Mississippi State Board of Dental Examiners

Saturday, November 18, 2017

Frequently Asked Questions -- >
  Dental Auxiliaries

Dental Assistants in dental office
  • How did the Board respond to the latest American Dental Association (ADA) survey entitled "2014 Survey of Legal Provisions for Delegating Intraoral Functions to Dental Assistants and Dental Hygienists"?
  • Click on the following for the Board's survey responses: 2014 Survey of Legal Provisions for Delegating Intraoral Functions to Dental Assistants and Dental Hygienists
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  • Do dental assistants need to be licensed by the Board prior to performing dental assisting procedures?
  • No. The Board does NOT license dental assistants in the same manner in which it licenses dentists and dental hygienists. Dental assistants may be hired by licensed Mississippi dentists to perform those procedures allowed by the Board’s laws and regulations to be delegated to dental assistants, EXCEPT EXPOSING RADIOGRAPHS, without the necessity of being licensed or permitted to do so by the Board. If, however, a dental assistant will be EXPOSING RADIOGRAPHS as part of his/her dental assisting duties, that dental assistant must apply for and be issued a valid Mississippi Radiology Permit PRIOR TO exposing any radiographs. Please refer to FAQs for Radiology Permits for more information regarding the application for and issuance of Mississippi Radiology Permits.
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  • I see phrases such as “certified” dental assistant or “accredited” dental assisting program or school. What does the Board consider as a “certified” dental assistant or “accredited” dental assisting program or school?
  • Albeit someone may work as a dental assistant in the State of Mississippi without the need to be “licensed” as a dental assistant, if that person exposes radiographs as part of his/her dental assisting duties, that person must be issued a currently valid and renewed Mississippi Radiology Permit PRIOR TO exposing radiographs. For purposes of issuing Mississippi Radiology Permits, the Board ONLY recognizes the phrase “certified dental assistant” as being a dental assistant who currently has passed all requirements and examinations to receive certification by the Dental Assisting National Board, Inc. (DANB). Current DANB certification may be used to fulfill the requirements for being issued a Mississippi Radiology Permit. Additionally, the only “accredited dental assisting programs or schools” recognized by the Board for purposes of issuing Mississippi Radiology Permits are those dental assisting schools/programs that currently are accredited by the Commission on Dental Accreditation (CODA) through the American Dental Association (ADA). Graduation from an ADA/CODA-accredited dental assisting program may be used to fulfill the requirements for being issued a Mississippi Radiology Permit. For purposes of issuing radiology permits, only DANB-certified dental assistants or ADA/CODA-accredited dental assisting graduates are recognized by the Board. No other “certification” or “accreditation” are recognized by the Board and may be used as fulfilling the requirements for a Mississippi Radiology Permit. Refer to Board Regulation 25 for more information regarding the application for and issuance of Mississippi Radiology Permits.
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  • Which dental professionals are allowed to "clean teeth"?
  • Only a licensed dentist or dental hygienist may "clean teeth." Under no circumstances may dental assistants be allowed to scale or remove "calcareous deposits," which have been defined as "dental calculus, both subgingival and supragingival." Refer to Miss. Code Ann. 73-9-3 and Board Regulation 13.
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  • May dental assistants use ultrasonic instruments?
  • No. Only licensed dentists and dental hygienists may use ultrasonic instruments. Refer to Board Regulation 13.
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  • Who may place subgingival medicated cords?
  • Only licensed dentists may place subgingival medicated cords (e.g., Actisite). Additionally, at its 07/29/2016 meeting, the Board considered a request from Mississippi Delta Community College's (MDCC) dental hygiene program regarding the difference between an "antimicrobial agent" and an "antimicrobial fiber." At that meeting, the Board re-affirmed the stipulation in Board Regulation 13 and follow-up determinations that the only dental auxiliary who can place antimicrobial fibers and agents are licensed Mississippi dental hygienists; however, no dental auxiliaries are allowed to place epinephrine-impregnated retraction cords. Refer to Board Regulation 13.
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  • Can dental auxiliaries place sealants?
  • Yes. Currently licensed dental hygienists and dental assistants may place sealants under the direct supervision of a currently licensed dentist.
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  • Can dental auxiliaries perform tooth whitening procedures?
  • Yes. Currently licensed dental hygienists and dental assistants may perform tooth whitening procedures under the direct supervision of a currently licensed dentist.
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  • Can dental auxiliaries administer local anesthesia?
  • No. Only currently licensed dentists may administer local anesthesia. Refer to Board Regulation 29.
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  • Is a permit required for dental assistants to administer radiographs?
  • Yes. Under no circumstances may a dental assistant administer radiographs without the appropriate radiology permit. Also, dental hygienists who are graduates of ADA-accredited dental hygiene programs, who are not licensed in Mississippi, and who are working in Mississippi as dental assistants must have radiology permits before administering radiographs. Refer to Board Regulation 25.
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  • May dental auxiliaries (dental hygienists and/or dental assistants) perform procedures on patients while the dentist is not in the office?
  • Absolutely not. This is a serious violation of the Mississippi Dental Practice Act. All auxiliaries must be under the "direct" supervision of a licensed Mississippi dentist; therefore, it is immaterial whether the dentist is "on the way to the office," "only out for lunch or an errand," "out due to illness or vacation," etc. Refer to Miss. Code Ann. 73-9-3 and 73-9-5 and Board Regulation 13.
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  • What does the Board mean by stating that dental auxiliaries must be under the "direct" supervision of a licensed Mississippi dentist?
  • As noted earlier, all dental auxiliaries must be under the "direct" supervision of a licensed Mississippi dentist. The Board has defined the term "direct" supervision to mean the following:
  • A dentist is physically present in the dental office or treatment facility, personally diagnoses the condition to be treated, authorizes the procedures to be performed, remains in the dental office or treatment facility while the procedures are being performed by the auxiliary, and evaluates the performance of the dental auxiliary. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to start nitrous oxide under the direct supervision of a licensed Mississippi dentist?
  • Yes. A dentist currently licensed by the State of Mississippi may instruct a competent dental auxiliary as to the placement and monitoring of nitrous-oxide inhalation anxiolysis under his/her direct supervision. These dental auxiliaries must, at all times, be currently certified in Cardiopulmonary Resuscitation. Remember, too, that any patients under nitrous oxide must be continuously monitored. Refer to Board Regulation 29 for additional information regarding administration of anesthesia and Board Regulation 45 for additional information regarding Cardiopulmonary Resuscitation.
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  • Are dental auxiliaries allowed to apply topical anesthetics?
  • Yes. Licensed Mississippi dental hygienists and dental assistants may apply topical anesthetics under the direct supervision of a licensed Mississippi dentist. Refer to Board Regulation 29 for additional information regarding administration of anesthesia.
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  • Are dental hygienists allowed to perform gingival curettage with Biolase?
  • No. Licensed Mississippi dental hygienists are not allowed to perform gingival curettage with Biolase; however, licensed Mississippi dentists may use Biolase for gingival curettage. Refer to Miss. Code Ann. 73-9-3 and Board Regulation 13.
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  • Are licensed Mississippi nurses allowed to administer local anesthetics in the dental office?
  • No. Only a licensed Mississippi dentist may administer local anesthetics in the dental office. Refer to Board Regulation 29 for more detailed information as to the administration of anesthesia.
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  • Are dental auxiliaries allowed to use the Kavo Diagnodent?
  • Yes. Licensed Mississippi dental hygienists and dental assistants may use the Kavo Diagnodent under the direct supervision of a licensed Mississippi dentist. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to perform brush biopsies?
  • No. Licensed Mississippi dental hygienists and dental assistants are not allowed to perform brush biopsies. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to administer Oraqix?
  • Licensed Mississippi dental hygienists, under the direct supervision of licensed Mississippi dentists, may administer Oraqix, a form of dental topical anesthetic, both supragingivally and subgingivally; however, dental assistants may not administer this product. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to carve and pack amalgams and place matrix bands?
  • Dental auxiliaries ARE NOT ALLOWED to carve and pack amalgams. However, at its 05/14/2010 meeting, the Board determined that dental auxiliaries ARE ALLOWED to place matrix bands. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to perform sulcular debridement of periodontal pockets using a Diode dental laser? Also, are dental hygienists allowed to utilize lasers for bacteria reduction and/or reduction of pocket depths?
  • No. At its 02/24/2006 meeting, the Board determined that licensed Mississippi dental hygienists and dental assistants are not allowed to perform sulcular debridement of periodontal pockets using a Diode dental laser. Furthermore, at its 03/12/2010 meeting, the Board considered a request as to whether licensed Mississippi dental hygienists are allowed to use lasers for bacteria reduction and/or reduction of pocket depths. The Board noted this question had been addressed by its 02/24/2006 determination, wherein the Board opined that licensed Mississippi dental hygienists and dental assistants ARE NOT allowed to perform sulcular debridement of periodontal pockets using a Diode dental laser. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to remove facial hair with lasers in a dental office?
  • No. At its 06/16/2006 meeting, the Board determined that licensed Mississippi dental hygienists and dental assistants are not allowed to remove facial hair with lasers in a dental office. Refer to Board Regulation 13.
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  • Are licensed Mississippi dental hygienists and dental assistants allowed to place and pack retraction cords?
  • Yes. At its 06/16/2006 meeting, the Board reaffirmed a previous determination that licensed Mississippi dental hygienists and dental assistants may place and pack retraction cords under the direct supervision of a licensed Mississippi dentist. However, pursuant to item number 11 in Board Regulation 13, licensed Mississippi dental hygienists and dental assistants may not place any subgingival medicated cords; although, the placement of periodontal treatment agents may be performed by licensed Mississippi dental hygienists.
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  • Are dental auxiliaries allowed to adjust the gingival side of complete or partial dentures?
  • Yes. At its 02/02/2007 meeting, the Board discussed a request for clarification regarding whether dental auxiliaries are allowed to adjust the gingival side of complete or partial dentures. It was the consensus of the Board that, pursuant to the current reading of Board Regulation 13 , gingival side adjustments of partial or complete dentures are allowed to be delegated to dental auxiliaries under the direct supervision of licensed Mississippi dentists.
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  • Are licensed Mississippi dental hygienists allowed to use soft tissue lasers to assist in the treatment of periodontal diseases and other soft tissue disorders?
  • No. At its 04/06/2007 meeting, the Board determined that licensed Mississippi dental hygienists are not allowed to use soft tissue lasers to assist in the treatment of periodontal diseases and other soft tissue disorders under the direct supervision of licensed Mississippi dentists. Refer to Board Regulation 13.
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  • Are licensed Mississippi dental hygienists allowed to administer Arestin?
  • Yes. At its 04/06/2007 meeting, the Board determined that licensed Mississippi dental hygienists are allowed to administer Arestin since it is not an antimicrobial fiber, according to the current guidelines of Board Regulation 13, item number 11. Additionally, at its 07/29/2016 meeting, the Board considered a request from Mississippi Delta Community College's (MDCC) dental hygiene program regarding the difference between an "antimicrobial agent" and an "antimicrobial fiber." At that meeting, the Board re-affirmed the stipulation in Board Regulation 13 and follow-up determinations that the only dental auxiliary who can place antimicrobial fibers and agents are licensed Mississippi dental hygienists; however, no dental auxiliaries are allowed to place epinephrine-impregnated retraction cords. Refer to Board Regulation 13.
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  • Is a dentist required to conduct an initial oral examination on all new patients-of-record before referring these patients to the dental hygienist for treatment?
  • Yes. At its 11/03/2006 meeting, the Board determined that a dentist must conduct an initial oral examination on all new patients-of-record prior to referring them to the dental hygienist for treatment. Additionally, at its 02/02/2007 meeting, the Board further clarified its 11/03/2006 determination regarding procedures a dental hygienist is allowed to perform on new patients-of-record before the dentist conducts an initial oral examination on these patients. The Board determined that a dental hygienist is allowed to take the health history and blood pressure; however, no intraoral procedures or radiographs shall be performed by the dental hygienist on any new patients until the dentist performs an initial oral examination prior to referring these new patients for dental hygiene treatment. On 08/01/2008, the Board was requested to clarify this determination as it relates to dental, dental hygiene, and dental assisting teaching institutions. The Board noted that for private sector dental practices and dental, dental hygiene, and dental assisting teaching institutions, the Board expects the dentist to perform a cursory examination prior to any treatment being rendered to the patient which would involve any intraoral procedure on new patients of record prior to referring them for dental hygiene treatment.
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  • Who is allowed to draw blood in a dentist's office?
  • At its 11/05/2010 meeting, the Board considered a question regarding who is allowed to draw blood in a dentist’s office. Several questions were addressed regarding platelet rich plasma, e.g., due to the fact that this blood must be drawn and processed within an hour, can blood be drawn in the dental office; can the dentist draw blood; can a dental auxiliary draw blood; can a registered nurse draw blood in a dental office; and is there anyone who can draw blood in a dental office. The Board determined that documentation must be maintained noting the licensure or certification of any individual performing Venipuncture in the dental office.
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  • Are dental auxiliaries allowed to tighten dental implants?
  • No. At its 08/19/2011 meeting, the Board considered whether the tightening of dental implants may be delegated to dental auxiliaries, and the Board voted to amend item 5 of Board Regulation 13 to NOT allow “[t]he placement, cementation, or final torquing of inlays, permanent crowns, fixed bridges, removable bridges, partial dentures, full dentures, or implant abutments” to be delegated to dental auxiliaries. Refer to Board Regulation 13.
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  • Are dental auxiliaries allowed to perform Face Bow procedures, and, if so, is prior training in Face Bow required?
  • Yes. At its 08/10/2012 meeting, the Board determined that dental auxiliaries are allowed to perform this procedure without prior training being necessary.
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  • Is direct supervision required for dental hygienists who provide dental services SOLELY on tribal lands? In essence, does the Board even have authority over dental treatment rendererd on tribal lands?
  • At its 10/31/2014 meeting, the Board considered an inquiry as to whether licensed Mississippi dental hygienists working on TRIBAL LANDS are allowed to work under the general supervision of a licensed Mississippi dentist insofar as the application of fluoride varnish under “public health” auspices is concerned. Furthermore, the inquiry questioned whether the Board has authority over these dental auxiliaries when providing services on TRIBAL LANDS. Based upon its research and advice from legal counsel, the Board determined that if the Mississippi licensed dentist or dental auxiliary provides services ONLY TO TRIBAL MEMBERS AND ONLY ON TRIBAL LANDS, the Board has no jurisdiction other than should a complaint regarding quality of care issues insofar as patient treatment be filed with the Board, whereupon, the Board would investigate the complaint and work closely with tribal authorities. Furthermore, if the dentist or dental auxiliaries providing services ARE NOT licensed Mississippi dentists or dental auxiliaries, the Board would report such complaint to the state wherein such individuals are licensed. The Board reiterated that this determination applies ONLY to TRIBAL LANDS and ONLY for work performed on TRIBAL MEMBERS. This determination does NOT pertain to dental work performed on tribal land on non-tribal members. Refer to Board Regulation 13.
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  • In reading Miss. Code Ann. 73-9-5(2) regarding “recognized” dental hygienists being allowed to practice under the general supervision of licensed Mississippi dentists while making public demonstrations of dental hygiene for educational purposes, has the word “recognized” been defined by the Board?
  • Yes. The word "recognized" was defined by the Board via amendments to Board Regulation 13 adopted at the Board's 04/21/2015 meeting. In the section entitled "Supervision and Recognition of Dental Auxiliaries," the Board added a new item 3, specifically to define the word "recognized" as it pertains to the general supervision of Mississippi dental hygienists. Refer to Board Regulation 13 for the complete text of this definition, as there are strict limitations in such circumstances for both the licensed Mississippi dental hygienist and the licensed Mississippi dentist providing the general supervision.
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  • Are dental auxiliaries allowed to make the Essix vacuum permanent retainer?
  • Yes. At its 07/31/2015 meeting, the Board determined that dental auxiliaries are allowed to make the Essix vacuum permanent retainer, inasmuch as the Board does not consider this to be the activation or adjustment of orthodontic appliances, such activation or adjustment being prohibited by Board Regulation 13.
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  • Are licensed Mississippi dental hygienists allowed to practice Orofacial Myology without having to work under the direct supervision of licensed Mississippi dentists?
  • Yes. At its 01/22/2016 meeting, the Board considered a request as to whether licensed Mississippi dental hygienists could practice Orofacial Myology. At that meeting, the Board determined that licensed Mississippi dental hygienists are allowed to provide these services under the direct supervision of licensed Mississippi dentists; however, if dental hygienists advertise the availability of such services and their ability to perform them, such advertisements must not reflect that these services are being performed under the auspices of Mississippi dental hygiene licenses. In other words, if a licensed Mississippi dental hygienist wishes to provide these services without announcing that the individual holds a Mississippi dental hygiene license, the Board has determined that it has no purview in this matter.
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  • Are licensed Mississippi specialists allowed to employ dental hygienists to perform dental hygiene procedures, such procedures being provided pursuant to the Board's laws and regulations?
  • Yes. At its 07/29/2016 meeting, the Board determined that all licensed Mississippi specialists are allowed to hire and utilize the services of licensed Mississippi dental hygienists as those services fall within the definition of dental hygiene stipulated by Miss. Code Ann. 73-9-5, the Board's Regulations, and the appropriate Board determinations. Refer to Miss. Code Ann. 73-9-5, Board Regulation 13, and FAQs for dental scope of practice.
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  • Is a licensed Mississippi dentist allowed to delegate the taking of alginate impressions to dental auxiliaries insofar as such impressions being taken for space maintainers, e.g., band and loop or other temporary appliances for maintaining space due to premature loss of primary dentition?
  • No. At its 07/29/2016 meeting, the Board considered a request concerning the above delegation to both dental hygienists and dental assistants, and it determined that, pursuant to guidelines already set forth in Board Regulation 13, item 4 under "Delegation of Duties to Dental Auxiliaries," dental auxiliaries are NOT ALLOWED to take impressions for space maintainers, such as band and loop or other temporary appliances for maintaining space due to premature loss of primary dentition, inasmuch as Board Regulation 13 already prohibits dental auxiliaries from the "taking of any impression of the human mouth or oral structure that will be used in the restoration, repair, or replacement of any natural or artificial teeth or for the fabrication or repair of any dental appliance.” Refer to Board Regulation 13.
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