Dental Hygienist Duties by State Before licensure as a dental hygienist, a dental hygienist must: Graduate from an accredited dental hygiene program; Successfully complete of the written National Board Dental Hygiene Examination (National Board Examination); Successfully complete of a regional or state clinical board examination (Clinical Board Examinations) Once these steps have been completed, an applicant for licensure must then contact the state licensing authority in the state where he/she wishes to practice. As licensing requirements vary from state to state, it is necessary to contact each licensing authority in a given state for its specific application requirements and procedures. Examples of additional types of requirements may be needed for licensure include: successful completion of a jurisprudence exam; proof of CPR certification; letters of recommendation from dentists licensed in the state in which applicants wish to obtain licensure; official transcripts from high school and colleges attended, official confirmation of the absence of a criminal record, and official letters from the boards of dentistry where licensure is held. Information about services that can be provided by dental hygienists, as well as the different levels of service has been compiled below: State
Services that can be provided:
Supervision Required:
AL
Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure; Sealants; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast; Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures;
Direct Supervision Levels; dentist needs to be present to provide all services.
DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist. For dental hygienists, General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For Dental Health Aide Therapists (DHAT), hygienist can provide services as she determines appropriate without specific authorization.
AK
Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue; Curettage
Licensure Renewal/Advanced Hygiene Licensure Requirements: For licensure renewal, a dental hygienist must earn 12 hours every year reported on renewal form. CPR required and 2 hours of infection control every two year.
For licensure renewal, a dental hygienist must earn 14 hours every two years, listed on licensure renewal form. CPR required. A DHAT must have 4,000 hours experience within the last 5 years. Board
AZ
Administer N20
Direct supervision levels required; dentist needs to be present to provide all services.
Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures
General Supervision Levels; dentist needs to authorize prior to services, but need not be present.
DH Diagnosis/ Assessment Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants
These procedures are not allowed to be done by a dental hygienist. For dental hygienists, dentist needs to authorize prior to services, but need not be present. Dental hygienist working under contract for schools, public health settings and institutions may screen and apply fluoride unsupervised.
Local Anesthesia; Administer N20; Place Perio Dressings; Remove Perio Dressings; Place Sutures;
Direct Supervision Levels required; dentist needs to be present to provide all services. A dental hygienist with a written affiliated practice agreement with a dentist may assess for and perform dental hygiene services on patients who meet certain financial criteria and are enrolled in a federal, state, county or local healthcare program
AR
Root Planing; Soft Tissue Curettage; Study Cast Impressions; Remove Sutures
General supervision required for all hygienists; dentist needs to authorize prior to services, but need not be present.
DH Diagnosis/ Assessment Treatment Planning Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure Sealants; Study Cast Impressions
These procedures are not allowed to be done by a dental hygienist. General supervision required; dentist needs to authorize prior to services, but need not be present.
Local Anesthesia; Root Planing; Soft Tissue Curettage; Administer N20
Direct Supervision Levels required; dentist needs to be present to provide all services.
must approve collaborative agreement.
For licensure renewal, a dental hygienist must earn 54 hours every 3 years. Must also be current in CPR and earn 4 hours infectious disease 2 hours in chemical dependency, tobacco cessation, ethics, risk management or jurisprudence. A maximum 14 hrs practice management, healthcare delivery is required. Hygienists with written affiliated practice agreement must have 5 years practice and actively engaged in dental hygiene practice for at least two thousand hours in the five years immediately preceding the affiliated practice relationship. Direct Medicaid reimbursement allowed.
For licensure renewal, a dental hygienist must earn 40 hours every two years. Must be current in CPR and earn 2 hours infection control.
CA
CO
CT
Topical Anesthesia; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Local Anesthesia; Soft Tissue Curettage; Administer N20 Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Study Cast Impressions; DH Diagnosis/ Assessment; Treatment Planning
Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Unsupervised practice in all settings for all licensed dental hygienists for the oral prophylaxis and preventive and therapeutic services. The dental hygienist may also own a dental hygiene practice.
Local Anesthesia; Root Planing; Soft Tissue Curettage; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
Direct Supervision Levels required; dentist needs to be present.
Administer N20; Place Sutures
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists with 2 years experience may practice without supervision in institutions, public health facilities, group homes and schools.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning
For dental hygienists, general supervision levels required; dentist needs to authorize prior to services, but need not be present; For Registered Dental Hygienists in Alternative Practice (RDHAP), hygienist can provide services as she determines appropriate without specific authorization. In government created or administered public health program, a dental hygienist may provide screening and apply fluorides and sealants without supervision.
For licensure renewal, a dental hygienist must earn 25 hours every two years. Must be current in CPR.
RDHAPs must earn a bachelors degree equivalent, 3 years clinical practice, and completion of 150 clock hour special course and exam.
Dental hygienists do not need to earn any continuing education hours. No special requirements for Independent Practice Dental Hygienists. Direct Medicaid reimbursement allowed.
Dental hygienists do not need to earn any continuing education hours. 2 years experience required for unsupervised practice in public health
Only General Supervision Level allowed for DH Diagnosis/ Assessment and Treatment Planning.
DE
DC
FL
Local Anesthesia
Direct Supervision Levels; dentist needs to be present.
Soft Tissue Curettage; Administer N20; Place Sutures Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Local Anesthesia; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Local Anesthesia; Administer N20; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
Direct Supervision Levels; dentist needs to be present.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present (Fluoride varnish allowed to be done in public health settings only).
Root Planing; Soft Tissue Curettage; Study Cast Impressions
Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a
settings. Direct Medicaid reimbursement allowed.
For licensure renewal, a dental hygienist must earn 24 hours every two years. CPR required, but not included in 24 hour CE requirement. Limit on management subjects.
For licensure renewal, a dental hygienist must earn 15 hours every two years. Two hours of CPR must be part of 15 hour requirement
For licensure renewal, a dental hygienist must earn 24 hours every two years. Must be current in CPR (cannot use hrs). Two hours in prevention of medical errors and 2 hrs every third biennium in domestic violence required.
GA
HI
ID
IL
Local Anesthesia; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning X‐Rays; Prophylaxis; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio; Dressings; Remove Sutures
dental hygienist.
Local Anesthesia; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. Except for administering local anesthesia, General Supervision Levels (dentist needs to authorize prior to services, but need not be present) allowed for public health settings
Administer N20; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Registered dental hygienists (RDHs) can provide services in hospitals, long term care facility, public health facility, health or migrant clinic or other board approved setting if dentist affiliated with setting authorizes services.
Direct Supervision Levels; dentist needs to be present.
Administer N20; Study Cast Impressions
Direct Supervision Levels; dentist needs to be present.
Soft Tissue Curettage; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing;
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
For licensure renewal, a dental hygienist must earn 22 hours every two years. Must earn CPR (up to 4 hrs) and 15 hrs must be “clinical science”
For licensure renewal, a dental hygienist must earn 20 hours every two years and be current in CPR.
For licensure renewal, a dental hygienist must earn 24 hours every 2 years and be current in CPR RDHs must be an employee of the facility or obtain extended care permit. ECP requires 1,000 hours experience in last 2 years
For licensure renewal, a dental hygienist must earn 32 hours every three years
Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings; Remove Sutures
IN
IA
and be current in CPR.
Local Anesthesia; Administer N20
Direct Supervision Levels; dentist needs to be present.
Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia; Fluoride; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Prophylaxis; X‐Rays; Pit/ Fissure Sealants
Direct Supervision Levels; dentist needs to be present, but for dental hygienists in public settings, General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; DH Diagnosis/ Assessment
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Registered dental hygienists (RDHs) may provide services based on standing orders and a written agreement with a dentist in schools, Head Start settings, nursing facilities FQHCs (Federally Qualified Health Centers), public health vans, free clinics, community centers and public health programs. Only General Supervision Level allowed for DH Diagnosis/ Assessment and Treatment Planning.
Local Anesthesia; Administer N20
Direct Supervision Levels; dentist needs to be present.
Study Cast Impressions; Place Perio Dressings;
General Supervision Levels required; dentist needs to
For licensure renewal, a dental hygienist must earn 14 hours every two years. Must earn CPR (up to 2 hrs credit) and 2 hours in Ethics. No more than 5 hrs practice management.
For licensure renewal, a dental hygienist must earn 30 hours every two years. Must earn CPR–can claim up to 3 hours. Must earn Iowa based child/dependent abuse every 5 yrs. RDHs must have 3 years clinical experience and submit annual report on number of patients/services to department of health. All dental hygiene services (except local anesthesia and nitrous) may be provided once to each patient. To perform repeat services other than assessment, screening and
KS
KY
LA
Remove Perio Dressings; Remove Sutures; Treatment Planning
authorize prior to services, but need not be present.
fluoride, dentist must examine.
Soft Tissue Curettage; Place Sutures
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
For licensure renewal, a dental hygienist must earn 30 hours every two years.
X‐Rays; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; Topical Anesthesia; Fluoride; DH Diagnosis/ Assessment; Treatment Planning
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienist with an extended care permit I or II may treat patients in schools, head start programs, state correctional institutions, local health departments, indigent care clinics, adult care homes, hospital long term units, or at the home of homebound persons on medical assistance. Only General Supervision Level allowed for DH Diagnosis/ Assessment and Treatment Planning.
Local Anesthesia
Direct Supervision Levels required for local anesthesia; dentist needs to be present. Placing Sutures is not allowed. Direct Supervision Levels; dentist needs to be present.
Local Anesthesia; Topical Anesthesia; Fluoride; Administer N20 Prophylaxis; X‐Rays; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Soft Tissue Curettage; Place Sutures; Treatment Planning Local Anesthesia; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Dental hygienist with an extended care permit I or II must have 1,800 hours experience. CPR required only if RDH administers anesthesia.
For licensure renewal, a dental hygienist must earn 30 hours every two years. CPR required. Approved HIV/AIDS course every 10 years.
For licensure renewal, a dental hygienist must earn24 hours every two years. CPR
Perio Dressings; Remove Sutures
ME
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants
Direct Supervision Levels required for local anesthesia; dentist needs to be present. For hygienists practicing in a public health setting, General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Place Perio Dressings
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For a dental hygienist practice in a public or private school, hospital or other non-traditional practice setting under a public health supervision status (granted by the dental board on a case-by-case basis), hygienist can provide services as she determines appropriate without specific authorization.
Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Direct Supervision Levels; dentist needs to be present.
A dental hygienist licensed as an independent practice dental hygienist may practice without supervision by a dentist in all settings.
(required for general supervision) up to 3 hours credit. No more than 12 hours by practice management courses.
For licensure renewal, a dental hygienist must earn 30 hours every two years. CPR required. An Independent Practice Dental Hygienist must possess a bachelor's degree from a CODA accredited dental hygiene program and 2,000 work hours of clinical practice in a private dental practice during the two years preceding the application or possess an associate degree from a CODA accredited dental hygiene program and 6,000 work hours of clinical practice in a private dental practice during the six years preceding the application. They are also required to provide a referral plan to patients in need of additional care by a dentist. For hygienists practicing in public settings, a dental hygienist must apply to the board to practice providing such information the board deems necessary. The board must take into
MD
MA
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Local Anesthesia
Direct Supervision Levels required for local anesthesia; dentist needs to be present.
Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Public Health Dental Hygienists may provide dental hygiene services without the supervision of a dentist in public health settings; hygienist can provide services as she determines appropriate without specific authorization.
Local Anesthesia
Direct Supervision Levels required for local anesthesia; dentist needs to be present.
Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
consideration whether the program will fulfill an unmet need, whether a supervising dentist is available and that the appropriate public health guidelines and standards of care can be met and followed. For licensure renewal, a dental hygienist must earn 30 hours every two years. Must be current in CPR, and earn 2 hours in infection control and abuse and neglect. Courses must concern clinical knowledge and ability to treat.
For licensure renewal, a dental hygienist must earn 20 hours every two years. Must earn CPR to administer anesthesia. Public Health Dental Hygienists must have a minimum of three years full-time clinical experience practicing in a public health setting and appropriate training as determined by the department of public health. Prior to providing services, a public health dental hygienist must have a written collaborative agreement with a local or state government agency or institution, or licensed dentist that states the level of communication with the dental hygienist to ensure patient health and safety. Public health dental hygienists shall provide patients
MI
MN
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists, who qualify for recognition as a grantee health agency by the Department of Community Health may provide dental hygiene services for patients who are not assigned by a dentist. These hygienists can provide services as she determines appropriate without specific authorization.
Local Anesthesia; Soft Tissue Curettage; Administer N20
Direct Supervision Levels; dentist needs to be present.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Local Anesthesia; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
with a written referral to a dentist and an assessment of further dental needs. For licensure renewal, a dental hygienist must earn 36 hours every three years. CPR required to administer local anesthesia. The director of community health shall designate a person as a grantee health agency for a 2-year period if the person applies to the department of community health on a form provided by the department of community health and meets all of the following requirements: is a public or nonprofit entity, or a school or nursing home, that administers a program of dental care to a dentally underserved population, employs or contracts with at least 1 dentist or 1 dental hygienist, submits a program overview indicating the approximate population to be served, the method by which the service is to be provided, the procedures for program oversight and direction, and the name and license number of the dentist and dental hygienist, if applicable, who are performing from the Michigan dental association or its successor organization. For licensure renewal, a dental hygienist must earn 25 hours every two years and be current in CPR. Minimum 15 hrs in “core” courses required. Must complete two of the following categories per
MS
Prophylaxis; X‐Rays; Pit/ Fissure Sealants; Fluoride; Root Planing Topical Anesthesia
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. A dental hygienist may be employed or retained by a health care facility, program, or nonprofit organization to perform dental hygiene services without the patient first being examined by a licensed dentist if the dental hygienist has entered into a collaborative agreement with a licensed dentist that designates authorization for the services provided by the dental hygienist.
cycle—infection control; record keeping; ethics; patient communications; management medical emergencies; and treatment and diagnosis. Must maintain a “portfolio” to record documentation of fundamental and elective professional development activities, CPR certification, and a biennial selfassessments (on a board approved form)
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage
Direct Supervision Levels; dentist needs to be present (Fluoride varnish allowed to be done in public health settings by General Supervision Levels).
Local Anesthesia; Topical Anesthesia; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place
These procedures are not allowed to be done by a dental hygienist.
Dental hygienists in health care settings must have been engaged in the active practice of clinical dental hygiene for not less than 2,400 hours in the past 18 months or a career total of 3,000 hours, including a minimum of 200 hours of clinical practice in two of the past three years. Has documented participation in courses in infection control and medical emergencies within each continuing education cycle and maintains current certification in advanced or basic cardiac life support as recognized by the American Heart Association, the American Red Cross, or another agency that is equivalent to the American Heart Association or the American Red Cross. For licensure renewal, a dental hygienist must earn 20 hours every two years. CPR, up to 4 hrs, required; 8 hrs for advanced CPR.
Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning MO
MT
NE
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists may provide services without supervision in public health settings to Medicaid eligible children; hygienist can provide services as she determines appropriate without specific authorization.
Local Anesthesia; Administer N20; Remove Perio Dressings
Direct Supervision Levels; dentist needs to be present.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Administer N20
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For hygienists with a limited access permit from the board, hygienist can provide services as she determines appropriate without specific authorization.
X‐Rays; Local Anesthesia; Topical Anesthesia; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; Fluoride; Pit/ Fissure Sealants
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. The Department of Health may authorize an unsupervised Registered Dental Hygienist (RDH) to provide public health related services in a public
For licensure renewal, a dental hygienist must earn 30 hours every two years. CPR required. Not less than 25 hrs must be directly related to updating and maintaining skills and knowledge in treatment, health and safety of patient. Public Health Dental Hygienists must have 3 years experience. Direct Medicaid reimbursement allowed.
For licensure renewal, a dental hygienist must earn 36 hours every three years and be current in CPR. Limited access permit hygienists must earn 2400 hours experience in the last 3 years; 3000 hours over career with 350 hours each of the last 2 years. Additional 12 hours CE every 2 year; liability insurance.
For licensure renewal, a dental hygienist must earn 30 hours every two years and be current in CPR (up to 4 hours.) RDHs must have 3000 hours experience
health setting or a healthcare or related facility; hygienist can provide services as she determines appropriate without specific authorization. X‐Rays; Local Anesthesia; Topical Anesthesia; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning NV
Prophylaxis; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning; Soft Tissue Curettage; X‐Rays; Root Planing; Administer N20; Place Sutures
NH
Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root Planing
in at least 4 of last 5 years; professional liability insurance.
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For registered dental hygienists (RDHs) with Public Health Endorsements, hygienist can provide services as she determines appropriate without specific authorization. General supervision always required for soft tissue cutterage. Direct Supervision Levels required for x-rays, root planning; and administering N20. RDHs, allowed to perform these tasks (general supervision for x-rays; where general supervision is allowed; no authorization needed for root planning and administering N20); placing sutures is not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Under public health supervision, dental hygienists may provide procedures authorized by a dentist in a public or private school, hospital or institution, or residence of a homebound patient provided the dentist reviews patient records once in a 12 month period.
For licensure renewal, a dental hygienist must earn 15 hours every year and be current in CPR. No special requirements for RDH Public Health Endorsements.
For licensure renewal, a dental hygienist must earn 20 hours every two years. Must be current in CPR (up to 3 hours per year) and may only take subjects related to practice. No special requirements for public health dental hygienists.
NJ
NM
NY
X‐Rays; Topical Anesthesia; Study Cast Impressions; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Local Anesthesia; Administer N20
Direct Supervision Levels required for local anesthesia; dentist needs to be present
Soft Tissue Curettage; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure Sealants; Root Planing
Direct Supervision Levels required for local anesthesia; dentist needs to be present. For
Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Prophylaxis; X‐Rays; Fluoride; DH Diagnosis/ Assessment; Pit/ Fissure Sealants; Root Planing Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For those in Collaborative Practice of Dental Hygiene (CPDH), hygienist can provide Prophylaxis,, X‐Rays, and Fluoride services as she determines appropriate without specific authorization.
Place Perio Dressings; Administer N20; Place Sutures; Remove Sutures; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Local Anesthesia; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
Direct Supervision Levels; dentist needs to be present.
Direct Supervision Levels; dentist needs to be present.
For licensure renewal, a dental hygienist must earn 20 hours every two years. No volunteer work considered for CE. Must be current in CPR. Up to 10 hours for teaching or research.
For licensure renewal, a dental hygienist must earn 45 hours every three years and be current in CPR. Course in infection control techniques and sterilization procedures. CPDHs must have 2400 hours active practice in past 18 months or 3000 hours in 2 of past 3 years. Direct Medicaid reimbursement allowed. Each collaborative practice agreement must contain protocols for care. For licensure renewal, a dental hygienist must earn 24 hours every three years and be current in CPR, (Up to 3 hrs, 41/2
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing
NC
ND
OH
Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Root Planing; Study Cast Impressions; Remove Perio Dressings; Place Sutures; Remove Sutures
Direct Supervision Levels; dentist needs to be present. If a supervising dentist is available for consultation, diagnosis and evaluation, and has authorized the dental hygienist to perform the services, and exercises that degree of supervision appropriate to the circumstances, dentist needs to authorize prior to services, but need not be present. In nursing homes a hygienist can perform a complete oral examination of a resident and then determine treatment priorities; plan for continuing oral hygiene and dental care.
hrs advanced CPR, up to 12 hrs ACLS or PALS). State approved class in infection control required every 4 years. Courses must be related to professional practice, no practice management. No special requirements needed for general supervision dental hygienists.
These procedures are not allowed to be done by a dental hygienist. For Registered Dental Hygienists (RDHs) in Public Health, dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia; dentist needs to be present
Local Anesthesia; Pit/ Fissure Sealants; Soft Tissue Curettage; Administer N20; Place Perio Dressings; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Administer N20; Place Sutures; DH Diagnosis/ Assessment Local Anesthesia; Root Planing; Soft Tissue
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia; dentist needs to be present. Root Planing and Soft Tissue Cutterage, must be done upon direct order of a dentist.
For licensure renewal, a dental hygienist must earn six hours every year and be current in CPR. Public Health RDH needs additional requirements IF they work under “direction”.
For licensure renewal, a dental hygienist must earn 16 hours every two years. 2 hours in CPR infection control required; only 3 hours may be non-clinical.
For licensure renewal, a dental hygienist
Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
present.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning OK
Local Anesthesia; Administer N20; Remove Sutures Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings
OR
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. A dentist may authorize in writing a dental hygienist to perform services one time on a patient in a setting outside the office prior to any dentist contact/exam if the hygienist refers the patient back to the authorizing dentist.
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For limited Access Permit (LAP) holders, hygienist can provide services as she determines appropriate without specific authorization, except for providing local anesthesia. Only hygienists with LAP permit may provide DH Diagnosis/ Assessment and Treatment Planning.
Administer N20; Place Sutures
Direct Supervision Levels; dentist needs to be present to administer N20; hygienists may not place sutures.
must earn 12 hours every two years. Up to 4 hrs volunteer service allowed. CPR required if in clinical practice.
For licensure renewal, a dental hygienist must earn 30 hours every three years and be current in CPR. One course in ethics every three years required. No more than 3 hours in practice Management. General supervision dental hygienists must have 2 years experience. For licensure renewal, a dental hygienist must earn 3 hours must be related to medical emergencies in dental office. Up to 6 hours for volunteer services; community oral health instruction authorship of a professional publication, participation on dental board, peer review, or quality of care review procedures, test development for clinical dh exam may be earned. LAP Hygienists must earn 12 hours of CE every two years (in addition to the 24 hours required for all dental hygienists) to renew permit. 2,500 supervised
PA
RI
SC
Prophylaxis; ; X‐Rays; Local Anesthesia; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Remove Sutures
Direct Supervision Levels; dentist needs to be present. Public health dental hygiene Practitioners may provide care in a variety of public health settings without the supervision or prior authorization of a dentist., except for providing local anesthesia, which can only be done under direct supervision.
Topical Anesthesia; Fluoride
Direct Supervision Levels; dentist needs to be present. For hygienists with General Supervision Levels; dentist needs to authorize prior to services, but need not be present.
Soft Tissue Curettage; Administer N20; Place Perio Dressings; Remove Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants; Root Planing; DH Diagnosis/ Assessment
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists working under a dentist’s general supervision can initiate dental hygiene treatment to residents of nursing facilities and can provide services as she determines appropriate without specific authorization, except Diagnosis/Assessment.
Soft Tissue Curettage; Administer N20; Place Sutures; Treatment Planning Local Anesthesia; Topical Anesthesia Study Cast Impressions; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Direct Supervision Levels; dentist needs to be present.
experience, liability insurance. For licensure renewal, a dental hygienist must earn 20 hours every two years and be current in CPR. Public health dental hygiene practitioners must have 3,600 hours and are required to take five hours of continuing education dedicated to public health matters during each licensure period. Must also have expense and liability insurance.
For licensure renewal, a dental hygienist must earn 20 hours every two years. One hour per year must be earned in OSHA Bloodborne Pathogen Standards if practicing in dental setting. No volunteer work considered for CE.
For licensure renewal, a dental hygienist must earn 14 hours every two years and be current in CPR.
Fluoride; Pit/ Fissure Sealants; Root Planing; Prophylaxis; X‐Rays; Fluoride
SD
TN
TX
Soft Tissue Curettage; Administer N20; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Administer N20; Local Anesthesia
Direct Supervision Levels; dentist needs to be present. Dental hygienists employed by or contacted through the Department of Health and Environment Control may provide services under general supervision that does not require prior examination by a dentist in settings such as schools or nursing homes.
Dental Hygienists in public health settings must carry professional liability insurance.
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; X‐Rays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio
These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. A dentist may delegate services for a period of 6
Direct Supervision Levels; dentist needs to be present.
For licensure renewal, a dental hygienist must earn 75 hours every five years and be current in CPR (can receive credit). One hour every year in dental radiography required. Up to 6 hrs for volunteer work allowed.
For licensure renewal, a dental hygienist must earn 30 hours every two years and be current in CPR.
For licensure renewal, a dental hygienist must earn 12 hours every year. OSHA, CPR not included in 12 hrs, but are
UT
VT
Dressings; Remove Perio Dressings; Remove Sutures
months without seeing the patient first to a dental hygienist practicing in a nursing facility, school based health center, or community health center. The hygienist must refer the patient to a dentist following treatment. The hygienist may not perform a second set of services until the patient has been examined by a dentist.
required (PALS and ACLS do qualify). No volunteer work considered for CE, except that licencees may get up to 6 hours for providing consultation to the dental board. Must complete an online (no credit) jurisprudence assessment every 3 years.
Local Anesthesia; Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Local Anesthesia; Administer N20
Direct Supervision Levels; dentist needs to be present.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Dental Hygienists in public health settings must have 2 years practice experience For licensure renewal, a dental hygienist must earn 30 hours every two years. No volunteer work considered for CE.
DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Local Anesthesia Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants; Root Planing
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists may provide hygiene services in public health settings under the supervision of a dentist via a general supervision agreement. The agreement authorizes the dental hygienist to provide services, agreed to between the dentist and the
For licensure renewal, a dental hygienist must earn 18 hours every two years. No volunteer work considered for CE. Public Health dental hygienists must have three years licensed clinical practice experience and in good standing in Vermont.
dental hygienist. The agreement does not require physical presence of the dentist but it stipulates that the supervising dentist review all patient records.
VA
WA
Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Administer N20
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present; may only be performed by a hygienist on patients 18 or older.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
Virginia Pilot Project seeks to assess the impact dental hygienists practicing in an expanded capacity under remote supervision have on increasing access to dental health care for underserved populations. The following Dental Health Professional Shortage areas: Cumberland Plateau, Lenowisco and Southside counties. Dental hygienist will refer patients without a dental provider to a dentist with the goal of establishing a dental home.
Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.
Local Anesthesia; Soft Tissue Curettage; Administer N20; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. May see patients in “senior centers” if hygienist has a written agreement with dentist to provide “off-site” supervision. Dental hygienists who are school endorsed may assess for and apply sealants and fluoride varnishes and perform prophylaxis in community-based sealant programs carried out in
For licensure renewal, a dental hygienist must earn 15 hours every year and be current in CPR. Dental hygienists allowed to monitor sedation requires 4 CE hours in CPR every 2 years. Hygienists in the Virginia Pilot Program must be Employed by Department of Health and 2 years experience.
For licensure renewal, a dental hygienist must earn 15 hours every year and must be current CPR at renewal. No volunteer work considered for CE. Dental hygienists working in senior centers must have 2 years experience and must collect patient data to submit to health department. Dental hygienists working in schools
schools. Unsupervised practice in hospitals, nursing homes, home health agencies, group homes (for the elderly, handicapped or youth), state institutions under department of health and human services, jails, and public health facilities provided the hygienist refers patient to a dentist for dental treatment and needed care.
WV
WI
Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Fluoride
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists, who meet specific requirements, may provide dental hygiene services without the supervision of a dentist in hospitals, schools, correctional facilities, jails, community clinics, long term care facilities, nursing homes, home health agencies, group homes, state institutions under the Department of Health and Human Resources, public health facilities, homebound settings and Accredited Dental Hygiene Education programs.
Direct Supervision Levels; dentist needs to be present.
Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Local Anesthesia; Place Perio Dressings; Remove Perio Dressings; Remove Sutures
Direct Supervision Levels; dentist needs to be present.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. The statute does not require the presence or
must have Sealant/Fluoride Varnish Endorsement from Department of Health. Hygienist must submit data to the Department of Health concerning patient demographics, treatment, reimbursement, referrals, etc. Dental hygienists in health care settings must have two years clinical experience within the last five years. For licensure renewal, a dental hygienist must earn 20 hours every two years and current in CPR. At least 2 hours of infection control, tobacco use or oral effects substance abuse required.
Unsupervised dental hygienists must have 2 years and 3,000 hours of clinical dental hygiene experience; six additional continuing education hours this must include 3 hours in medical emergencies and 3 hours in general public health content. The dental hygienist and supervising dentist must submit an annual report to the West Virginia Board of Dental Examiners of services rendered. For licensure renewal, a dental hygienist must earn 12 hours every two years and be current in CPR certification (up to 2 hrs credit). 2 hours of infection control required.
supervision of a dentist in a public or private school, a dental or dental hygiene school or a facility owned by a local health department.
WY
Place Sutures; Soft Tissue Curettage; Administer N20; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Administer N20; Pit/ Fissure Sealants; Place Perio Dressings; Remove Perio Dressings
These procedures are not allowed to be done by a dental hygienist.
Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride; Root Planing; Study Cast Impressions; Remove Sutures
General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.
Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning
These procedures are not allowed to be done by a dental hygienist.
Direct Supervision Levels; dentist needs to be present.
No special requirements for hygienists in a school setting.
No CE required for licensure renewal of a dental hygienist.
Information about services that can be provided by dental hygienists, as well as the different levels of service was compiled using three separate documents from the American Dental Hygienist Association: http://www.adha.org/governmental_affairs/downloads/direct_access.pdf http://www.adha.org/governmental_affairs/downloads/fiftyone.pdf http://www.adha.org/governmental_affairs/downloads/CE.pdf
