Scope of Practice, Supervision Levels, and Delegated Duties
This section covers what a dental hygienist may do and under whose supervision; the exam tests supervision levels and delegated services.
The supervision framework
Dental hygiene practice in Kentucky is authorized and supervised by a dentist. 'Direct supervision' generally means the dentist has examined or authorized the service and is physically present on the premises and available. 'General supervision' means the dentist has authorized the service but is not required to be on the premises, as defined in statute and Board rules. The exact setting matters: school sealant programs and public health settings may have specific supervision rules.
Core hygiene services
Within the dental hygiene scope are prophylaxis, scaling and root planing, polishing, fluoride application, sealants, radiographs, and patient education. These may be delegated only when the hygienist is licensed and the service is within the statutory definition. The dentist retains responsibility for the overall diagnosis and treatment plan.
What is not delegated
Dentists may not delegate services that require the dentist's statutory authority, such as definitive diagnosis, prescribing, surgery, or final restorative treatment, to an unlicensed or improperly supervised hygienist. A hygienist may not perform an expanded function without the required certification.
Worked example
A dentist asks a hygienist to place sealants at a school health fair while the dentist is at the office. If the applicable regulation permits general supervision in that public health setting and the dentist has authorized the service, the hygienist may proceed. The same service in a private office with no authorization would be a scope violation.
Traps
Confusing 'the dentist is reachable by phone' with direct supervision. Treating a standing order as authority for every service. Assuming a hygienist can never work without the dentist in the building; general supervision exists but is setting-specific.