Cal. Code Regs. tit. 16 § 1105.2

Current through Register 2024 Notice Reg. No. 49, December 6, 2024
Section 1105.2 - Required Curriculum
(a) The curriculum of an educational program shall meet the requirements of this section.
(b) The curriculum shall include education in the dental hygiene process of care and shall define the competencies graduates are to possess at graduation, describing
(1) the desired combination of foundational knowledge, psychomotor skills, communication skills, and professional behaviors and values required,
(2) the standards used to measure the students' independent performance in each area, and
(3) the evaluation mechanisms by which competence is determined.
(c) The organization of the curriculum shall create opportunities for adjustments to and research of, advances in the practice of dental hygiene to ensure that graduates will have the knowledge, skills, and abilities to function within the dental hygiene scope of practice.
(d) The content of the curriculum shall include biomedical and dental sciences and dental hygiene sciences and practice. This content shall be of sufficient depth, scope, sequence of instruction, quality and emphasis to ensure achievement of the educational program's standard of competency.
(1) Biomedical and Dental Sciences Content
(A) Cariology
(B) Dental Materials
(C) General and Maxillofacial Pathology and/or Pathophysiology
(D) Head, Neck and Oral Anatomy
(E) Immunology
(F) Oral Embryology and Histology
(G) Oral Pathology
(H) Pain management
(I) Periodontology
(J) Pharmacology
(K) Radiography
(L) Dental Anatomy and Morphology
(2) Dental Hygiene Sciences and Practice Content
(A) Community Dental Health
(B) Dental Hygiene Leadership
(C) Evidence-based Decision Making and Evidence-based Practice
(D) Health Informatics
(E) Health Promotion
(F) Infection and Hazard Control Management
(G) Legal and Ethical Aspects of Dental Hygiene Practice
(H) Medical and Dental Emergencies
(I) Oral Health Education and Preventive Counseling
(J) Patient Management
(K) Preclinical and Clinical Dental Hygiene
(L) Provision of Services for and Management of Patients with Special Needs
(M) Research
(N) Provision of Oral Health Care Services to Patients with Bloodborne Infectious Diseases
(3) Approved educational programs shall, at a minimum, specifically include instruction in local anesthesia, nitrous oxide-oxygen analgesia and periodontal soft tissue curettage in accordance with the provisions of this subdivision.
(A) An educational program shall:
(i) Provide infection control equipment according to the requirements of California Code of Regulations (CCR), Title 16, Division 10, Chapter 1, Article 1, Section 1005;
(ii) Provide faculty to provide instruction to students in accordance with the minimum standards set forth in Section 1941 of the Business and Professions Code; and
(iii) Retain staff who have taken a board-approved eight (8) hour course in infection control or possess a current California registered dental assistant (RDA) or registered dental assistant in extended functions (RDAEF) license.
(B) An educational program shall provide at least one complete nitrous oxide-oxygen unit for each six (6) students enrolled in the course and shall include a fail-safe flowmeter, functional scavenger system and disposable or sterilizable nasal hoods for each laboratory partner or patient. All tubing, hoses and reservoir bags shall be maintained and replaced at regular intervals to prevent leakage of gases. When not attached to a nitrous oxide-oxygen unit, all gas cylinders shall be maintained in an upright position, secured with a chain or in a cart designed for storage of gas cylinders.
(C) An educational program shall comply with local, state, and federal health and safety laws and regulations.
(i) All students shall have access to the program's hazardous waste management plan for the disposal of needles, cartridges, medical waste and storage of oxygen and nitrous oxide tanks.
(ii) All students shall have access to the program's clinic and radiation hazardous communication plan.
(iii) All students shall receive a copy of the program's bloodborne and infectious diseases exposure control plan, which shall include emergency needlestick information.
(D) General Curriculum Content. Areas of didactic, preclinical and clinical instruction shall include:
(i) Indications and contraindications for all patients of:
1. periodontal soft tissue curettage;
2. administration and reversal of local anesthetic agents;
3. nitrous oxide-oxygen analgesia agents
(ii) Head and neck anatomy;
(iii) Physical and psychological evaluation procedures;
(iv) Review of body systems related to course topics;
(v) Theory and psychological aspects of pain and anxiety control;
(vi) Selection of pain control modalities;
(vii) Pharmacological considerations such as action of anesthetics and vasoconstrictors, local anesthetic reversal agents and nitrous oxide-oxygen analgesia;
(viii) Recovery from and post-procedure evaluation of periodontal soft tissue curettage, local anesthesia and nitrous oxide/oxygen analgesia;
(ix) Complications and management of periodontal soft tissue curettage, local anesthesia and nitrous oxide-oxygen analgesia emergencies;
(x) Armamentarium required and current technology available for local anesthesia, nitrous oxide-oxygen analgesia and periodontal soft tissue curettage;
(xi) Techniques of administration of maxillary and mandibular local infiltrations, field blocks and nerve blocks, nitrous oxide-oxygen analgesia and performance of periodontal soft tissue curettage;
(xii) Proper infection control procedures according to the provisions of 16 CCR section 1005;
(xiii) Patient documentation that meets the standard of care, including, but not limited to, computation of maximum recommended dosages for local anesthetics and the tidal volume, percentage and amount of the gases and duration of administration of nitrous oxide-oxygen analgesia;
(xiv) Medical and legal considerations including patient consent, standard of care, and patient privacy.
(E) Specific Curriculum Content.

Curriculum relating to the administration of local anesthetic agents, administration of nitrous oxide-oxygen analgesia, and performance of periodontal soft tissue curettage shall meet the requirements contained in 16 CCR section 1107.

Out-of-state dental hygiene programs that are accredited by the Commission on Dental Accreditation or an approved accrediting body and who provide instruction according to this subdivision may be approved by the Board to meet the requirements set forth in Business and Professions Code section 1909 and shall submit:

(i) An "Application for Approval of an Out-of-State Dental Hygiene Educational Program Course in Soft Tissue Curettage, Local Anesthesia, and Nitrous Oxide-Oxygen Analgesia (SLN)" DHBC SLN-04 (New 10/2021) hereby incorporated by reference; and
(ii) A SLN course syllabus certified by the educational program (to include individual SLN requirements set forth in 16 CCR 1107(b)(9)) for the out-of-state RDH educational program; and
(iii) Payment of an application fee of $500 to the Board.

Each approved course shall submit a biennial report "Periodontal Soft Tissue Curettage, Local Anesthesia, and Nitrous Oxide-Oxygen Analgesia (SLN) Course Provider Biennial Report" (DHBC SLN-03, Rev 03/2021) incorporated by reference at section 1107(a)(5).

(F) Out-of-State Applicants for Licensure. An out-of-state applicant for dental hygiene licensure may be certified by the Board that they have met current California SLN requirements pursuant to 16 CCR section 1107(b)(9). In addition to all requirements required by the Board to be licensed as a dental hygienist in California, out-of-state applicants shall submit:
(i) An "Application for Certification of Out-of-State Dental Hygiene Education in Soft Tissue Curettage, Local Anesthesia, and Nitrous Oxide-Oxygen Analgesia (SLN)" DHBC SLN-05 (New 10/2021) hereby incorporated by reference; and
(ii) An SLN course syllabus (to include individual SLN requirements set forth in 16 CCR 1107(b)(9)) certified by the educational program for the RDH educational program of which the applicant is a graduate; and
(iii) A "Certification of Completion of SLN Course Requirements" DHBC SLN-06 (New 10/2021) hereby incorporated by reference, from the RDH educational program of which the applicant is a graduate; and
(iv) Payment of an application fee of $500 to the Board.
(4) Requirements for Radiation Safety and Radiography Techniques Instruction.

Approved educational programs shall, at a minimum, specifically include instruction in radiation safety and radiography techniques and shall comply with the requirements in accordance with the provisions of this subdivision in order to secure and maintain approval by the Board. The course of instruction in radiation safety and radiography techniques offered by a dental hygiene educational program (DHEP) approved by the Board for instruction in dental hygiene shall be deemed to be an approved radiation safety course if the DHEP has submitted evidence satisfactory to the Board that it meets all the requirements set forth below.

(A) A DHEP shall provide infection control equipment and follow infection control procedures according to the requirements of 16 CCR section 1005, all federal and state laws, rules, regulations, and all approved national and state accreditation standards established by the Department of Health Care Services (DHCS), Occupational Safety and Health Administration (OSHA), and the Commission on Dental Accreditation (CODA).
(B) Facilities.

There shall be a sufficient number of safe, adequate, and educationally conducive lecture classrooms, radiography operatories, developing/processing facilities or digital equipment, and viewing spaces for mounting, viewing and evaluating radiographs. Adequate sterilizing facilities shall be provided, and all disinfection and sterilization procedures shall comply with 16 CCR 1005, all applicable accreditation standards, and state and federal laws, rules, and regulations.

(i) A radiographic operatory shall be deemed adequate if it complies with the California Radiation Control Regulations (17 CCR commencing with section 30100), is properly equipped with supplies and equipment for practical work and includes for every five students at least one functioning radiography machine which is adequately filtered and collimated in compliance with 17 CCR 30311 and 17 CCR 30311.1 and which is equipped with the appropriate position-indicating devices for each technique being taught.
(ii) The developing or processing facility shall be deemed adequate if it is of sufficient size, based upon the number of students, to accommodate students' needs in learning processing procedures and is properly equipped with supplies and equipment for practical work using manual, automatic, or digital equipment.
(iii) Radiology areas shall provide protection to patients, students, faculty, and observers in full compliance with all applicable state and federal laws, rules, and regulations.
(C) Program Content.

Sufficient time shall be available for all students to obtain laboratory and clinical experience to achieve minimum competence in the various protocols used in the application of dental radiographic techniques.

(i) A detailed course outline shall be provided to the students which clearly states curriculum subject matter and specific instructional hours in the individual areas of didactic, laboratory, preclinical, and clinical instruction.
(ii) General program objectives and specific instructional unit objectives shall be stated in writing and shall include theoretical aspects of each subject as well as practical application. The theoretical aspects of the program shall provide the content necessary for students to make judgments regarding dental radiation exposure. The course shall ensure that students who successfully complete the course can expose, process, and evaluate dental radiographs with minimum competence.
(iii) Objective evaluation criteria shall be used for measuring student progress toward attainment of specific course objectives. Students shall be provided with specific unit objectives and evaluation criteria that will be used for all aspects of the curriculum including written, practical, and clinical competencies and examinations.
(iv) Areas of instruction shall include at least the following as they relate to exposure, processing and evaluations of dental radiographs:
(1) Radiation physics and biology;
(2) Radiation protection and safety;
(3) Recognition of normal anatomical landmarks and abnormal conditions of the oral cavity as they relate to dental radiographs;
(4) Radiograph exposure and processing techniques using manual, automatic, and computerized digital methods;
(5) Radiograph mounting and/or sequencing, and viewing, including anatomical landmarks of the oral cavity;
(6) Intraoral techniques and dental radiograph armamentaria, including holding devices;
(7) Interproximal examination including principles of exposure, methods of retention and evaluation;
(8) Intraoral examination including, principles of exposure, methods of retention and evaluation;
(9) Identification and correction of faulty radiographs;
(10) Infection control in dental radiographic procedures; and
(11) Radiographic record management.
(D) Radiation Safety.

Sufficient hours of didactic and laboratory instruction shall be provided to ensure that a student successfully demonstrates competency in radiation safety. Successful completion of a radiation safety competency must be achieved at a minimum of 75% and shall be required prior to utilization of radiographic techniques in laboratory and clinic.

(E) Laboratory Instruction.

Sufficient hours of laboratory instruction shall be provided to ensure that a student successfully completes on a radiology manikin at a minimum the procedures set forth below. A procedure has been successfully completed only if each radiograph is of diagnostic quality.

(i) Two (2) full mouth periapical series, consisting of at least eighteen (18) radiographs each, four (4) of which must be bitewings;
(ii) Two (2) bitewing series, consisting of at least four (4) radiographs each; and
(iii) Developing or processing and mounting of analog exposed radiographs, or computer digital exposure and sequencing may be utilized.
(iv) Student and instructor written evaluation of radiographs.
(F) Clinical Experience.

There shall be sufficient clinical experiences as part of an organized program of instruction, to obtain clinical competency in radiographic techniques. Clinical instruction shall include clinical experience on four (4) different patients with one (1) of the four (4) patients to be utilized for clinical competency. Clinical experience shall include:

(i) Successful completion of a minimum of four (4) full mouth periapical series, consisting of at least eighteen (18) radiographs each, four (4) of which must be bitewings. Such radiographs shall be of diagnostic quality. All exposures made on patients shall only be made for diagnostic purposes and shall in no event exceed three (3) additional exposures per patient. If traditional film packets are utilized, they must be double film.
(ii) Performance of all clinical procedures on patients under the general supervision of a licensed dentist.
(iii) Either or both:
a. Processing and mounting of analog exposed radiographs;
b. Computer digital exposure and sequencing.
(iv) Student and instructor written evaluation of radiographs.
(G) Clinical Facilities.

Clinical facilities shall have the necessary equipment and accessories appropriate for the procedures to be performed and such equipment and accessories must be in safe operating condition. The clinical facilities shall be subject to the same requirements as those specified in subdivision (d)(4)(B).

(H) Length of Instruction.

Instruction shall be of sufficient duration for the student to develop minimum competence in the radiation safety techniques and shall in no event be less than thirty-two (32) clock hours, including at least eight (8) hours of didactic instruction, at least twelve (12) hours of laboratory instruction, and at least twelve (12) hours of clinical instruction.

(e) An educational program shall provide for breadth of experience and student competency in patient experiences in all classifications of periodontal disease including mild, moderate, and severe involvement.
(f) An educational program shall provide for breadth of experience and student competency in providing patient experiences in dental hygiene care for the child, adolescent, adult, geriatric, and special needs patients.

Cal. Code Regs. Tit. 16, § 1105.2

1. New section filed 4-20-2016; operative 4-20-2016 pursuant to Government Code section 11343.4(b)(3) (Register 2016, No. 17).
2. Change without regulatory effect amending subsection (d)(3)(D)(xii) filed 3-27-2017 pursuant to section 100, title 1, California Code of Regulations (Register 2017, No. 13).
3. Amendment of subsection (d)(1)(C), new subsection (d)(2)(N), amendment of subsection (d)(3)(A), new subsections (d)(3)(A)(i)-(iii), amendment of subsections (d)(3)(D)(xii) and (d)(3)(E), new subsections (d)(3)(E)(i)-(f) and amendment of NOTE filed 3-30-2022; operative 7-1-2022 (Register 2022, No. 13).

Note: Authority cited: Sections 1905, 1906, 1909 and 1944, Business and Professions Code. Reference: Sections 1905, 1912, 1914, 1941, 1944 and 1950.5, Business and Professions Code.

1. New section filed 4-20-2016; operative 4/20/2016 pursuant to Government Code section 11343.4(b)(3) (Register 2016, No. 17).
2. Change without regulatory effect amending subsection (d)(3)(D)(xii) filed 3-27-2017 pursuant to section 100, title 1, California Code of Regulations (Register 2017, No. 13).
3. Amendment of subsection (d)(1)(C), new subsection (d)(2)(N), amendment of subsection (d)(3)(A), new subsections (d)(3)(A)(i)-(iii), amendment of subsections (d)(3)(D)(xii) and (d)(3)(E), new subsections (d)(3)(E)(i)-(f) and amendment of Note filed 3-30-2022; operative 7/1/2022 (Register 2022, No. 13).