Allowable Duties of Registered Dental Assistants
Law and regulation specifically define the duties that a Registered Dental Assistant (RDA) is allowed to perform, the level of dentist supervision required, and the settings in which the duties may be performed. It is a criminal offense to perform illegal functions, as well as grounds for license discipline of both the person performing the illegal function and any person who aid or abets such illegal activity.
The duties that RDAs are allowed to performed are specified in Section 1086 of the regulations.
Following are frequently asked questions about allowable duties:
- May auxiliaries bleach teeth?
Dental Board regulations were changed effective February 23, 2000, to allow RDAs, under direct supervision, to apply bleaching agents, and to activate bleaching agents with a non-laser light-curing device.
- Who may place fluoride varnishes?
A fluoride varnish is considered a non-toxic topical agent, and can therefore be placed by an unlicensed dental assistant under the direct supervision of a California licensed dentist, as well as all categories of licensed auxiliaries.
- May RDAs use slow or high-speed handpieces?
The use of an slow-speed or high-speed handpieces by RDAs is not specifically prohibited by law or regulation, except that (1) those certified to perform coronal polishing are limited to using "an appropriation rotary instrument with rubber cap or brush and a polishing agent" (Regulation Section 1067(h); and (2) the procedure is not intended to cut hard or soft tissue.
However, law also prohibits dental personnel from performing any service which they are not competent to perform, or which is not in accordance with customs and standards of the dental profession, as provided in Section 1684 ofthe Dental Practice Act:
"1684. In addition to other acts constituting unprofessional conduct under this chapter, it is unprofessional conduct for a person licensed under this chapter to perform, or hold himself or herself out as able to perform, professional services beyond the scope of his or her license and field or fields of competence as established by his or her education, experience, training, or any combination thereof. This includes, but is not limited to, the use of any instrument or device in a manner that is not in accordance with the customary standards and practices of the dental profession..."Therefore, it is up to the practitioner and his or her employer to assure that the above requirements are fully met before using a device to avoid disciplinary and/or criminal action.
- Who may perform coronal polishing, and when? Is coronal polishing considered an oral prophylaxis?
An unlicensed dental assistant may not perform coronal polishing. Only alicensed RDA may perform coronal polishing, AFTER successful completion of a Board-approved course and submission of certification thereof to COMDA.
A licensed dentist or registered dental hygienist must determine that the teeth to be polished are free of calculus or other extraneous material PRIOR to coronal polishing.
Coronal polishing may not be intended or interpreted as a complete oral prophylaxis, which is a procedure which can be performed only by a licensed dentist or registered dental hygienist.
An oral prophylaxis is defined in Regulation Section 1067(g) as:
"Oral prophylaxis' means the preventive dental procedures including complete removal of explorer-detectable calculus, soft deposits, plaque, stains, and the smoothing of unattached tooth surfaces. The objective of this treatment shall be creation of an environment in which hard and soft tissues can be maintained in good health by the patient."
- May a RDA administer anesthesia, or insert or remove IV lines?
No RDA may insert IV lines, administer anesthesia and medicines via the IV, and or remove IV lines, unless the person possesses another license (such as R.N. or L.V.N.) that allows them to perform such duties.
While Regulation Section 1085 allows DA's to perform such basic supportive procedures as extra-oral duties, the "extra-oral" duties of inserting IV lines, administering anesthesia, or removing such lines do not meet the definition of a"basic supportive procedure", which is defined in Regulation Section 1067(l) as:
"Basic supportive dental procedures' means fundamental duties or functions which may be performed by an unlicensed dental assistant under the supervision of a licensed dentist because of their technically elementary characteristics, complete reversibility and inability to precipitate potentially hazardous conditions for the patient being treated."
For specific questions about the RDA Application or Examinations, or to request that an application be sent to you, send an email to: DAProgram@dca.ca.gov