SUBCHAPTER 16G - DENTAL HYGIENISTS
SECTION .0100 - FUNCTIONS THAT MAY BE DELEGATED
21 NCAC 16G .0101 FUNCTIONS That MAY BE DELEGATED
A dental hygienist may be delegated functions to be performed under the control and supervision of a dentist who shall be responsible for any and all consequences or results arising from performance of such acts and functions. In addition to the functions set out in G.S. 90-221(a) and 21 NCAC 16H .0203, functions that may be delegated to a dental hygienist provided that the dentist first examined the patient and prescribed the procedure include:
(1) performing periodontal screening;
(2) performing periodontal probing;
(3) performing subgingival exploration for or removal of hard or soft deposits;
(4) performing sulcular irrigation;
(5) applying resorbable sulcular antimicrobial or antibiotic agents;
(6) using ultrasonic scalers for prophylaxis;
(7) performing scaling and root planning;
(8) applying oral cancer screening products in preparation for the dentist's examination and diagnosis of oral cancer;
(9) using laser fluorescence detectors in preparation for the dentist's examination and diagnosis of cavities;
(10) applying resin infiltration treatment for incipient smooth surface lesions, following the dentist's diagnosis that the lesion is non-penetrable; or
(11) applying silver diamine fluoride.
History Note: Authority G.S. 90-41; 90-221; 90-223(b); 90-233;
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Amended Eff. April 1, 2017; August 1, 2016; April 1, 2015; August 1, 2008; August 1, 2000; May 1, 1989; October 1, 1985; March 1, 1985;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;
Amended Eff. April 1, 2018.
21 NCAC 16G .0102 FUNCTIONS WHICH SHALL NOT BE DELEGATED
History Note: Authority G.S. 90‑221(a); 90‑223(b);
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Amended Eff. May 1, 1989.
Repealed Eff. August 1, 2000.
21 NCAC 16g .0103 PROCEDURES PROHIBITED
Those procedures that require the professional education and skill of a dentist and shall not be delegated to a dental hygienist include:
(1) performing comprehensive examination, diagnosis, and treatment planning;
(2) performing surgical or cutting procedures on hard or soft tissues, including laser, air abrasion, or micro-abrasion procedures;
(3) placing or removing therapeutic sulcular nonresorbable agents;
(4) issuing prescription drugs, medications, or work authorizations;
(5) performing the final placement or intraoral adjustment of a fixed or removable appliance;
(6) performing intraoral occlusal adjustments that affect function, fit, or occlusion of any temporary or permanent restoration or appliance;
(7) performing direct pulp capping or pulpotomy;
(8) placing sutures;
(9) performing final placement or cementation of orthodontic bands or brackets;
(10) performing the placement or cementation of final restorations;
(11) administering any anesthetic by any route except the administration of:
(a) topically-applied agents intended to anesthetize only cutaneous tissue; or
(b) local anesthetics by dental hygienists certified in accordance with G.S. 90-221(a) and this Section, and administered under the direct supervision of a North Carolina licensed dentist;
(12) using a high-speed handpiece intraorally;
(13) performing cementation of endodontic posts;
(14) condensing Amalgam;
(15) using a transcutaneous electrical nerve stimulation (TENS) unit;
(16) applying formocresol;
(17) placing stainless steel crown on permanent or primary teeth;
(18) performing pulp vitality testing;
(19) performing curettage;
(20) placing periodontal or surgical dressing;
(21) performing oral brush biopsy;
(22) taking bite registration or elastometrics;
(23) placing eugenol wick in dry socket;
(24) fabricating or delivering sleep apnea appliance;
(25) removing, replacing, or torqueing either impression or prosthetic implant abutments; and
(26) administering any sedation or general anesthesia pharmacological agents, including drawing a dosage into a syringe.
History Note: Authority G.S. 90‑221(a); 90‑223(b);
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Amended Eff. August 1, 2016; August 1, 2008; August 1, 2000; May 1, 1989; March 1, 1985;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;
Amended Eff. July 1, 2022; September 1, 2020; April 1, 2018.
21 NCAC 16G .0104 DEFINITION: DIRECT CONTROL AND SUPERVISION
History Note: Authority G.S. 90‑223(b);
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Repealed Eff. January 1, 1983.
21 NCAC 16G .0105 EMPLOYMENT OF DENTAL HYGIENIST
History Note: Authority G.S. 90‑28; 90‑48; 90‑223(b);
Eff. September 3, 1976;
Readopted Eff. September 26, 1977;
Amended Eff. January 1, 1983;
Repealed Eff. May 1, 1989.
21 NCAC 16G .0106 DENTAL HYGIENE SCHOOL EXTENSION FACILITIES AND OFF CAMPUS CLASSES
(a) Dental hygiene schools may operate extension facilities and conduct off-campus hygiene classes in which dental hygiene services are provided to members of the public at Board approved sites, including non-profit health care facilities serving low income populations, state and county institutions with resident populations, hospitals, state or county health department and area health education centers.
(b) Dental hygiene schools which operate extension facilities or conduct hygiene classes off-campus must notify the Dental Board of the location and nature of each facility or off campus course location, the names of the students assigned thereto, and the names and qualifications of all instructors functioning therein.
(c) No student enrolled in an off-campus dental hygiene class or extension facility may receive fees, compensation or remuneration of any kind for providing dental hygiene services in accordance with G.S. 90-29(c)(4) or G.S. 90-233(c)(2).
History Note: Authority G.S. 90-29(c)(4); 90-233(c)(2);
Eff. November 1, 2009;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018.
21 ncac 16G .0107 DENTAL HYGIENE LICENSURE BY ENDORSEMENT BASED ON MILITARY SERVICE
(a) An applicant for a dental hygiene license by endorsement based on military service shall submit to the Board:
(1) a notarized application form provided by the Board at www.ncdentalboard.org that includes the information and materials required by 21 NCAC 16C .0301(a); and
(2) written evidence demonstrating the applicant has satisfied the conditions set forth in G.S. 93B-15.1(a), including engaging in the active practice of dental hygiene for at least 1,000 hours per year for at least two of the five years preceding the date of application.
(b) In addition to the requirements of Paragraph (a) of this Rule, an applicant for licensure by endorsement based on military service shall satisfy the requirements in 21 NCAC 16C .0501(b).
(c) The Board shall receive all information and documentation required under Paragraphs (a) and (b) of this Rule for the application to be complete. Applications that are not completed within one year of being submitted to the Board shall be disregarded as expired.
(d) Any applicant who changes his or her address shall notify the Board office in writing within 10 business days.
(e) Any license obtained through fraud or by any false representation shall be revoked.
History Note: Authority G.S. 90-223; 90-224(c); 90-229; 93B-15.1;
Eff. September 19, 2013;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;
Amended Eff. March 1, 2020.
21 ncac 16G .0108 DENTAL HYGIENE LICENSURE BY ENDORSEMENT BASED ON STATUS AS MILITARY SPOUSE
(a) An applicant for a dental hygiene license by endorsement based on the applicant's status as a military spouse shall submit to the Board:
(1) a notarized application form provided by the Board at www.ncdentalboard.org that includes the information and materials required by 21 NCAC 16C .0301(a); and
(2) written evidence demonstrating the applicant is married to an active member of the U.S. military and the applicant satisfies the conditions set forth in G.S. 93B-15.1(b), including engaging in the active practice of dental hygiene for at least 1,000 hours per year for at least two of the five years preceding the date of application.
(b) In addition to the requirements of Paragraph (a) of this Rule, an applicant for licensure by endorsement based on status as a military spouse shall satisfy the requirements in Rule 21 NCAC 16C .0501(b).
(c) The Board shall receive all information and documentation set forth in Paragraphs (a) and (b) of this Rule for the application to be complete. Applications that are not completed within one year of being submitted to the Board shall be disregarded as expired.
(d) Any applicant who changes his or her address shall notify the Board office in writing within 10 business days.
(e) Any license obtained through fraud or by any false representation shall be revoked.
History Note: Authority G.S. 90-223; 90-224(c); 90-229; 90-232; 93B-15.1;
Eff. September 19, 2013;
Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;
Amended Eff. March 1, 2020.
21 ncac 16g .0109 dental hygienist certification to administer local anesthetics
(a) To apply for certification to administer local anesthetics by block or infiltration techniques:
(1) a dental hygienist holding a valid dental hygiene license issued or renewed by the Board on or after October 1, 2021, shall submit to the Board a certificate of completion from a dental hygiene program meeting the requirements set out in G.S. 90-225.2 that was completed within five years prior to the date of the application; or
(2) a dental hygienist licensed in North Carolina or any other state or territory who has been practicing dental hygiene for the two year period set out in G.S. 90-225.3(a)(2) shall submit to the Board evidence that, within five years prior to the date of the application, the applicant completed a course or courses meeting the requirements of G.S. 90-225.3(a)(3), including a certified letter stating the applicant's completion of the required injections in a course. For purposes of this Rule, "certified" shall mean the letter bears:
(A) the notarized signature of a licensed dentist instructor who supervised the applicant's completion of the injections during the course or courses; or
(B) the official seal or stamp of the school, college, or continuing education provider through which the applicant completed the course or courses.
(b) If an applicant completed the course of study required pursuant to G.S. 90-225.2 or G.S. 90-225.3(a)(3) more than five years prior to submitting the application materials set out in Paragraph (a) of this Rule, the applicant shall retake a course or courses meeting the requirements of G.S. 90-225.3(a)(3) before the applicant may be certified to administer local anesthetics, unless the applicant submits documentation showing the applicant has been practicing dental hygiene, including the administration of local anesthetics by infiltration and block techniques, for the two year period prior to the date of the application.
(c) The requirements set out in Paragraph (a) of this Rule are in addition to any other applicable requirements set out in this Chapter for the issuance or renewal of a dental hygiene license.
(d) As a condition to renew a certificate to administer local anesthetics, each dental hygienist shall complete two clock hours of continuing education each calendar year in satisfaction of the requirements of G.S. 90-225.3(c), which may be among those chosen to satisfy the requirements set out in 21 NCAC 16I .0201(a).
(e) A dental hygienist certified in accordance with this Rule shall conduct administration of local anesthetics only under the direct supervision of a North Carolina licensed dentist.
History Note: Authority G.S. 90-221; 90-223; 90-225.2; 90-225.3;
Temporary Adoption Eff. November 1, 2021;
Eff. July 1, 2022.