Dental Assistant Requirements in Arkansas: Registration, X-Ray Rules & Allowed Duties

Board Rule Article XVII defines three titles.

A Dental Assistant is a staff member of a duly licensed dentist involved in direct patient care, a category that includes both of the other two titles.

A Registered Dental Assistant is a Dental Assistant who has obtained one or more Board permits to perform expanded duties: nitrous oxide/oxygen analgesia, dental radiographic equipment operation, coronal polishing, or monitoring patients under deep sedation or general anesthesia.

A Certified Dental Assistant is a Dental Assistant currently certified by the Dental Assistant National Board.

Ark.

Code Ann. §17-82-403 bars anyone from performing a dental assistant's expanded duties, as the Board defines them, without a permit.

To get one, §17-82-404 requires a written application, an examination and licensing fee the Board sets, good moral character, and graduation from a Board-approved dental assistant training program, with the fee refunded only if the Board finds the applicant unqualified to test.

Once issued, §17-82-405 keeps a permit in force until forfeited, suspended or revoked, but requires the dental assistant to re-register it with the Board on January 1 of every odd-numbered year, paying a registration fee the Board sets at no more than sixty dollars.

Every function delegated to a dental assistant, expanded duty or not, must be performed under personal supervision.

Article XVII defines that as five conditions: the dentist is in the office or treatment facility, has personally diagnosed the condition being treated, has personally authorized the procedure, remains in the office or treatment facility while the procedure is performed, and evaluates the assistant's performance before the patient is dismissed.

The supervising dentist decides whether to delegate a given task based on the assistant's skills, the patient's needs, the task's requirements, and whether proof of competence is required, and stays liable for negligent performance by the assistant.

Beyond the specific expanded duties described elsewhere in the rule, Article XVII lets a dentist delegate to a Dental Assistant any dental task that doesn't require a licensed dentist's or hygienist's professional skill, as long as it happens under the dentist's personal supervision on the premises and its effect is reversible.

An assistant who holds a coronal polishing permit may also be delegated to place dental sealants, again only under the dentist's supervision.

The rule does not print a task-by-task list of routine duties beyond this general reversible-effect standard.

Operating dental radiographic equipment is among the four expanded duties Article XVII reserves to a Registered Dental Assistant who holds the matching permit; performing it without the permit is a prohibited activity.

To obtain the permit, an assistant must complete a Board-approved radiography course, pass a competency examination, submit the designated fee, pass a jurisprudence examination on the Dental Practice Act and Board rules, and show proof of current Healthcare Provider CPR — except that a Certified Dental Assistant or a graduate of a CODA-accredited program need only submit proof of graduation or certification plus the fee.

Assistants who held a radiography permit before November 1, 2011 are exempt from the course requirement unless they operate imaging equipment beyond conventional flat film, such as cone beam CT.

The rule reserves diagnosis, treatment planning and prescribing medication to a licensed dentist, and bars anyone but a dentist from any procedure that irreversibly alters the oral anatomy.

It then lists specific prohibited activities for dental assistants: diagnosis and treatment planning; scaling, root planing and curettage; surgical or cutting procedures on hard or soft tissue; prescribing, injecting, inhaling or parenterally administering drugs except where the Board permits; placing, seating or removing final or permanent restorations; final placement of orthodontic brackets; any procedure causing irreversible alteration of the oral anatomy; performing any of the four expanded duties without the matching permit; and any function the rules assign to a dental hygienist under Regulation XI A.

Administering nitrous oxide/oxygen analgesia and monitoring patients under deep sedation or general anesthesia are both expanded duties that require their own Board permits.

For the nitrous oxide permit, an assistant must complete a Board-approved nitrous oxide administration and monitoring course, submit the certificate and fee, pass a jurisprudence exam, and show proof of current Healthcare Provider CPR.

The separate sedation monitoring permit additionally requires already holding the nitrous oxide permit, being a Certified Dental Assistant, Registered Dental Assistant, Registered Nurse or Licensed Practical Nurse, and completing the AAOMS Anesthesia Assistant's training program or a Board-approved equivalent within the two years before applying — though licensed physicians with six months of anesthesia experience and Certified Registered Nurse Anesthetists are exempt from the education and permit requirements.

A Registered Dental Assistant must give the Board proof of completing two hours of continuing education on infection control every two-year reporting period in order to renew a permit to perform expanded duties, reported in the manner Article XIV sets out.

The rule does not print a continuing education requirement for the base Dental Assistant or Certified Dental Assistant titles beyond what holding an expanded-duty permit requires.