Delegation of Tasks and Supervision of Dental Assistants and Auxiliaries
Delegation is the dentist's act
The dentist may delegate tasks to dental assistants and auxiliaries, but the delegating dentist remains responsible for the patient and for the assistant's competence. Michigan limits delegation to tasks that are within the dentist's scope, are not reserved to another licensed profession, and can be safely performed by the assistant after appropriate training. Diagnosis, treatment planning, prescribing, surgical procedures, and tasks requiring professional judgment cannot be delegated.
Expanded functions
Registered dental assistants may perform certain expanded functions, such as coronal polishing, fluoride application, and sealant placement, only after completing Board-approved training and any required examination. The office must have written protocols and the dentist must authorize the delegation. A hygienist may supervise assistants in some settings, but the hygienist cannot delegate a task that the hygienist is not authorized to perform or that requires the hygienist's own judgment.
Worked example
A dentist asks an untrained assistant to scale calculus because the hygienist is busy. Scaling is within the practice of dental hygiene and is not a delegable assistant function. The assistant cannot do it, and the hygienist should not sign off on it. The correct response is to reschedule or have the hygienist perform the service.
Traps
On-the-job experience alone does not create expanded-function authority. A dentist's verbal order does not override the statute or rule. Do not let a hygienist delegate a hygiene service to an assistant; the authority to delegate runs from the dentist, not from the hygienist.