Dental Hygienists - Expanded Functions
Delegation
Pursuant to IAC 650--Chapter 10, dentists may delegate expanded function duties to licensed dental hygienists if the hygienist 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 10 for specific requirements.
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 hygienists, 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
Level 1 procedures include:
1. Taking occlusal registrations for purposes other than mounting study casts;
2. Placement and removal of gingival retraction;
3. Fabrication and removal of provisional restorations;
4. Applying cavity liners and bases and bonding systems for restorative purposes; and
5. Taking final impressions.
Dental hygienists who complete training in all Level 1 expanded functions are Certified Level 1 expanded functions providers. Dental hygienists must be a Certified Level 1 provider prior to completing training in Level 2 expanded functions.
Level 2 Expanded Functions
A dentist may delegate any of the Level 1 or Level 2 expanded function procedures to a dental hygienist who is a certified Level 2 provider. Dental hygienists must successfully complete training for all Level 2 expanded function procedures before becoming certified Level 2 providers.
Level 2 procedures include:
1. Placement and shaping of amalgam following preparation of a tooth by a dentist;
2. Placement and shaping of composite following preparation of a tooth by a dentist;
3. Forming and placement of stainless steel crowns;
4. Taking records for the fabrication of dentures and partial dentures; and
5. Tissue conditioning (soft reline only).
Approved training program:
University of Iowa College of Dentistry
Contact: Penni Ryan
801 Newton ROAD
Iowa City IA 52242
Phone: 319-335-7166; Fax: 319-335-7155
Email: penni-ryan@uiowa.edu
www.dentistry.uiowa.edu/ce
Expanded Functions Course Resource List
Board-approved courses are available for expanded function training. You may download and use these resources for the didactic and clinical/lab components. The initial assessment and postcourse competency assessment must be developed by the dentist and be available in the dental office as part of the documentation of training for that particular course. The other reference(s) may be used as a supplement for the didactic component. Some of the approved courses are available in two formats, .html and .pdf. If you wish to download or print the courses for future use, the .pdf format is useful. When both formats are offered, you can select the format you prefer.
Continuing education credit hours will be awarded for completion of courses as specified.
1. Taking Occlusal Registrations for purposes other than mounting study casts:
Suggested reference to supplement didactic component:
Dawson, E.F.; Center for Advanced Dental Study, 111 2nd Ave. NE, Suite 1109, St. Peters, Fl. 33701-3443
Approved training programs:
Lifepoint Dental Partners
110 SE Grant St. #101
Ankeny, IA 50021
Phone: 515-965-1800 Fax: 888-278-0530
leanns@lifepointdental.com
Midwest Dental
Contact: Linda Aschtgen, CDA, RDA, EFDA
680 Hehli Way
Mondovi, WI 54755
815-742-0476
laschtgen@midwest-dental.com
2. Placement & Removal of Gingival Retraction:
Suggested references to supplement didactic component:
Miller, Michael, DDS; Reality, The Information Source for Esthetic Dentistry, The Techniques, Volume 1, p. 31-33.
Phinney, Donna J., Halstead, Judy H.: Delmar’s Handbook of Assisting, p. 406-407.
Approved training programs:
Lifepoint Dental Partners
110 SE Grant St. #101
Ankeny, IA 50021
Phone: 515-965-1800 Fax: 888-278-0530
leanns@lifepointdental.com
Midwest Dental
Contact: Linda Aschtgen, CDA, RDA, EFDA
680 Hehli Way
Mondovi, WI 54755
815-742-0476
laschtgen@midwest-dental.com
3. Fabrication and Removal of Provisional Restorations:
Board rules, which prohibit the delegation and removal of synthetic material, apply to permanent materials and do not prohibit the removal of temporary cement. In addition to those provisional restorations mentioned in the course materials, orthodontic brackets and bands are also included in the definition of a provisional appliance when referring to this Fabrication and Removal of Provisional Restoration course of study. Successful completion of the portion of this course that refers to the removal of supragingival temporary cement will authorize dental assistants to perform this function.
Download the approved on-the-job training course: Making Preliminary Adaptation of Temporary Crowns
Suggested references to supplement didactic component:
Phinney, Donna J., Halstead, Judy H.: Delmar’s Handbook of Assisting, p. 408-411.
Strupp, William; 2370 Sunset Pt. Rd., Clearwater, Fl. 33675-1423
Gordon Christensen tape, “Simple Temporary Restorations.”
Approved training programs:
Lifepoint Dental Partners
110 SE Grant St. #101
Ankeny, IA 50021
Phone: 515-965-1800 Fax: 888-278-0530
leanns@lifepointdental.com
Midwest Dental
Contact: Linda Aschtgen, CDA, RDA, EFDA
680 Hehli Way
Mondovi, WI 54755
815-742-0476
laschtgen@midwest-dental.com
4. Applying Cavity liners and Bases and Bonding Systems for Restorative Purposes
Approved training programs:
Lifepoint Dental Partners
110 SE Grant St. #101
Ankeny, IA 50021
Phone: 515-965-1800 Fax: 888-278-0530
leanns@lifepointdental.com
Midwest Dental
Contact: Linda Aschtgen, CDA, RDA, EFDA
680 Hehli Way
Mondovi, WI 54755
815-742-0476
laschtgen@midwest-dental.com
5. Taking final impressions
Access the approved on-the-job training course for use in the dental office: Final Impressions
Suggested references to supplement didactic component:
Miller, Michael, DDS; Reality, The Information Source for Esthetic Dentistry, The Techniques, Volume 1, p. 30-40.
Phinney, Donna J., Halstead, Judy H.: Delmar’s Handbook of Assisting, p. 234-236.
Approved training programs:
Lifepoint Dental Partners
110 SE Grant St. #101
Ankeny, IA 50021
Phone: 515-965-1800 Fax: 888-278-0530
leanns@lifepointdental.com
Midwest Dental
Contact: Linda Aschtgen, CDA, RDA, EFDA
680 Hehli Way
Mondovi, WI 54755
815-742-0476
laschtgen@midwest-dental.com