Scope of Practice and Supervision Levels for Dental Hygienists
Supervision is task-specific
Nevada uses supervision categories to match dentist involvement to risk. Direct supervision generally means the dentist is physically present in the office and available during the service. Indirect supervision generally means the dentist has authorized the service and is available by phone or other means but is not necessarily on site. General supervision generally means the dentist has authorized the service but is not present; it is limited to specified tasks and settings. Board regulations control which category applies.
Hygiene scope
Within hygiene scope, common services include prophylaxis, scaling and root planing, polishing, fluoride, sealants, radiographs, and patient education. Expanded duties-such as local anesthesia-require additional training and a permit, and remain subject to the required supervision. A hygienist cannot diagnose, prescribe, or perform surgery.
Public-health settings
Nevada recognizes limited public-health arrangements that let hygienists serve schools, clinics, and similar settings under less direct dentist involvement. These are setting-specific and do not authorize private-office practice without the required supervision.
Worked example
A hygienist is asked to place sealants at a school clinic. The dentist has signed a written authorization but is not on site. The hygienist must confirm that the setting qualifies for the reduced supervision level and that the specific task is allowed; otherwise the service is outside the lawful supervision model.
Traps
'General supervision' is not a synonym for independent practice. A dentist's verbal 'go ahead' does not satisfy a written-authorization requirement. Expanded duties need both training and a current permit; one without the other is not enough.