Dental Assistants - Expanded Functions
Pursuant to IAC 650--Chapter 23, dentists may delegate expanded function duties to registered dental assistants if the assistant 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.
In order to be eligible to complete training in expanded functions, a dental assistant must qualify based on one of the following:
1. Be a graduate of an ADA-accredited dental assistant program; or
2. Be currently certified by the Dental Assisting National Board (DANB); or
3. Have at least one year of clinical practice as a registered dental assistant; or
4. Have at least one year of clinical practice as a dental assistant in a state that does not require registration.
Documentation of Expanded Functions Training
All expanded function training must be properly documented to ensure compliance with Board rules. Documentation of training must be maintained by the dentist in the office of practice. The Board has developed a sample training documentation form.
As a reminder, like all intraoral duties performed by registered dental assistants, expanded function duties must be performed under the direct supervision of a licensed dentist. Direct supervision means the dentist has delegated the task and is present in the treatment facility.
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
Level 2 Expanded Functions
A dentist may delegate any of the Level 1 or Level 2 expanded function procedures to a registered dental assistant who is a certified Level 2 provider. Registered dental assistants must successfully complete training for all Level 2 expanded function procedures before becoming certified Level 2 providers.
- 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