Delegation of Duties and Expanded Functions
What a dentist may delegate
The dentist is responsible for the overall care and may delegate duties to hygienists and assistants only within the limits set by statute and board rule. Delegation cannot include diagnosis, treatment planning, prescribing, or surgical procedures reserved to the dentist. The dentist must retain supervision and cannot delegate responsibility for the patient.
Expanded functions
Indiana recognizes expanded functions that require additional board-approved education and certification, such as certain restorative, polishing, sealant, and anesthesia-related tasks. Certification is function-specific: certification in one expanded function does not authorize another. Even a certified assistant or hygienist must perform the function under the supervision level the rule requires, and the dentist must be available as required.
Worked example
An assistant who has completed a board-approved coronal-polishing course is asked to place a temporary restoration while the dentist is at lunch. The answer is no on two grounds. First, coronal polishing certification does not authorize placing restorations. Second, the dentist is not present, so any function requiring direct supervision cannot be performed. The correct analysis is to identify the function, check whether it is delegable, check the assistant's specific certification, and confirm the supervision level.
Traps that cost marks
- Treating 'certified' as a general license to perform any expanded function.
- Assuming a hygienist may perform all expanded functions without separate training.
- Forgetting that the dentist remains legally responsible for delegated care.
- Ignoring the supervision requirement even when certification is valid.