24.138.406    FUNCTIONS FOR DENTAL AUXILIARIES

(1) Dental auxiliaries may work under the direct supervision of a licensed dentist per ARM 24.138.301 if the auxiliary:

(a) was instructed and qualified to perform in a dental assisting program accredited by the Commission on Dental Accreditation or its successor; or

(b) was instructed and trained by a licensed dentist; or

(c) was instructed and trained in a board-approved continuing education course.

(2) A certified dental assistant may work under the general supervision of a licensed dentist per ARM 24.138.301.

(3) A dental auxiliary working under the direct supervision of a licensed dentist per ARM 24.138.301 may perform the following dental procedures including, but not limited to:

(a) making radiographic exposures as prescribed by the supervising dentist as referenced in (12);

(b) initiating, adjusting, and monitoring nitrous oxide flow for a patient who has been prescribed and administered nitrous oxide by a licensed dentist;

(c) taking impressions for study or working casts;

(d) removing sutures and dressings;

(e) applying topical anesthetic agents;

(f) providing oral health instructions;

(g) applying topical fluoride agents;

(h) removing excess cement from coronal surfaces;

(i) placing and removing rubber dams;

(j) placing and removing matrices;

(k) collecting patient data;

(l) polishing amalgam restorations;

(m) placing and removing temporary restoration with hand instruments only;

(n) placing pit and fissure sealants; and

(o) coronal polishing.

(4) A certified dental assistant working under the general supervision of a licensed dentist per ARM 24.138.301 is prohibited from performing the following functions:

(a) initiating, adjusting, and monitoring nitrous oxide flow for a patient who has been prescribed and administered nitrous oxide by a licensed dentist;

(b) applying silver diamine fluoride agents;

(c) placing and removing rubber dams;

(d) placing and removing matrices;

(e) polishing amalgam restorations; and

(f) applying topical anesthetic agents.

(5) A certified dental assistant working under the general supervision of a licensed dentist may place pit and fissure sealants following an in-person comprehensive oral examination or periodic examination within the preceding 30 days.

(6) Dental auxiliaries performing any intraoral procedure must be under the direct supervision of a licensed dentist, except that a certified dental assistant may work under the general supervision of a licensed dentist.

(7) No dentist shall allow any dental auxiliary to perform the following:

(a) diagnosis and treatment planning as per 37-4-401, MCA;

(b) cutting hard or soft tissue or extracting teeth;

(c) prescribing any drugs as per 37-4-401, MCA;

(d) administering or dispensing any drug, without the prior authorization of the supervising dentist;

(e) administering intravenous and intramuscular injections or local anesthetic;

(f) placing, carving, or condensing any permanent restorations;

(g) taking final impressions of the involved arch for crowns, bridges, implant prosthesis, partial dentures, or complete dentures;

(h) bonding or cementing any fixed prosthesis, including veneers, except for provisionals;

(i) bonding or cementing orthodontic brackets or orthodontic appliances that would provide activation upon cementation;

(j) placing sulcular medicinal or therapeutic materials;

(k) periodontal probing;

(l) air polishing; or

(m) prophylaxis as defined in ARM 24.138.301.

(8) Dentists shall not delegate to dental auxiliaries any duties or responsibilities regarding patient care that cannot be delegated to dental auxiliaries under 37-4-408, MCA, and board rules.

(9) The assignment of tasks and procedures to dental auxiliaries shall not relieve the dentist from liability for all treatment rendered the patient.

(10) A dentist shall not employ, supervise or otherwise use more dental auxiliaries than the dentist can reasonably supervise in keeping with the dentist's ethical and professional responsibilities.

(11) The employing dentist shall verify that a dental auxiliary's qualifications comply with the statutes and rules of the board.

(12) A dentist licensed to use or direct the use of an x-ray producing device must ensure that the radiation source under the dentist's jurisdiction is used only by individuals competent to use it, as per ARM 37.14.1003. Only a licensed dentist may prescribe radiation dosage and exposure.

(a) A dental auxiliary, under the direct supervision of a licensed dentist, may expose radiographs only if the auxiliary:

(i) has graduated from an accredited program of dental assisting, dental hygiene, or dentistry accredited by the Commission on Dental Accreditation or its successor; or

(ii) has been certified in dental radiology as a result of military experience; or

(iii) has successfully completed a board-approved radiology written examination.

(b) A certified dental assistant may expose radiographs under the general supervision of a licensed dentist.

(c) For dental auxiliaries beginning work in Montana after January 1, 2016, radiology certification from other states will no longer be accepted, with the exception of a board-approved written examination. Dental auxiliaries who acquired radiology certification in other states and were employed as dental auxiliaries in Montana prior to January 1, 2016, will be grandfathered.

(13) Proof of current certification must be readily available for review by the public or the board upon request.

 

History: 37-4-205, 37-4-408, MCA; IMP, 37-4-408, MCA; NEW, 1995 MAR p. 2795, Eff. 11/23/95; AMD, 1996 MAR p. 3118, Eff. 12/6/96; TRANS, from Commerce, & AMD, 2003 MAR p. 2435, Eff. 10/31/03; AMD, 2007 MAR p. 43, Eff. 1/12/07; AMD, 2010 MAR p. 411, Eff. 2/12/10; AMD, 2015 MAR p. 1904, Eff. 10/30/15; AMD, 2020 MAR p. 588, Eff. 3/28/20.