subchapter 16w – public health hygienists

section .0100 - PUBLIC HEALTH HYGIENISTS

21 NCAC 16W .0101        DIRECTION DEFINED

(a)  A public health hygienist may perform clinical procedures under the direction of a licensed dentist, as defined by 21 NCAC 16A .0101(9), and in accordance with G.S. 90-233(a).

(b)  The specific clinical procedures delegated to the hygienist shall be completed, in accordance with a written order from the dentist, within 270 days of the dentist's in-person evaluation of the patient.

(c)  The dentist's evaluation of the patient shall include a comprehensive oral examination, medical and dental health history, and diagnosis of the patient's condition.

(d)  A public health hygienist may provide educational information, such as instruction in brushing and flossing, without the direction of a licensed dentist.

History Note:        Authority G.S. 90-223; 90-233(a);

Temporary Adoption Eff. October 1, 1999;

Eff. April 1, 2001;

Amended Eff. April 1, 2016; July 1, 2015;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;

Amended Eff. February 1, 2020.

21 NCAC 16W .0102        TRAINING FOR PUBLIC HEALTH HYGIENISTS

(a)  Prior to performing clinical procedures pursuant to G.S. 90-233(a) under the direction of a licensed dentist, a public health hygienist shall have:

(1)           five years of experience in clinical dental hygiene;

(2)           unexpired CPR certification, taken in a live hands-on course;

(3)           six hours of continuing education in medical emergencies each year in addition to the minimum continuing education required for license renewal; and

(4)           other training as may be required by the Oral Health Section of the Department of Health and Human Services.

(b)  For purposes of this Rule, a minimum of 4,000 hours, the majority of which must be spent performing prophylaxis or periodontal debridement under the supervision of a licensed dentist, shall be equivalent to five years experience in clinical dental hygiene.

(c)  Notwithstanding Subparagraph (a)(1) and Paragraph (b) of this Rule, a public health hygienist may place sealants under the direction of a licensed dentist if the hygienist has a minimum of 2,000 hours of clinical experience assisting in the placement of sealants with the Oral Health Section of the Department of Health and Human Services.

History Note:        Authority G.S. 90-223; 90-233(a);

Temporary Adoption Eff. October 1, 1999;

Eff. April 1, 2001;

Amended Eff. July 1, 2015;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;

Amended Eff. October 1, 2019.

21 NCAC 16W .0103        TRAINING FOR PUBLIC HEALTH HYGIENISTS PERFORMING PREVENTIVE PROCEDURES

(a)  Public health hygienists who provide only educational and preventive procedures such as application of fluorides, fluoride varnishes, and oral screenings, and not clinical procedures, shall be subject to the training provisions set out in Paragraph (b) of this Rule instead of the training provisions required by 21 NCAC 16W .0102.

(b)  A public health hygienist may perform preventive procedures as set out in Paragraph (a) of this Rule under the direction of a duly licensed public health dentist if the hygienist:

(1)           maintains CPR certification; and

(2)           completes such other training as may be required by the Oral Health Section of the Department of Health and Human Services.

History Note:        Authority G.S. 90-223; 90-233(a);

Temporary Adoption Eff. February 8, 2000;

Eff. April 1, 2001;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018.

21 NCAC 16W .0104        DENTAL ACCESS SHORTAGE AREAS

(a)  Public health hygienists who are practicing under Rule .0101(a) of this Section and who perform procedures in public schools, nursing homes, rest homes, long-term care facilities, and rural and community clinics provided through federal, State, county, or local governments in areas identified by the Office of Rural Health in the Department of Health and Human Services as dental access shortage areas may:

(1)           perform clinical hygiene procedures as described in G.S. 90-221 under the direction of a dentist based on a written standing order, rather than an in-person evaluation by the dentist as set forth in Rule .0101(c) of this Section; and

(2)           supervise a Dental Assistant who assists the public health hygienists in the procedures described in Subparagraph (a)(1) of this Rule. For purposes of this Rule, Dental Assistant means any person classified as a Dental Assistant II or permitted to perform functions of a Dental Assistant II pursuant to 21 NCAC 16H .0104(a) or (b).

(b)  Public health hygienists working under supervision of a dentist in accordance with G.S. 90-233(a) and providing services at facilities identified in Paragraph (a) of this Rule who are performing services pursuant to a written standing order from the dentist must complete the procedures ordered within 270 days.

(c)  Dentists providing services at facilities pursuant to Paragraph (a) of this Rule are providing public health services and may supervise more than two public health hygienists at the same time who are performing dental hygiene functions.

History Note:        Authority G.S. 90-223; 90-233(a); 90-233(b);

Eff. February 1, 2020.