Dental Hygiene Scope of Practice and Supervision Levels
What the exam tests
This domain tests whether you can place a task within the New Hampshire dental hygiene scope and identify the supervision level the task requires. The statute is RSA 317-A and the Board of Dental Examiners rules fill in definitions and settings.
Core rules
- Routine hygiene services-prophylaxis, scaling and root planing, fluoride, sealants, radiographs, and education-are performed under dentist supervision.
- Direct supervision generally means the dentist is physically present in the office, has examined the patient, and has authorized the procedure. The prior examination and authorization matter as much as physical presence.
- Indirect or public-health arrangements allow care when the dentist is not on site only where a written protocol, standing order, or collaborative agreement authorizes it in a defined setting.
- Hygienists do not diagnose, prescribe, or interpret radiographs for treatment planning. Local anesthesia and nitrous oxide require additional Board-recognized education and certification and do not remove the supervision requirement.
Worked example
A hygienist in a private office wants to place sealants on a child. The dentist examined the child that morning and is in the office. Reasoning: sealants are within hygiene scope; the dentist's examination and on-site presence satisfy direct supervision; document the authorization. If the same service is delivered in a school program without a dentist on site, the hygienist must fit the off-site/public-health exception and follow its protocol and consent rules.
Traps that cost marks
Assuming a hygienist may “clear” a patient without a dentist examination; treating indirect supervision as a universal substitute for direct; thinking certification expands scope rather than adding a permitted procedure; and overlooking the written-protocol requirement for off-site care.