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Washington State Dental Association

DQAC Update: New Rules to Take Effect 3/13/17

The Dental Quality Assurance Commission (DQAC) recently adopted modified rules related to the scope of practice for registered dental assistants and licensed expanded function dental auxiliaries (EFDAs) (WAC 246-817-510, 520, 525, 540 and 545). These rule modifications update their scope of practice and eliminate confusion among dental professionals. 

Delegation definitions changes include (WAC 246-817-510): 
• Changing close supervision to be consistent with RCW 18.260.010. 
• Changing coronal polishing by moving the dentist’s responsibility for evaluation to prior to dismissing the patient to the list of allowable task as it is a condition of the task not defining the term. 
• Changing general supervision to be consistent with RCW 18.260.010. 
• Changing luxation by deleting a sentence that refers to what luxation is not. It is unnecessary. 
• Changing suturing by deleting a sentence that refers to what suturing is not. It is unnecessary. 
• Deleting noncredentialed person as it is not necessary. 
• Correcting elevating soft tissue, incising, oral prophylaxis, and volunteer dental assistant wording and grammar. 

Dental assistant allowable tasks changes include (WAC 246-817-520): 
• Adding placing cavity liners and bases; 
• Adding sterilize equipment and disinfect operatories; 
• Adding bonding attachments for clear removable orthodontic aligners; 
• Adding a dental assistant cannot intra-orally adjust or finish permanent restoration as part of polishing restorations; 
• Adding apply bonding agents to perform acid etch; 
• Adding remove orthodontic cement and orthodontic bonded resin material to fixed orthodontic appliances; 
• Detailing specific types of impressions and added digital scans; 
• Clarifying that starting and stopping the flow of nitrous oxide as part of assist in administration of inhalation minimal sedation (nitrous oxide); 
• Clarifying select and fit orthodontic bands; 
• Clarifying a dentist shall determine teethe are free of calculus before dismissing the patient after a dental assistant performs coronal polish; 
• Rewording place, expose, and process radiographs;
• Rewording placing a matrix and wedge for a direct restoration after a dentist has prepared the teeth; 
• Rewording fabricate, cement, and remove temporary crowns or temporary bridges; 
• Rewording prepare teeth for the bonding of orthodontic appliances; 
• Rewording give patient education in oral hygiene; 
• Adding language to require a dentist to ensure the dental assistant has demonstrated the skills necessary to perform each task competently, specifically to address use of high speed versus slow speed hand pieces; and
• Deleting taking health histories. 

Dental assistant prohibited tasks changes include (WAC 246-817-540): 
• Rewording intra-orally adjust and finish permanent restorations; and
• Deleting semi-permanent from placing of permanent restorations in natural teeth. 

Expanded function dental auxiliary (EFDA) allowable tasks changes include (WAC 246-817-525): 
• Deleting all dental assistant tasks and referred to dental assistant rule; 
• Rewording place, carve, finish, and polish direct restorations; 
• Rewording place, expose, and process radiographs; and
• Adding language to require a dentist to ensure the EFDA has demonstrated the skills necessary to perform each task competently. 

Expanded function dental auxiliary prohibited tasks changes include (WAC 246-817-545): 
• Rewording intra-orally adjust and finish permanent inlays, crowns, and bridges; and
• Correcting reference to WAC 246-817-520 (4) (e). 

Source: Washington State Department of Health, 2/22/17 

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