Scope of Practice, Supervision Levels, and Delegation to Auxiliaries
Who may do what
The dentist owns the diagnosis and treatment plan and remains responsible for delegated care. The Act prohibits delegating diagnosis, treatment planning, prescribing, and surgical procedures reserved to dentists. Dental hygienists perform defined preventive and therapeutic services under the supervision level the rule assigns. Dental assistants may perform basic supportive tasks; expanded functions require Board-recognized training and the specified supervision.
Supervision categories
Indiana uses supervision categories such as direct, indirect and general. Direct supervision generally means the dentist is on the premises, has examined the patient and authorizes the procedure; indirect supervision generally means the dentist is on the premises but not physically in the operatory; general supervision generally means the dentist has authorized the service but is not on the premises. The exact boundaries come from the rule, not from office custom.
Worked example
A certified expanded-function assistant places and contours a restoration while the dentist is at a continuing-education course across town. Even if the patient was examined last week, this is not direct supervision. The assistant's certification does not supply the missing dentist presence. The procedure must wait or the dentist must be present as the rule requires.
Traps that cost marks
Treating 'the dentist signed the chart' as authorization for any auxiliary to do any task. Confusing indirect and general supervision. Assuming a hygienist may independently scale and diagnose without the required exam. Assuming on-the-job training substitutes for required certification.