W. Va. Code R. § 5-13-6

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 5-13-6 - General Supervision of Dental Hygienists

6.1 A dental hygienist may provide, for not more than fifteen consecutive business days or not more than three consecutive weeks, preventive dental hygiene services to patients when the supervising dentist is not physically present at the location at which the services are provided if all of the following requirements are met;

6.1.1. The dental hygienist shall apply to the Board for a general supervision permit. The application shall be submitted on a form to be supplied by the Board and pay a fee as set forth in the Board's rule. Fees Established by the Board, 5CSR3.

6.1.2. The dental hygienist shall have two years and three thousand hours of clinical dental hygiene experience.

6.1.3. The dental hygienist shall provide proof of successful completion of a three hour course in the identification and prevention of medical emergencies as part of continuing education credits for licensure every two years.

6.1.4. The supervising dentist shall have examined the patient, including a medical history review, diagnosis and treatment planning, not more than twelve months prior to the date the dental hygienist provides the dental hygiene services to the patient. A dental hygienist under general supervision may not treat a patient more than two consecutive times without a licensed dentist conducting an examination.

6.1.5. The dental hygienist shall comply with written protocols or written standing orders established by the supervising dentist, including an updated medical history. The dental hygienist shall inform the patient or parent or guardian of a child that dental hygiene services were provided under general supervision and shall document such notification in the patient record.

6.1.6. The dental hygienist shall consult with the supervising dentist or an attending physician if a significant change has occurred in the patient's medical history to determine that the patient is in a medically stable condition prior to receiving dental hygiene services.

6.1.7. The supervising dentist shall not have more than three dental hygienists treating patients under general supervision in dental offices or treatment facilities at any time when the dentist is not physically present.

6.1.7.a. The dental hygienist may practice under general supervision, consistent with conditions outlined in this section, in the following settings; private dental offices, hospitals, schools, correctional facilities, jails, community clinics, long term care facilities, nursing homes, home health agencies, group homes, state institutions under the Department of Health and Human Resources, public health facilities, homebound settings and accredited dental hygiene education programs.

6.1.7.a.1. Facilities used for oral prophylaxis, sealant placement, or both, shall have adequate lighting, suction and isolation of teeth.

6.1.7.a.2. The dental hygienist shall submit an annual report to the Board of services rendered while practicing under general supervision in all settings other than a private dental office or Accredited Dental Hygiene Education program. The supervising dentist shall review and sign this report.

6.1.7.a.3. All applications and reporting forms shall be provided by the Board.

6.1.7.b. The following procedures may be performed by a dental hygienist when practicing under general supervision;

6.1.7.b.1. Placing, exposing, developing, and mounting dental radiographs;

6.1.7.b.2. Charting existing restorations and missing teeth;

6.1.7.b.3. Taking impressions for study cast and pouring models;

6.1.7.b.4. Recording medical and dental histories;

6.1.7.b.5. Applying topical anesthetic agents;

6.1.7.b.6. Applying topical anticariogenic agents;

6.1.7.b.7. Applying pit and fissure sealants following diagnosis within four months by the supervising dentist;

6.1.7.b.8. Checking for and removal of loose orthodontic bands and loose brackets;

6.1.7.b.9. Taking intra- and extra-oral photographs;

6.1.7.b.10. Complete dental prophylaxis, which may include supra- and subgingival scaling of teeth and polishing of coronal and/or exposed surfaces of teeth;

6.1.7.b.11. Dental health education;

6.1.7.b.12. Nutritional counseling;

6.1.7.b.13. Recording periodontal findings;

6.1.7.b.14. Scaling excessive cement from the surfaces of teeth and restorations;

6.1.7.b.15. Performing screenings and diagnostic tests of teeth and surrounding tissues, including but not limited to restorative chartings, caries activity test, cytology smears, salivary analysis and smears, vitality tests, and recording findings for interpretation by a supervising dentist;

6.1.7.b.16. Placing of subgingival medicaments, fibers, chips, etc.;

6.1.7.b.17. Finishing and polishing restorations with a slow speed hand piece;

6.1.7.b.18. Debridement and/or root planing of teeth; and

6.1.7.b.19. Applying bleaching agents.

6.2. The following procedures may be performed by a dental hygienist with no supervision of a licensed dentist:

6.2.1. Dental health education;

6.2.2. Nutritional counseling;

6.2.3. Preparing a generalized oral screening with subsequent referral to a dentist; and

6.2.4. Applying flouride.

6.3 A person shall not do any of the following:

6.3.1. Practice dental hygiene in a manner that is separate or otherwise independent from a supervising dentist:

6.3.2. Establish or maintain an office or practice that is primarily devoted to the provision of dental hygiene services;

6.3.3. Administer local anesthesia under general supervision; or

6.3.4. Use dental lasers under general supervision.

W. Va. Code R. § 5-13-6