Section 1220.240  Prescribed Duties of Dental Hygienists

a)         Dental hygienists may perform the operative procedure of dental hygiene, consisting of oral prophylaxis procedures.

b)         Dental hygienists may perform dental health education functions and may record case histories and oral conditions observed.

c)         Dental hygienists may perform all procedures that may be performed by an appropriately trained dental assistant.

d)         Dental hygienists shall not perform those procedures that constitute the practice of dentistry as described in the Illinois Dental Practice Act. Hygienists may not perform procedures that require the professional judgment and skill of a dentist. Such prohibited procedures include, but shall not be limited to, the following:

1)         Making denture adjustments.

2)         Condensing or carving amalgam restorations.

3)         Placing and finishing composite restorations.

4)         Taking final impressions for the fabrication of prosthetic appliances, crowns, bridges, inlays, onlays or other restorative or replacement dentistry.

5)         Permanently cementing permanent crowns or bridges.

6)         Permanently re-cementing permanent crowns or bridges that have come loose.

e)         Dental hygienists may administer and monitor nitrous oxide under the following conditions:

1)         The dental hygienist functions under the supervision of the dentist who remains in the facility;

2)         The dental hygienist may administer (start the flow of) nitrous oxide to the patient and control the induction of the gas, so that the patient is at a level of analgesia not anesthesia;

3)         The dental hygienist may remove the patient from nitrous oxide when the hygiene procedures have been completed; and

4)         The dental hygienist is responsible for obtaining proof of certification, validating completion of a 12 hour course relative to nitrous oxide analgesia and submitting certification to the dentist.  Such course shall have been completed no earlier than December 31, 1994.  A dental hygienist who completed the 12 hour course shall complete an additional 2 hour course in nitrous oxide analgesia administration.  The dental hygienist, who has not completed the 12 hour course, shall complete an approved course of 14 hours relative to the administration and monitoring of nitrous oxide analgesia and submit certification of successful completion to the dentist.  Such course shall have been completed no earlier than January 1, 1998.  An individual who graduated from an approved dental hygiene program after January 1, 1998 that contained nitrous oxide analgesia administration and monitoring in the curriculum shall not be required to complete the 14 hour course upon proof to the dentist of the required curriculum.  Proof of nitrous oxide analgesia education shall be made available to the Division upon request.  The required hours shall include both didactic and clinical components and be given by a continuing education sponsor approved pursuant to Section 1220.440 or a dental hygiene program approved by the Division pursuant to Section 1220.250.

f)          Dental hygienists may administer local anesthetics under the following conditions:

1)         The dental hygienist functions under the supervision of the dentist who remains in the facility.

2)         The dental hygienist is responsible for obtaining proof of certification, indicating successful completion of a 32 hour course that contains 24 hours of lecture and 8 hours of clinical training relative to the administration of local anesthetics and submitting certification to the dentist.  An individual who graduated from an approved dental hygiene program after January 1, 1999 that contained administration of local anesthetics in the curriculum shall not be required to complete the 32 hour course upon proof to the dentist of the required curriculum.  Proof of completion of education shall be made available to the Division upon request.  The required hours shall include both didactic and clinical components and be given by a continuing education  sponsor approved pursuant to Section 1220.440 or a dental or a dental hygiene program approved by the Division pursuant to Section 1220.250.  The course shall contain at a minimum the following topics:

A)        Patient preevaluation, which includes dental and medical health history (e.g., drug interactions/anxiety/pain and a physical evaluation);

B)        Pharmacology (e.g., drugs/types, vasoconstrictors, dosages, toxicity);

C)        Recordkeeping;

D)        Anatomy/Neuroanatomy/Physiology;

E)         Armamentarium;

F)         Techniques that include adjunctive use of topical anesthetics, mandibular block and infiltration;

G)        Complications;

H)        Post-operative instructions; and

I)          Clinical experience that includes combining techniques for quadrant anesthesia and practical use of different techniques in all areas of oral cavity.

3)         A dental hygienist who was licensed in another state and was authorized to administer local anesthesia in that jurisdiction will not be required to complete an additional course.  Proof shall be submitted to the dentist and shall be made available to the Division upon request.

g)         The licensed dentist need not be present in the facility for a dental hygienist to perform the procedures set forth in this Section (except for the administration and monitoring of nitrous oxide and the administration of injectable local anesthetics, which must be done under the direct supervision of a dentist as outlined in subsection (e)(1)) on persons who reside in a long-term care facility licensed by the State of Illinois or a mental health or developmental disability facility operated by the Department of Human Services hospital or other similar institution and are unable to travel to a dental office because of illness or infirmity.  The dentist shall personally examine and diagnose the patient and determine which services are  necessary to be performed, which shall be contained in a written order to the hygienist.  The order must be implemented within 90 days after its issuance and an updated medical history and oral inspection must be performed by the hygienist immediately prior to beginning the procedures to ensure that the patient's health has not changed in any manner to warrant a re-examination by the dentist.

h)         All intraoral procedures performed by a dental auxiliary, except those provided for in subsections (b) and (g), must be examined by the supervising dentist prior to the dismissal of the patient from the facility that day.

(Source:  Amended at 30 Ill. Reg. 19656, effective December 18, 2006)