-
Placement of Sealants
-
Placement of restorative
materials limited to amalgam restorative materials
-
Placement of restorative
materials limited to nonmetallic restorative
materials, including direct-bonded restorative
materials
-
Aspiration and retraction,
excluding placement of gingival retraction materials
-
Intra-oral instrument
transfer
-
Preliminary charting of
missing and filled teeth
-
Elastomeric impressions
for diagnostic models and models to be used for
opposing models in the construction of appliances
and restorations
-
Taking impressions for the
construction of custom athletic mouth protectors/mouthguards
-
Taking impressions for the
construction of trays for application of medicaments
-
Application of disclosing
solutions
-
Caries susceptibility
testing
-
Demonstration of oral
hygiene procedures, including, but not limited to,
use of toothbrushes and dental floss
-
Shade selection for
fabrication of appliances or restorations
-
Application of topical
anesthetics
-
Pulp testing
-
Fluoride application,
limited to liquid or gel applications
-
Topical applications of
desensitizing agents to teeth
-
Application of periodontal
dressings (packs)
-
Removal of periodontal
dressings (packs)
-
Suture removal
-
Placement of rubber dam
over preplaced clamp, and removal of clamp and
rubber dam
-
Application of cavity
varnish Placement of surgical dressings
-
Removal of surgical
dressings
-
Intra-oral bite
registrations for diagnostic model articulation
-
Intra-oral bite
registrations for restorations
-
Intra-oral bite
registrations for appliances
-
Standard, diagnostic,
radiologic procedures for the purpose of
contributing to the provision of dental services
-
All supportive services
necessary to the maintenance of a hygienic practice
environment, including, but not limited to, all
sterilizing procedures
-
Physical positioning of
the patient
-
Monitoring of vital signs
-
Assistance during
administration of life-support activities, and any
other non-invasive procedures deemed necessary by
the supervising dentist to maintain the health and
safety of the patient
-
Taking photographs
-
Recording patient
treatment
-
Measurement of blood
pressure and body temperature
-
Other common tests deemed
necessary by the supervising dentist
-
Repair, construction and
finishing of metallic and plastic prosthetic devise
-
Compilation of
radiographic data for interpretation by the dentist,
i.e., tracings, etc
-
Progress reports
-
Consultations (oral or
written)
-
Oral hygiene instructions
-
Instruction /Use of
intra-oral hygiene devices
-
Instruction /Normal
nutrition information as it relates to dental health
-
Behavioral modification
-
Instruction /
Self-adjustment of orthodontic appliances and all
other post-operative and post-insertion
instructions, as deemed appropriate by the
supervising dentist
-
All non-invasive
supportive services normally utilized in conjunction
with the treatment by the dentist of fascia pain or
TMJ syndrome
-
Preparing the teeth for
restorations or for the bonding of orthodontic
brackets by treating the supragingival coronal
surfaces of the teeth to be bonded with a
conditioning or etching agent and by the placement
of a bonding agent adhesive
-
Polymerization of
light-activated restorative or bonding materials
-
Impressions for removable
or fixed orthodontic appliances
-
Preliminary selection and
sizing of orthodontic bands and arch wires
-
Checking for and removal
of loose orthodontic bands
-
Checking for and removal
of loose orthodontic brackets
-
Placement and removal of
orthodontic arch wires, auxiliary arch wires, and
ligation of same to orthodontic bands and/or
brackets
-
Placement and removal of
orthodontic separators and ties
-
Irrigation and drying of
canals during endodontic procedures
-
Placement of medication in
the pulp chamber(s) of teeth with non-vital pulp or
instrumented root canals
