Scope of Practice and Permits
Who may do what
The dentist holds ultimate responsibility for diagnosis, treatment planning, and delegation. Hygienists may provide prophylaxis, scaling and root planing, sealants, radiographs, and patient education within the Board's rules; some services, such as local anesthesia, require an additional permit. Dental assistants may perform basic chairside duties and, with expanded-function training, specified reversible procedures. The key is not the job title but the rule's list of delegated tasks and the required supervision level.
Supervision language
Oklahoma uses supervision categories in Board rules. Direct supervision generally means the dentist is on the premises, has examined the patient, and is available to evaluate; general supervision means the dentist has authorized the service but is not necessarily on-site. The exact definition controls. A dentist cannot delegate a task the rules reserve to dentists, and an assistant cannot upgrade by watching a video or holding another state's certificate.
Permits
Sedation, general anesthesia, and nitrous oxide analgesia require Board permits with specified training, equipment, monitoring, and rescue drugs. Hygienist local anesthesia and expanded-function assistant status also require permits or certifications. Permits are specific: a nitrous permit does not authorize IV sedation, and an expanded-function certificate does not authorize surgery.
Worked example
A hygienist with a local anesthesia permit is asked to give an inferior alveolar block while the dentist is across town. Even with the permit, the supervision rule likely requires the dentist on the premises and patient evaluation; general supervision is not enough for local anesthesia. The permit expands the hygienist's scope but does not eliminate the supervision requirement.
Traps
Do not confuse direct with dentist physically holding the instrument, and do not assume general supervision allows any hygienist service. Do not let an assistant perform a procedure merely because it is reversible. Check the permit and the current rule before delegating.