Scope of Practice, Supervision Levels, and Delegation
The three supervision levels
Direct supervision: the dentist is physically present in the office, has examined the patient, and evaluates the result before dismissal. Indirect supervision: the dentist is on the premises and available, but need not evaluate the patient immediately. General supervision: the dentist is not on the premises; the patient has been examined, the procedure is authorized (often by standing order), and the dentist is reachable for consultation. Match the function to the level named in the rule - do not assume a function permitted under direct supervision is permitted under general.
Nondelegable core
Diagnosis, treatment planning, prescribing, and irreversible or surgical procedures remain with the dentist. Reversible, protocol-driven tasks - radiographs, coronal polishing, fluoride, sealants, impressions, temporaries - may be delegated to hygienists or licensed dental assistants according to their own scope and any required certification. Expanded restorative functions for assistants require specific training and credentialing and are tightly supervised.
Hygienists
Hygienists provide assessment, prophylaxis, scaling and root planing, sealants, fluoride, radiographs, and (with the required qualifications) local anesthesia and nitrous oxide. Minnesota also allows hygienists to practice under a collaborative agreement in specified public health and community settings where a dentist is not on site - a narrow exception, not general independent practice.
Traps
Treating "general supervision" as independent practice; assuming unlicensed front-office staff may expose radiographs or polish; assuming a hygienist may diagnose caries and design a treatment plan.
Rule of thumb: test any delegation against three filters - is the person licensed for the function, is the procedure reversible, and does the rule authorize that supervision level? Fail any one and the delegation is unprofessional conduct.