(1) A dental therapist may only practice dental therapy under the supervision of a dentist and under a written practice plan contract. The contract, at a minimum, must contain:

(a) The elements listed in RCW 18.265.060; and

(b) Limited conditions and emergency procedures.

(i) Limited conditions include nonsurgical extractions when a patient is classified as an American Society Anesthesiologists (ASA) I or ASA II.

(ii) Prior approval and consultation from the supervising dentist is required for patients classified as ASA III.

(2) The practice plan must be:

(a) Signed by the supervising dentist and a dental therapist and must outline the mutually agreed upon functions that the dentist authorizes the dental therapist to perform and the level and type of supervision that is required;

(b) Submitted to the secretary upon license renewal; and

(c) Submitted to the secretary within 30 days of any substantive revision.