Supervision of Personnel
In all instances, a dentist assumes responsibility for determining, on the basis of diagnosis, the specific treatment patients will receive and which aspects of treatment may be delegated to qualified personnel. A dentist may only delegate to a dental hygienist those services that are within their authorized scope of practice.
“Direct supervision” means that the dentist is present in the treatment facility, but it is not required that the dentist be physically present in the treatment room. Direct supervision is required for a dental hygienist administering local anesthesia or nitrous oxide inhalation analgesia, or for a hygienist providing services to a new patient, except under public health supervision. The dentist must conduct an examination during an initial visit by a new patient.
“General supervision of a dental hygienist” means that a dentist has examined the patient and has prescribed authorized services to be provided by a dental hygienist. The dentist need not be present in the facility while these services are being provided. If a dentist will not be present, the following requirements shall be met:
1. Patients or their legal guardians must be informed prior to the appointment that no dentist will be present and therefore no examination will be conducted at that appointment.
2. The hygienist must consent to the arrangement.
3. Basic emergency procedures must be established and in place and the hygienist must be capable of implementing these procedures.
4. The treatment to be provided must be prior prescribed by a licensed dentist and must be entered in writing in the patient record.
“Public health supervision” may be provided to a dental hygienist who has entered into a written public health supervision agreement with a dentist. For more information, please refer here.
Public health settings defined
For the purposes of this rule, public health settings are limited to schools; Head Start programs; federally qualified health centers; public health dental vans; free clinics; nonprofit community health centers; nursing facilities; and federal, state, or local public health programs.