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Dental Hygienists

Practice of Dental Hygiene Defined
Local Anesthesia
Nitrous Oxide
Expanded Functions
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Practice of Dental Hygiene Defined

“Practice of dental hygiene” means the performance of the following educational, therapeutic, preventive and diagnostic dental hygiene procedures which are delegated by and under the supervision of a dentist licensed pursuant to Iowa Code chapter 153.

  1. Educational. Assessing the need for, planning, implementing, and evaluating oral health education programs for individual patients and community groups; conducting workshops and in-service training sessions on dental health for nurses, school personnel, institutional staff, community groups and other agencies providing consultation and technical assistance for promotional, preventive and educational services.
  2. Therapeutic. Identifying and evaluating factors which indicate the need for and performing (1) oral prophylaxis, which includes supragingival and subgingival debridement of plaque, and detection and removal of calculus with instruments or any other devices; (2) periodontal scaling and root planing; (3) removing and polishing hardened excess restorative material; (4) administering local anesthesia with the proper permit; (5) administering nitrous oxide inhalation analgesia in accordance with IAC 650--Chapter 29; (6) applying or administering medicaments prescribed by a dentist, including chemotherapeutic agents and medicaments or therapies for the treatment of periodontal disease and caries.
  3. Preventive. Applying pit and fissure sealants and other medications or methods for caries and periodontal disease control; organizing and administering fluoride rinse or sealant programs.
  4. Diagnostic. Reviewing medical and dental health histories; performing oral inspection; indexing dental and periodontal disease; making occlusal registrations for mounting study casts; testing pulp vitality; analyzing dietary surveys.

Note: Students enrolled in an accredited dental hygiene school are exempt from the requirements for licensure for all activities directly related to the curriculum and activities of the accredited program. Dental hygienists enrolled in a residency program in Iowa must apply for and be issued a resident license before practicing clinically.

Local Anesthesia

Iowa Administrative Code 650 authorizes a dental hygienist to administer local anesthesia provided the following requirements are met:

  1. The dental hygienist holds both an active dental hygiene license and local anesthesia permit issued by the Iowa Dental Board.
  2. The local anesthesia is prescribed by a licensed dentist.
  3. The local anesthesia is administered under the direct supervision of the dentist. Direct supervision requires the supervising dentist to be present in the treatment facility, but it is not required that the dentist be physically present in the treatment room.

If you wish to administer local anesthesia in Iowa, you must make application for a local anesthesia permit, meet the requirements stated above. Obtaining your dental hygiene license does not automatically qualify you to administer local anesthesia. The application for a local anesthesia permit requires the following:

  1. A completed application form including the application fee.
  2. Evidence that formal training in the administration of local anesthesia has been completed within 12 months of the date of application. The formal training must be conducted by a school accredited by the American Dental Association Commission on Dental Accreditation; or
  3. If you currently practice local anesthesia out of state, you must submit evidence of completion of formal training in the administration of local anesthesia conducted by a school accredited by the American Dental Association Commission on Dental Accreditation and submit documented evidence of ongoing practice in the administration of local anesthesia.

Local anesthesia permits expire on August 31 of every odd-numbered year (at the same time of the hygiene license). Renewal of the permit requires a completed renewal form and payment of the renewal fee.

Nitrous Oxide

A dental hygienist may administer nitrous oxide inhalation analgesia provided the administration of nitrous oxide inhalation analgesia has been delegated by a dentist and the following conditions are met:

  1. The hygienist has completed Board-approved training;
  2. The dentist provides direct supervision;
  3. The dentist has established a written office protocol for taking vital signs, adjusting anesthetic concentrations, and addressing emergency situations that may arise.

A dental hygienist may monitor a patient under nitrous oxide inhalation analgesia provided all of the following requirements are met:

  1. The hygienist has completed a Board-approved course of training or has received equivalent training while a student in an accredited school of dental hygiene;
  2. The task has been delegated by a dentist and is performed under the direct supervision of a dentist;
  3. Any adverse reactions are reported to the supervising dentist immediately; and
  4. The dentist dismisses the patient following completion of the procedure.

​​​​Expanded Functions

Pursuant to IAC 650--Chapter 23, “a dentist may delegate an expanded function duty to a licensed dental hygienist if the assistant has completed Board-approved training....” Certain other restrictions and limitations apply.  Find additional information on expanded functions training here.

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