Pursuant to IAC 650--Chapter 23, dentists may delegate expanded function duties to licensed dental hygienists and registered dental assistants if the practitioner has completed board-approved training in the specific expanded function that will be delegated. Certain restrictions and limitations apply. Please refer to IAC 650--Chapter 23 for specific requirements.
Pursuant to IAC 650--23.7(4), dental hygienists and dental assistants who completed board-approved expanded functions training prior to January 1, 2020, can continue to perform the expanded functions for which training was previously completed. Documentation of board-approved training shall be maintained in each facility where these services are performed. Documentation shall be provided upon request.
IAC 650--Chapter 23 effective 10/30/2019.
Level 1 Expanded Functions
Basic Level 1. Dental hygienists or dental assistants who train in some, but not all, Level 1 expanded function procedures are deemed to be basic expanded function dental hygienists or dental assistants. A dentist may delegate to dental hygienists or dental assistants only those Level 1 expanded function procedures for which training has been successfully completed.
Certified Level 1. Expanded function dental hygienists or dental assistants who have successfully completed training for all Level 1 expanded function procedures and have been issued a certificate of completion by a board-approved training program are deemed to be certified Level 1 dental hygienists or dental assistants.
Level 1 Expanded Functions
- Taking occlusal registrations.
- Placement and removal of gingival retraction material.
- Fabrication, temporary cementation, and removal of provisional restorations.
- Applying cavity liners and bases; desensitizing agents; and bonding systems, to include the placement of orthodontic brackets, following the determination of location by the supervising dentist.
- Monitoring of patients receiving nitrous oxide inhalation analgesia, which may include increasing oxygen levels as needed, pursuant to the following:*
- A dentist shall induce a patient and establish the maintenance level;
- A dental assistant may make adjustments that decrease the nitrous oxide concentration during the administration of nitrous oxide;
- A dental assistant may turn off the oxygen delivery at the completion of the dental procedure.
- Taking final impressions.
- Removal of adhesives using nonmotorized hand instrumentation.*
- Placement of Class 1 temporary filling materials.
- Recementation of provisional restorations
*Expanded functions for dental assistants.
Level 2 Expanded Functions
Certified Level 2. Registered dental assistants and licensed dental hygienists who complete training in all Level 1 and Level 2 expanded functions are Certified Level 2 expanded functions providers. A dentist may delegate any of the Level 1 or Level 2 expanded function procedures to a registered dental assistant or licensed dental hygienists who is a certified Level 2 provider.
: Before beginning Level 2 training, expanded function dental hygienists or dental assistants must have a minimum of one year of clinical practice as a certified Level 1 dental hygienist or dental assistant and pass an entrance examination administered by the Level 2 training program.
Level 2 Expanded Functions
- Placement and shaping of amalgam following preparation of a tooth by a dentist.
- Placement and shaping of adhesive restorative materials following preparation of a tooth by a dentist.
- Polishing of adhesive restorative material using a slow-speed handpiece.
- Fitting of stainless steel crowns on primary posterior teeth, and cementation after fit verification by the dentist.
- Tissue conditioning (soft reline only).
- Extraoral adjustment to acrylic dentures without making any adjustments to the prosthetic teeth.
- Placement of intracoronal temporary fillings following preparation of a tooth by a dentist.
Approved training program:
University of Iowa College of Dentistry
Contact: Amanda Shoemaker
801 Newton ROAD
Iowa City IA 52242
Phone: 319-335-7166; Fax: 319-335-7155
*Also approved to provide training in the monitoring of nitrous oxide, an expanded function for dental assistants.
Expanded Functions Training Approval
Pursuant to IAC 650--Chapter 23, expanded function training shall be eligible if the training has been prior-approved by the Board. If you wish to submit an expanded functions training course for approval, you may find an expanded functions training approval request form here.
1. An initial assessment to determine the base entry level of all participants in the program.
2. A didactic component in accordance with IAC 650--23.7(3);
3. A laboratory component, if necessary, in accordance with IAC 650--23.7(3);
4. A clinical component, which may be obtained under the personal supervision of the participant’s supervising dentist while the participant is concurrently enrolled in the training program in accordance with IAC 650--23.7(3); and
5. A post-course competency assessment at the conclusion of the training program.
Certificate of Completion
Upon the successful conclusion of Board-approved training, training programs are required to issue a certificate of completion for the expanded function(s) in which training was completed. The certificate shall be prominently displayed at the facility where the services will be provided.
Expanded Functions Training Providers
The following providers have been approved to provide training in all Level 1 expanded functions unless otherwise noted. Approved expanded functions training courses are available to both dental assistants and dental hygienists who wish to train in expanded functions. The following training providers have received approval for the current expanded functions and have been updated for the new minimum training standards.
Approved Level 1 Expanded Functions Training Providers
David Davidson, D.D.S.
8573 Urbandale Ave
Urbandale, IA 50322
Impact Dental Training
5965 Merle Hay Road, Suite D
PO Box 434
Johnston, IA 50131
Gentle Family Dentists
Contact: Carol Moreno, D.D.S.
1205 N Columbus St.
West Liberty, IA 52776
Kirkwood Community College
Contact: Kari Rosetti
6301 Kirkwood Blvd. SW
Cedar Rapids, IA 52404
Phone: 563-398-5626; Fax: 319-398-7741