Expanded Functions

Recent Rule Changes Related to Expanded Functions

On November 21, 2022, the Iowa Dental Board adopted rulemaking related to expanded functions.  The notification of adoption was published as ARC 6733C in the Iowa Administrative Bulletin on December 12, 2022.  The rule changes will be effective January 18, 2023.  You can view the complete rules in IAC 650--Chapter 23.

Eligibility Requirements for Dental Assistants

In order to be eligible to complete training in expanded functions, registered dental assistants must qualify based on one of the following. Note: Dental assistant trainees are not eligible to train in expanded functions.

      1.   Be a graduate of an ADA-accredited dental assistant program; or
      2.   Be currently certified by the Dental Assisting National Board (DANB); or
      3.   Have at least three months of clinical practice as a registered dental assistant; or
      4.   Have at least three months of clinical practice as a dental assistant in a state that does not require registration.

Certificate of Completion

Board-approved expanded function training providers are required to issue certificates of completion following the successful conclusion of the training.  Dental hygienists and registered dental assistants must keep the certificate of completion or equivalent documentation on file in each office where expanded functions are provided.   Licensees and registrants who do not have proof of Board-approved training are prohibited from providing expanded function services.

Level 1 Expanded Functions

A dentist may delegate to dental hygienists or registered dental assistants those Level 1 expanded function procedures for which training has been successfully completed.  Dental hygienists or registered dental assistants may train in any of the Level 1 expanded function procedures and are not required to train in all of the procedures.

1. Taking occlusal registrations.
2. Placement and removal of gingival retraction material.
3. Fabrication, temporary cementation, and removal of provisional restorations following review of the fit and function by the supervising dentist, and temporary recementation of provisional restorations.
4. Applying cavity liners and bases.
5. Applying bonding systems, which may include the placement of the attachments used in clear aligner systems, following review of the fit and function by the supervising dentist.
6. Placement, bonding, and removal of provisional orthodontic restorations as follows:
   a.   Placement or bonding of orthodontic brackets and bands or provisional orthodontic appliances following review of the fit and function by the supervising dentist; and
   b.   Removal of adhesive, orthodontic brackets and bands, or provisional orthodontic appliances using nonmotorized hand instrumentation.
7. Monitoring of patients receiving nitrous oxide inhalation analgesia, which may include increasing oxygen levels as needed, pursuant to the following:*
   a.   A dentist shall induce a patient and establish the maintenance level;
   b.  A dental assistant may make adjustments that decrease the nitrous oxide concentration during the administration of nitrous oxide;
   c.   A dental assistant may turn off the oxygen delivery at the completion of the dental procedure.
8. Taking final impressions;
9. Removal of adhesives using nonmotorized hand instrumentation.*
10. Placement of temporary restorative materials following preparation of the tooth by a dentist;
11. Extraoral adjustment to acrylic dentures without making any adjustments to the prosthetic teeth; and
12. Tissue conditioning (soft reline only).

*Expanded functions for registered dental assistants.  Scope of practice for licensed dental hygienists.

Level 2 Expanded Functions

A dentist may delegate to dental hygienists or dental assistants those Level 2 expanded function procedures for which training has been successfully completed.  Dental hygienists or dental assistants are not required to train in all of the Level 2 procedures.

Please Note: Before beginning Level 2 training, expanded function dental hygienists or dental assistants must have successfully completed the prerequisites, for which training will be completed, as established by the Board-approved Level 2 expanded function training provider.

1. Placement and shaping of amalgam following preparation of a tooth by a dentist. 
2. Placement and shaping of adhesive restorative materials following preparation of a tooth by a dentist. 
3. Polishing of adhesive restorative material using a slow-speed handpiece. 
4. Fitting of stainless steel crowns on primary posterior teeth, and cementation after fit verification by a dentist.
5. Placement of sealants.* 

*Level 2 expanded function for registered dental assistants.

Level 2 expanded function procedures refer to both primary and permanent teeth except as otherwise noted.  Training in Level 2 expanded functions may be separated between application of the services on primary or permanent teeth as determined by the accredited training provider.