N.J. Admin. Code § 13:30-1A.4

Current through Register Vol. 56, No. 21, November 4, 2024

Section 13:30-1A.4 - Scope of practice of licensed dental hygienist under general supervision

(a) Dental office or dental clinic. A licensed dental hygienist practicing under the general supervision of a licensed dentist in a dental office or a dental clinic may:

1. Perform a complete prophylaxis including the removal of all hard and soft deposits from all surfaces of human natural and restored teeth to the epithelial attachments and the polishing of natural and restored teeth;

2. Perform root planing;

3. Provide prophylactic and preventive measures such as the application of fluorides and pit and fissure sealants and other recognized topical agents for the prevention of oral disease or discomfort;

4. Place intrasulcular therapeutic medications approved by the Food and Drug Administration, as directed by a dentist;

5. Assess soft and hard tissue of the head, neck, and oral cavity and note deformities, defects, and abnormalities therein;

6. Fabricate mouth guard appliances;

7. Remove excess cement from crowns or other restorations and orthodontic appliances;

8. Remove sutures;

9. Place and remove periodontal dressings and other surgical dressings;

10. Trial size (pre-select) orthodontic bands, wires, stainless steel crowns, and temporary crowns intra-orally or on diagnostic models;

11. Make radiographic exposures as permitted by the Department of Environmental Protection pursuant to 26:2D-24 et seq.;

12. Provide oral health education including dietary analysis and clinical instruction in order to promote dental health;

13. Apply topical anesthetic agents;

14. Take and record vital signs;

15. Retract patient's cheek, tongue, or other tissue parts during a dental procedure;

16. Remove such debris as is normally created in the course of treatment during or after dental procedures by vacuum devices, compressed air, mouthwashes, and water;

17. Take dental photographs including the use of intraoral cameras;

18. Select shades of prosthetic appliances;

19. Apply hot or cold packs pursuant to the direction of a licensed dentist;

20. Assess whether there is carious activity by the use of detecting agents and carious detection instruments. Such instruments shall not include lasers that are capable of altering, cutting, burning, or damaging hard or soft tissue;

21. Etch teeth in preparation for sealants and desensitizing agents;

22. Use a curing light for the application of sealants;

23. Isolate the operative field for the placement of sealants, including the placement and removal of rubber dams;

24. Take alginate impressions for diagnostic casts, bleaching trays, and athletic mouth guards;

25. Take impressions for orthodontic appliances;

26. Place orthodontic separators. The supervising licensed dentist shall review the placement to ensure proper placement of the orthodontic separators;

27. Remove bands and brackets without the use of rotary instruments;

28. Remove primary adhesive, without the use of rotary instruments, after debanding and/or debonding; and

29. Perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.

(b) Institution. A licensed dental hygienist practicing under the general supervision of a New Jersey licensed dentist in an institution may:

1. Perform a complete prophylaxis including the removal of all hard and soft deposits from all surfaces of human natural and restored teeth to the epithelial attachments and the polishing of natural and restored teeth;

2. Perform root planing;

3. Provide prophylactic and preventive measures such as the application of fluorides and pit and fissure sealants and other recognized topical agents for the prevention of oral disease or discomfort;

4. Assess soft and hard tissue of the head, neck, and oral cavity and note deformities, defects, and abnormalities therein;

5. Make radiographic exposures as permitted by the Department of Environmental Protection pursuant to 26:2D-24 et seq.;

6. Provide oral health education including dietary analysis and clinical instruction in order to promote dental health;

7. Take and record vital signs;

8. Take dental photographs including the use of intra-oral cameras;

9. Use a curing light for the application of sealants;

10. Etch teeth in preparation for sealants and desensitizing agents;

11. Isolate the operative field for the placement of sealants, including the placement and removal of rubber dams;

12. Apply topical anesthetic agents;

13. Take impressions for orthodontic appliances;

14. Remove bands and brackets without the use of rotary instruments;

15. Remove primary adhesive, without the use of rotary instruments, after debanding and/or debonding; and

16. Perform emergency treatment to provide immediate relief from an offending appliance, such as clip a protruding arch wire or remove a loose bracket.

(c) School setting. A licensed dental hygienist practicing under the general supervision of a licensed dentist in a school setting:

1. May administer to that school's students, with written parental or guardian consent, preventive measures such as the application of fluorides, complete removal of biofilm with prophy paste containing fluoride, pit and fissure sealants, as well as other recognized topical agents, including topical anesthetics, for the prevention of oral disease or associated discomfort and the detection of caries, and may use a curing light for the application of sealants, provided that:

i. The licensed dental hygienist complies with the Occupational Safety and Health Administration (OSHA) and Centers for Disease Control and Prevention (CDC) requirements of 13:30-8.5; and

ii. When applying sealants, the licensed dental hygienist conforms to the assessment guidelines set forth by the supervising dentist and adheres to acceptable treatment protocol standards, including maintaining a dry field;

2. When making radiographic exposures, shall make radiographic exposures as permitted by the Department of Environmental Protection, pursuant to N.J.S.A. 26:2D-24et seq., provided that the exposures are made for the school's students and written parental or guardian consent is obtained; and

3. Shall comply with the notification requirements at (f)3 below and provide written notice of the administered treatment to the supervising dentist, school, and parent/guardian.

i. A copy of the parental/guardian consent; and

ii. The written record of treatment by the licensed dental hygienist.

(d) The supervising dentist of a licensed dental hygienist practicing under the general supervision in a school setting shall:

1. Maintain for at least seven years:

i. A copy of the parental/guardian consent; and

ii. The written record of treatment by the licensed dental hygienist; and

2. Review, within 30 days of treatment by the licensed dental hygienist, the written record of treatment to ensure compliance with the assessment guidelines, treatment protocol standards, and notification requirements set forth at (c) above.

i. If, upon review, the supervising dentist determines that the proper notification was not sent to the parent/guardian, the supervising dentist shall ensure that it is sent to the parent/guardian.

(e) Notwithstanding the provisions of (a) above, a New Jersey licensed dentist, in his or her sole discretion, may require direct supervision in his or her dental office.

(f) A licensed dental hygienist may practice dental hygiene under general supervision provided that:

1. The licensed dental hygienist treats only existing patients of record, except for school settings, as provided in (c) above. For purposes of this subchapter, an existing patient of record is a dental patient examined by a licensed dentist of the dental office, dental clinic, or institution, within the immediately preceding 365-day period and who has a dental treatment plan that is prescribed by the dentist.

2. In dental offices, the patient is notified, as soon as it is known, that the dentist will not be present, and is given the option to reschedule to a time when the dentist will be present.

3. After performing an assessment, a licensed dental hygienist who reasonably believes that a person has either dental caries or some other medical or dental condition requiring diagnosis, treatment, or medical referral by a dentist shall so inform the supervising dentist in writing, within seven days. If it appears that emergent care is indicated, the licensed dental hygienist shall immediately, but no later than 24 hours, notify the supervising dentist.

4. The licensed dental hygienist holds a current certification in Basic or Advanced Cardiac Life Support by the American Heart Association, the American Red Cross, or an equivalent organization approved by the Board.

N.J. Admin. Code § 13:30-1A.4

Repealed by R.2005 d.309, effective 9/19/2005.
See: 37 N.J.R. 1149(a), 37 N.J.R. 3709(a).
Section was "Resumption of active practice by inactive dental hygienist".
New Rule, R.2016 d.084, effective 7/18/2016.
See: 47 N.J.R. 3097(a), 48 N.J.R. 1462(b).
Section was "Reserved".
Amended by R.2018 d.106, effective 5/21/2018.
See: 49 N.J.R. 1821(a), 50 N.J.R. 1282(a).
In (a)23, deleted "and" from the end; in (a)24, substituted a semicolon for a period at the end; added (a)25 through (a)29; in (b)11, deleted "and" from the end; in (b)12, substituted a semicolon for a period at the end; and added (b)13 through (b)16.
Amended by R.2021 d.035, effective 4/19/2021.
See: 51 N.J.R. 1648(a), 53 N.J.R. 619(c).
Recodified former (c) as (c) and (d); recodified former (d) and (e) as (e) and (f); and rewrote (c) and (d).
Amended by R.2022 d.003, effective 1/3/2022.
See: 51 N.J.R. 1648(a), 53 N.J.R. 614(a), 54 N.J.R. 83(a).
In (c)1, inserted "complete removal of biofilm with prophy paste containing fluoride,".