MN Dental Jurisprudence Exam New Update 2023 Actual Test with complete solution

*general supervision

The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises.

*indirect

The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel.

direct

The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel.

personal

The dentist is personally operating on a patient and authorizes the allied dental personnel to aid in treatment by concurrently performing supportive procedures.

DH, DT or DA must do these before administering nitrous

take a course with a minimum of 12 hours total comprised of didactic instruction, personally administering and managing at least 3 individual supervised cases

who can place sealants after completing a course by a school accredited by the commission on dental accreditation?

DH, DT, DA

*WHO can give local anesthesia after completing a course on local anesthesia from a school accredited by the Commission on Dental Accreditation

DH and DT (not DA)

*Dental hygienists and licensed dental assistants shall not take impressions and bite registrations for _____________ of fixed and removable prostheses.

Final construction

*Before removal of bond material, a dental hygienist or licensed dental assistant must successfully complete a course in the use of ____________ for the express purpose of the removal of bond material from teeth.

rotary instruments

Scope of Practice

DH and DA with restorative functions can place, contour, and adjust amalgam, glass ionomers, and stainless steel crowns on class _______
(supragingival)

Class I, II, V
– a dental hygienist or dental assistant must successfully complete a board approved course on these specific restorative procedures.

application of pit and fissure sealants

DH – general
LDA – indirect

*Administer LA

DH – general

*monitor a patient on nitrous

DH – General
LDA – Indirect

T/F — DH or LDA shall NOT take impressions and bite registrations for the FINAL construction of fixed and removable prostheses.

True

*Utilizing rotary instruments for the removal of bond material from teeth

DH – indirect
LDA – indirect

Performing any or all restorative procedures limited to placing, contouring, & adjusting amalgam, glass ionomers, and Class I and V supra composite restorations

DH – indirect
LDA – indirect

*managing and removing IV lines

DH – indirect
LDA – indirect

*placing an IV line

DH – direct
LDA – direct

administering any medications or agents

Personal DH and RDA

*Perform preliminary charting including assessments and existing restoration, determine the perio status, and formulate the DH tx plan in coordination with DDS

DH – general

*make referrals in consultation with DDS

DH – general

*complete prophy with scaling, root planing, and polishing restorations

DH – general

dietary and nutritional counseling

DH – general

*replacement, cementation and adjustment of INTACT temporary restorations

DH – general
LDA – general

*remove overhangs

DH – general

Complete preliminary charting of oral cavity and surrounding structures w/ exception of perio probing and assessment of the perio structure

LDA – general

of course DH can do this too, with probing

take photographs intra or extra orally

DH – general
LDA – general

take vital signs

DH – general
LDA – general

place temporary fillings

DH – general
LDA – general

*cut arch wires, remove loose bands or brackets

DH – general
LDA – general

*take X-rays

DH – general
LDA – general

*take impressions for casts and bite registrations

DH – general
LDA – general

*place and remove ortho separators

DH – general
LDA – general

*deliver vacuum-formed ortho retainers

DH – general
DA – general

*etch enamel surfaces; apply and adjust sealants

DH – general
LDA – indirect

*monitor a patient on nitrous oxide

DH – general
LDA – indirect

*mechanical polishing clinical crowns (calculus must be removed by DDS or DH before polishing)

DH – general
LDA – indirect

*remove excess cement from inlays, crowns, bridges, ortho appliances with HAND INSTRUMENTS

DH – general
LDA – indirect

apply topical fluoride and bleaching agents prescribed by DDS

DH – general
LDA – indirect

*can a LDA or DH place a cavity liner or endo filler

no

place topical gel before injection

DH – general
LDA – indirect

*place and remove rubber dam

DH – general
LDA – indirect

*Preselect ortho bands

DH – general
LDA – indirect

can a LDA give local anesthesia?

No

*remove and replace ligature ties and arch wires

DH – general
LDA – indirect

*remove sutures

DH – general
LDA – indirect

Perform restorative procedures limited to: placing, contouring, and adjusting amalgam
restorations and glass ionomers; adapting and cementing stainless steel crowns; and placing,
contouring, and adjusting class I, II, & V supragingival composite restorations on primary and permanent teeth.

DH – Indirect
LDA – indirect

*place and remove periodontal packs

DH – General
LDA – indirect

*dry root canals with paper points

DH – general
LDA – indirect

*remove bond material with rotary instruments after removal of ortho

DH – direct
LDA – direct

*place and remove matrix bands

DH – direct
LDA – direct

fabricate, cement, and adjust temporary crowns

DH – direct
LDA – direct

*remove temporary RESTORATIONS with hand instruments only

DH – direct
LDA – direct

*etch enamel surfaces before bonding of ortho by DDS

DH – direct
LDA – direct

*attach prefit and preadjusted ortho appliances

DH – direct
LDA – direct

*remove fixed ortho brackets

DH – direct
LDA – direct

remove excess bond material from appliances

DH – general
LDA – direct

*administer N2O2

DH – general
LDA – direct

T/F – ONLY a dentist can cement ortho bands and adjust ortho wires

true

Concurrently perform supportive services if the dentist holds a valid general anesthesia or moderate sedation certificate, is personally treating a patient, and authorizes the allied dental personnel to aid in treatment including the administration of medications into an existing intravenous line, an enteral agent, or emergency medications in an emergent situation.

DH – personal
LDA – personal
(apply meds)

*Place nonsurgical retraction material for gingival displacement.

DH – direct
LDA – direct

-Perform preliminary charting of the oral cavity, oral health instruction and disease prevention, including nutritional counseling, dietary analysis.

-Apply topical medications such as, but not limited to, topical fluoride and cavity varnishes in appropriate dosages.

*****-Perform mechanical polishing

GENERAL (DT and ADT)

-Etch appropriate enamel surfaces, apply and adjust pit and fissure sealants.

-Placement of temporary restorations.

-Fabrication of soft occlusal guards and athletic mouthguards.

-Pulp vitality testing.

GENERAL (DT and ADT)

-Administer local anesthesia.

-Administer nitrous oxide inhalation analgesia

*****Application of desensitizing medication or resin

-Tissue conditioning and soft reline.

DT – general
ADT – general

-Atraumatic restorative therapy.

*Tooth reimplantation.

-Dressing changes.

-Dispense and administer analgesics, anti-inflammatories, and antibiotics as (permitted by the collaborative management agreement)

general ADT and DT

-Cavity preparation; and restoration of primary and permanent teeth

-Pulpotomies on primary teeth

-pulp capping on primary and permanent teeth.

-Stabilization of reimplanted teeth.

-Remove sutures.

-Brush biopsies.

DT – indirect
ADT – general

-Extraction of periodontaly diseased permanent teeth with mobility of +3 to +4 as permitted by the collaborative management agreement. (Not including unerupted, impacted, fractured)

-Oral evaluation and assessment of dental disease and the formation of an individualized treatment plan authorized by a collaborating dentist

-Make appropriate referrals to dentists, physicians, and other practitioners in consultation with the collaborating dentist.

ADT – GENERAL
—DT cannot do these

-Repair of defective prosthetic devices

-Placement of temporary crowns: and preparation and placement of preformed crowns

*Provide emergency palliative treatment of dental pain

-Extractions of baby teeth

DT – indirect
ADT – general

LDA General Supervision (all)

-cut arch wires on ortho appliance
-remove loose bands on ortho appliance
-remove loose brackets on ortho appliances
-re-cement intact temp restorations
-place temp fillings, not including temporization of Inlays, onlays, crowns, and bridges
-take radiographs
-impressions for casts and appropriate bite registration, not to include impressions and bite registrations for final construction of fixed and removable prostheses
-deliver vacuum-formed ortho retainers
-place and remove elastic ortho separators
-complete prelim charting
-take photographs extra and intraorally
-vital signs – pulse, bp as directed by dds
-obtain informed consent for treatments authorized by the supervising dentist pursuant to the licensed da scope

DH Direct supervision (all)

Etch for ortho, remove CRs, fabricate temp restorations, place/remove matrix bands, remove ortho cement with rotary instruments, attach ortho appliances, remove fixed ortho bands/brackets, initiate and place IV lines, place nonsurgical retraction material for gingival displacement.

DH personal supervision

Help DDS with sedation if completed extra education.

Rules, regulations, and CE requirements

____

*can a dentist accept money for making a referral (renumeration = $) to another dentist?

nope

*the patient can be terminated for:

– pt failure to comply with treatment or professional advice (ex: advanced perio)
– consistent tardiness or failed appts
– failure to pay for services rendered
– behavior mngmt issues

*Can a LDA scale and clean mandibular anteriors on a pediatric patient?

NO
The LDA and DDS would both be held accountable

*Who could be in trouble by the Board of Dentistry if a DH/LDA practices beyond their scope of practice, even when the DDS did NOT request them to and the DH/LDA acted on their own

both the DDS and DH/LDA

Ad: “Our practice specialized in cosmetic dentistry, promising superior results in the quest to achieve your perfect smile”

What is wrong w/ the above ad?

DDS cannot say they are SUPERIOR and cannot PROMISE the results of a tx.

They are creating a false/unjustified expectation.
Also, cosmetic dentistry is not recognized as a ‘specialty’ by the ADA

In advertising a dental office, the DDS cannot use terms such as “top” or “best”. They cannot make a claim that a survey, ballot, or poll constitutes a ranking for who they are or what they do; ex) “the top 15%” or “voted best..” T/F

true

5 components of CPR training

-AED
-Barrier mask or bag for ventilation
-Foreign body airway obstruction
-Two person rescuer
-Adult, child, and infant CPR

Good Samaritan Law

a person at the scene of an emergency who knows that another person is exposed to or has suffer harm shall give reasonable assistance to the exposed person

Criminal law

law that deals with crime and the legal punishment of criminal offenses (crime against society)

Civil law

deal with disputes between individuals, organizations, or between the two, in which compensation is awarded to the victim

What actions would cause an immediate suspension of a Dental Professional License?

1. Dependence on alcohol, drugs, or other substances
2. Writing unauthorized prescriptions

*How many CE credits does a LDA, DDS, DT and DH need to have in a 2 year period?

25 for LDA and DH
50 for DDS and DT’s

fundamental credits

directly related to clinical practice of dentistry

*minimum of 15 credits for LDA and DH;
30 for DDS and dental therapists

Core Subjects (fundamental credits)

areas of knowledge that relate to public safety and professionalism
*minimum of 2 different core subjects needed in 2 yrs

*what are core subjects??

-Record Keeping
-Ethics
-Infection Control
-Patient Communication
-Management of med. emergencies
-Diagnosis and tx. planning (optional for DH/LDA)

CPR is a _________ credit

Fundamental; must be updated every 2 yrs

*self assessment is a _____ credit

Fundamental; printed from ADA website; usually updated every 2yrs. completed and put in professional portfolio; 1 credit

Can all of your credits be earned in the fundamental category?

yes, but they cannot all be in the elective category

*elective credits

activities directly related to, or supportive of the practice of dentistry;

Max. of 10 credits for DH/LDA; 20 for DDS and dental therapists

ex) Self-study-scholarly articles
Scholarly activities- presentations
Volunteering/Community Service
General Attendance- 3 credits for a state or national dental convention

BOD will randomly select individuals for an audit; you will be notified by letter and have ____ days to submit COPIES of your CE record

60 days (never send an original)

*Each dental professional is required to keep documentation of their CE for the current 2 year cycle AND the previous ____ year cycle

past 2 year cycle

*all dental professionals must notify the board of dentistry within _________ of a name or address change

30 days

***T/F : must display annual renewal certificate w/ license in plain sight for pts to see. When renewing license, copies can be requested* if one is employed at multiple practices.

(One must carry a wallet copy if they float to variety of offices)

True (you cannot make copies yourself)

*All DHCP must renew their license every _____ on the date when they originally got their license

2 years

When is reading a professional article considered a fundamental credit and when is it an elective credit?

A professional article w/ a post test is considered fundamental

Reading a professional article for the information is considered elective

the board can grant a GUEST LICENSE for a DA, DDS, DH if the following conditions are met

1. must be currently licensed
2. is currently engaged in practice
3. is approved by the board
4. was established by a non profit organization that is tax exempt
5. provides dental care to patients who have difficulty accessing to care
6. must agree to treat “indigent” patients
7. has to pay a non refundable free no more than $75
8. guest license must be renewed anually and expires on Dec. 31
9. the care must be provided without compensation
10. board requires proof of application
11.must be subject to all state rules and regulations

continuing education waiver for a dental professional who is RETIRED from active practice and has limited the provision of dental care services

-board may require written documentation that they are retired — proof they are not working as a full time dental professional (maybe working a few times a month)
-must complete and document at least 5 hours of approved courses on infection control, medical emergencies, etc.
-provide documentation of current CPR certificate

what is the boards mission?

to ensure that all MN citizens receive quality dental health care from competent dental health care professionals

MN Board of Dentistry has _______ members

9 total :
– 5 DDS
– 1 LDA
– 1 DH
– 2 public members

who appoints the 9 members of the board?

governor

what qualifications must the DH, DA, & DDS have to become part of the board?

lawfully in active practice in the state for 5 years immediately preceding appointment into the board

how long can members serve?

2 consecutive 4-year-terms (8 years total)

practicing dental hygienists may provide what services?

1-provides care that is educational, preventative, and therapeutic through observation, assessment, eval, counseling, and therapeutic services to establish and maintain oral health
2-evaluates pt heath status through review of med and dental histories, assesses and plans dh care needs, performs a prophy including complete removal of calc, accretions and stains by scaling, polishing, and performs root planing and debridement
3- administers local and nitrous
4- provides other related services as permitted by rules of the board

DH

A person of GOOD MORAL CHARACTER, who has graduated from a DH PROGRAM accredited by the commission on Dental Accreditation and established in an institution accredited by an agency recognized by the US department of education to offer college-level programs, may apply for licensure

DH program

min of 2 academic years of dental hygiene education

The services provided by a dental hygienist shall not include what?

final diagnosis

all dental hygiene services must be provided under supervision of a licensed dentist. T or F

True

a DH may be employed by a nonprofit organization to preform DH services without the pt first being examined by a licensed DDS if the Dental hygienist….

– has been engaged in active practice of clinical dh for no less than 2400 hours in past 18 mo or a career total of 3,000 hours

-has entered into a collaborative agreement with a licensed DDS that designates authorization for the services provided by dental hygienist

-has documented participation in courses in infection control and med emergencies within each continuing education cycle

– maintains CPR certificate from AHA or American red cross

dental hygiene services authorized to be performed are:

1- oral health promotion
2- removal of deposit and stain from surface of teeth
3- application of topical preventive or prophy agents, including fluoride varnish and pit and fissure sealants
4- polishing and smoothing restorations
5- removal of marginal overhangs
6- performance of preliminary charting
7- taking radiographs
8- performance of SRP
(all under general supervision)

does the dentist need to examine the pt or be present during injection of local anesthesia or nitrous once delegated in collaborative agreement with licensed dds and dh?

no

DH collaborative agreement must include..

1- consideration for med comp pt and med conditions for which dental eval and treatment plan must occur prior to provision of dh services
2- age and procedure specific standard collaborative practice protocols, including recommended intervals for the performance of dh services and a period of time in which an exam by dds should occur
3- copies of consent to treatment form provide to patient by dental hygienist
4- specific protocols for the placement of pit and fissure sealants and requirements for follow up care to assure efficacy of sealants after applications
5- procedure for creating and maintaining dental records for the patients that are treated

collaborative management agreement between a DDS and a DT must include:

1. settings where the DT can serve
2. any practice limitations (DT vrs. ADT) with the level of supervision
3. procedure specific protocalls
4. procedure to maintain dental records
5. a plan to manage medical emergencies
6. quality assurance plan (referral, chart review, follow up care)
7. protocalls for administering and dispensing meds
8. supervision criteria for DAs

dental hygiene consent to treatment must include statement stating that

dh services provided are not a substitute for dental exam by licensed dds

A DT is limited to practicing in settings that serve ______

low income, uninsured, and underserved patients

referal form

for all referrals to pt for further procedures, dh must fill out and provide a copy for collaborating dds

health care facility or nonprofit organizations are limited to: (for collaborative agreement)

hospital, nursing home, home health agency, group home serving elderly, disabled, or juveniles; state-operated facility licensed by commissioner of human services or commissioner of corrections; and federal, state, or local public health facility, community clinic, tribal clinic, schools

what must be on every complete upper and lower denture and removable dental prosthesis?

patients name and social security number

if ssn and pt name on prosthesis is not practicable id should be presented as follows:

– ssn of pt may be omitted if name of pt is shown
-initials of pt must be shown alone if use of pt name is impracticable
– identification marks may be omitted in entirety if none of the forms of id are practicable or clinically safe

do you ID mark older prosthesis without this info?

yes

applicant must submit new background check if more than ____________ has Relapsed since the applicants last submitted background check to the board

1 year

no license issued to any applicant who refuses to consent to a criminal background check or fails to submit fingerprints within __________ after submission of application for licensure

90 days

how long does a person have to challenge accuracy of a report of background check

30 days after they get their report back

how long does the board give the applicant to challenge the accuracy or completeness of the report

180 days

when temp license is suspended, the regulated person shall be provided with at least _______________ notice of any hearing held pursuant to this section

10 days

if the board has not completed its investigation and final order within _________________ days the temp suspension shall be lifted unless the regulated person requests a delay in disciplinary preceedings for any reason

30 days

self-reporting: when should a regulated person who is diagnosed as infected with HIV, HBV, or HCVreport the info to the commissioner

no more than 30 days after learning of the diagnosis or 30 days after becoming licensed or registered by the state

*infection control reporting- a regulated person shall, within _____________, report to the appropriate board personal knowledge of a serious failure or a pattern of failure by another regulated person to comply with accepted and prevailing infection control procedures related to prevention of hiv hbv and hcv transmission

10 days

how long after an infection control report does the designated office have to meet with the board

30 days of receiving report

without hearing, the board may temporarily suspend the right to practice of a regulated person if they find they have refused to submit or comply with monitoring….

infection control

it is unlawful for any person to..

-enable a unlicensed person to practice dentistry
-practice without a license
-not go by his or her own name (and degree)

regulated person shall be provided with at least ________notice of a hearing under temp suspension infection control

20 days

supervising dds requirements

-board-approved MN licensed dds for at least 5 consecutive years
-license shall not be subject to, or pending, corrective or disciplinary action within the previous five years according to NN statutes
– acceptable written agreement between limited licensed dds and supervising dds- may only supervise 1 for duration of agreement- written agreement shall include info acknowledgment that limited dds agrees to practice clinical dentistry at least 1,100 hours annual for a period of 3 consecutive years
-no more than 2 limited licensed dds are allowed to practice gen dentistry under supervision in one facility
-modifications to written agreement must be submitted in writing to board within 7 business days
-supervising dds must inform the board in writing about the termination of a written agreement with a limited dds within 7 business day of termination
-must inform board in writing about any known disciplinary or malpractice proceedings involving the limited dds w/I 7 business days of proceeding
-submit performance eval no earlier than 90 days before completion of limited dds practice period
-disciplinary actions

limited license dds agrees to practice clinical dentistry for at least _________ hours annually, for a period of __________ consecutive years

1,100
3 years

*applicant for dental assisting and DH requires. ..

-application
-copy of diploma or certificate
-submit evidence of satisfactory passing boards state and national boards
-picture
-backround check*******

*DA without license can…

-perform all duties not directly related with performing dental treatment or services on patients
-retract
-assist with the placement or removal of rubber dam and accessories used for its placement and retention as directed by operating dds
-remove debris with suction devices, air, mouthwash, water
-aid dh and licensed da in their duties
-apply fluoride varnish in community setting under licensed dds

*what is biennial term

properly renewed license or permit issued by board valid from first day of month following expiration for 24 months until renewed or terminated according to procedures in this part

*a DT can supervise no more than ____ licensed or non-licensed DAs in any one practice setting

4

*A DT must enter into a __________ with a DDS

collaborative management agreement
(all agreements but be reviewed, signed. updated and submitted to the board EVERY YEAR)

Amount of credit hours each biennial a dentist, specialty, guest full faculty or DT needs.

50

minimum of _____ credit hours for dentists and DT’s of fundamental CE’s

30

maximum of ___credit hours of elective CEs for DT and DDS

20

_ credit hours each biennial cycle for a hygienist and dental assistant; minimum of __ of fundamental and maximum of __ elective

25, 15, 10

A minimum of _ courses must be completed in _ of the core subject areas per biennial cycle

2, 2

Core subjects

Infection control, record keeping, ethics, management of med emergencies, pt communications, diagnosis and treatment planning.

Fundamental

Activities directly related to the provision of clinical dental services

elective

Activities directly related to, or supportive of the practice of dentistry, dental hygiene, or dental assisting

clinical subject

Subjects directly related to the provision of dental care and treatment to pts

core subject

ares of knowledge that relate to public safety and professionalism

acceptable documentation for CE hours

Every form should include: name and location of organization/presenter, contact information and credentials or training that qualifies presenter to teach course, course title, date, hours and subject matter.

*specialty dental practices:

– dental public health
– endodontics
– oral and maxillofacial radiology & pathology
– oral surgery
– ortho
– pediatric dentistry
– periodontics
– prosthodontics

A dental tech and DDS may practice in the same facility but may each have their own practice.

True;

* the DDS is not responsible for the dental tech unless the tech is EMPLOYED by the DDS

*what if a patient stops by and asks the tech for a denture adjustment??
what about for it to be cleaned?

lab tech cannot do either

*how many dental therapists can a dentist have?

5

*a dentist can have a collaborative agreement with no more than ______ DH’s unless authorized by the Board

4

what do you need in order to advertise for sales, construction, reproduction, or repair??
(dental prosthetic appliances)

a written work order from a DDS (good for 2 years)

*non licensed dental assistants:

can be trained ON THE JOB, on site with dentist
duties: retract the cheek, suction, transfer instruments, mix cements, help in sterilization, turn rooms around, set up/tear down, set pts, and walk pts out. (general???)

a DDS is responsible for ensuring that any DA complies with …

– completing a CPR course and maintaining certificate
-compliance with most current infection control guidelines

*limited licensed dental assistants

non licensed but have taken a course in taking RADIOGRAPHS

Sedation

____

Minimal Sedation (Conscious sedation)

-to reduce anxiety — Anxiolysis
-lightest form of sedation
-ex: N2O2, oral meds, or IV sedation (need 12 hours of a course with 3 different “practice cases”)

characterized by moderate impairment to the patient’s cognitive function and coordination, but leaves unaffected the patient’s ventilator and cardiovascular

minimal sedation

Moderate Sedation (still conscious)

relaxed, awake and can still respond
ex: N2O2, oral meds, IV sedation (need 60 hours during an extra course with practice)

Deep sedation (unconscious)

can only be performed by an anesthesiologist or an oral surgeon (need extra schooling)

*means a depressed level of consciousness produced by a pharmacological agent during which the patient cannot be easily aroused but responds purposefully following repeated or painful stimulation

deep sedation

*general anesthesia (unconscious)

for extreme cases of dental care
*oral and maxillofacial surgeons

Infection Control

——

high level disinfection

Elimination of all microorganisms except bacterial spores

decontamination

Removal, inactivation, or destruction of HBV and HIV on a surface or item to the point where HBV and/or HIV are no longer capable of causing infection and the surface or item is rendered safe for barehanded touching, use or disposal.

Disinfection

destroys most pathogenic and other microorganisms by physical or chemical means
-does not ensure the degree of safety associated with sterilization processes
(ex: sanitary wipes used to wipe down the cubicle)

sterilization

destroys all microorganisms, including substantial numbers of resistant bacterial spores, by heat (steam autoclave, dry heat, and unsaturated chemical vapor) or liquid chemical sterilants

*Use surface barriers on ______ to protect, particularly for surfaces that are hard to clean

light switches, radiographic equipment, drawer handles, computers (change barriers between patients) —-still need to use EPA approved wipes to clean after barriers are removed

The _______________ regulates low- and intermediate-level disinfectants that are used on surfaces

Environmental Protection Agency

The ____________ regulates liquid chemical sterilants/high-level disinfectants

Food and Drug Administration

Any disinfectant used in a dental setting should be registered by the ____________ and be approved for use in health care settings

Environmental Protection Agency (EPA)

can you use disinfectant wipes from the grocery store?

no, the are not EPA registered

*what does PPE include?

gloves, masks, gowns, and eye protection

disposal of liquid and human waste (blood)

all liquid and human waste, including floor wash water, must be disposed of through trap drains into a public sanitary sewer system

*what type of gloves should you use?

chemical and puncture resistant gloves
-even for “household cleaning” of the dentist office

use barrier protective coverings as appropriate for noncritical equipment surfaces that are

1) touched frequently with gloved hands during patient care
2) likely to become contaminated with blood or body substances
3) hard to clean (e.g., computer keyboards).

Digital radiography sensors are considered

semicritical (they go inside of patients’ mouths but don’t puncture mucous membranes)
-use a barrier then cleaned with high level disinfectant wipes between patients

what types of FLOORS are NOT recommended

carpeting

*hand pieces and intraoral instruments that can be removed from the air and waterlines of dental units are considered ___

semi-critical
-should be heat sterilized between patients
-do not just wipe them down!!
examples: high-speed, low-speed, electric, endodontic, and surgical handpieces

Dental health care personnel should use water that meets environmental protection agency regulatory standards for drinking water

≤500 colony forming units (CFU)/mL

Can contaminated dental unit waterlines transmit disease?

yes

*DHCP should receive infection prevention training:

1. When they are hired
2. When new procedures affect their occupational exposure
3. Annually
4. According to state or federal requirements

*dental techs must have a work order from the DDS and will keep their work order on infection control for ____ years

2

*training should include:

-A description of their exposure risks
-Review of prevention strategies and infection prevention policies and procedures
-Discussion of how to manage work-related illness and injuries
-Review of work restrictions for the exposure or infection

*The infection prevention coordinator

will be responsible for developing and maintaining a written infection prevention program; monitoring/evaluating the program; and implementing quality improvement measures as needed.

*extracted teeth are infectious and should be disposed in

medical waste containers

(but not if it has amalgam in it) — find out local regulations regarding disposal of amalgam

*can we give patients their teeth after extractions?

yes, it is no longer our responsibility once it is handed over

extracted teeth for educational purposes must be…

-Cleaned so there is no visible blood or debris.
-Kept moist in a simple solution such as water or saline
placed in a container with a secure lid to prevent leaking during transport or storage, and labeled with the biohazard symbol until sterilization
Heat-sterilized to allow for safe handling.

if you get poked by a needle, instrument or were exposed by blood.. you should

1. Wash the site of the needlestick or cut with soap and water.
2. Flush splashes to the nose, mouth, or skin with water.
3. Irrigate eyes with clean water, saline, or sterile irrigants.
4. Report the incident to your supervisor or the person in your practice responsible for managing exposures.
5. Immediately seek medical evaluation from a qualified health care professional1 because, in some cases, postexposure treatment may be recommended and should be started as soon as possible.
6. fill out incident form and submit to board

*OSHA (Occupational Safety and Health Act) requires

employers make hep B vaccine available to all employees who have potential contact w/ blood or OPIM (other potentially infectious materials)

*What employees need Hep B vaccination?

any employee that has potential for contact with blood

Every dental office needs to have a written exposure plan; written policies and procedures for prompt reporting, evaluation, counsel, tx. and follow-up to occupational exposures. T/F

True

*Exposure training should include:

1) Description of their exposure risks
2) Review of prevention strategies & infection control policies/procedures
3) Discussion regarding how to manage work related illnesses and injuries
4) Review of work restrictions for the exposure/infection

*When to wash hands:

-before treating a patient
-before gloves are put on
-right after gloves are taken off
-after treating a patient

Fingernails should be kept SHORT; Artificial nails carry greater ______ and are implicated in fungal and bacterial infections

gram negative organisms

when should your eyewear be cleaned?

between every patient and after your last patient at the end of the day

*A surgical mask that covers both the nose and mouth and protective eye wear w/ solid side shields (or a face shield) should be worn by DHCP
T/F

true

when should you change your mask?

-when it becomes wet or visibly soiled
-between patients
-every 3 hours

*destruction of most bacteria, some viruses, and fungi( but not mycrobaterium tuberculosis or bacterial spores) -through the exposure to a chemical registered with EPA as hospital disinfectant but with —-no label claim for tuberculdcidal

low level disinfection

*destruction of mycobacterium tuberculosis, vegetative bacteria, most viruses and fungi (not bacterial spores) through exposure to a chemical registered with EPA hospital disinfectant WITH label claim for tubercluocidal activity

intermediate level disinfection

means the destruction of all forms of microbial life except high numbers of bacterial spores through exposure to a chemical registered with enviormental protection agency “sterilant”

high level disinfection

T/F: Change protective clothing when it becomes visibly soiled as soon as feasible if penetrated by blood or saliva

true

*When should you change gloves?

between patients, and when they become torn or punctured

critical items

penetrate soft tissue or bone; GREATEST risk of transmitting infection and needs to be sterilized by HEAT
(hand instruments, ultrasonic)

Semi critical items

contact mucous membranes but don’t penetrate
**high level disinfectant required
**sterilization by heat still recommended
(dental mirror, impression trays)

non-critical items

pose least risk for transmission of infection
-contacts skin only
**disinfection with EPA registered wipes
(blood pressure cuff, dental chair, etc.)

*chemical indicators

indicator tape: does NOT prove sterile
(ex: brown colored tag after heat sterilization on outside of instrument case)

*biological indicators

spore testing assess by killing highly resistant microbes
-best way to tell if sterilizing equipment is working properly
-MUST be performed WEEKLY

dirty uniforms and lab coats should be _____ at the location where they were used

bagged
–must be handled as little as possible
–must not be sorted or rinsed

if spore test comes back positive….

indicated that the sterilizer is not working properly and items are NOT sterile
-needs to be corrected and temporarily be out of service

T/F
a tooth with an amalgam filling in it is considered hazardous waste only

false: hazardous and infectious

autoclaving =

sterilizing
-destroy all microbes

what testing should be available to all DHCW for those concerned that they may be infected by HIV

serologic testing

how should the amalgam scrap be stored and handled

stored in a closed unbreakable container labled ” hazardous “contains mercury” and should be recycled

website for more info on infection control

https://www.cdc.gov/oralhealth/infectioncontrol/questions/

Record Keeping

—-

*Dental records must include

– pt’s name, address, DOB
– if minor, need parent’s name
– name and telephone number of contact person
– name of insurance and ID number if applicable
– patient’s reason for visit
– dental and medical history
– clinical exam
– diagnosis and treatment plan
– informed consent
– progress note

*informed consent consists of…

giving options
benefits
risks
cost
patient’s approval (signature)

*correction of records

notations must be legible, written in ink, no erasures or white outs
-if incorrect info is on paper, must cross out with one line and initialed

*transfer of records

digital Xrays must be transfered by compact or optical disc, electric communication, or printed on high quality photographic paper
-need diagnostic quality using proper exposure settings

* T/F: as a request of patient, records must be transferred, even if their bill hasn’t been paid

True

*when electronic records are kept, a dentist must keep either a _____________ or use an _____________

duplicate hard copy
unalterable electronic record

*adults records must be kept for _____ years beyond last time they were seen

7

A minor (child) records must be kept for ____ years beyond the age of 18

7

*can the dentist charge a patient a fee for transferring records?

yes.

should original X-rays or forms be sent if requested??

No, NEVER. diagnostic duplicate X-rays and records must be copied and sent

who decides the max. fee a DDS can charge?

Minnesota Department of Health

the provider can charge for copies of records

no more than 75 cents per page AND $10 charge for time spent

When a pt requests a copy of the pt’s record for purposes of reviewing current medical care

the provider must not charge a fee

means an accumulation of written documentation of professional development activites

portfolio

each licensee must establish a portfolio for the purpose of:

-record professional development activities
-monitor CE
-retain acceptable documentaion of professional activities
-CPR certificate

Ethics

if a dental therapist, dental hygienist,or a dental assistant performs a services not authorized by the dentist, that behavior is called

conduct of unbecoming a licensee

failure to cooperate with the minnesota board dentistry is considered which of the following

conduct unbecoming a licensee

fraud upon a patient’s or third party payers is called

conduct unbecoming

violation of any statues of the dental practice act shall be guilty of ______ ______

gross misdamenor

what is the common tort liability in dentistry

negligence

what concept is demonstrated in the philosophy that all patients should recieve the same quality of dental care?

justice

what is the term for voluntary standards for behavior established by a professor

code of ethics

what does DHCP stand for

dental health care personal

which of the following is elected position on the minnesota board of dentistry?
-public board member
-executive director
-secretary
-dentist

secretary

if a licnesed dental professional fails to report the habitual use of drugs and alcohol by their employing dentist, the licnesed dental professions shall be subject to which of the following?
a. civil penalties
b. censure
c. tort liability
d. discrimination

a. civil penalties

for a dental therapist to become an advanced dental therpist, the dental therapist must complete how many hours of dental therapy clinical practice?

2000 hours

*a professional firm must submit a _________ to the board of dentistry?

annual report

*________ would be considered an elective professional development activity?

dental management practice course

* a course in treatment planning and diagnosis
all applicants for licensure in mn must do which of the following if they fail the clinical examination or the licensure exam twice as specified by board rule

get more education and training

*which of the following would be considered a fundamental professional development activity

a course in treatment planning and diagnosis

_________ means a corporation, partnership, sole proprietor, or business enity engaged in the manufacturer or repair of dental prosthetic appliances

dental laboratory

*To administer general anesthesia, a dentist must complete what?

1 year residency

*T/F OSHA aims to protect the providers/clinicians and CDC aims to protect all patients

true

TERMS


person
includes an individual, corporation, partnership, or any other legal entity

state
when used in reference to a state other than MN, means any other state of the U.S., District of Columbia, and the Commonwealth of Puerto Rico

CODA stands for
Commission on Dental Accreditation

Dental health care personnel (DHCP)
individuals who work in a dental practice who may be exposed to body fluids such as blood or saliva

assistant
any person who assists a dentist in carrying out the basic duties of a dental office

health care facility, program, or nonprofit organization includes
hospital; nursing home; home health agency; group home serving the elderly, disabled, or juveniles; state operated facility licensed by the commissioner of human health services or the commissioner of corrections; federal, state, or local public health facility, community clinic, tribal clinic, school authority, head start program, or nonprofit organization that saves individuals who are uninsured or who are MN health care public program recipients

General supervision
The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises

Indirect supervision
The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel

Direct supervision
The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel

Personal Supervision
The dentist is personally operating on a patient and authorizes the allied dental personnel to aid in treatment by concurrently performing supportive procedures

Public health supervision
A type of supervision in which a licensed dental hygienist may provide dental hygiene services, as specified by state law or regulations, when such services are provided as part of an organized community program in various public health settings, as designated by state law, and with general oversight of such programs by a licensed dentist designated by the state

Medical emergency
Medically necessary care which is immediately needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, or prevent placing the physical or mental health of the patient in serious injury

Patient
A natural person who has received healthcare services from a provider for the treatment or examination of a medical, psychiatric, or mental condition, the surviving spouse & parents of a deceased patient or a person that the patient appoints in writing as a representative

for minors: patient includes a parent or guardian or a person acting as a parent or guardian in the absence of a parent or guardian

analgesia
the diminution or elimination of pain as a result of the administration of an agent including but not limited to local anesthesia, nitrous oxide, & pharmacological & nonpharmalogical methods

anxiolysis/minimal sedation
has to do w/sedation; a relaxed state & usually the patient is awake; patient can follow directions or answer questions

Deep sedation
a depressed level of consciousness produced by a pharmacological or nonpharmological method or a combination of both during which patients can’t be easily aroused but respond purposefully following repeated or painful stimulation; characterized by impairment of the patients ability to independently maintain ventilatory function, spontaneous ventilation potentially being inadequate to meet a patients needs & the need for assistance in maintaining a patients airway; patients cardiovascular function doesn’t typically require assistance

Enteral
A technique of administration in which the agent is ABSORBED through the gastrointestinal tract or oral mucosa such as w/ oral, rectal, or sublingual administration

General anesthesia
An induced state of unconsciousness produced by a pharmacological or nonpharmacological method or combination during which patients are not arousable even by painful stimulation; characterized by the frequent impairment of the patient’s need for assistance in maintaining a patent airway, the need for (+) pressure ventilation due to depressed spontaneous ventilation or drug induced depression of neuromuscular function, & potential impairment of cardiovascular function

Inhalation
A technique of administration in which the gaseous or volatile is introduced into the pulmonary tree & whose primary effect is due to absorption through the pulmonary bed

minimal sedation
a minimally depressed level of consciousness produced by a pharmacological or nonpharmalogical method that retains the patients ability to independently & continuously maintain an airway & respond normally to tactile stimulation & verbal command; characterized by moderate impairment to the patients cognitive function & coordination but leaves unaffected the patients ventilatory & cardiovascular functions

nitrous oxide inhalation analgesia
the administration by inhalation of a combination of nitrous oxide & oxygen producing an altered level of consciousness that retains the patients ability to independently & continuously maintain an airway & respond appropriately to physical stimulation or verbal command

parenteral
a technique of administration in which the drug bypasses the gastrointestinal tract such as w/intramuscular, intravenous, intranasal, submucosal, subcutaneous, or intraocular administration

transdermal/transmucosal
technique of administration in which the drug is administered by a patch or iontophoresis

Another term for general anesthesia is
deep sedation

pediatric advanced life support (PALS)
an advanced life support educational course for the pediatric health care provider that teaches the current certification standards of the American academy of pediatrics or the American heart association; PALS certificate must be obtained through the American heart association

Advanced cardiac life support (ACLS)
an advanced educational course for a health care provider that teaches a detailed medical protocol for the provision of life saving cardiac care in settings ranging from the prehospital environment to the hospital setting

ACLS course must include
1) advanced airway management skills
2) cardiac drug usage
3) defibrillation
4) arrhythmia interpretation
****certificate must be obtained through the American Heart Association

CPR training for dental professionals must include
~AED training/operation
~Barrier mask or bag for ventilation training
~Foreign body airway obstruction
~Two person rescuer for adult, child, & infant
~Adult, child, and infant CPR

***course must be obtained through the American heart association health care provider course or the American Red Cross professional rescuer course

initial license term
valid from the date issued until the last day of the licensee’s birth month in either the following even numbered year for an even numbered birthdate year or the following odd numbered year for an odd numbered birthdate

biennial term
a properly renewed license or permit issued by the board is valid from the 1st day of the month following expiration for 24 months until renewed or terminated

DUTIES/SCOPE OF PRACTICE (56% of exam)


T/F a patients oxygen levels always need to be monitored w/any type of sedation
true; record in patient chart!

scaling
removal of calculus deposits from the teeth

etching
roughing up the tooth surface chemically so that bond material adheres (think of the process of placing sealants)

Dentist
a person of good moral character who has graduated from a dental program accredited by CODA

T/F it would be acceptable for a dentist to treat an emergency patient who is not their regular patient & who regularly saw a different dentist
true

Licensed dental practice (general duties/scope of practice-broad definition; not specific)
~uses a dental degree or designation & the person is able to diagnose, treat, prescribe or operate for any disease, pain, deformity, injury, or physical condition of the human tooth, teeth, alveolar process, gums or jaw or adjacent structures
~manager, proprietor, operator, or conductor of a place where dental operations are performed
~performs dental operations of any kind
~uses a roentgen or x-ray machine for dental treatment or diagnostic purposes
~extracts a human tooth/teeth or corrects or attempts to correct malpositions of the human teeth or jaw
~offers & undertakes by any means or methods to diagnose, treat, or remove stains or accretions from human teeth or jaw
~takes impressions or performs any phase of any operation incident to replace part of a tooth or the whole tooth or teeth or associated tissues by means of a filling, crown, bridge, inlay, or onlay
~furnishes, supplies, constructs, reproduces, repairs, or offers to furnish, supply, construct, reproduce, or repair prosthetic dentures, plates, bridges, or other substitutes for natural teeth
~performs any clinical operation included in the curricula of recognized dental schools or colleges

resident dentist
a person who is a graduate of a dental school & is an enrolled graduate student or student of an advanced dental education program & isn’t licensed to practice dentistry in MN

requirements/scope of practice of a resident dentist
~obtain from the board a license to practice dentistry as a resident dentist (must be designated “resident license dentist”)
~authorizes the licensee to practice dentistry only under the supervision of a licensed dentist
~license must be renewed annually

does a resident dentist license qualify a person for licensure?
no

Resident dental provider scope of practice
~License is to practice as a resident hygienist or DT & license must be designated “resident dental provider license”
~licensee can only practice under the supervision of a licensed dentist or DT

DT
a person of good moral character who has graduated w/a bachelor or masters degree from a dental therapy education program that has been approved by the board per accredited by CODA or another board approved national accreditation organization

Practice of Dental therapy (DT)
1) works under the supervision of a MN licensed dentist under a collaborative management agreement
2) practices in settings that serve low income, uninsured, & underserved patients or are located in dental health professional shortage areas
3) provides oral health care services including oral evaluation & assessment; educational, palliative, therapeutic, & restorative services within the context of the collaborative management agreement

DH
a person of good moral character who has graduated from a dental hygiene program (must be a minimum of 2 years) accredited by CODA & established by the U.S. department of education to offer college level programs

Practice of Dental Hygienists
1) provide care that’s educational, preventative, & therapeutic through observation, assessment, evaluation, counseling, and therapeutic services to establish & maintain oral health
2) evaluates patient health status through review of medical & dental histories, assess & plans dental hygiene care needs, performs a prophylaxis including complete removal of calculus deposits, accretions, & stains by scaling, polishing, & performs root planing & debridement
3)administers local anesthesia & nitrous oxide inhalation analgesia
4) provides other services as permitted by rules of the board

Exemptions/exceptions to the practice of dentistry
1) dentist or DH in any branch of the armed services of the U.S., the U.S. public health service, or the U.S. veterans administration
2) any dental students attending an accredited school by the Commission on Dental Accreditation (CODA)when acting under indirect supervision of a MN licensed dentist & under instruction of a licensed dentist, DT, DH, or DA
3) practice of licensees from other states or countries while appearing as clinicians under the auspices of a duly approved dental school/college o a reputable dental society/club
4) people taking exams for licensure administered or approved by the board
5) dentists & DH licensed by the states during their functioning as examiners responsible for conducting licensing exams
6) use of x-rays or other diagnostic imaging modalities from making radiographs or other similar records in a hospital under the supervision of a physician or dentist or someone accredited in diagnostic imaging
7) those under a written work order by a DDS or ADT to construct, alter, repair, or duplicate a denture, partial dentures, crown, bridge, splint, ortho, prosthetic or other dental appliance

DA
a person of good moral character who has graduated from a dental assisting program accredited by CODA

T/F a DA can take scans for Invisalign under indirect supervision
True

who has the authority to administer influenza vaccines
the dentist

what is the limitations on a dentist administering the flu vaccine
can only be administered to patients 19 & older

what are the requirements/regulations for dentists administering the flu vaccine
1) immediate access to emergency response equipment (must include oxygen, epinephrine, & other allergic rxn response equipment)
2) trained or have successfully completed a program approved by the MN Board of Dentistry in administration of vaccines
3) must comply with guidelines established by the federal advisory committee on immunization practices relating to vaccines
4) after dentist has administered, must report the administration of the immunization to the MN immunization information connection or notify the patients primary physician or clinic

what must the training for administering immunizations include
1) education material on the disease and vaccination as a method of disease prevention
2) contraindications & precautions
3) intramuscular administration
4) communication of risks & benefits; legal requirements
5) reporting of adverse events
6) documentation required by federal law
7) storage & handling of vaccines

what must a faculty member who practices dentistry before beginning duties in a school of dentistry or dental program do?
apply for a limited or full faculty license

Can a faculty dentist practice dentistry if they’re not licensed?
no

how long is a faculty license valid
during the time the holder remains a faculty member at a dental school or within a dental program

limited faculty dental license
entitles the holder to practice dentistry within the school & its affiliated teaching facilities but ONLY for the purposes of teaching or conducting research (unless the dentist was a faculty member on Aug 1, 1993)

a limited faculty license must be renewed
Annually

full faculty dental license
entitles the holder to practice dentistry w/in the school & its affiliated teaching facilities & elsewhere if the license holder is employed 50% or more by the school in the practice of teaching or research & upon successful review by the board of the applicants qualifications

a full faculty license must be renewed
Biennially

speciality dentists
the board may grant 1 or more specialty licenses in the areas of speciality defined by the board; limited to practice in their specialty as designated by their specialty license

applicants for a specialty license must
1) successfully completed a postdoctoral specialty program accredited by CODA or announced a limitation of practice before 1967
2) have been certified by a specialty board approved by the MN board of dentistry or provide evidence of passing a clinical exam for licensure required in another state or Canada; oral & maxillofacial surgeons must have a MN medical license in good standing
3) been in active practice or a postdoctoral educational program or U.S. government service AT LEAST 2,000 HRS IN THE 36 MONTHS PRIOR TO APPLYING
4) be interviewed by board committee (if requested)
5) present complete records of sample patients treated by the applicant (SAMPLE MUST BE DRAWN FROM PATIENTS TREATED DURING THE 36 MONTHS PRIOR TO APPLICATION; if requested)
6) pass board approved English proficiency test if English is not the applicants primary language
7) pass all components of the national board dental exams
8) pass MN jurisprudence exam
9) abide by professional ethical conduct requirements
10) meet all other requirements specified by the board

T/F an applicant applying for a specialty license in oral & maxillofacial surgery must have a MN medical license in good standing
true

specialty dentist application requirements
1) completed app from the board
2) at least 2 character references from 2 different dentists for each specialty area (1 from a dentist practicing in same specialty area & 1 from the director of each specialty program attended)
3) a licensed physicians statement attesting to the applicants physical & mental condition
4) statement from licensed ophthalmologist or optometrist attesting to applicants visual accuracy
5) app fee
6) notarized, unmounted passport type photo (3×3) taken not more than 6 months before the date of application

what happens to a specialty dentist if the dentist has announced a limitation of practice?
a specialty dentist holding a general dentist license is limited to practicing in the dentists specialty area(s)

Guest license
Allows a dentist, DH, or DA to practice in MN if licensee holds a dental license in another state

Guest license granting conditions
1) currently licensed from another state & in good standing
2) currently practicing in another state
3) practice is limited to a public health setting in MN approved by the board
4) agrees to treat indigent patients who meet eligibility criteria determined by the clinic
5) licensee has applied & paid fee not more than $75

When do guest licenses need to be renewed
Annually; license expires on Dec. 31 of each year

Are guest licensees subject to the same rules as those holding a license in MN
Yes

What happens if a guest license gets revoked
The MN board of dentistry reports it to the licensees regulatory state board

Guest license for voluntary purposes
~licensee must hold a license to practice in another state
~licensee may not receive compensation
~licensee will provide care to patients who have difficulty accessing care
~subject to state laws regarding dental care & scope of practice

guest license for voluntary purposes limitations
~licensee can only provide dental care services not to exceed 10 days in a calendar year
~expire on dec 31 of each year

Emeritus applies to
Retirees & allows them to retain their title

Who can apply for an emeritus active license?
A person licensed to practice dentistry, DT, DH, or DA if the person is retired from practice, in compliance w/board requirements, & not the subject of current disciplinary action

Emeritus active licensee scope of practice
~pro Bono or volunteer dental practice
~paid practice not to exceed 500 hrs per calendar year for the exclusive purpose of providing licensing supervision to meet the board’s requirements
~not held out as a full licensee

The services provided by a DH shall not include _____ & must be provided under the supervision of a licensed dentist
final diagnosis or treatment plan

Requirements for DA’s & DH’s to perform restorative procedures
1) completion of board approved course on restorative procedures
2) course includes a component that sufficiently prepares the licensed DA or DH to adjust the occlusion on the newly placed restoration
3) a licensed dentist or licensed ADT has authorized the procedure
4) licensed dentist or licensed ADT is in the clinic while procedure is being performed (indirect supervision)
5) faculty who taught course must have prior experience in teaching these procedures in an accredited dental education program

restorative procedures for DA & DH under indirect supervision
1) place, contour, & adjust amalgam restorations
2) place, contour, & adjust glass ionomer
3) adapt & cement stainless steel crowns
4) place, contour, & adjust class I, II, & V supra gingival composite restorations on primary & permanent dentition

DT’s are limited to practicing in
settings that serve low income, uninsured, and undeserved patients or in a healthcare shortage area

DT scope of practice (general supervision)
1) oral health instruction & disease prevention education including nutritional counseling & dietary analysis
2) preliminary charting of the oral cavity
3) making radiographs
4) mechanical polishing
5) application of topical preventative or prophylactic agents including fluoride varnishes & pit & fissure sealants
6) pulp vitality testing
7) application of desensitizing medication or resin
8) fabrication of athletic mouthguards
9) placement of temporary restorations
10) fabrication of soft occlusal guards
11) tissue condition & soft reline
12) atraumatic restorative therapy
13) dressing changes
14) tooth reimplementation
15) administration of local anesthetic
16) administration of nitrous oxide

DT scope of practice (indirect supervision)
1) emergency palliative treatment of dental pain
2) placement & removal of space maintainers
3) cavity prep
4) restoration of primary & permanent teeth
5) placement of temporary crowns
6) prep & placement of preformed crowns
7) pulptomies of primary teeth
8) indirect & direct pulp capping on primary & permanent teeth
9) stabilization of reimplemented teeth
10) extractions of primary teeth
11) suture removal
12) brush biopsy
13) repair of defective prosthetic devices
14) recementing of permanent crowns

What drugs can a DT dispense under a collaborative management agreement with a dentist?
analgesics, anti-inflammatories, & antibiotics

T/F a licensed DT can dispense or administer narcotic drugs
false

ADT certification requirements
1) complete a DT education program
2) pass an exam to demonstrate competency under the DT scope of practice
3) be a licensed DT
4) complete 2,000 hrs of DT clinical practice under direct or indirect supervision
5) graduate from a masters ADT program
6) pass a board approved certification exam to demonstrate competency under ADT scope of practice
7) submit app & fee

What distinguishes an ADT’s scope of practice from a DT’s scope of practice?
An ADT can
1)conduct an oral evaluation & assessment of dental disease & the formation of an individualized treatment plan authorized by the collaborating dentist (general supervision)
2) perform nonsurgical extractions of periodontally diseased permanent teeth w/ tooth mobility of +3 to +4 if authorized in advance by the dentist
3) can administer & dispense analgesics, anti inflammatories, & antibiotics including the authority to dispense sample drugs

(of course, the ADT can perform the same duties as a DT as well)

T/F A ADT can extract a tooth for any patient if the patient if the tooth is unerupted, impacted, fractured, or needs to be sectioned for removal
false

What is required of licensees who have the authority to prescribe opioids and other controlled substances?
licensees must obtain at least 2 hrs of continuing education credit during each renewal period on best practices in prescribing opioids & controlled substances including nonpharmalogical & implamentable device alternatives for treatment of pain & ongoing pain management

T/F A DT, DH, or LDA can administer general anesthesia, deep sedation, moderate sedation, or minimal sedation
false

general anesthesia or deep sedation educational training requirements
1) a didactic & clinical program at a board accredited dental school, hospital, or graduate medical or dental program resulting in the dentist becoming clinically competent in the administration of general anesthesia (program must be equivalent to a program for advanced specialty education in oral & maxillofacial surgery) OR a 1 yr residency in general anesthesia at an institution certified by the American society of anesthesiology, the American medical association, or the joint commission on hospital accreditation resulting in the dentist becoming clinically competent in the administration of general anesthesia (residency must include a minimum of 390 hrs of didactic study, 1,040 hrs of clinical anesthesiology, & 260 cases of administration of anesthesia to an ambulatory outpatient)
2) ACLS or PALS course w/ continued certification
3) CPR certification w/continued certification

what must a dentist who administers general anesthesia/deep sedation or moderate sedation be prepared & competent to do?
diagnose, resolve, & reasonably prevent any untoward reaction or medical emergency that may develop any time after the administration. Dentist shall apply current standard of care to continuously monitor & evaluate a patients bp, pulse, respiratory function (requires the monitoring of tissue oxygenation or the use of a superior method of monitoring), & cardiac activity

How should a dentist administer general anesthesia/deep sedation or moderate sedation?
only by the application of the appropriate systems & drugs for the delivery of general anesthesia/deep sedation

T/F Prior to the discharge of a patient under general anesthesia/deep sedation or moderate sedation, a dentist must assess the patient to ensure the patient is no longer at risk for cardiorespiratory depression
true

T/F A patient who was given general anesthesia/deep sedation or moderate sedation is able to take care of themselves after discharge
false; a patient must be discharged into the care of a responsible adult

moderate sedation educational training requirements
1) a course resulting in the dentist becoming clinically competent to administer moderate sedation & documentation from the instructor on successful completion to be submitted to the board
***must include a minimum of 60 hrs of didactic education in bother enteral & parenteral administration; personally administering & managing at least 10 individual supervised cases of parenteral moderate sedation (max of 5 cases can be performed on a patient simulated manikin)
2) ACLS or PALS course w/continued certification
3) CPR certification w/continued certification

What is required of dentists, DT, DH, & LDA to administer nitrous oxide inhalation analgesia?
~CPR certification & continued certification
~must only use fail-safe anesthesia equipment capable of (+) pressure respiration
~satisfactory completion of a course on the administration of nitrous oxide inhalation analgesia from a board accredited institution & submit original documentation to the board
***must be a minimum of 12 hrs of didactic instruction; personally administering & managing at least 3 individual supervised cases of analgesia; supervised clinical experience using fail safe anesthesia equipment capable of (+) pressure respiration

What is required of DT, DH, & LDA to administer nitrous oxide inhalation analgesia
~must be under the appropriate level of supervision by a dentist who is currently licensed & can administer nitrous oxide inhalation analgesia

Does a dentist who is administrating general anesthesia/deep sedation, moderate sedation, or nitrous oxide inhalation analgesia need to inform the board?
yes

Can DH & LDA graduates prior to Sept. 2, 2004 administer nitrous oxide inhalation analgesia?
yes but they must inform the board & provide the board w/ the name, address, & phone number of the accredited dental school/program in which they graduated; current CPR certification w/continued certification

Can DT graduates prior to Aug. 1, 2013 administer nitrous oxide inhalation analgesia?
yes but they must inform the board & provide the board w/ the name, address, & phone number of the accredited dental school/program in which they graduated; current CPR certification w/continued certification

who can administer analgesia
a dentist who is currently licensed to practice dentistry in MN

who can administer minimal sedation
a dentist who is currently licensed to practice dentistry in MN

When must a dentist, DT, DH, or LDA report to the board of any incident that arises from the administration of nitrous oxide inhalation analgesia, general sedation/deep sedation, moderate sedation, local anesthesia, analgesia, or minimal sedation?
~a serious or unusual outcome that produces a temporary or permanent physiological injury, harm, or other detrimental effect to 1 or more of a patients body systems
~minimal sedation unintentionally becoming moderate sedation or deep sedation/general anesthesia when the licensee doesn’t have a certificate for administering general anesthesia or moderate sedation

how long does a dentist, DT, DH, or LDA have to report to the board of any incident that arises from the administration of nitrous oxide inhalation analgesia, general sedation/deep sedation, moderate sedation, local anesthesia, analgesia, or minimal sedation?
with/in 10 business days of the incident

T/F a dentist can not administer general anesthesia/deep sedation or moderate sedation unless the dentist possess a general anesthesia or moderate sedation certificate from the board
true

general anesthesia certificate from the board
authorizes a dentists to administer general anesthesia/deep sedation, moderate sedation, or to provide dental services to patients under general anesthesia/deep sedation or moderate sedation when a dentist employs or contracts another licensed health care professional w/ the qualified training & legal qualification to administer moderate sedation

moderate sedation certificate from the board
authorizes a dentists to administer moderate sedation, or to provide dental services to patients under moderate sedation when a dentist employs or contracts another licensed health care professional w/ the qualified training & legal qualification to administer moderate sedation

Application requirements for an initial general anesthesia or moderate sedation certificate
~application & fee
~info on office facilities
~support staff training
~emergency protocols
~monitoring equipment
~record keeping procedures

T/F a dentist is not required to possess an additional certificate for deep or moderate sedation if they have a valid certificate for general anesthesi
true

T/F a dentist does not need to undergo an inspection as part of the general anesthesia or moderate sedation certificate application
false

T/F a dentist can administer general anesthesia, deep sedation, or moderate sedation after their certificate expires
false

How long does a dentist have to renew their general anesthesia or moderate sedation certificate before it’s terminated by the board
60 days

T/F a certificate issued by the board must be conspicuously displayed in plain site of patients in every office in which the dentist administers general anesthesia, deep sedation, or moderate sedation
true

T/F a dentist shall not provide dental services to a patient who is under general anesthesia, deep sedation, or moderate at any location other than a hospital unless the dentist possesses the applicable contracted sedation provider certificate issued by the board
true

specialty areas in dentistry include
1) dental public health
2) endodontics (endodontist)
3) oral & maxillofacial pathology (oral pathologist)
4) oral & maxillofacial radiology (oral radiologist)
5) oral & maxillofacial surgery (oral surgeon/oral maxillofacial surgeon)
6) orthodontics & dent-facial orthopedics (orthodontist)
7) pediatric dentistry (pediatric dentist/pedodontist)
8) periodontics (periodontist)
9) prosthodontics (prosthodontist)

T/F in order for a licensed dentist to advertise a speciality area, they must have completed an accredited postdoctoral course of study in the specialty area in which they advertise
true

unlicensed dental assistant duties (all)
~perform all duties not directly related w/performing dental treatment or services on patients
~retract during a dental operation
~assist w/placement or removal of a rubber dam & accessories as directed by an operating dentist
~remove debris by the use of vacuum devices, compressed air, mouthwash, & water that’s normally accumulated during the course of treatment rendered by the licensed dentist
~provide any assistance including the placement of articles & topical medication in a patients oral cavort in response to a specific direction bu a licensed dentist who is able to provide PERSONAL supervision
~aid LDA & DH in their duties
~apply fluoride varnish in a community setting under the authorization & direction of a licensed practitioner as long as the community setting maintains appropriate patient records of treatment

LDA delegated duties (all)
GENERAL SUPERVISION
~cut arch wires on ortho appliances
~remove loose bands on ortho appliances
~remove loose brackets on ortho appliances
~recement intact temporary restorations
~place temporary fillings (NOT including inlays, inlays, crowns, or bridges)
~take radiographs
~take impressions & bite registrations
~deliver vacuum formed ortho retainers
~place & remove elastic ortho separators
~complete preliminary charting of the oral cavity & surrounding structures NOT periodontal probing & assessment of periodontal structures
~take extraoral & intraoral photos
~take vital signs as directed by a dentist
~obtain informed consent
~remove & place ligature ties & remove & replace existing arch wires on ortho appliances
~Apply topical fluoride, including foam, gel, or varnish

INDIRECT SUPERVISION
~apply topical medications including bleaching agents & cavity varnishes
~place & remove rubber dam
~remove excess cement from inlays, crowns, bridges, & ortho appliances w HAND INSTRUMENTS ONLY
~perform mechanical polishing to clinical crowns NOT INCLUDING INSTRUMENTATION (removal of calculus by instrumentation must be done by a dentist or DH prior to polishing)
~preselect ortho bands
~place & remove periodontal dressings
~remove sutures
~monitor a patient who has been induced by a dentist into nitrous oxide inhalation analgesia
~place initial arch wires on ortho appliances
~dry root canals w/paper points
~place cotton pellets & temporary restorative materials into endodontic access openings
~etch appropriate enamel surfaces; apply & adjust pit & fissure sealants (must have completed a course on pit & fissure sealants from an accredited school)
~restorative procedures if completed a board approved course on specific procedure includes:
-place, contour, & adjust amalgam restorations
-place, contour, & adjust glass ionomer
-adapt & cement stainless steel crowns
-place, contour, & adjust class I, II, & V supragingival composite restorations on primary & permanent teeth
~maintain & remove intravenous lines (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
~monitor a patient during preop, intraop, & postop phases of general anesthesia or moderate sedation using noninvasive instrumentation such as pulse oximeters, electrocardiograms, bp monitors, & capnography (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)

DIRECT SUPERVISION
~remove access bond material from ortho appliances
~remove bond material from teeth w/rotary instruments after removal of ortho appliances (must have completed a board approved course in the use of rotary instruments for the express purpose of the removal of bond material from teeth)
~etch appropriate enamel surfaces before bonding of ortho appliances by a dentist
~fabricate, cement, & adjust temporary restorations intraorally or extraorally
~remove temporary restorations w/HAND INSTRUMENTS ONLY
~place & remove matrix bands
~administer nitrous oxide inhalation analgesia
~attach prefit & preadjusted ortho appliances remove fixed ortho bands & brackets
~initiate & place an intravenous line in preparation for intravenous medications & sedation for a dentist who holds a certificate in general anesthesia or moderate sedation (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
~place nonsurgical retraction material for gingival displacement (must have completed a board approved course in nonsurgical retraction material for gingival displacement)

PERSONAL SUPERVISION
~if the dentist holds a certificate in general anesthesia or moderate sedation & is personally treating a patient, an LDA can aid in the physical management of medications including the preparation & administration of medications into an existing intravenous line (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)

limited license dental assistant permit delegated duty
can take dental radiographs under general supervision if completed a board approved course & passing exam in radiographs

DH delegated duties (all)
****for a DH to perform ortho duties, must either have graduated a DH program prior to Sept. 1, 2019 or if graduated after Sept. 1, 2019 DH program must also have included training in Ortho procedures & received a Ortho procedure certificate from school or successfully completed a board approved course in ortho procedures & received certificate from course sponsor!

GENERAL SUPERVISION
~complete preliminary charting of the oral cavity & surrounding structures including case histories, initial & periodic exams & assessments to determine periodontal status; creation of a DH treatment plan in coordination w/dentists treatment plan
~take extraoral & intraoral photos
~take vital signs as directed by a dentist
~obtain informed consent
~make referrals to dentists, physicians, & other practitioners in consultation w/ the dentist
~complete debridement, prophylaxis, & nonsurgical periodontal therapy
~etch appropriate enamel surfaces; apply & adjust pit & fissure sealants
~administer local anesthesia (must have completed a didactic & clinical program sponsored by an accredited dental or DH school & results in the DH becoming clinically competent)
~administer nitrous oxide inhalation analgesia
~take radiographs
~apply topical medications including topical fluoride, bleaching agents, cavity varnishes, & desensitizing agents
~place sub gingival medicaments
~fabrication & delivery of custom fitted trays
~nutritional counseling
~salivary analysis
~remove marginal overhangs
~remove sutures
~place & remove periodontal dressings
~place & remove isolation devices or materials for restorative purposes
~polish restorations
~remove excess cement from inlays, onlays, crowns, bridges, or ortho appliances
~fabrication, placement, replacement, cementation, & adjustment of temporary crowns or restorations
~remove temporary crowns or restorations w/ HAND INSTRUMENTS ONLY
~place & remove matrix systems & wedges
~place nonsurgical retraction material for gingival displacement (must have completed a board approved course in nonsurgical retraction material for gingival displacement)
~cut arch wires on ortho appliances
~remove loose bands on ortho appliances
~remove loose brackets on ortho appliances
~remove access bond material from ortho appliances
~preselect ortho bands
~place & remove elastic ortho separators
~remove & place ligature ties & remove & replace existing arch wires on ortho appliances
~deliver vacuum formed ortho retainers

INDIRECT SUPERVISON
~restorative procedures if completed a board approved course on specific procedure includes:
-place, contour, & adjust amalgam restorations
-place, contour, & adjust glass ionomer
-adapt & cement stainless steel crowns
-place, contour, & adjust class I, II, & V supragingival composite restorations on primary & permanent teeth
~place initial arch wires on ortho appliances
~maintain & remove intravenous lines (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
~monitor a patient during preop, intraop, & postop phases of general anesthesia or moderate sedation using noninvasive instrumentation such as pulse oximeters, electrocardiograms, bp monitors, & capnography (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)

DIRECT SUPERVISION
~etch appropriate enamel surfaces before bonding of ortho appliances by a dentist
~remove bond material from teeth w/rotary instruments after removal of ortho appliances
~attach prefit & prefitted ortho appliances
~remove fixed ortho bands & brackets
~initiate & place an intravenous line in preparation for intravenous medications & sedation for a dentist who holds a certificate in general anesthesia or moderate sedation (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)

PERSONAL SUPERVISION
~if the dentist holds a certificate in general anesthesia or moderate sedation & is personally treating a patient, a DH can aid in the physical management of medications including the preparation & administration of medications into an existing intravenous line (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)

T/F for a DH to perform ortho duties, must either have graduated a DH program prior to Sept. 1, 2019 or if graduated after Sept. 1, 2019 DH program must also have included training in Ortho procedures & received a Ortho procedure certificate from school or successfully completed a board approved course in ortho procedures & received certificate from course sponsor!
true

cut arch wires on ortho appliances
LDA-general
DH-general

T/F it would be acceptable for an LDA to place temporary fillings to provide palliative treatment under general supervision
true

T/F it would be acceptable for a hygienist to administer nitrous oxide under indirect supervision
true; a DH can do this under general supervision

T/F it would be acceptable for an LDA to scale supragingivally under direct supervision
false; an LDA can not perform anything supragingivally & scaling must be done by a dentist or DH

T/F it would be acceptable for an LDA to remove excess bonding material on an Ortho appliance under indirect supervision

remove loose bands on ortho appliances
LDA-general
DH-general

remove loose brackets on ortho appliances
LDA-general
DH-general

take radiographs
LDA-general
DH-general
DT-general
ADT-general

take impressions & bite registrations
LDA-general
DH-general

deliver vacuum formed ortho retainers
LDA-general
DH-general

place & remove elastic ortho separators
LDA-general
DH-general
DT-general

Complete preliminary charting of oral cavity and surrounding structures w/ exception of perio probing and assessment of the perio structure
LDA-general

preliminary charting of the oral cavity & surrounding structure
LDA-general (CANNOT PROBE OR ASSESS PERIODONTAL STRUCTURE)
DH-general
DT-general
ADT-general

take extraoral & intraoral photos
LDA-general
DH-general

take vital signs as directed by dentist
LDA-general
DH-general

obtain informed consent
LDA-general
DH-general

Remove and replace ligature ties and arch wires on orthodontic appliances
LDA-general
DH-general

Apply topical fluoride including foam, gel, or varnish
LDA-general
DH-general
DT-general
ADT-general

apply topical medications including bleaching agents & cavity varnishes as prescribed by the dentist
LDA-indirect
DH-general
DT-general
ADT-general

place & remove rubber dam
LDA-indirect
DH-general

remove excess cement from inlays, crowns, bridges, & north appliances w/ HAND INSTRUMENTS ONLY
LDA-indirect
DH-general

perform mechanical polishing to clinical crowns NOT including instrumentation
LDA-indirect
DH-general

perform mechanical polishing including instrumentation
DT-general
ADT-general

preselect ortho bands
LDA-indirect
DH-general

place and remove periodontal dressings
LDA-indirect
DT-general
DH-indirect
ADT-general

remove sutures
LDA-indirect
DT-indirect
DH-general
ADT-general

place initial arch wires on ortho appliances
LDA-indirect
DH-indirect

etch appropriate enamel surfaces
LDA-indirect
DH-general
DT-general
ADT-general

apply pit & fissure sealants
LDA-indirect
DH-general
DT-general
ADT-general

adjust pit & fissure sealants
LDA-indirect
DH-general
DT-general
ADT-general

restorative procedures if completed a board approved course on specific procedure includes:
-place, contour, & adjust amalgam restorations
-place, contour, & adjust glass ionomer
-adapt & cement stainless steel crowns
-place, contour, & adjust class I, II, & V supragingival composite restorations on primary & permanent teeth
LDA-indirect
DH-indirect

maintain & remove intravenous lines (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
****DENTIST MUST HOLD A GENERAL ANESTHESIA OR MODERATE SEDATION CERTIFICATE
LDA-indirect
DH-indirect

monitor a patient during preop, intraop, & postop phases of general anesthesia or moderate sedation using noninvasive instrumentation such as pulse oximeters, electrocardiograms, bp monitors, & capnography (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
****DENTIST MUST HOLD A GENERAL ANESTHESIA OR MODERATE SEDATION CERTIFICATE
LDA-indirect
DH-indirect

remove excess bond material from ortho appliances
LDA-direct
DH-general

remove bond material from teeth w/rotary instruments after removal of ortho appliances
LDA-direct
DH-direct
***both must have board approved course

etch appropriate enamel surfaces before bonding of ortho appliances by a dentist
LDA-direct
DH-direct

Remove fixed ortho bands and brackets
LDA-direct
DH-direct

initiate & place an intravenous line in preparation for intravenous medications & sedation for a dentist who holds a certificate in general anesthesia or moderate sedation (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training)
LDA-direct
DH-direct

place nonsurgical retraction material for gingival displacement (must have completed a board approved course in nonsurgical retraction material for gingival displacement)
LDA-direct
DH-general

Perform preliminary charting of the oral cavity & surrounding structures to include case histories, perform initial & periodic exams & assessments to determine periodontal status & formulate a dental hygiene treatment plan in coordination w/ a dentist’s treatment plan
DH-general

make referrals to dentists, physicians, & other practitioners in consultation w/a dentist
DH-general
ADT-generral

obtain informed consent w/in the scope of practice
DH-general
LDA-general

perform mechanical polishing to clinical crowns NOT INCLUDING INSTRUMENTATION (removal of calculus by instrumentation must be done by a dentist or DH before mechanical polishing)
DH-general
LDA-indirect

complete debridement, prophylaxis, & nonsurgical periodontal therapy
DH-general

place sub gingival medicaments
DH-general

salivary analysis
DH-general

Administer nitrous oxide inhalation analgesia
DH-general
LDA-direct
DT-general
ADT-general

monitor a patient who has been induced by a dentist into nitrous oxide inhalation analgesia
DH-general
LDA-indirect

fabrication & delivery of custom fitted trays
DH-general

Remove marginal overhangs
DH-general

place & remove isolation devices or materials for restorative purposes
DH-general

place & remove matrix bands
LDA-direct

place & remove matrix systems & wedges
DH-general

T/F An LDA can replace temporary crowns or restorations
false; an LDA can only fabricate, cement, & adjust under direct supervision

Replacement of temporary crowns or restorations must be done by a dentist or a DH under general supervision

place temporary fillings NOT including temporization of inlays, inlays, crowns, or bridges
LDA-general

recement intact temporary restorations
LDA-general

remove temporary crowns or restorations w/hand instruments only
DH-general
LDA-direct

remove excess cement from inlays, onlays, crowns, bridges, or ortho appliances
DH-general; must have Ortho certificate or board approve course to remove excess cement from ortho appliances if graduated in 2019 or later

LDA-indirect (hand instruments only)

polish restorations
DH-general

T/F An LDA can apply desensitizing agents
false

T/F if the dentist holds a certificate in general anesthesia or moderate sedation & is personally treating a patient, a LDA & a DH can aid in the physical management of medications including the preparation & administration of medications into an existing intravenous line (must have completed a board approved course comprised of intravenous access & general anesthesia & moderate sedation training) under personal supervision
true

Administer local anesthesia
DH-general (must have completed a didactic & clinical program sponsored by an accredited dental or DH school & results in the DH becoming clinically competent)

DT-general
ADT-general

apply desensitizing agents
DH-general
DT-general
ADT-general

nutritional counseling & dietary analysis
DT-general
DH-general
ADT-general

T/F A LDA can place a wedge matrix system
false

placement of temporary restorations
DT-general
ADT-general

fabrication of soft occlusal guards & athletic mouthguard
DT-general
ADT-general

pulp vitality testing
DT-general
ADT-general

tissue conditioning & soft reline
DT-general
ADT-general

Atraumatic restorative therapy
DT-general
ADT-general

dispense & administer analgesics, anti inflammatories & antibiotics permitted by the collaborative management agreement
DT-general
ADT-general

provide analgesics, anti inflammatories, & antibiotics
ADT-general

tooth reimplantation
DT-general
ADT-general

stabilization of reimplanted teeth
ADT-general
DT-indirect

cavity preparation & restoration of primary & permanent teeth
ADT-general
DT-indirect

pulpotomies on primary teeth; indirect & direct pulp capping on primary & permanent teeth
ADT-general
DT-indirect

placement & removal of space maintainer (fixed or removable)
ADT-general
DT-indirect

brush biopsies
ADT-general
DT-indirect

Repair of defective prosthetic devices
ADT-general
DT-indirect

placement of temporary crowns; prep & placement of preformed stainless steel & resin crowns
ADT-general
DT-indirect

provide emergency palliative treatment of dental pain
ADT-general
DT-indirect

recement permanent crowns
ADT-general
DT-indirect

extractions of primary teeth
ADT-general
DT-indirect

Extraction of periodontaly diseased permanent teeth with mobility of +3 to +4 as permitted by the collaborative management agreement
ADT-general

Oral evaluation and assessment of dental disease and the formation of an individualized treatment plan authorized by a collaborating dentist
ADT-general

T/F under most circumstances, allied dental professionals must wear a name tag identifying themselves & their occupation
true

Another name for conscious sedation is
nitrous oxide

who in the office can dismiss a person who was previously under conscious sedation?
a) DH
b) LDA
c) dentist
d) all of the above
D all of the above

who in the office can administer conscious sedation?
a) DH
b) LDA
c) dentist
d) all of the above
D all of the above

INFECTION CONTROL (26% of exam)


blood borne disease
diseases that are spread through the exposure to, inoculation of, or injection of blood; or exposure to blood contained in body fluids, tissues, or organs; include infections caused by agents such as the human immunodeficiency virus (HIV) & hepatitis B (HBV)

Infection control
Programs, procedures, & methods to reduce the transmission of agents of infection for the purpose of preventing or decreasing the incidence of infectious diseases

minimum conditions for a dental office
1) premises must be kept neat & clean, free of rubbish, ponded water, or other conditions that would have a tendency to create a public health nuisance
2) housekeeping facilities & services utilized to ensure comfortable & sanitary conditions
3) office must be kept free of ants, flies, roaches, rodents, insects, or vermin
4) refuse must be kept in approved containers & emptied frequently
5) heating, lighting, & other service equipment must conform to state & local heating regulations & codes; individual room heaters must be kept away from combustible materials
6) water supply must be of a safe, sanitary quality from a source that’s approved by the agent of a community health board; must be piper under pressure & according to required regulations
7) plumbing must be in compliance w/ all plumbing codes; hand w
ashing stations must be located conveniently to working areas & must have soap, towels, & drain must be trapped & connected directly to the waste disposal system
8) disposal of liquid & human waste-all must be disposed through trap drains into a public sanitary sewer system
9) rooms must be clean
10) compliance w/ most up to date infection control standards
11) sharps & infectious waste disposed of according to MN statutes
12) hazardous waste requirements must be followed
13) ionizing radiation requirement compliance

clinical practice location
site at which a regulated person practices

contaminated
the presence or the reasonably anticipated presence of potentially infectious materials on an item or surface

Decontamination
the removal, inactivation, or destruction of HBV & HIV on a surface or item to the point where HBV &/or HIV are no longer capable of causing infection & the surface or item is rendered safe for barehanded touching, use, or disposal

disinfection
~destroys MOST pathogenic and other microorganisms by physical or chemical means
~does not ensure the degree of safety associated with sterilization processes

sterilization
destroys ALL microorganisms, including substantial numbers of resistant bacterial spores, by heat (steam autoclave, dry heat, and unsaturated chemical vapor) or liquid chemical sterilants

use surface Barries on
light handles, back of patient chair, keyboards, drawer handles, radiograph equipment or any other surface thats hard to clean

The __ regulates LOW & INTERMEDIATE LEVEL disinfectants
Environmental protection agency (EPA)

The _____ regulates CHEMICAL STERILANTS/HIGH LEVEL disinfectants
food & drug administration (FDA)

Any disinfectant used in a dental setting should be registered by the __ and be approved for use in health care settings
Environmental protection agency (EPA)

digital radiograph sensors are considered
semi critical

What type of floors are NOT RECOMMENDED especially in patient treatment rooms/operatory
carpeting

Dental health care personnel should use water that meets environmental protection agency regulatory standards for drinking water
≤500 colony forming units (CFU)/mL

Can dental unit waterlines (DUWL) transmit disease
yes

how long should air-water syringe be purged for to prevent disease transmission?
1 minute at the beginning of the day; 30s between patients

exposure incident
a person has eye, mucous membrane, non intact skin, or parenteral contact w/potentially infectious material at a clinical practice location

DHCP should receive infection prevention training
1)When they are hired
2) When new procedures affect their occupational exposure
3) Annually
4) According to state or federal requirements

high level disinfection
the elimination of viability of all microorganisms except bacterial spores

commissioner
commissioner of health

regulated person
a licensed dentist, DH, dentist physician (dentist w/ medical license), or a registered dental assistant who currently practices

HBV
the hepatitis B virus with the e antigen present in the most recent blood test

HCV
the hepatitis C virus

HIV
the human immunodeficiency virus

T/F A person with actual knowledge that a regulated person has been diagnosed as infected with HIV, HBV, or HCV may file a report with the commissioner
true

A dentist, LDA, DH, or a dental physician who’s diagnosed w/ HIV, HBV, or HCV must report that information to the commissioner promptly & as soon as medically necessary for disease control purposes but no more than __ days after learning of the diagnosis or becoming licensed or registered by the state
30 days

A licensed dentist, LDA, DH, DT, or ADT shall within __, report to the board personal knowledge of a serious failure or pattern of failure by another dentist, LDA, DH, DT, ADT, or any person working in a dental facility to comply w/ accepted & prevailing infection control procedures relating to the prevention of HIV, HBV, or HCV transmission
10 days

A board may refuse to grant a license or registration or may impose disciplinary or restrictive action against a licensee who
1) fails to follow accepted and prevailing infection control procedures, including a failure to conform to current recommendations of the Centers for Disease Control for preventing the transmission of HIV, HBV, and HCV, or fails to comply with infection control rules promulgated by the board. Injury to a patient need not be established;
2) fails to comply with infection control requirements
3) fails to comply with any monitoring or reporting requirement

infection control monitoring contract between the commissioner & the board must include
1) board shall inform the commissioner of a licensee who is infected w/ HIV, IBV, or HCV
2) commissioner has a right to provide any information necessary to the board about a licensee infected w/ HIV, HBV, or HCV
3) board shall not take action on grounds relating solely to the HIV, HBV, or HCV status of a regulated person until after referral by the commissioner
4) board shall forward to the commissioner any information on a regulated person who is infected with HIV, HBV, or HCV that the department of health requests

Monitoring plan for a regulated person infected w/ HIV, HBV, or HCV includes
1) addresses the scope of professional practice & determines that the practice constitutes an identifiable risk of transmission from regulated person to patient
2) submission of frequency of reports relating to the health status of regulated person
3) any other requested information

T/F the board, w/o hearing, can temporarily suspend a regulated persons license who fails to submit or comply w/ monitoring requirements
true

T/F the board is not authorized to conduct infection control inspections of the clinical practice of a regulated person
false

the board must provide __ notice to the clinical practice prior to infection control inspection
at least 3 business days

Where/what does the infection control inspector from the board have access to?
~all areas of the practice setting where patient care is rendered or drugs or instruments are held that come into contact with a patient
~An inspector is authorized to interview employees and regulated persons in the performance of an inspection ~observe infection control procedures
~test equipment used to sterilize instruments
~review and copy all relevant records, excluding patient health records

The infection prevention coordinator
will be responsible for developing and maintaining a written INFECTION PREVENTION PROGRAM; monitoring/evaluating the program, & implementing quality improvement measures as needed

parenteral
taken into the body in a manner other than through the digestive canal

PPE
any equipment or overclothes that reduce the risk of a persons clothing, skin, eyes, mouth, or other mucous membranes coming into contact w/ potentially infectious materials (PIM) at. a clinical practice location
INCLUDES BUT NOT LIMITED TO
~aprons
~clinic jackets
~eyewear/safety glasses w/ side shield
~face shields
~foot & leg coverings
~gloves
~gowns
~lab coats
~masks

Potentially infectious materials
1) human blood, human blood components, products made from human blood
2) semantic, vaginal secretions, cerebrospinal fluid, pleural fluid, pericardial fluid, amniotic fluid, saliva in dental procedures, any body fluid thats visibly contaminated w/blood & all body fluid in secretions where its difficult or impossible to differentiate body fluids
3) any unfixed tissue or organ (other than intact skin) from a human (dead or living)
4) HIV-containing cell, tissue, or other organ cultures; HIV or HBV-containing culture media or other solns; blood, organs, or other tissues from experimental animals infected w/HIV or HBV

sharps
objects that can penetrate the skin; include but not limited to scalpels, needles, tofflemere bands, broken glass, broken capillary tubes, & exposed ends of dental wires

sharps disposable
must be placed in a typically red leakproof & puncture proof container with a closed lid & biohazard label; place as close to disposable pickup as possible

sterilization
the destruction of all microbial life including bacterial spores

a regulated person w/knowledge of an exposure incident must
~ensure that the exposed patient & w/patients permission the patients primary healthcare provider is informed
~patient is offered assistance in securing follow up care immediately or as soon as possible after the patient is subjected to an exposure incident
~if it occurs in a facility that has written procedures regarding exposure incident, regulated person must inform the individual in charge of written exposure incident procedures

T/F a regulated person must disclose to a patient who is subjected to an exposure incident the identity of the source
false; identity of the source must be kept private unless the source has explicitly given authorization to be identified

general infection controls
~do not cut, bend, or break contaminated needles
~must minimize exposure to contaminated sharps by not recapping or removing sharp from its base unless regulated person can demonstrate that no safer alternative is feasible, the action is required by specific medical procedure, or that the base is reusable
RECAPPING OF NEEDLES MUST BE DONE BY USING A MECHANICAL DEVICE OR THE ONE HANDED TECHNIQUE!
~minimize splashing, spraying, spattering, & generation of droplets of potentially infectious materials
~do not perform mouth pipetting or suctioning
~in between patients, must remove & replace protective coverings
~must remove debris & residue & decontaminate equipment prior to repair or transported to another site for repair; IF EQUIPMENT CANNOT BE DECONTAMINATED BEFORE REPAIR; LABEL “POTENTIALLY CONTAMINATED”
~pick up contaminated objects in a manner that bare or covered skin doesn’t come into contact w/contaminated sharps

multiple dose vials infection control
~a disposable needle &/or syringe thats used to w/draw fluid from a multiple dose vial MUST NOT BE USED MORE THAN ONCE
~a reusable needle &/or syringe thats used to w/draw fluid from a multiple does vial must be sterilized before each use

when do you wash your hands
~if they become visibly soiled
~between gloving changes
~beginning of the day
~anytime they touch or become contaminated
~end of the day
~prior to cleaning & disinfecting
~in between patients

infection controls for contaminated equipment, instruments, & devices
~all debris & residue from reusable equipment, instruments, & devices must be removed
~equipment, instruments, & devices which come into contact w/ a patients vascular system or other normally sterile areas of the body (critical items!) must be sterilized
~reusable equipment, instruments, & devices which come into contact w/a patients intact mucous membrane but doesn’t penetrate body surfaces (semi-critical items) must be sterilized or high level disinfected
~reusable equipment, instruments, & devices which come into a patients intact skin (non critical items) must be decontaminated
~work surfaces must be decontaminated immediately or as soon as possible after the surfaces become contaminated & prior to treatment of the next patient

T/F items & surfaces must be precleaned before they can be disinfected
true

T/F a regulated person can transfer contaminated disposable sharps or potentially infected material from one container to another
false

infection controls for disposable & reusable contaminated sharps
~immediately or as soon as possible after use & until the sharps are disposed of, store disposable contaminated sharps in a container (typically red w/ a biohazard label) that is puncture resistant, leakproof on sides & bottom & closable
~do not store in a manner that allows a person to reach by hand into the containers where the sharps are placed
~containers for sharps must be placed where they’re easily accessible to healthcare workers & as close as possible to the immediate area where sharps are used & can reasonably be expected to be found
~place containers for sharps where the contents do not impose undue risk of exposure incident at a clinical practice location
~must maintain containers for disposable contaminated sharps upright through/o use
~must replace container for sharps before it becomes full

general infection controls for PPE
~must wear appropriate PPE in situations where its reasonably anticipated that the person may have skin, eye, mucous membrane, or parenteral contact w/ potentially infectious material
~appropriate PPE must be worn in situations where potentially infectious materials may be splashed, sprayed, spattered, or otherwise generated
~contaminated disposable PPE must not be used in the care of more than 1 patient
~PPE must be replaced as necessary to protect oneself & patients from transmission of HBV or HIV
~PPE must be discarded after tis ability to function as a barrier is compromised
~contaminated PPE must be stored to not pose undue risk of an exposure incident

gloves must be worn when
~it can be reasonably anticipated that contact w/potentially infectious material, mucous membranes, or non intact skin may occur
~vascular access procedures are performed
~contaminated surfaces or items are touched

sterile gloves must be worn for & during
surgery requiring sterile technique

what type of gloves are worn for cleaning, disinfecting, or sterilizing?
utility gloves

T/F its acceptable to use sterile non-latex gloves for surgical procedures
true

infection controls for gloves
~must replace gloves for every new patient
~disregard & change gloves (examination, sterile, & utility) when they become worn or punctured or after their ability to function as a barrier is otherwise compromised

infection controls regarding masks, face shields, & eyewear
~must change your mask for each new patient
~change your mask every 3 hrs
~change mask if it becomes contaminated
~face shields, reusable masks, &/or protective eyewear must be disinfected between patients & decontaminated as necessary
~PATIENTS MUST ALWAYS WEAR PROTECTIVE EYEWEAR DURING TREATMENT

T/F surfaces must be decontaminated immediately or as soon as possible after potentially infectious materials are spilled
true

contaminated linen/laundry
~must be handled as little as possible w/minimum agitation
~must be placed in bags that prevent leakage at the location where its used
~must not be stored or rinsed in patient care areas

OSHA (Occupational Safety and Health Act) requires
employers make hep B vaccine available to all employees who have potential contact w/ blood or OPIM (other potentially infectious materials)

What employees need Hep B vaccination?
any employee that has potential for contact with blood

T/F Every dental office needs to have a written exposure plan; written policies and procedures for prompt reporting, evaluation, counsel, treatment, & follow-up to occupational exposures
true

Exposure training should include
1) Description of their exposure risks
2) Review of prevention strategies & infection control policies/procedures
3)Discussion regarding how to manage work related illnesses and injuries
4) Review of work restrictions for the exposure/infection

Fingernails should be kept SHORT; Artificial nails carry greater __ and are implicated in fungal and bacterial infections
gram (-) organisms

T/F chemical indicators prove that items are sterile
false

biological indicators
SPORE TESTING assesses sterilizing equipment by killing highly resistant microbe
~best way to tell if sterilizing equipment is working properly
~MUST be performed WEEKLY

if a spore test comes back (+)
~indicates that the sterilizer is not working properly and items are NOT sterile
~needs to be corrected and temporarily be out of service

T/F autoclaving is a form of sterilization & kills all microbes
true

what testing should be available to all DHCW for those concerned that they may be infected by HIV
serologic testing

T/F OSHA aims to protect the providers/clinicians and CDC aims to protect all patients
true

single use items
items that are only used once on one patient
EXAMPLES
patient napkins, surface barriers, syringe needles, plastic orthodontic brackets, and sterilization pouches

sterilant
Destroys all microorganisms including high numbers of bacterial spores

high level disinfectant
Destroys all microorganisms but not necessarily high numbers of bacterial spores

intermediate level disinfectant
Destroys vegetative bacteria, most fungi and most viruses, inactivates mycobacterium tuberculosis var. bovis (is tuberculocidal)

low level disinfectant
Destroys vegetative bacteria, some fungi and some viruses, doesn’t inactivate M. Tuberculosis var. bois (isn’t tuberculocidal)

What is the primary role of the CDC in dentistry
establish recommendations and guidelines for infection control

What type waste is extracted teeth considered to be and how should they be disposed of
Extracted teeth are potentially infectious materials. If they are given to the patient directly, extracted teeth must be disinfected first. However, if extracted teeth aren’t given to the patient, the dental office may chose to use them for educational purposes which requires the extracted teeth to be sterilized. If the dental office chooses not to keep the extracted teeth, different procedures to dispose of them depend on if the teeth contain amalgam fillings. For example, if the teeth contains amalgam, they must be immersed in full strength glutaraldehyde for thirty minutes and then can be disposed of according to office local regulation

critical instruments
those that touch bone or penetrate soft tissue
EXAMPLES
~surgical instruments, forceps, scalpels, bone chisels, scalars, and burs
STERILIZATION METHOD
sterilization

semi critical instruments
touch mucous membranes but won’t touch bone or penetrate soft tissue
EXAMPLES
mouth mirrors, amalgam condenser
STERILIZATION METHOD
sterilization OR high level disinfectant

non critical instruments
contact only with intact skin
EXAMPLE
dental radiograph sensor
STERILIZATION METHOD
intermediate to a low level disinfectant or basic cleaning

RECORD KEEPING (12% of exam)


Which of the following is true regarding what must be included in a patient’s chart or record?
a) start & end time of treatment
b) all treatment must be recorded except for preventive treatment
c) medication thats prescribed after hours
d) all of the above
D all of the above; EVERYTHING GETS RECORDED IN A PATIENTS CHART OR RECORD

T/F a complete medical & dental history does NOT need to be completed for emergency treatment
false; if its a regular patient, can just update their history but new patients/infrequent patients must complete both

T/F DHCP only has to sign their initials in patient notes when they’re in a group practice
false; patient notes must ALWAYS be signed by a DHCP

The board may obtain medical data & health records of a licensee or applicant w/o consent if the information is requested by the board as part of a
Physical or chemical dependency assessment

Removable dental prostheses owner identification
Every complete upper & lower denture & removable prosthesis fabricated by a dentist or by a dentists or DT work order must be marked w/the patients social security number (must be permanent, legible, & cosmetically acceptable)

if it’s not practicable:
~the ss # may be omitted if the name of the patient is shown
~the initials of the patient may be shown alone if the name of the patient is impracticable
~the identification marks may be omitted entirely if none of the forms are practicable or clinically safe

Do you mark older removable dental prostheses without an identification?
Yes at the time of any subsequent rebasing (any device prior to August 1, 1978)

Health record
Any information whether oral or recorded in any form or medium that relates to the past, present, or future physical or mental health or condition of a patient; the provision of health care to a patient; or the past, present, or future payment for the provision of health care to a patient

Identifying information
Patients name, address, DOB, gender, parents or guardians name regardless of the age of the patient, & other nonclinical data which can be used to uniquely identify a patient

Patient access to dental records
upon request, a provider shall supply to a patient complete & current information by the provider concerning any diagnosis, treatment, & prognosis of the patient in terms & language the patient can understand

Copies of health records to a patient
Upon a written request, a provider at a reasonable cost shall promptly furnish to the patient:
1) copies of the patients health record including but not limited to lab reports, x-rays, prescriptions, & other technical information used in assessing the patients health condition
2) the pertinent portion of the record relating to a condition specified by the patient
***w/patients consent, the provider may instead furnish a summary of the record
cost of releasing health records to a patient
the provider or its representative may charge the patient no more than .75 cents per page + $10 for time spent retrieving & copying the records
~the provide may charge no more than the actual cost of reproducing x-rays plus no more than $10 for time spent retrieving & copying the x-rays
~if the patient is requesting copies for the purpose of appealing a denial of social security disability income or social security disability benefits, the provider can only charge the $10 retrieval fee

when can a provider withhold health records from the patient?
when the provider reasonably determines that the information is detrimental to the physical or mental health of the patient or is likely to cause the patient to inflict self harm or to harm another; provider may supply the information to an appropriate third party or another provider who may then release the information to the patient

a provider or a person who receives health records may not release a patients health records to a person w/o
1) a signed & dated consent from the patient or patients legally authorized rep authorizing the release
2) specific authorization in law
3) a representation from a provider who holds a signed & dated consent form from the patient

how long is a patients consent valid
1 yr or for a period specified in the consent or provided by law

exceptions to patient consent
1) a medical emergency when the provider is unable to obtain the patients consent due to the patients condition or the nature of the medical emergency
2) to other providers w/in related health care entities when necessary for the current treatment of the patient
3) to a health care facility licensed by the state or licensed in another state when the patient is returning to a health care facility & can’t provide consent; resides in a health care facility & has services provided by an outside resource & is unable to provide consent
4) a provider may release a deceased patients health care records to another provider for the purposes of diagnosing or treating the deceased patients surviving adult child

T/F dental or other health services may be given to minors of any age w/o the consent of a parent or guardian when in the professionals judgement, the risk to the minors life or health is of such a nature that treatment should be given w/o delay & the requirement of consent would result in delay or denial of treatment
true

T/F A minor must also have the consent of a parent or legal guardian to receive a hepatitis B vaccine
false

Dental records must include _ for each patient
1) personal data
~name
~address
~DOB
~if the patient is a minor, name of the patients parent or guardian
~name & phone # of an emergency contact
~name of the patients insurance carrier & insurance identification #
2) Patients reason for visit (“CC” in quotes!)
3) dental & medical history
~must be updated/checked at each visit
4) clinical exam
~recording of existing oral health status
~any radiographs used/taken
~facsimiles/results of any other diagnostics used
5) diagnosis
6) treatment plan
~must be agreed upon written & dated treatment plan except fir routine dental care
7) informed consent
~the dentist, ADT, DT, DH, LDA discussed w/the patient the treatment options & the prognosis, benefits, & risks of each treatment that’s w/in the scope of practice of the licensee
~the patient has consented to the treatment chosen
8) progress notes
~must be in chronological order of treatment & each separate treatment line must be dated
~all treatment provided
~all medications used & materials placed
~treatment provider by the license #, name, or initials
~if applicable, the identity of the collaborating dentist authorizing treatment by license #
~administration info for nitrous oxide inhalation analgesia including indication for use, dosage, duration of administration, posttreatment oxygenation period prior to discharge, patients status at discharge

How do you correct dental records?
DO NOT USE WHITE OUT OR ERASURES
~crossed out w/a single line (should still be able to see/read initial record recorded) & include the initials, license #, & date of healthcare worker who corrected the record

how long does a dentist need to maintain a patients dental records?
7 yrs beyond the time the dentist last treated the patient; if a minor, 7 yrs past the age of majority

transfer of dental records
digital radiographs shall be transferred by compact or optical disc, electronic communication, or printing on high quality photographic paper
****must reveal images of diagnostic quality using proper exposure settings & processing procedures

T/F when electronic records are kept, a dentist must keep either a duplicate hard copy record or use an unalterable electronic record
true

ETHCIS (6% of exam)


if a licnesed dental professional fails to report the habitual use of drugs and alcohol by their employing dentist, the licnesed dental professions shall be subject to which of the following?
a. civil penalties
b. censure
c. tort liability
d. discrimination
civil penalties

T/F it’s acceptable for a dentist to send out a flier to a community about the dental practice that has some of his/her educational credentials on it
false; ALL credentials must be on the flier/ad

Is it acceptable behavior for a dentist to leave a group practice & open up their own practice in the same community?
yes; dentist CANNOT advertise anything about the former clinic

Grounds for refusal, suspension, revoke, limit, or modifying licensure
1) fraud or deception in connection w/ the practice of dentistry or securing a license certificate
2) conviction of a felony or gross misdemeanor reasonably related to the practice of dentistry
3) conviction of an offense involving moral turpitude
4) habitual overindulgence in the use of intoxicating liquors
5) improper or unauthorized prescription, dispensing, administering, or personal or other use of any legend drug, any chemical, or any controlled substance
6) conduct unbecoming a person licensed to practice dentistry, DT, DH, or DA or conduct contrary to the best interest of the public
7) gross immortality
8) any physical, mental, emotional, or other disability which adversely affects the ability to perform the services for which the person is licensed in
9) revocation or suspension of a license or equivalent authority to practice in another state, territory, or country
10) failure to maintain adequate safety & sanitary conditions for a dental office in accordance w/the standards established by the board
11) employing, assisting, or enabling in any manner an unlicensed person to practice dentistry
12) failure or refusal to attend, testify, & produce records as directed by the board
13) violation or failure to comply w/ the rules of the board of dentistry or any disciplinary order issued by the board
14) knowingly providing false or misleading info that’s directly related to the care of the patient unless done for an accepted therapeutic purpose such as the administration of a placebo
15) aiding suicide or aiding attempted suicide

Conduct unbecoming
fraud upon a patient’s or third party payers

if a dental therapist, dental hygienist,or a dental assistant performs a services not authorized by the dentist, &/or fails to cooperate with the MN board of dentistry that behavior is called
Conduct of unbecoming of a licensee

What can the board do if a licensee gets their license refused, suspended, revoked, limited, or modified?
1) impose a fixed civil penalty not exceeding $10,000 for each violation to deprive a licensee of any economic advantage gained by reason of violation, to discourage similar violations, or to reimburse the board for the cost of the investigation & proceeding
2) order the dentist, DT, DH, or DA to provide unremunerated service
3) censor or reprimand
4) any other action as allowed by law & justified by the facts of the case

what is the common tort liability in dentistry
Negligence

what concept is demonstrated in ethical principles that all patients should receive the same quality of dental care?
justice

what is the term for voluntary standards for behavior established by a leader or an individual in authority
code of ethics

Good Samaritan Law
a person at the scene of an emergency who knows that another person is exposed to or has suffered harm shall give reasonable assistance to the exposed person

Criminal Law/crime against society
law that deals with crime and the legal punishment of criminal offenses

Civil law
disputes between individual vs individual, organization vs organization, or individual vs organization; compensation is awarded to the victim

Is a person excused from testifying at proceedings initiated by the board of dentistry on the ground that it may tend to incriminate the person
no

What must a person do to not be prosecuted on a case initiated by the board of dentistry
Must claim a privilege against self incrimination (DOES NOT apply to prosecution for perjury or for producing evidence)

regulations on advertising of dental services & appliances
~No person shall advertise in any manner the sale, supply, furnishing, construction, relining, or repair of prosthetic dentures, bridges, plates, or other appliances to be used or worn as substitutes for natural teeth WITHOUT A WRITTEN WORK ORDER BY A LICENSED DENTIST
~ads MUST contain “a written work order from a licensed dentist is required” in at least 10 point font

What happens if a person violates the rules & regulations of the MN board of dentistry?
~guilty of a gross misdemeanor
~upon conviction, punished by a fine of not more than $3,000 or by imprisonment in the county jail for not more than a year or both

Another name for conduct unbecoming a licensee is
conduct contrary to the best interests of the public

conduct unbecoming a licensee includes
1) engaging in personal conduct that brings discredit to the profession of dentistry
2) gross ignorance or incompetence in the practice of dentistry or repeated performance that falls below accepted standards
3) making suggestive, lewd, lascivious, or improper advances to a patient
4) dentists charging a patient an unconscionable fee or charging for services not rendered
5) performing unnecessary services
6) DT, DH, or LDA performing services not authorized by the dentist
7) accepting rebates, split fees, or commissions (apply to dentists only) from any source associated w/the service rendered to the patient that isn’t approved or registered by the board
8) falsifying records including payments, licensure, CDE, etc
9) perpetrating fraud upon patients, third party payers or others relating to the practice of dentistry
10) failing to cooperate w/the board or its agents
11) failing to maintain adequate safety & sanitary conditions for a dental office
12) failing to provide access to & transfer of medical & dental records prescribed by MN statues

T/F an improper name &/or unjustified name used in dental practice is a violation of MN statutes & is subject to disciplinary action by the board
true

T/F false, fraudulent, misleading, or deceptive statements can be used in dental advertising
false

false, fraudulent, misleading, or deceptive statements includes
~a misrepresentation of fact
~likely to mislead or deceive because in context it makes only a partial disclosure of relevant facts
~intended or likely to create false or unjustified expectations of a favorable result
~appeals to an individuals anxiety in an excessive or unfair way
~contains material claims of superiority that can’t be substantiated
~misrepresents a dentists credentials, training, experience, or ability
~contains other misrepresentations or implications that in reasonable probability will cause an ordinary, prudent person to misunderstand or be deceived

T/F fees for routine services must be included on a dental ad
true

T/F set fees cannot be advertised in a dental ad
false

How long must an advertised fee be honored?
during the entire time period stated in the ad; if no time period was stated, must be honored for 30 days or until the next publication whichever is later

What is an individual guilty of when acting in fraud of securing licenses
Gross misdemeanor

it is unlawful for any person to
~enable a unlicensed person to practice dentistry ~practice without a license
~ a licensee to not go by their own name & degree

COLLABORATIVE AGREEMENTS (at least 2 questions on exam)


under the collaborative agreement between a dentist & DH, how much clinical experience must they have in the past 18 months?
1,000 hours

Collaborative practice for DH in community settings without the patient first being examined by a licensed dentist requires the DH to
1) enter into a collaborative agreement w/a licensed dentist that designates authorization for the services provided by the DH
2) has documented completion of a course on medical emergencies w/in each continuing education cycle
3) practice in a health care facility, program, or nonprofit organization

How many DH’s can a dentist enter into a collaborative with
no more than 4

the collaborative agreement between a DH & a dentist must include
1) consideration for medically compromised patients & medical conditions for which dental evaluation & treatment plan must occur prior to DH services
2) age & procedure specific standard collaborative protocols including recommended intervals for the performance of DH services and a period of time in which an examination by a dentist should occur
3) copies of consent to treatment form provided to the patient by the DH (must include a statement advising the patient that the DH services provided are not a substitute for a dental exam by a licensed dentist)
4) protocols for the placement of pit & fissure sealants & requirements for follow up care to issue the efficacy of the sealants after application
5) procedure for keeping & maintaining dental records

***must be signed & maintained by the dentist, DH, & the faculty, program, or organization
*****must be renewed annually

If additional services are needed outside the scope of practice, patient referral must be
kept in the patients health care record

Collaborative agreement between dentist & DH
a written agreement w/a licensed dentist who authorizes & accepts responsibility for the services performed by the DH

How many DA’s can a DT enter into a collaborative agreement with at one practice setting?
no more than 4 licensed DA’s or unlicensed DA’s

How many DA’s can a dentist enter into a collaborative agreement with w/o board authorization
no more than 2 licensed DA’s

Collaborative practice for DA’s in community settings without the patient first being examined by the dentist, without the dentists diagnosis or treatment plan, & without the dentist being present at the location where services are being performed requires the DA to
1) practice in a health care facility, program, or nonprofit organization
2) DA must be in a collaborative agreement w/ a dentist & DH that designates authorization for the services provided by the DA
3) must have documented completion of a course on medical emergencies w/in each continuing education cycle

Scope of practice under a collaborative agreement between DA & dentist
*GENERAL SUPERVISION
1) provide oral health promotion, disease prevention education
2) take vital signs
3) obtain informed consent for treatments authorized under collaborative agreement
4) apply topical preventative agents including fluoride varnishes & pit & fissure sealants
5) perform mechanical polishing to clinical crowns not including instrumentation
6) complete preliminary charting of the oral cavity & surrounding structures except periodontal probing & assessment of the periodontal structure
7) take intramural & extraoral photos
8) take radiographs

A collaborating dentist is limited to entering into a collaborative agreement with no more than __ DT’s or ADT’s at any one time
no more than 5

The Collaborative agreement between a dentist & DT must include
1) practice settings where services may be provided & the populations to be served
2) any limitations on the services provided including the level of supervision required by the collaborating dentist
3) age & procedure specific practice protocols including case selection criteria, assessment guidelines, & imaging frequency
4) procedure for creating & maintaining dental records for patients that are treated by the DT
5) plan to manage medical emergencies in each practice setting where care is provided
6) quality assurance plan for monitoring care providing by the DT including patient care review, referral follow up, & a quality assurance chart review
7) protocols for administering & dispensing medications including the specific conditions & circumstances under which these medications are to be dispensed & administered
8) criteria relating to the provision of care to patients w/specific medical conditions or complex medical histories including requirements for consultation prior to caer
9) supervision criteria for DA
10) plan for the provision of clinical resources & referrals in situations which are beyond the scope of practice of the DT

T/F A collaborating dentist must ensure that a dentist is available to the ADT for timely consultation during treatment if needed
true

Under a collaborative agreement between dentists, DA’s, DH’s, DT’s, and ADT’s, who is held responsible if the DA, DH, DT, or ADT practices outside of their scope of practice
the dentist & the DA, DH, DT, or ADT

Collaborative agreement between a supervising dentist (must be licensed for at least 5 yrs) & a limited general dentist
~duties are performed under general supervision
~practice limitations
~acknowledgement that the limited dentist agrees to practice clinical dentistry for at least 1,100 hrs annually for 3 consecutive yrs

how many limited licensed general dentists can a supervising dentist supervise during the collaborative agreement
1

how many limited licensed general dentists can practice in one dental facility
no more than 2

how long does the supervising dentist have to submit a written performance evaluation to the board of a limited licensed general dentist
no earlier than 90 days before limited dentists practice period & no later than 7 business days following completion of limited dentists practice period

Graduates of nonaccredited dental programs
~must be in a 3yr collaboration between the licensee and the dentist to practice under general supervision ~if no disciplinary action needed in 3yr collab, unlimited license is granted

BOARD OF DENTISTRY, LICENSING REQUIREMENTS, PORTFOLIOS


if the executive director of the board decides a formal complaint needs an investigation, they will forward the complaint to whom?
the board & the boards members take action; the complaint is not forwarded to anyone

Which of the following is NOT a core subject?
a) office management
b) patient communications
c) medical emergencies
d) ethics
A office management

Display of names & certificates
The initial license & renewals of every dentist, DT, DH, or DA must be displayed in every office in which the person practices in plain sight of the patients near or on the entrance door to every office ~when approved by the board, can display a wallet sized initial license & renewals at nonprimary practice locations

T/F a dentist can accept money for making a referral (renumeration = $) to another dentist?
false

a patient can be terminated for
~failure to comply with treatment or professional advice
~consistent tardiness or failed appts
~failure to pay for services rendered
~behavior management issues

Licensed by credentials for dentists, DH, DA
1) pass all boards & certified
2) good moral character & abides by code of ethics
3) passed English proficiency if English is not primary language
4) licensed in another state or Canada & does not have/any pending disciplinary action

-Dentist & DH only: must have been in active practice for at least 2,000 hours within 36 months of app date or passed board approved reentry program w/in 36 months of app date

-DA only: must meet all expanded functions curriculum equivalency requirements of a board approved DA program in MN

Denial of licensure by credentials for dentists, DH, or DA
~board may notify the applicant of any specific remedy that the applicant could take which when passed, would qualify applicant for licensure
~denial DOES NOT prohibit applicant from applying for licensure

T/F its acceptable behavior to write a patient a letter dismissing them from the practice
true

Emeritus inactive license requirements
~applicant must be in compliance w/board requirements
~can’t be the subject of current disciplinary action resulting in suspension, revocation, disqualification, condition, or restriction of the licensee to practice dentistry

Emeritus inactive license
NOT a license to practice; formal recognition of completion of a persons dental career in good standing

How long does an emeritus active license need to be renewed?
Every two years; the renewal date is the same as the licensees renewal date when they were in active practice

Requirements for renewing an emeritus active license
1) complete app
2) pay the renewal fee
3) report at least 25 continuing education hrs completed since the last renewal & must include:
-at least 1 hr in 2 different required CORE areas
-at least 1 hr of infection control
-dentists & DT at least 15 hrs of fundamental credits; at least 7 hrs for DH & DA
-for dentists & DT no more than 10 elective credits; for DH & DA no more than 6

How many days will the board issue a final report for the suspension of a license?
110 days

license and licensee owing state taxes
the board may not issue or renew a license to practice dentistry if the licensee or applicant owes the state delinquent taxes in the amount of $500 or more
-license can only be renewed or granted if the commissioner of revenue issues a tax clearance certificate & the licensee or applicant forwards a copy of the clearance to the board

taxes
all taxes payable to the commissioner of revenue including penalty & interest due on those taxes

delinquent taxes do not include a tax liability if
1) an administrative or court action contests the amount or validity of the liability has been filed or served
2) the appeal period has not expired
3) the licensee or applicant has entered into a payment agreement to pay the liability and is current w/payments

When must a dentist, DT, DH, or DA notify the board of a change of address
within 30 days (written notice either personally or by first class mail)

How long is a licensure applicants criminal background check results valid for
1 yr

T/F the applicant or licensee must submit a completed criminal history records check consent form & a full set of fingerprints to the board
true

T/F the board can issue a license to an applicant who refuses to submit a criminal background check &/or fails to submit a full set of fingerprints
false

T/F the board can suspend a license if the licensee fails to pay child support
true

what happens if a licensure applicant is intentionally in nonpayment, default, or breach of a repayment or service obligation under any federal educational loan, loan repayment, or service conditional scholarship program?
the board may refuse to grant a license or may impose disciplinary action on the licensee

CDE
professional development & continuing dental education

clinical subject
those subjects directly related to the provision of dental care & treatment to patients

core subject
areas of knowledge that relate to public safety & professionalism as determined by the board
INCLUDES
~record keeping
~ethics
~patient communications
~management of medical emergencies
~treatment & diagnosis
course
an educational offering, class, presentation, meeting, or other similar event

Elective activities
Activities directly related to, or supportive of, the practice of dentistry, DT, DH, or DA
EXAMPLES
~general attendance at a state or national dental convention (max of 3 cr)
~volunteer or community service (mission work, volunteer clinic work, dental health presentation to students or groups, etc)
~scholarly activities (presentations, writing a published dental article, test construction, research, etc)
~dental practice management courses
~leadership or committee involvement w/ the board (max 3cr)

Fundamental activities
Activities directly related to the provision of clinical dental services

portfolio
an accumulation of written documentation of professional development activities

professional development
activities that include but aren’t limited to continuing education, community services, publications, & career accomplishments through/o a professionals life

self assessment
an ungraded examination provided by the board intended to help determine strengths & weaknesses in specific areas of dental practice

limited general dentists
graduate of a non accredited dental program

limited general dentists application requirements
1) completed board evaluation of international education (if applicable)
2) an original or notarized copy of passing b board approved language testing (if applicable)
3) an original affidavit of licensure
4) completed dental questionnaire
5) personal letter/curriculum/resume
6) an original or notarized copy of dental diploma & translation if applicable
7) proof of clinical dental practice
8) an original or notarized copy of other dental credentials
9) completed board approved infection control training
10) an original or notarized copy of national dental board exams
11) application & fee
12) evidence of having passed board approved clinical exam w/in 5 yrs proceeding application (if applicant fails a third time even after additional education/training, the applicant is PROHIBITED from retaking the exam & cannot practice!)
13) evidence of passing jurisprudence exam
14) written agreement between applicant & supervising dentist
15) documentation of current CPR certification
16) statement from licensed physician attesting to applicants physical & mental condition completed w/in 12 months proceeding app
17) statement from ophthalmologist or optometrist attesting to applicants visual acuity w/in 12 months proceeding application

limited general dentists professional development requirements
1) minimum of 2 different core subjects as part of fundamental activities
2) self assessment exam
3) current CPR certification
***total hrs of professional development activities is 75 hrs (minimum of 45 hrs in fundamental; max of 30 hrs in electives); must complete at least 25 hrs each year

biennial renewal license requirements
1) application & fee (must be postmarked no later than the last day of the licensee’s birth month)
2) applicants signature
3) compliance w/professional development requirements & current CPR certification
4) applicants office & office address
5) license number
6) whether the licensee has been engaged in the active practice of dentistry during the preceding 2 yrs whether w/in or w/o the state
7) any other information requested by the board

what happens if a licensee does not meet the renewal deadline?
The board will send a notice to the last address on file w/ any additional late fees required & a new application deadline (must be at least 33 days after the notice is sent out by the board); failure to respond by new deadline results in the termination of a right to practice

the minimum number of required hrs of fundamental professional development activities per biennial cycle is
Dentists & DT: 50 hrs
DH & LDA: 25 hrs

the minimum number of required hrs of elective activities per biennial cycle is
Dentists & DT: 30 hrs
DH & LDA: 15 hrs

T/F A licensee can earn all required hrs in fundamental activities
true

the maximum number of elective activities directly related or supportive of dental practice is
Dentists & DT: 20 hrs
DH & LDA: 10 hrs

professional development is credited on an
hr per hr basis

what happens if the licensee is unable to meet professional development requirements due to extenuating circumstances?
may apply for an extension to the board via a written request
***must include a complete explanation, the renewal period, # of credits earned, & plan for completing the rest of the needed credits

T/F An infection control course is not mandatory to maintain licensure
false

professional development activities
include but not limited to continuing education, community services, publications, & career accomplishments through/o a professionals life

documenting professional development activities
~completed self assessment exam
~copy of the front & back of a completed CPR card from the American heart association or the American red cross
~confirming documentation from the presenting organization that provides the attendees name, license #, name of organization or presenter, course date, # of cr hrs, subject matter, program title
~personal log of published articles read by the licensee including the title, name of author, name of journal, & date of publication
***must be in a professional portfolio

how long does a licensee need to keep documentation of fundamental & elective activities
24 months after each biennial renewal period for the purpose of an audit requested by the board

How long does a licensee have to submit their portfolio if they’re randomly selected for an audit by the board?
60 days from the notification date

T/F a licensee is not considered to be actively licensed during the portfolio audit process
false

What happens if a licensee fails a portfolio audit?
1) the board may grant the licensee up to 6 months to comply w/written requirements to resolve deficiencies OR
2) the board may initiate disciplinary actions against the licensee

What are some possible reasons that a licensee may fail a portfolio audit issued by the board
1) lack of proof of documentation or participation
2) credit earned outside of renewal period being audited
3) excess of earned hrs in a category having a maximum if a deficiency exits
4) lack of earned hrs in a category having a minimum of a deficiency exits
5) failure to submit the portfolio
6) unacceptable professional development sources
7) fraudulently earned or reported hrs

T/F failure to comply w/ the board’s requirements by the end of the grace period for a failed portfolio audit will result in the termination of a license and right to practice
true

the board shall notify in writing each licensee regarding the # of continuing education credits earned during their current __ year CDE cycle as of that date
five

T/F a full faculty dentist may not apply previous continuing education credits towards the applicable professional development requirements when establishing a biennial professional development portfolio if the dentist earned the credits during the five yr period prior to Jan 1, 2005
false

how long does a dentist have to respond to a written advertising complaint from the board w/o receiving a violation
30 days

annual reports to be submitted to the board must include
~name & registered office of the firm
~address(s) at which the firm is providing dental services
~name & address of each director, officer, shareholder, & their position title
~a certification as to the licensure status of each shareholder, director, officer, employee, & agent

Board
the state board of dentistry

state
when used in reference to a state other than MN, means any other state of the U.S., District of Columbia, and the Commonwealth of Puerto Rico

Board of Dentistry members
2 public members, 5 dentists, 1 DA (dental assistant), 1 DH (dental hygienist)

Who appoints the Board of Dentistry Members?
the governor

Board of Dentistry members maximum term
two four year terms (8 yrs. total)

90 days prior to end of term for Board of Dentistry members
dental associations recommend at least 2 dentists, 2 LDA’s or 2 DH’s

How long does the governor have prior to the end of term to make appointments to the Board of Dentistry?
30 days

What happens if there is a vacancy on the Board of Dentistry
within 60 days after the occurrence of a vacancy, dental associations must recommend at least 2 dentists, 2 LDA’s, or 2 DH’s; governor makes appointment within 30 days

Board of Dentistry elected leadership members
president, Vice President, and secretary

Board of Dentistry executive secretary
not a member of the board; in the unclassified civil service

licensure requirements for DDS, DT, DH, DA
1) application & fee
2)evidence of passing boards (state & national; must be taken within 5 years before the board receives app for licensure)
3) abiding by professional ethical conduct requirements
4) meeting other requirements of the board
5) COPY of certificate/diploma of dental program
6) background check & fingerprints (90 days after submitting licensure application; 30 days after getting report back to challenge background check)
7) photo

What are the qualifications of DDS, DA, or DH to serve on the board of dentistry?
must been lawfully in active service in MN for 5 years immediately preceding appointment

What is the mission of the MN board of dentistry?
promote and protect public health and safety; and ensure that every licensed dental professional practicing in the state meets the requirements for safe, competent and ethical practice

What happens if a DDS, DA, DH, or DT fails the clinic examination?
Can only fail the clinic exam 2x before needing extra training/education specified by the board

Continuing education & professional development waiver
~must be retired from active practice (DDS, DT, DH, DA)~scope of practice is limited w/o pay in a public health, community, or tribal clinic or a nonprofit org that provides services to indigent or recipients of medical assistance or Minnesotacares program ~board may require written documentation ~licensee must document at least 5 HRS of approved courses in infection control, medical emergencies & medical management for the continuing education cycle ~provide documentation of current CPR certification from the American Heart Association healthcare provider course or the American Red Cross professional rescuer course

Who is eligible for an examination waiver?
~Graduate of a dental school accredited by CODA~passed all components of of national boards~completed a postdoctoral general residency program (GPR) or advanced education in general dentistry (AEGD) after Jan 1 2004 (must be at least 1 yr & include an assessment of the residents competence to practice dentistry)

DENTAL TECHNICIANS & DENTAL LABS


Dental Laboratory
A corporation, partnership, sole proprietor or business entity engaged in the manufacture or repair of dental prosthetic appliances (DOES NOT include dental labs physically located w/in a dental practice)

Material content notice
A notice that contains the complete material content information of a dental prosthetic appliance including whether United States Food & Drug Administration (FDA) compliant materials were used
***must go into the patients record

Work authorization
A written instrument by which a dental lab subcontracts to another dental lab all or part of the manufacture or repair of a dental prosthetic appliance authorized by a work order by a licensed dentist

Work order
A written instrument prescribed by a licensed dentist directing a dental lab to manufacture or repair a dental prosthetic appliance for an individual patient

All dental laboratories physically located in MN must __ w/the board of dentistry
register

T/F a dental lab can perform or authorize any dental technological work without a work order from a licensed dentist
False; a written work order by a licensed dentist is required

What must be included in a material content notice from a registered dental lab
1) country of origin where the technological work was performed in whole or in part
2) name, physical address, & registration number of the lab or labs that manufactured or repaired the dental prosthesis either directly or indirectly

Who is responsible for obtaining the material content notice from the dental lab?
The license dentist who submitted the written work order

T/F a dentist can only use registered dental labs
true

dental technician scope of practice
MUST HAVE A WRITTEN WORK ORDER FROM A LICENSED DENTIST
~construct, repair, alter, reline, reproduce, or duplicate any prosthetic device or other structure to be used in the human mouth

A work authorization form from a licensed dentist to a dental technician must include
~date & city where authorization was issued
~name of lab or technician to whom the authorization was issued
~the name of the patient or identifying symbol
~description of work authorized
~the signature of the dentist in their actual handwriting
~dentists license # issued by the board

A duplicate copy of each written authorization issued by the dentist shall be retained by the dentist for not less than
2 yrs

The original copy of each written authorization issued by the dentist shall be retained by the dental technician or lab for not less than
2 yrs

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