Delegated and Expanded Functions; Local Anesthesia and Nitrous Oxide Permits
What the exam tests
Questions test which functions a dentist may delegate to a dental hygienist, which require additional credentials, and what supervision applies. Local anesthesia and nitrous oxide are the highest-risk delegated functions and are tested heavily.
Core rules
- A dentist may delegate dental hygiene procedures to a licensed hygienist. The hygienist may not accept delegation of a procedure outside the dental hygiene scope or outside the hygienist’s training.
- Local anesthesia administration requires a separate Illinois permit. The hygienist must complete Department-approved education and apply for the permit; administration is under direct supervision.
- Nitrous oxide-oxygen analgesia also requires a permit and direct supervision, with the dentist available and the patient monitored.
- Expanded functions require specific training or certification. A hygienist cannot create authority by verbal permission alone; the underlying statute or rule must authorize the function.
Worked example
An dentist asks a hygienist to give an inferior alveolar injection. The hygienist has completed a local anesthesia course but has not received the Illinois permit. The correct answer is that the hygienist may not administer the injection. Course completion alone is not authority; the permit must be issued, current, and the dentist must provide direct supervision. Accepting the delegation would expose both the hygienist and the dentist to discipline.
Traps
- Treating a certificate of course completion as a permit.
- Assuming a permit from another state satisfies Illinois.
- Performing expanded functions because “the dentist said it was okay.”
- Confusing direct supervision with general supervision for anesthesia.