Scope of Practice, Delegation, and Supervision
Domain 2 tests who may perform which clinical task and at what supervision level. Illinois answers this through the Act's definitions plus the delegation rules, and the dentist remains responsible for delegated care.
Dentist scope and delegation
The dentist's scope is the full practice of dentistry, including diagnosis, treatment planning, prescriptions, surgery, and sedation permits. Delegation is permitted only for tasks that are not diagnosis or treatment planning, and only to a person the dentist has trained or who holds required certification.
Hygienist scope and supervision
Hygiene practice includes prophylaxis, scaling, polishing, radiographs, sealants, fluoride, and education. In private practice the hygienist works under the supervision level the rule assigns to each service: direct supervision means the dentist is on the premises and has examined the patient; general supervision means the dentist authorized care but is absent. Public health dental hygienists have a limited exception in specified settings.
Assistants
Assistants perform reversible, delegated tasks; expanded functions such as radiography or sealants require the training the rules specify. An assistant may not diagnose caries or tell a patient what treatment is needed.
Worked example
A hygienist is asked to look at a bitewing and tell the patient she has two cavities requiring fillings. She may expose and mount the image, but interpreting it as a diagnosis and proposing treatment is the dentist's nondelegable duty. The correct response is to report the image to the dentist, who diagnoses and treatment-plans.
Traps
- Assuming general supervision lets an untrained assistant perform expanded functions.
- Confusing "the dentist checked it later" with direct supervision, which requires presence.
- Letting a hygienist deliver a diagnosis because she saw the image first.