NH Dental Jurisprudence common mistakes
NH Dental Jurisprudence · Understand the traps and how to avoid them.
On a delegation scenario, the candidate checks only whether the dentist was physically in the office, then concludes the assistant or hygienist may perform the procedure 'under general supervision.'
Candidates collapse New Hampshire's supervision categories into a single on-premises/off-premises test and treat 'general supervision' as permission for independent practice, when general supervision still requires the dentist to have authorized the treatment and to be available as the rules specify.
What to do instead
Build a three-row table for direct, indirect, and general supervision with columns for dentist location, whether a prior exam and written treatment plan are required, and which functions each tier permits. On every delegation question, state the supervision level first, name the function second, then match the two against the rule.
Selects that a dental assistant may perform an expanded function (for example placing or carving restorative material, taking a final impression, or performing coronal polishing) because 'the dentist was right there' or because assistants did it at a previous office in another state.
Office custom and interstate experience feel authoritative, so candidates substitute remembered practice patterns for New Hampshire's enumerated list of delegable assistant functions and any required board-approved expanded-function training or certification.
What to do instead
Memorize the statutory list of assistant functions and tag each one as direct-supervision-only, delegable under indirect supervision, or non-delegable. Adopt a default rule for the exam: a function that is not expressly listed is not delegable, regardless of the dentist's willingness to supervise.
Attributes enforcement of workplace safety, insurance billing, or patient compensation to the dental board, e.g., choosing that the board will order the dentist to pay a patient's repair costs or will cite the office for an OSHA violation.
Candidates blur 'who regulates the practice of dentistry' with 'who regulates the workplace, insurance programs, and civil disputes,' because all of these appear in the same office setting.
What to do instead
Sort facts by regulator before answering: the dental board handles licensure, scope, competence, and discipline; workplace safety agencies handle occupational exposure rules; Medicaid and other payers handle billing; courts handle damages. If an answer choice gives the board a remedy it does not issue - money damages, criminal fines - eliminate it.
Answers an infection-control item by saying 'any CDC-compliant policy is sufficient,' without addressing the written exposure control plan, sterilization monitoring records, handpiece and dental unit waterline maintenance, sharps handling, or the reporting duties in the state rules.
Candidates study infection control from clinical memory and continuing-education courses rather than from the administrative chapter, so they recognize the concept but not the documentation and monitoring obligations the exam tests.
What to do instead
Maintain a one-page checklist of the items the rules require - written exposure control plan, hepatitis B offer and training records, spore testing and sterilization logs, waterline protocols, PPE and sharps requirements, post-exposure follow-up - and map each question to one checklist line rather than answering from general principle.
States that records may be destroyed after a short interval, that an error may be fixed by erasing or backdating an entry, or that copies may be withheld until an unpaid balance is paid.
Business instincts and front-office habits conflict with the record rules, and candidates have usually never read the retention provision or the amendment provision.
What to do instead
Learn the retention period and the minor-patient exception as written, and remember that a patient's request for copies is not conditioned on payment of fees for treatment. For corrections, use the exam's safe pattern: never alter or backdate; add a dated, signed addendum that preserves the original entry.
Chooses 'consent was valid because the patient signed the form' even where the scenario shows no discussion of material risks or alternatives, or a patient who could not understand the discussion.
Candidates equate documentation with the consent process, because the signed form is the only visible artifact in a real practice.
What to do instead
Test consent against four elements separately: capacity, disclosure of material risks and reasonable alternatives, voluntary authorization, and documentation. On each item, identify which element the facts attack; a signature alone satisfies only the fourth.
Assumes a dentist may keep practicing while a renewal is pending, or counts any continuing-education hours toward the requirement without checking the cycle, category limits, or acceptable sources.
Candidates remember a total hour number from a prep course but not the renewal date, the categories, or the rule that practice authority ends at expiration.
What to do instead
Learn the renewal cycle, the CE categories and any limits on self-study or non-clinical hours, and the rule that there is no grace period for practicing on an expired license. If a question turns on a specific number you cannot recall with confidence, reason from the principle that practice authority stops at expiration and flag the item for review.
Selects that any licensed dentist may administer nitrous oxide or moderate sedation, or that a dental assistant may monitor the patient during sedation, based on holding a general license.
Sedation authority is permit-based rather than part of the base license, and candidates who have not separated the permit tiers default to 'the dentist is licensed, so the dentist may do it.'
What to do instead
Build a permit-tier table for nitrous oxide, minimal/moderate sedation, and deep sedation or general anesthesia, listing required training, equipment, and the number and qualifications of monitoring personnel. Before answering, ask which permit the dentist actually holds.
Approves dismissing a patient mid-treatment, or for nonpayment, with no written notice, no time to find another dentist, no transfer of records, and no plan for emergencies.
Candidates treat the dentist-patient relationship as an ordinary commercial relationship that can be ended at will, rather than as one that carries a duty not to abandon.
What to do instead
Memorize the elements of a defensible termination: written notice, enough time for the patient to secure replacement care, provision or transfer of records, and continued availability for emergencies during the transition. If any element is missing in the facts, the answer is abandonment.
Answers that a dentist may decline to treat a patient, or may charge a higher fee, because the patient has HIV, hepatitis, or another infectious condition.
Fear-based reasoning and outdated practice patterns override the public-health rule, and candidates do not connect the question to anti-discrimination and standard-precautions obligations.
What to do instead
Apply standard precautions to every patient and treat infectious status as irrelevant to the decision to treat. The only lawful basis to decline is that the needed care is outside the dentist's competence, in which case the patient is referred appropriately - not refused because of the diagnosis.