Scope of practice and supervision levels for dentists, dental hygienists, and dental assistants
What the domain tests
This domain tests who may perform which dental procedure and how much dentist involvement is required. Montana allocates tasks through licensure and supervision levels. Supervision is a legal combination of authorization, dentist availability, and physical presence-not merely a job title.
Supervision levels
- Direct supervision: the dentist is on the premises, has examined the patient, authorizes the procedure, and is immediately available.
- Indirect supervision: the dentist has examined and authorized care and is available in the office, though not necessarily in the operatory.
- General supervision: the dentist has authorized services and is available for consultation but is not on the premises; it applies only where board rules allow, often for specified hygienist services.
Dentists diagnose, plan treatment, perform surgical, restorative, endodontic, and prosthetic care, and prescribe. Hygienists provide assessment, prophylaxis, scaling and root planing, radiographs, fluoride, sealants, and-only with required authorization-local anesthesia. Assistants provide supportive and expanded duties only after approved training and under the required supervision.
Worked example
A hygienist working under general supervision notices a new mobile tooth and wants to scale the area. She may provide authorized hygiene care, but she may not diagnose the cause or promise treatment. She documents the finding and refers the patient for a dentist’s examination.
Traps
“General supervision” does not mean independent practice; a dentist cannot delegate diagnosis; an assistant’s title does not authorize hygiene treatment.