Scope of Practice for Dentists, Dental Hygienists, and Dental Assistants
Scope of Practice for Dentists, Dental Hygienists, and Dental Assistants
This domain tests who may legally perform which procedure, and under what level of supervision. Most items hinge on matching a task to the correct provider and supervision category.
Dentist. Diagnosis, treatment planning, prescribing, and all irreversible procedures are reserved to the dentist, who may delegate only what regulation permits and who remains responsible for the delegated care.
Supervision levels. Direct means the dentist is on the premises and personally supervises the procedure. Indirect means the dentist has authorized the service and is available but not necessarily in the operatory. General means the dentist authorized the service but is not required to be on site. Regulations assign each delegated function to a specific level.
Hygienist. Prophylaxis, scaling, radiographs, sealants, and fluoride are core hygiene services. Local anesthesia and nitrous oxide require an additional Board permit and direct supervision. A public health dental hygienist may practice in approved public health settings under looser supervision, but that status does not extend to private-office practice.
Assistant. Assistants perform supportive, reversible functions and may perform expanded functions only with the required certification and supervision.
Worked example. A hygienist wants to place a sealant in a private office while the dentist is away at a meeting. Unless the regulation places sealants under general supervision for that setting, the dentist's absence makes the service unauthorized; the correct answer is to wait for direct or indirect supervision as the rule requires.
Traps. Confusing direct with indirect supervision; assuming a hygienist may give local anesthesia without a permit; letting an uncertified assistant perform an expanded function; and assuming the dentist is absolved of responsibility once a task is delegated.