Delegation, Supervision, and Collaborative Practice Arrangements
Delegation is dentist-driven
The dentist holds ultimate responsibility for diagnosis, treatment planning, prescriptions, and overall care. A hygienist may perform delegated dental hygiene services within scope and supervision; a hygienist may not redelegate those services to an unlicensed person. Dental assistants may perform only tasks the Board’s rules permit, often under direct supervision, such as radiography with registration or certain expanded functions with formal training.
Collaborative and public-health arrangements
Ohio uses written arrangements to extend hygiene services into public-health settings. These are not independent practice: the dentist authorizes services, the hygienist follows the agreement and supervision level, and records flow back to the dental home or authorizing dentist. A collaborative agreement cannot authorize a procedure outside the hygienist’s statutory scope.
Worked example
A dentist asks a hygienist to have a dental assistant place sealants so the schedule runs faster. Sealants may be within hygiene scope, but delegation to an assistant depends on the assistant’s registration, training, and the rule’s supervision level. If the assistant lacks the required credential, the answer is no-even with the dentist present. The dentist cannot orally expand an assistant’s scope.
Traps
Delegation is not a transfer of liability. Standing orders do not replace patient-specific authorization where required. Do not let unlicensed staff perform scaling, polishing, or radiographs. Do not confuse “collaborative” with “unsupervised.”