Scope of Practice and Permitted Duties of Dentists, Dental Hygienists, and Dental Assistants
Scope of practice defines what each licensed professional may legally do. Dentists have the broadest scope: they diagnose, treatment plan, perform surgical and nonsurgical procedures, prescribe medications, and delegate tasks. Dental hygienists focus on preventive care: prophylaxis, scaling and root planing, periodontal maintenance, application of sealants and fluoride, and patient education. They may administer local anesthesia and nitrous oxide if certified and under direct supervision. Dental assistants perform supportive tasks: suctioning, passing instruments, taking radiographs if certified, and applying topical fluoride. They may perform coronal polishing and sealants if certified. Expanded functions require additional training and certification. Traps include confusing which tasks require direct vs. indirect supervision, or assuming hygienists can diagnose. Rule of thumb: any task that involves diagnosis, treatment planning, or irreversible procedures is reserved for dentists unless explicitly delegated by Board rule. For example, a hygienist cannot extract teeth or prepare cavities. A common exam question asks who may perform a specific task; always check the Board's rules for supervision levels. Also, assistants cannot perform procedures that are considered the practice of dentistry or dental hygiene without proper certification. The Board maintains lists of allowable duties and supervision requirements. Candidates should know that violation of scope of practice is unprofessional conduct. Example: A dental assistant may take radiographs only if they have completed a Board-approved radiology course and are under direct supervision. Another example: A hygienist may administer local anesthesia only if certified and under direct supervision of a dentist. Understanding these boundaries is crucial for legal compliance.