive IV medication, sedation or  general anesthesia; and
2. Adjust the rate of intravenous fluids infusion only to maintain or keep the line patent or open.

A dental hygienist may provide the following duties under direct visual supervision of a dentist authorized by the Board to provide moderate sedation:

1. Draw up and prepare medications;
2. Follow instructions to deliver medication into an intravenous line upon verbal command;
3. Adjust the rate of intravenous fluids infusion beyond a keep-open rate; and
4. Adjust an electronic device to provide medications such as an infusion pump.

Anesthesia Assistant Permit Application

Anesthesia Assistant Courses Accepted by the NDBDE

• The Dental Anesthesia Assistant National Certification Examination (DAANCE) is a two-part 36 hour continuing education program comprised of self-study material and a standardized computer based exam. The course is designed for auxiliary who assist a dentist or OMFS with a valid ND sedation or anesthesia permit. DAANCE certification is valid for five years. To recertify, assistants must retake the DAANCE examination every five years and maintain current BLS and/or ACLS certifications. Note: Online CPR certifications are not accepted.The course meets the requirements for a ND Class I Dental Anesthesia Assistant Permit.  
• Sedation Consult, LLC:  Allan Schwartz, DDS, CRNA provides a 3 day course,  Monitoring Sedation/General Anesthesia & I.V. Certification, for dental hygienists and registered dental assistants who have not taken DAANCE. The course meets the requirements for requirements of ND Class II Dental Anesthesia Assistant Permit.  
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New Technology - NDBDE Policy

New technologies have enhanced the preventive and therapeutic duties hygienists may provide. It is the position of the Board that 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 NDBDE 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.