(a)
On or after January 1, 2026, a provider of a course for instruction in interim therapeutic restorations and radiographic decisionmaking for a registered dental assistant in extended functions shall apply for board approval to offer the course and submit all of the following to the board:
(1)
An application prescribed by the board that shall specify the name of the course or educational program administrator or director, the name of the course provider, the name of the course, and the location where the course will be offered.
(2)
The application fee prescribed by regulation.
(3)
A detailed course curriculum
evidencing that the course is sufficient in length for the students to develop competency in placement of protective restorations, but shall be, at a minimum, 16 hours in length and include all of the following:
(A)
Four hours of didactic training, which may take place in an in-person or online environment, and shall include:
(i)
Review of pulpal anatomy.
(ii)
Theory of adhesive restorative materials used in the placement of adhesive protective restorations, including mechanisms of bonding to tooth structure, handling characteristics of the materials, preparation of the tooth prior to material placement, and placement techniques.
(iii)
Criteria used in clinical dentistry pertaining to the use and placement of adhesive protective restorations, which
shall include:
(I)
Patient factors, as follows:
(ia)
According to the American Society of Anesthesiologists Physical Status Classification, the patient is Class III or less.
(ib)
The patient is cooperative enough to have the interim therapeutic restoration placed without the need for special protocols, including sedation or physical support.
(ic)
The patient, or responsible party, has provided consent for the interim therapeutic restoration procedure.
(id)
The patient reports that the tooth is asymptomatic, or if there is mild sensitivity that stops within a few seconds of the removal of the offending stimulus.
(II)
Tooth
factors, as follows:
(ia)
The lesion is accessible without the need for creating access using a dental handpiece.
(ib)
The margins of the lesion are accessible so that clean, noninvolved margins can be obtained around the entire periphery of the lesion with the use of hand instrumentation.
(ic)
The depth of the lesion is more than two millimeters from the pulp on radiographic examination or is judged by the supervising licensed dentist to be a shallow lesion such that the treatment does not endanger the pulp or require the use of local anesthetic.
(id)
The tooth is restorable and does not have other significant pathology.
(iv)
The protocols to deal with adverse outcomes used in the
placement of adhesive protective restorations, including mechanisms of bonding to tooth structure, handling characteristics of the materials, preparation of the tooth prior to material placement, and placement techniques.
(v)
Criteria for evaluating successful completion of adhesive protective restorations, including, but not limited to, restorative material not in hyper occlusion, no marginal voids, and minimal excess material.
(vi)
Protocols for adverse outcomes after interim therapeutic restoration placement, including, but not limited to, exposed pulp, tooth fracture, gingival tissue injury, high occlusion, open margins, tooth sensitivity, rough surface, complications, or unsuccessful completion of adhesive protective restorations, including situations requiring immediate referral to a dentist.
(vii)
Protocols
for followup of adhesive protective restorations, including, but not limited to, at least two followup examinations of the interim therapeutic restoration within a 12-month period.
(B)
Four hours of laboratory training, which shall be held at a physical facility, and include placement of 10 adhesive protective restorations where students demonstrate competency in this technique on typodont teeth.
(C)
Eight hours of clinical training, which shall be held at a physical facility, and include experiences where students demonstrate, at minimum, placement of five interim therapeutic restorations under direct supervision of faculty.
(4)
A detailed course curriculum evidencing that the course is sufficient in length for the students to develop competency in making decisions about which radiographs to expose to facilitate
diagnosis and treatment planning by a dentist, but shall be, at a minimum, four hours in length and include all of the following:
(A)
Didactic instruction, including all of the following:
(i)
The concept of managing caries and individualizing treatment based on a caries risk assessment.
(ii)
Guidelines for radiographic decisionmaking, including, but not limited to, both of the following concepts:
(I)
The American Dental Association’s Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure (Revised 2012).
(II)
The American Academy of Pediatric Dentistry’s Guidelines on Prescribing Dental Radiographs.
(iii)
The guidelines developed by Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry (Pacific) for use in training for Health and Workforce Pilot Project No. 172, including both of the following:
(I)
Instruction on specific decisionmaking guidelines that incorporate information about the patient’s health, radiographic history, time span since previous radiographs were taken, and availability of previous radiographs.
(II)
Instruction pertaining to the general condition of the mouth, including the extent of dental restorations present and visible signs of abnormalities, including broken teeth, dark areas, holes in teeth, demineralization, visible carious lesions, and remineralization.
(B)
Laboratory training
that includes case-based examination with various clinical situations where trainees make decisions about which radiographs to expose and demonstrate competency to faculty based on these case studies.
(C)
Simulated clinical experiences consisting of a review of various clinical cases with instructor-led discussion about radiographic decisionmaking in these clinical situations.
(5)
Evidence of student access to adequate equipment and facilities to satisfy the educational requirements as specified in this section.
(6)
Evidence that the physical facilities required under this section have all of the following:
(A)
A patient clinic area, laboratory, and radiology area.
(B)
Access to equipment
necessary to develop dental assisting skills in radiographic decisionmaking.
(C)
Infection control equipment as required by the board.
(7)
Evidence that the physical facilities and equipment are maintained and replaced in a manner designed to provide students with a course that will meet the educational objectives set forth in this section.
(8)
Evidence that all students have access to all of the following:
(A)
A hazardous waste management plan for the disposal of needles, cartridges, medical waste, and storage of oxygen and nitrous oxide tanks.
(B)
A clinic hazard communication plan.
(C)
A copy of the course’s bloodborne and
infectious diseases exposure control plan, which shall include emergency needlestick information.
(9)
Written clinical and laboratory protocols to ensure adequate asepsis, infection and hazard control, and disposal of hazardous wastes, which shall comply with the board’s regulations and other federal, state, and local requirements. The course provider shall provide such protocols to all students, faculty, and appropriate staff to assure compliance with such protocols. Adequate space shall be provided for preparing and sterilizing all armamentaria.
(10)
Evidence that the course is established at the postsecondary educational level.
(b)
The course content may be incorporated into a current registered dental assistant in extended functions program.
(c)
For
course enrollment, the course provider shall ensure submission by the student of satisfactory evidence of both of the following requirements:
(1)
A current, active license as a registered dental assistant in extended functions issued on or after January 1, 2010.
(2)
A current certification in basic life support from American Red Cross, American Heart Association, American Safety and Health Institute, American Dental Association’s Continuing Education Recognition Program, or Academy of General Dentistry’s Program Approval for Continuing Education.
(d)
The program or course director shall do both of the following:
(1)
Ensure all faculty involved in clinical evaluation of students maintain currency in evaluation protocols for interim therapeutic
restoration placement and radiographic decisionmaking.
(2)
Ensure that all faculty responsible for clinical evaluation have completed a one-hour methodology course in clinical evaluation for interim therapeutic restoration placement and radiographic decisionmaking before instruction.
(e)
Satisfactory completion of a course in interim therapeutic restoration and radiographic decisionmaking is determined using criteria-referenced completion standards, where the instructor determines when the trainee has achieved competency based on these standards, but trainees take varying amounts of time to achieve competency. Any student who does not achieve competency in this duty in the specified period of instruction may receive additional training and evaluation. In cases where, in the judgment of the faculty, students are not making adequate progress, they shall be discontinued from the
program.
(f)
Each student shall pass a written examination which reflects the entire curriculum content.
(g)
Each student shall pass a simulated clinical examination in which the student successfully completes the application of three of the five interim therapeutic restoration placements required for clinical instruction under faculty supervision.
(h)
Each approved course shall be subject to board review at any time for compliance with the requirements under this section. The board may withdraw approval at any time that it determines that the course does not meet the requirements set forth in this section.
(i)
The program or course director shall be responsible for notifying the board in writing of any changes to the course content, physical
facilities, and faculty within 10 days of such changes.
(j)
The board may adopt regulations to implement this section.
