Code of Massachusetts Regulations › 234 CMR - BOARD OF REGISTRATION IN DENTISTRY › Title 234 CMR 5.00 - REQUIREMENTS FOR THE PRACTICE OF DENTISTRY, DENTAL HYGIENE, AND DENTAL ASSISTING › Section 5.11 - Delegable Procedures

Current through Register 1525, July 5, 2024
Registered Dental Hygienists (RDH), Public Health Dental
				Hygienist (PHDH), Expanded Function Dental Assistant (EFDA), Certified
				Assistant (CA), Formally-trained Dental Assistant (FTDA), and Dental Assistant
				Trained on the Job (OJT) and may perform the following dental procedures
				pursuant to the designated level of supervision or direction: General
				Supervision (G), Written Collaborative Agreement (WCA), Direct Supervision (D),
				Immediate Supervision (I) or Delegation Not Allowed (N/A).
DELEGATED DUTY
RDH
PHDH
EFDA
CA
FTDA
OJT
(1)
Review medical and dental history and consult when
							 necessary with medical practitioner
G
WCA
G
G
G
G
(2)
Perform preliminary evaluation to determine needed
							 dental hygiene services
G
WCA
N/A
N/A
N/A
N/A
(3)
Make referrals to dentists, physicians, and other
							 practitioners in consultation with a dentist
G
WCA
N/A
N/A
N/A
N/A
(4)
Provide oral health instruction
G
WCA
G
G
G
D
(5)
Perform dietary screening for dental disease
							 prevention and control
G
WCA
G
G
G
N/A
(6)
Conduct dental screenings
G
WCA
N/A
N/A
N/A
N/A
(7)
Record dental screenings
G
WCA
D
D
D
D
(8)
Expose radiographs
G
WCA
G
G
G
G
(9)
Evaluate radiographs for provision of dental hygiene
							 services
G
WCA
N/A
N/A
N/A
N/A
(10)
Take intra-oral photographs
G
WCA
G
G
G
G
(11)
Perform and record charting of the oral cavity and
							 surrounding structures, including but not limited to, existing dental
							 restorations, lesions and periodontal probing depths
G
WCA
N/A
N/A
N/A
N/A
(12)
Record charting of the oral cavity and surrounding
							 structures, including but not limited to, dental restorations, lesions and
							 periodontal probing depths
G
WCA
D
D
D
D
(13)
Take and record vital signs
G
WCA
G
G
G
G
(14)
Perform minor emergency denture adjustments to
							 eliminate pain and discomfort in nursing homes and other residential or long
							 term care facilities
G
WCA
N/A
N/A
N/A
N/A
(15)
Perform pulp testing
D
N/A
N/A
N/A
N/A
N/A
(16)
Apply anti-cariogenic agents, including fluoride
							 varnish
G
WCA
G
G
G
D
(17)
Apply topical anesthetic agents
G
WCA
G
G
G
D
(18)
Apply and adjust dental sealants
G
WCA
G
D
D
N/A
(19)
Take impressions for study casts, bite registrations,
							 including for identification purposes, night guards, and custom fluoride and
							 bleaching trays pursuant to a dentist's prescription or order
G
WCA
G
G
G
I
(20)
Take impressions for athletic mouth
							 guards
G
WCA
G
G
G
I
(21)
Retract lips, cheek, tongue and other oral tissue
							 parts
G
WCA
G
G
G
G
(22)
Irrigate and aspirate the oral cavity
G
WCA
G
G
G
G
(23)
Re-cement and adjust intact temporary restorations
							 intra-orally
G
WCA
G
G
G
N/A
(24)
Place temporary restorations (not including
							 temporization of inlays, on-lays, crowns, and bridges) to provide palliative
							 treatment
G
WCA
G
G
G
I
(25)
Assist or monitor nitrous oxide
							 analgesia
I
I
I
I
I
I
(26)
Place and remove gingival retraction
							 materials
D
D
D
D
D
D
(27)
Apply cavity varnish, liner(s) and bonding
							 agents
I
I
I
I
I
I
(28)
Apply desensitizing agents
G
WCA
G
D
D
D
(29)
Place restorative materials in tooth for condensation
							 and finishing by the dentist
I
I
I
I
I
I
(30)
Remove temporary restorations with hand
							 instruments
G
WCA
G
I
I
N/A
(31)
Place and remove wedges
G
WCA
G
D
D
I
(32)
Place and remove matrix bands
G
WCA
G
D
D
I
(33)
Place and remove dental dams
G
WCA
G
G
G
D
(34)
Place and remove periodontal
							 dressings
G
WCA
G
G
G
N/A
(35)
Remove sutures
G
WCA
G
G
G
D
(36)
Removal of implant healing caps/cover screws for
							 restorative procedures
I
I
I
I
I
I
(37)
Dry root canals with paper points
I
I
I
N/A
N/A
N/A
(38)
Place cotton pellets and temporary restorative
							 materials into endodontic openings
G
WCA
G
D
D
D
(39)
Remove excess cement and bonding agents from bridges
							 and appliances with hand instruments
G
WCA
G
D
D
I
(40)
Cement and remove temporary crowns and
							 bridges
G
WCA
G
G
G
I
(41)
Insert and/or perform minor adjustment of night mouth
							 guards, athletic mouth guards, and custom fluoride trays
G
WCA
G
G
G
I
(42)
Select and adapt stainless steel crowns or other
							 preformed crown for insertion by dentist
I
I
I
I
I
I
(43)
Perform sub-gingival and supra-gingival
							 scaling
G
WCA
N/A
N/A
N/A
N/A
(44)
Polish teeth, after dentist or dental hygienist has
							 determined that teeth are free of calculus, with slow speed hand
							 piece
G
WCA
G
G
G
N/A
(45)
Administer local anesthesia pursuant to
							 234 CMR 6.00
D
D
N/A
N/A
N/A
N/A
(46)
Perform gross debridement and/ or scaling and root
							 planing
G
WCA
N/A
N/A
N/A
N/A
(47)
Prepare and perform oral cytological smears or
							 studies
D
N/A
N/A
N/A
N/A
N/A
(48)
Use diagnostic and periodontic non-cutting
							 lasers
D
N/A
N/A
N/A
N/A
N/A
(49)
Preliminarily fit crowns to check contacts, adjust
							 occlusion on crowns inside the mouth
G
WCA
D
D
N/A
N/A
(50)
Place temporary soft liners in a removal
							 prosthesis
G
WCA
D
D
I
N/A
(51)
Obtain endodontic cultures
D
N/A
D
D
I
N/A
(52)
Apply bleaching agents and activate with non-laser
							 non-curing device
G
WCA
D
D
D
I
(53)
Fabricate provisional restorations
							 intraorally
G
WCA
G
D
D
I
(54)
Place and condense amalgam
							 restorations
D
N/A
D
N/A
N/A
N/A
(55)
Carve, contour, adjust amalgam
							 restorations
D
N/A
D
N/A
N/A
N/A
(56)
Place and finish composite
							 restorations
D
N/A
D
N/A
N/A
N/A
(57)
Adjust dentures on the tissue side to eliminate
							 tissue irritation
G
WCA
G
N/A
N/A
N/A
(58)
Place temporary sedative
							 restorations/fillings
G
WCA
G
I
N/A
N/A
(59)
Place Stainless Steel Crowns
D
D
D
I
I
N/A
(60)
Take impressions for orthodontic
							 retainers
G
WCA
G
G
G
D
(61)
Preliminary intra-oral fit of bands
G
WCA
G
G
G
D
(62)
Preliminary oral fit of arch wire
G
WCA
G
G
G
D
(63)
Select size of headgear
G
WCA
G
G
G
D
(64)
Place and remove orthodontic
							 separators
G
WCA
G
G
G
D
(65)
Place and remove orthodontic arch
							 wires
G
WCA
G
G
G
D
(66)
Etch appropriate enamel surfaces before bonding of
							 orthodontic appliances by a dentist
G
WCA
G
G
G
D
(67)
Place elastics and ligature wires
G
WCA
G
G
G
D
(68)
Remove fixed orthodontic appliances
G
WCA
G
G
G
D
(69)
Remove excess cement and bonding agents from
							 orthodontic appliances with hand instruments
G
WCA
G
G
G
D
(70)
Perform minor emergency palliative orthodontic
							 adjustments to eliminate pain and discomfort
G
WCA
G
G
G
I
(71)
Perform any other procedure approved by the
							 Board