Scope of Practice
Article 133 of the New York State Education Law is both a title and a practice law. This means that you must be licensed not only to use the title "certified dental assistant" in New York but also to provide certain dental assisting services.
- What functions may a New York State licensed registered dental assistant perform?
Answer: A New York State licensed registered dental assistant may
- provide patient education
- take preliminary medical histories and vital signs to be reviewed by the dentist
- place and remove rubber dams
- select and prefit provisional crowns
- select and prefit orthodontic bands
- remove orthodontic arch wires and ligature ties
- place and remove matrix bands
- take impressions for study casts or diagnostic casts
- remove periodontal dressings
- remove sutures placed by a licensed dentist
- take impressions for space maintainers, orthodontic appliances, and occlusal guards
- remove temporary cement
- apply topical anticariogenic agents to the teeth
- apply desensitizing agents to the teeth
- place and remove temporary separating devices
- place orthodontic ligatures
- take dental x-rays in accordance with Public Health Law (see question 16)
- perform such other dental supportive services authorized by the dentist and consistent with New York State laws, rules and regulations. (see question 6)
All supportive services must be performed under a licensed dentist's direct personal supervision.
- What are the functions that a New York State licensed registered dental assistant is prohibited from performing?
Answer: A New York State registered dental assistant shall not diagnose, perform surgical procedures, perform irreversible procedures or procedures that would alter the hard or soft tissue of the oral and maxillofacial area. Although authorized to do so, the Department has not yet specified any other procedures that a licensed certified dental assistant is prohibited from performing at this time.
- What does "consistent with New York State laws, rules and regulations" mean (see last bullet in question 4)?
Answer: New York State laws, rules and regulations set the boundaries within which licensed professionals may practice and within which others are prohibited from practicing unless otherwise authorized; this is called the scope of practice of the profession. This means that a New York State licensed registered dental assistant may not perform any of the duties or responsibilities limited to the scope of practice of dentistry or dental hygiene. For example, no dental assistant may apply pit and fissure sealants because this procedure is within the scope of practice of a dental hygienist and is not explicitly listed within the scope of practice of a licensed registered dental assistant.
- Where can information be found regarding the scope of practice of dentistry and dental hygiene?
Answer: The scope of practice is within the laws and regulations of the State of New York, which may be found on the Dental Board Web site. For dentistry, the scope of practice may be found in section 6601 of Education Law. For dental hygiene, the scope may be found in section 6606 of Education Law and section 61.9 of the Commissioner's Regulations. For the scope of practice for other licensed professions, please visit our Web site.
- What does a licensed dentist's "direct personal supervision" mean?
Answer: Direct personal supervision means supervision of dental procedures based on instructions given in the course of a procedure by a licensed dentist who remains in the dental office where the supportive services are being performed, personally diagnoses the condition to be treated, personally authorizes the procedures, and before dismissal of the patient, who remains the responsibility of the licensed dentist, evaluates the services performed by the licensed registered dental assistant.
- In addition to New York State licensed registered dental assistants, may any other dental personnel perform the supportive services within the scope of practice of a licensed registered dental assistant?
Answer: Yes. A student in a dental assisting program approved by the New York State Education Department as meeting the educational requirement for licensure may also perform these supportive services as part of that course of study. Additionally, a dental assistant who has been issued a limited permit to practice and individuals licensed or otherwise authorized to practice dentistry or dental hygiene in New York State may perform these supportive services. No other dental personnel may do so unless otherwise authorized.
- Are all New York State licensed registered dental assistants allowed to perform everything within the scope of practice of their profession?
Answer: Under Part 29 of the Rules of the Board of Regents, it is unprofessional conduct for a licensee to perform any services that are beyond his or her individual professional competence. Therefore, if a licensee is not competent to perform a function, even if it falls within the legal scope of practice, he or she may not perform the function. It is the responsibility of the licensee to practice within his or her abilities and expertise.
Furthermore, the supervising dentist must be aware of the competency of the assistant. It is unprofessional conduct for a licensee to delegate professional responsibilities he or she knows or has reason to know that the dental assistant or hygienist is not competent to perform.
- Does the new law allow New York State licensed registered dental assistants to place and remove temporary restorations; place, condense and carve amalgam restorations; and place and condense non-metallic restorations?
Answer: Yes, provided that the licensee is competent to perform these procedures. Demonstration of competency should include the successful completion of formal education, which may include coursework completed within the New York State approved dental assisting program or obtained through formal continuing education given by a continuing education provider approved by the Department including those providers approved by the American Dental Association Continuing Education Recognition Program (ADA CERP) or other similar accrediting agency.
As noted in question 10 above, if a New York State licensed registered dental assistant practices beyond his or her abilities and expertise, both the assistant and the dentist could be charged with professional misconduct.
- How can a patient identify if the person assisting the dentist is licensed as a New York State licensed registered dental assistant?
Answer: Every dental professional licensed by the New York State Education Department and practicing in New York State must conspicuously display his or her current certificate of registration to practice that profession. In hospitals and similar facilities licensed by the New York State Department of Health, such persons must wear tags showing name and profession.
- What letters may a New York State licensed registered dental assistant use after his or her name?
Answer: The protected title for a New York State licensed registered dental assistant is "certified dental assistant" as stated in section 6608-a of New York State Education Law. However, the New York State Board for Dentistry recognizes that New York State licensed dental assistants may use the letters RDA following their names to identify that they are licensed and registered to practice as dental assistants in the State of New York, if they so desire.
A New York State licensed "registered dental assistant" may perform the following supportive services to a licensed dentist under his or her direct personal supervision in the performance of dentistry:
NOTE: It is a Class E felony for an unlicensed person (other than a student in a registered dental assisting program, or a program completer working with a limited permit)
to perform functions limited to New York State licensed registered dental assistants. A Class E felony may be punishable by a fine of up to $5,000.00 and/or up to four years in prison.
Aiding and abetting three or more individuals in such illegal practice may also be subject to felony prosecution.