Professional Development: N20 Monitoring for the Dental Staff
  SC Board Guidelines for Nitrous Oxide Monitoring:  
  • Allied dental personnel (expanded duty dental assistants and hygienists) certified by the Board can by dentist’s direction initiate oxygenation and titrate in N2O to the dentist’s Rx level. An expanded duty dental assistant is a graduate of an accredited program, is a DANB Certified Dental Assistant or has worked chairside continually for 2 years.

  • Effective May 27, 1997 Board Regulation 39-13 Approved Procedures of Expanded Duty Dental Assistants, includes (9) “Monitor nitrous oxide anesthesia upon completion of a Board approved course and certification by the Board.” The regulation authorizes dental hygienists and expanded duty dental assistants who successfully complete a Board approved course and the State Board Nitrous Oxide Monitoring Examination to monitor nitrous oxide anesthesia.

  • In response to questions and concerns by the dental profession, the Board determined a need to clarify the definitions of the terms “monitor” and “administration” with regard to nitrous oxide. A good understanding of the regulation will result in compliance by the profession, fewer complaints and fewer disciplinary actions as a result of non-compliance.

  • “Administration” – the dentist’s determination of the need and level of nitrous oxide sedation regarding a particular patient.

  • “Monitor” – carrying out the orders of the dentist, to include the initiation of the flow of the nitrous oxide component.

  • Therefore, the dentist must diagnose the need for a patient to receive nitrous oxide and may designate the dental assistant to place the mask and set the nitrous oxide component at a level specified for that patient. The assistant may then maintain that flow or decrease the level of nitrous oxide component when oxygenating the patient, without specific direction of the dentist.
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