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OREGON BOARD OF DENTISTRY

 

DIVISION 35
DENTAL HYGIENE

818-035-0010
Definitions
All terms used in this Division shall have the meanings assigned under ORS 679.010 except that:
(1) "Limited Access Patient" means a patient who is unable to receive regular dental hygiene treatment in a dental office.
(2) "Long-Term Care Facility" shall have the same definition as that established under ORS 442.015(14)(b).
Stat. Auth.: ORS 679.250(7) & 680.150

Stats. Implemented: ORS 679.010 & 680.010

Hist.: DE 5-1984, f. & ef. 5-17-84; DE 2-1992, f. & cert. ef. 6-24-92; OBD 3-1998, f. & cert. ef. 7-13-98; OBD 2-2009, f. 10-21-09, cert. ef. 11-1-09
818-035-0020
Authorization to Practice
(1) A dental hygienist
may practice dental hygiene in the places specified by ORS 680.150 under general
supervision upon authorization of a supervising dentist.
(2) A dentist
who authorizes a dental hygienist to practice dental hygiene on a limited access
patient must review the hygienist's findings.
(3) A supervising
dentist, without first examining a new patient, may authorize a dental hygienist:
(a) To take
a health history from a patient;
(b) To take
dental radiographs;
(c) To perform
periodontal probings and record findings;
(d) To gather
data regarding the patient; and
(e) To diagnose,
treatment plan and provide dental hygiene services.
(4) When
hygiene services are provided pursuant to subsection (3), the supervising dentist
need not be on the premises when the services are provided.
(5) When
hygiene services are provided pursuant to subsection (3), the patient must be scheduled
to be examined by the supervising dentist within fifteen business days following
the day the hygiene services are provided.
(6) If a
new patient has not been examined by the supervising dentist subsequent to receiving
dental hygiene services pursuant to subsection (3), no further dental hygiene services
may be provided until an examination is done by the supervising dentist.
Stat. Auth.: ORS
679 & 680

Stats. Implemented:
ORS 680.150

Hist.: DE
7, f. 2-3-66, DE 8, f. 3-20-67, ef. 3-21-67; DE 11, f. 3-31-71, ef. 4-25-71; DE
17, f. 1-20-72, ef. 2-1-72; DE 21, f. 1-9-74, ef. 2-11-74; DE 5-1978, f. & ef.
6-14-78; DE 4-1980, f. & ef. 9-8-80; DE 5-1984, f. & ef. 5-17-84; Renumbered
from 818-010-0110; DE 3-1986, f. & ef. 3-31-86; DE 2-1992, f. & cert. ef.
6-24-92; OBD 3-2001, f. & cert. ef. 1-8-01; OBD 1-2008, f. 11-10-08, cert. ef.
12-1-08; OBD 1-2013, f. 5-15-13, cert. ef. 7-1-13
818-035-0025
Prohibitions
A dental hygienist may not:
(1) Diagnose and treatment plan
other than for dental hygiene services;
(2) Cut hard or soft tissue
with the exception of root planing;
(3) Extract any tooth;
(4) Fit or adjust any correctional
or prosthetic appliance except as provided by OAR 818-035-0030(1)(h);
(5) Prescribe, administer or
dispense any drugs except as provided by OAR 818-035-0030, 818-035-0040, 818-026-0060(11)
and 818-026-0070(11);
(6) Place, condense, carve or
cement permanent restorations except as provided in OAR 818-035-0072, or operatively
prepare teeth;
(7) Irrigate or medicate canals;
try in cones, or ream, file or fill canals;
(8) Use the behavior management
techniques of Hand Over Mouth (HOM) or Hand Over Mouth Airway Restriction (HOMAR)
on any patient.
(9) Place or remove healing
caps or healing abutments, except under direct supervision.
(10) Place implant impression
copings, except under direct supervision.
Stat. Auth.: ORS 679 & 680
Stats. Implemented: ORS 679.020(1)
Hist.: DE 2-1992, f. &
cert. ef. 6-24-92; DE 2-1997, f. & cert. ef. 2-20-97; OBD 7-1999, f. 6-25-99,
cert. ef. 7-1-99; OBD 2-2000(Temp), f. 5-22-00, cert. ef. 5-22-00 thru 11-18-00;
OBD 2-2001, f. & cert. ef. 1-8-01; OBD 15-2001, f. 12-7-01, cert. ef. 1-1-02;
OBD 2-2005, f. 1-31-05, cert. ef. 2-1-05; OBD 2-2007, f. 4-26-07, cert. ef. 5-1-07;
OBD 1-2008, f. 11-10-08, cert. ef. 12-1-08; OBD 4-2011, f. & cert. ef. 11-15-11;
OBD 1-2014, f. 7-2-14, cert. ef. 8-1-14; OBD 1-2015(Temp), f. & cert. ef. 4-17-15
thru 10-13-15; OBD 3-2015, f. 9-8-15, cert. ef. 10-1-15
818-035-0030
Additional Functions of Dental Hygienists
(1) In addition to functions set forth
in ORS 679.010, a dental hygienist may perform the following functions under the
general supervision of a licensed dentist:
(a) Make preliminary intra-oral
and extra-oral examinations and record findings;
(b) Place periodontal dressings;
(c) Remove periodontal dressings
or direct a dental assistant to remove periodontal dressings;
(d) Perform all functions delegable
to dental assistants and expanded function dental assistants providing that the
dental hygienist is appropriately trained;
(e) Administer and dispense
antimicrobial solutions or other antimicrobial agents in the performance of dental
hygiene functions.
(f) Prescribe, administer and
dispense fluoride, fluoride varnish, antimicrobial solutions for mouth rinsing or
other non-systemic antimicrobial agents.
(g) Use high-speed handpieces
to polish restorations and to remove cement and adhesive material.
(h) Apply temporary soft relines
to complete dentures for the purpose of tissue conditioning.
(i) Perform all aspects of teeth
whitening procedures.
(2) A dental hygienist may perform
the following functions at the locations and for the persons described in ORS 680.205(1)
and (2) without the supervision of a dentist:
(a) Determine the need for and
appropriateness of sealants or fluoride; and
(b) Apply sealants or fluoride.
Stat. Auth.: ORS 679 & 680
Stats. Implemented: ORS 679.025(2)(j)
Hist.: DE 5-1984, f. &
ef. 5-17-84; DE 3-1986, f. & ef. 3-31-86; DE 2-1992, f. & cert. ef. 6-24-92;
OBD 7-1999, f. 6-25-99, cert. ef. 7-1-99; OBD 1-2001, f. & cert. ef. 1-8-01;
OBD 15-2001, f. 12-7-01, cert. ef. 1-1-02; OBD 1-2004, f. 5-27-04, cert. ef. 6-1-04;
OBD 2-2005, f. 1-31-05, cert. ef. 2-1-05; OBD 3-2007, f. & cert. ef. 11-30-07;
OBD 1-2008, f. 11-10-08, cert. ef. 12-1-08; OBD 2-2009, f. 10-21-09, cert. ef. 11-1-09;
OBD 1-2014, f. 7-2-14, cert. ef. 8-1-14; OBD 1-2015(Temp), f. & cert. ef. 4-17-15
thru 10-13-15; OBD 3-2015, f. 9-8-15, cert. ef. 10-1-15
818-035-0040
Expanded Functions of Dental Hygienists
(1) Upon completion of a course of instruction
in a program accredited by the Commission on Dental Accreditation of the American
Dental Association or other course of instruction approved by the Board, a dental
hygienist who completes a Board approved application shall be issued an endorsement
to administer local anesthetic agents and local anesthetic reversal agents under
the general supervision of a licensed dentist. Local anesthetic reversal agents
shall not be used on children less than 6 years of age or weighing less than 33
pounds.
(2) Upon completion of a course
of instruction in a program accredited by the Commission on Dental Accreditation
of the American Dental Association or other course of instruction approved by the
Board, a dental hygienist may administer nitrous oxide under the indirect supervision
of a licensed dentist in accordance with the Board’s rules regarding anesthesia.
Stat. Auth.: ORS 679 & 680
Stats. Implemented: ORS 679.025(2)(j)
& 679.250(7)
Hist.: DE 5-1984, f. &
ef. 5-17-84; DE 3-1986, f. & ef. 3-31-86; DE 2-1992, f. & cert. ef. 6-24-92;
OBD 3-1998, f. & cert. ef. 7-13-98; OBD 7-1999, f. 6-25-99, cert. ef. 7-1-99;
OBD 8-1999, f. 8-10-99, cert. ef. 1-1-00; OBD 15-2001, f. 12-7-01, cert. ef. 1-1-02;
OBD 2-2007, f. 4-26-07, cert. ef. 5-1-07; OBD 3-2007, f. & cert. ef. 11-30-07;
OBD 1-2008, f. 11-10-08, cert. ef. 12-1-08; OBD 1-2014, f. 7-2-14, cert. ef. 8-1-14
818-035-0065
Expanded Practice Dental
Hygiene Permit
The Board shall issue an Expanded Practice
Permit to a Dental Hygienist who holds an unrestricted Oregon license, and completes
an application approved by the Board, pays the permit fee, and
(1) Certifies on the application
that the dental hygienist has completed at least 2,500 hours of supervised dental
hygiene clinical practice, or clinical teaching hours, and also completes 40 hours
of courses chosen by the applicant in clinical dental hygiene or public health sponsored
by continuing education providers approved by the Board; or
(2) Certifies on the application
that the dental hygienist has completed a course of study, before or after graduation
from a dental hygiene program, that includes at least 500 hours of dental hygiene
practice on patients described in ORS 680.205; and
(3) Provides the Board with
a copy of the applicant's current professional liability policy or declaration page
which will include, the policy number and expiration date of the policy.
(4) Notwithstanding OAR 818-035-0025(1),
prior to performing any dental hygiene services an Expanded Practice Dental Hygienist
shall examine the patient, gather data, interpret the data to determine the patient's
dental hygiene treatment needs and formulate a patient care plan.
(5) An Expanded Practice Dental
Hygienist may render the services described in paragraphs(6)(a) to (d) of this rule
to the patients described in ORS 680.205(1) if the Expanded Practice Dental Hygienist
has entered into a written collaborative agreement in a format approved by the Board
with a dentist licensed under ORS Chapter 679.
(6) The collaborative agreement
must set forth the agreed upon scope of the dental hygienist’s practice with
regard to:
(a) Administering local anesthesia;
(b) Administering temporary
restorations without excavation;
(c) Prescribing prophylactic
antibiotics and nonsteroidal anti-inflammatory drugs; and
(d) Referral parameters.
(7) The collaborative agreement
must comply with ORS 679.010 to 680.990.
(8) From the date this rule
is effective, the Board has the authority to grant a Limited Access Permit through
December 31, 2011, pursuant to ORS 680.200.
Stat. Auth.: ORS 680
Stats. Implemented: ORS 680.200
Hist.: OBD 1-1998, f. &
cert. ef. 6-8-98; OBD 3-2001, f. & cert. ef. 1-8-01; OBD 3-2007, f. & cert.
ef. 11-30-07; OBD 1-2010, f. 6-22-10, cert. ef. 7-1-10; OBD 4-2011, f. & cert.
ef. 11-15-11; OBD 2-2012, f. 6-14-12, cert. ef. 7-1-12; OBD 3-2015, f. 9-8-15, cert.
ef. 10-1-15
818-035-0066
Additional Populations
for Expanded Practice Dental Hygiene Permit Holders
A dental hygienist
with an Expanded Practice Permit may practice without supervision at locations and
on persons as described in ORS 680.205 (1)(a) through (e) and on the following additional
populations: Low-income persons, as defined by earning up to 200% of the Federal
Poverty Level or on specific population groups designated by the Dental Health Professional
Shortage Areas (DHPSA) that lack access to care and that are underserved.
Stat. Auth: ORS
679 & 680

Stats. Implemented:
680.205 & 679.250(9)

Hist.: OBD
2-2012, f. 6-14-12, cert. ef. 7-1-12; OBD 1-2013, f. 5-15-13, cert. ef. 7-1-13
818-035-0072
Restorative Functions of Dental Hygienists
(1) The Board shall
issue a Restorative Functions Endorsement (RFE) to a dental hygienist who holds
an unrestricted Oregon license, and has successfully completed:
(a) A Board
approved curriculum from a program accredited by the Commission on Dental Accreditation
of the American Dental Association or other course of instruction approved by the
Board, and successfully passed the Western Regional Examining Board’s Restorative
Examination or other equivalent examinations approved by the Board within the last
five years; or
(b) If successful
passage of the Western Regional Examining Board’s Restorative Examination
or other equivalent examinations approved by the Board occurred over five years
from the date of application, the applicant must submit verification from another
state or jurisdiction where the applicant is legally authorized to perform restorative
functions and certification from the supervising dentist of successful completion
of at least 25 restorative procedures within the immediate five years from the date
of application.
(2) A dental
hygienist may perform the placement and finishing of direct alloy and direct composite
restorations, under the indirect supervision of a licensed dentist, after the supervising
dentist has prepared the tooth (teeth) for restoration(s):
(a) These
functions can only be performed after the patient has given informed consent for
the procedure and informed consent for the placement of the restoration(s) by a
Restorative Functions Endorsement dental hygienist;
(b) Before
the patient is released, the final restoration(s) shall be checked by a dentist
and documented in the chart.
Stat. Auth.: ORS
679, 680

Stats. Implemented:
ORS 679.010(3), 679.250(7)

Hist.: OBD
2-2007, f. 4-26-07, cert. ef. 5-1-07; OBD 1-2013, f. 5-15-13, cert. ef. 7-1-13
818-035-0100
Record Keeping
(1) An Expanded Practice Dental Hygienist
shall refer a patient annually to a dentist who is available to treat the patient, and note in the
patient's official chart held by the facility that the patient has been referred.
(2) When a licensed dentist has authorized
an Expanded Practice Dental Hygienist to administer local anesthesia, place temporary restorations
without excavation or prescribe prophylactic antibiotics and nonsteroidal anti-inflammatory
drugs, the Expanded Practice Dental Hygienist shall document in the patient's official chart
the name of the collaborating dentist and date the collaborative agreement was entered into.
Stat. Auth.: ORS 680

Stats. Implemented: ORS 680.205(2)
& (3)

Hist.: OBD 1-1998, f. & cert.
ef. 6-8-98; OBD 1-2008, f. 11-10-08, cert. ef. 12-1-08; OBD 2-2009, f. 10-21-09, cert. ef. 11-1-09;
OBD 4-2011, f. & cert. ef. 11-15-11

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