Supervision Levels and Collaborative Practice Arrangements
What this domain tests
Oregon uses defined supervision categories for dental hygiene practice and a separate expanded practice pathway for community settings. Exam items test who must be present, what must be authorized, and when a hygienist may practice without a dentist on site.
Core rules
- Direct supervision generally requires the dentist to be on the premises and available; the dentist must authorize the procedure and may need to examine the patient.
- General supervision allows the hygienist to perform authorized services when the dentist is not on the premises, but the dentist remains responsible for authorization and follow-up.
- An expanded practice dental hygienist may provide services in approved community settings, such as schools, nursing facilities, and public health programs, without on-site supervision. The permit is limited to those settings and usually requires a referral or consulting relationship with a dentist.
- Collaborative arrangements are not blanket independent practice. They depend on the setting, population, and permit type.
Worked example
A hygienist is asked to provide sealants at a school. If she holds an expanded practice permit and the program meets the rule's setting requirements, she may screen and apply sealants without a dentist present. If she does not hold the permit, she needs general supervision authorization from a dentist and must follow the rule's examination and referral requirements.
Traps that cost marks
Treating general supervision as no dentist involvement at all. Assuming an expanded practice permit allows practice in any private dental office. Ignoring the requirement for a referral relationship. Confusing direct supervision with indirect supervision used in other states.