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Chapter 150-9 DELEGATED DUTIES

Rule 150-9-.01 General Duties of Dental Assistants

(1) A dental assistant shall be defined as one who is employed in a dental office to perform certain duties that assist the dentist. It is expected that the dental assistant will be familiar with the operations performed in the conduct of a dental practice; specifically, the sterilization of instruments, the general hygiene of the mouth, secretarial work, making appointments and bookkeeping. Under no circumstances may he or she perform any of the operations catalogued as dental hygiene treatments in Board Rule 150-5-.03(5).
(2) Direct supervision and control as it pertains to a dental assistant shall mean that a dentist licensed in Georgia is in the dental office or treatment facility, personally diagnoses the condition to be treated, personally authorizes the procedures and remains in the dental office or treatment facility while the procedures are being performed by the dental assistant and, before dismissal of the patient, evaluates the performance of the dental assistant.
(3) In addition to routine duties, the general duties identified below may be delegated to dental assistants under the direct supervision of a licensed dentist. These duties may only be delegated in those instances when they are easily reversible and will not result in increased risk to the patient:
(a) Make impressions for diagnostic models and opposing models.
(b) Place and expose radiographs after completing the training required by Ga. Comp. R. &Regs. 290-5-22-.04 titled X-Rays in the Health Arts.
(c) Remove sutures - other than wire sutures.
(d) Remove periodontal dressing.
(e) Place and remove rubber dams.
(f) Apply topical anesthetic.
(g) Remove visible excess cement from supramarginal areas of dental restorations and appliances with non-mechanical hand instruments.
(h) Fabricate extraorally temporary crowns and bridges.
(i) Cement temporary crowns and bridges with intermediate cement.
(j) Remove temporary crowns and bridges seated with intermediate cement.
(k) Place intracoronal temporary restorations using intermediate cement.
(l) Place drying and deoiling agents prior to the cementation of permanent crowns and bridges.
(m) Remove dry socket medication.
(n) Place and take off a removable prosthesis with a pressure sensitive paste after the appliance has been initially seated by the dentist.
(o) Etch unprepared enamel.
(p) Polish the enamel and restorations of the anatomical crown; however, this procedure may only be executed through the use of a slow speed handpiece (not to exceed 10,000 rpm), rubber cup and polishing agent. This procedure shall in no way be represented to patient as a prophylaxis. This procedure shall be used only for the purpose of enamel preparation for:
1. Bleaching,
2. Cementation of fixed restorations,
3. Bonding procedures including supramarginal enamel restorations after removal of orthodontic appliances. No direct charge shall be made to the patient for such procedure.
(q) Dry canals with absorbent points and place soothing medicaments (not to include endodontic irrigation); and place and remove temporary stopping with non-mechanical hand instruments only.
(r) Place matrix bands and wedges.
(s) Select, pre-size and seat orthodontic arch wires with brackets which have been placed by the dentist. Adjustment of the arch wire may only be made by the dentist.
(t) Select and pre-size orthodontic bands which initially must be seated by the dentist.
(u) Place and remove pre-treatment separators.
(v) Cut and tuck ligatures, remove ligatures and arch wires, remove loose or broken bands.
(w) Remove and recement loose bands that previously have been contoured and fitted by a dentist, but only after a dentist has examined the affected tooth and surrounding gingival and found no evidence of pathology.
(x) Perform phlebotomy and venipuncture procedures after appropriate training is acquired.
(y) Use a rubber cup prophy on a patient with primary dentition. A dental assistant may only begin providing rubber cup prophies after the dental assistant has completed a curriculum approved by the Board or a minimum of eight hours of on-the-job training in the provision of rubber cup prophies by a dentist licensed to practice in Georgia.

Rule 150-9-.02 Expanded Duties of Dental Assistants

(1) To meet the requirements of an expanded duty dental assistant, a dental assistant must have a high school diploma, or the equivalent thereof, proof of current CPR certification and a certificate documenting that he or she has successfully completed the course pertaining to the specific duties outlined in that certificate. Only those expanded duties, which are listed on the certificate(s), may be performed by an expanded duty dental assistant. An expanded duty dental assistant certificate may be issued by an accredited dental assisting program, a dental hygiene school, a dental school or a professional association recognized and approved by the Georgia Board of Dentistry to a candidate who has successfully completed the required certificate courses (each of which must be a minimum of four hours) from an accredited dental assisting program, a dental hygiene school, a dental school or professional association recognized and approved by the Georgia Board of Dentistry and met all other requirements of an expanded duty assistant; and completed an examination demonstrating competency in specific duties that is administered by a licensed dentist on behalf of the accredited dental assistant program, dental hygiene school, dental school or professional association recognized and approved by the Georgia Board of Dentistry.
(2) Eligibility for taking said courses requires that the candidate meet at least one of the following criteria:
(a) Possess current certification that the candidate is a Certified Dental Assistant.
(b) Be a graduate of a one (1) year accredited dental assisting program or a dental assisting program approved by the Board or be eligible for graduation.
(c) Have been employed as a chair side assistant by a licensed dentist for a continuous six (6) month period within the previous three (3) years. (Note: An expanded duties certificate would be issued to a candidate only upon proper proof of graduation.)
(3) The employer of the expanded duty assistant shall have readily available in the dental office a copy of the certificate(s) issued from the sponsor of the accredited course(s) of study to the expanded duty dental assistant. The expanded duties specific to the course(s) taken and in which [a] certificate(s) [has/have] been issued may be delegated to dental assistants, who are performing their duties under the direct supervision of a licensed dentist. The following expanded duties may be delegated to those assistants meeting the educational requirements established by Board Rule 150-9-.02(1) and possessing a certificate(s) of the course(s) taken delineating the duties specific to that course:
(a) Apply desensitizing agents to root surfaces of teeth and prepared dentinal surfaces of teeth prior to cementation of temporary restorations and crowns, bridges, or inlays.
(b) Place cavity liner, base or varnish over unexposed pulp.
(c) Intraoral fabrication of temporary crowns and bridges. All such adjustments must be performed extraorally.
(d) Perform face bow transfer.
(e) Make impressions to be used to repair a damaged prosthesis.
(f) Place periodontal dressing.
(g) Redressing (not initial placement of dressing) and removing dressing from alveolar sockets in post-operative osteitis when the patient is uncomfortable due to the loss of dressing from the alveolar socket in a diagnosed case of post-operative osteitis.
(h) Make impressions to be used to fabricate a night guard (bruxism or muscle relaxation appliance). All adjustments must be performed extraorally. Final adjustment must be made by the dentist.
(i) Monitor the administration of nitrous oxide/oxygen; turn off nitrous oxide/oxygen at the completion of the dental procedure and make adjustments to the level of nitrous oxide/oxygen, but only following the specific instructions of the dentist.
(j) Apply topical anticariogenic agents.
(k) Apply pit and fissure sealants, and primer and bonding agents to etched enamel or dentin; and light-cure with a fiber-optic light source (not to include the use of a laser device).
(l) Packing and removing retraction cord, as prescribed by the dentist, so long as said cord is used solely for restorative dental procedures.
(m) Changing of bleaching agent, following initial applications by the dentist, during the bleaching process of vital and non-vital teeth after the placement of a rubber dam; and applying the fiber-optic light source of a curing light for activation of the bleach (not to include the use of a laser device).
(n) Rebond brackets after a licensed dentist has examined the affected tooth and surrounding gingiva and found no evidence of pathology.
(o) Remove bonded brackets with hand instruments only.
(p) Make impressions for passive orthodontic appliances.
(q) Apply primer and bonding agents to etched enamel or dentin; and light cure with fiber-optic light source (not to include use of a laser device).
(r) Take and record vital signs.
(s) Size and fit stainless steel crowns on a primary tooth only.
(t) Place springs on wires.
(u) Place hooks on brackets.
(v) Remove loose or broken bonds.
(w) Remove ligature and arch wires.
(x) Band, select, and pre-size arch wires and place arch wires after final adjustment and approval by the dentist.
(y) Select, pre-fit, cement, cure, and remove ortho bands or brackets.
(z) Place and remove pre-treatment separators.
(aa) Digital scans for fabrication orthodontic appliances and models.

Rule 150-9-.03 Prohibited Use of Technologies by Dental Assistants

(1) General and expanded duty dental assistants shall not utilize laser equipment and technology in the course of the performance of their duties which are otherwise authorized by these rules.
(2) General and expanded duty dental assistants shall not utilize intraorally micro etching and/or air polishing equipment and technologies in the course of the performance of those duties otherwise authorized by these rules.