Supervision and delegation to dental hygienists, assistants, and expanded-function personnel
What the exam tests
This domain tests supervision levels and delegation to dental hygienists, assistants, and expanded-function personnel. Questions ask who may perform a task, under what supervision, and who remains responsible.
Core rules
- The dentist diagnoses, treatment-plans, and remains responsible for delegated care. Delegation must be authorized by the Dental Practice Act and Board rules, and the auxiliary must hold the required license, registration, or certification.
- Supervision categories usually turn on the dentist’s presence and authorization: direct supervision generally requires the dentist on the premises and available; general supervision allows authorized services under a dentist’s prior authorization without the dentist present. The exact category for each task is set by rule, not office custom.
- Hygienists may provide authorized hygiene services, including prophylaxis, scaling, and periodontal procedures, within their scope and supervision. Local anesthesia or other advanced services require additional certification and the required supervision.
- Assistants may perform reversible, listed supportive tasks; expanded-function assistants may perform only additional functions for which they trained and are recognized. Radiographs, impressions, and polishing are not automatically delegable in every form.
Worked example
A hygienist administers local anesthesia while the dentist is off-site. Even if the hygienist has hygiene licensure, the service requires the specific anesthesia credential and supervision level. The dentist’s absence and the missing credential make the delegation unlawful.
Traps that cost marks
“The dentist said it was okay” does not expand scope. A trained assistant is not automatically an expanded-function assistant. Do not assume another dentist’s presence satisfies supervision owed by the treating dentist. Scope questions are task-specific.