Dental Hygienist Duties By State – AGD - Academy of General ...

Dental Hygienist Duties by State 

Before licensure as a dental hygienist, a dental hygienist must: 

� Graduate from an accredited dental hygiene program; 

� Successfully complete of the written National Board Dental Hygiene Examination (National Board Examination); 

� Successfully complete of a regional or state clinical board examination (Clinical Board Examinations) 

Once these steps have been completed, an applicant for licensure must then contact the state licensing authority in the state where he/she 

wishes to practice. As licensing requirements vary from state to state, it is necessary to contact each licensing authority in a given state for its 

specific application requirements and procedures. Examples of additional types of requirements may be needed for licensure include: successful 

completion of a jurisprudence exam; proof of CPR certification; letters of recommendation from dentists licensed in the state in which applicants 

wish to obtain licensure; official transcripts from high school and colleges attended, official confirmation of the absence of a criminal record, and 

official letters from the boards of dentistry where licensure is held. 

Information about services that can be provided by dental hygienists, as well as the different levels of service has been compiled below: 

State Services that can be provided: Supervision Required: Licensure Renewal/Advanced Hygiene 

Licensure Requirements: 

AL Prophylaxis; X‐Rays; Local Anesthesia; Topical Direct Supervision Levels; dentist needs to be present For licensure renewal, a dental hygienist 

Anesthesia; Fluoride; Pit/ Fissure; Sealants; Root to provide all services. 

must earn 12 hours every year reported 

Planing; Soft Tissue Curettage; Administer N20; 

on renewal form. CPR required and 2 

Study Cast; Impressions; Place Perio Dressings; 

hours of infection control every two 

Remove Perio Dressings; Place Sutures; Remove 

Sutures; 

year. 

DH Diagnosis/ Assessment; Treatment Planning 

AK Prophylaxis; X‐Rays; Local Anesthesia; Topical 

Anesthesia; Fluoride; Pit/ Fissure Sealants; Root 

Planing; Soft Tissue; Curettage 

These procedures are not allowed to be done by a 

dental hygienist. 

For dental hygienists, General Supervision Levels 

required; dentist needs to authorize prior to services, 

but need not be present. For Dental Health Aide 

Therapists (DHAT), hygienist can provide services as 

she determines appropriate without specific 

authorization. 

For licensure renewal, a dental hygienist 

must earn 14 hours every two years, 

listed on licensure renewal form. CPR 

required. 

A DHAT must have 4,000 hours 

experience within the last 5 years. Board

Administer N20 

Study Cast Impressions; Place Perio Dressings; 


Sutures 

DH Diagnosis/ Assessment 

Treatment Planning 

AZ Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants 

Local Anesthesia; Administer N20; Place Perio 

Dressings; Remove Perio Dressings; Place 

Sutures; 

Root Planing; Soft Tissue Curettage; Study Cast 

Impressions; Remove Sutures 

DH Diagnosis/ Assessment Treatment Planning 

AR Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure 

Sealants; Study Cast Impressions 

Local Anesthesia; Root Planing; Soft Tissue 

Curettage; Administer N20 

Direct supervision levels required; dentist needs to be 

present to provide all services. 

General Supervision Levels; dentist needs to 

authorize prior to services, but need not be present. 



For dental hygienists, dentist needs to authorize prior 

to services, but need not be present. Dental hygienist 

working under contract for schools, public health 

settings and institutions may screen and apply 

fluoride unsupervised. 

Direct Supervision Levels required; dentist needs to 

be present to provide all services. 

A dental hygienist with a written affiliated practice 

agreement with a dentist may assess for and perform 

dental hygiene services on patients who meet certain 

financial criteria and are enrolled in a federal, state, 

county or local healthcare program 

General supervision required for all hygienists; 

dentist needs to authorize prior to services, but need 

not be present. 



General supervision required; dentist needs to 



be present to provide all services. 

must approve collaborative agreement. 


must earn 54 hours every 3 years. Must 

also be current in CPR and earn 4 hours 

infectious disease 2 hours in chemical 

dependency, tobacco cessation, ethics, 

risk management or jurisprudence. A 

maximum 14 hrs practice management, 

healthcare delivery is required. 

Hygienists with written affiliated 

practice agreement must have 5 years 

practice and actively engaged in dental 

hygiene practice for at least two 

thousand hours in the five years 

immediately preceding the affiliated 

practice relationship. Direct Medicaid 

reimbursement allowed. 


must earn 40 hours every two years. 

Must be current in CPR and earn 2 hours 

infection control.

Topical Anesthesia; Place Perio Dressings; 

Remove Perio Dressings; Place Sutures; 

Remove Sutures; DH Diagnosis/ Assessment; 


CA Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Root Planing; 



Sutures; DH Diagnosis/ Assessment; Treatment 

Planning 

Local Anesthesia; Soft Tissue Curettage; 


CO Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Study Cast 

Impressions; DH Diagnosis/ Assessment; 


Local Anesthesia; Root Planing; Soft Tissue 

Curettage; Place Perio Dressings; Remove Perio 

Dressings; Remove Sutures 

Administer N20; Place Sutures 

CT Prophylaxis; X‐Rays; Topical Anesthesia; 



Remove Perio Dressings; Remove Sutures; DH 

Diagnosis/ Assessment; Treatment Planning 



For dental hygienists, general supervision levels 

required; dentist needs to authorize prior to services, 

but need not be present; For Registered Dental 

Hygienists in Alternative Practice (RDHAP), hygienist 

can provide services as she determines appropriate 

without specific authorization. In government created 

or administered public health program, a dental 

hygienist may provide screening and apply fluorides 

and sealants without supervision. 

Direct Supervision Levels; dentist needs to be 

present. 

General Supervision Levels required; dentist needs to 


Unsupervised practice in all settings for all licensed 

dental hygienists for the oral prophylaxis 

and preventive and therapeutic services. The dental 

hygienist may also own a dental 

hygiene practice. 


be present. 





Dental hygienists with 2 years experience may 

practice without supervision in institutions, 

public health facilities, group homes and schools. 



Must be current in CPR. 

RDHAPs must earn a bachelors degree 

equivalent, 3 years clinical practice, and 

completion of 150 clock hour special 

course and exam. 

Dental hygienists do not need to earn 

any continuing education hours. 

No special requirements for 

Independent Practice Dental Hygienists. 

Direct Medicaid reimbursement 

allowed. 

Dental hygienists do not need to earn 

any continuing education hours. 

2 years experience required for 

unsupervised practice in public health

Local Anesthesia 

Soft Tissue Curettage; Administer N20; Place 

Sutures 

DE Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Root Planing 

Soft Tissue Curettage; Study Cast Impressions; 

Place Perio Dressings; Remove Perio Dressings; 

Remove Sutures 

Local Anesthesia; Administer N20; Place Sutures; 


DC Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Root Planing; Soft 

Tissue Curettage; Study Cast Impressions 

Local Anesthesia; Administer N20; Place Perio 

Dressings; Remove Perio Dressings; Remove 

Sutures 

Place Sutures; DH Diagnosis/ Assessment; 


FL Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Place Perio 


Sutures 


Impressions 

Only General Supervision Level allowed for DH 

Diagnosis/ Assessment and Treatment Planning. 


present. 










present. 




authorize prior to services, but need not be present 

(Fluoride varnish allowed to be done in public health 

settings only). 


present. 


settings. Direct Medicaid 

reimbursement allowed. 



CPR required, but not included in 

24 hour CE requirement. Limit on 

management subjects. 



Two hours of CPR must be part of 15 

hour requirement 



Must be current in CPR (cannot use hrs). 

Two hours in prevention of medical 

errors and 2 hrs every third biennium in 

domestic violence required.

Local Anesthesia; Administer N20; Place Sutures; 


GA Prophylaxis; Topical Anesthesia; Fluoride; Pit/ 

Fissure Sealants; Root Planing; Soft Tissue 

Curettage; Study Cast Impressions; Place Perio 

Dressings; Remove Perio; Dressings; Remove 

Sutures 

X‐Rays; Local Anesthesia; Administer N20; Place 


Planning 

HI Prophylaxis; X‐Rays; Local Anesthesia; Topical 


Planing; Soft Tissue Curettage; Study Cast 

Impressions; Place Perio Dressings; Remove 

Perio Dressings; Place Sutures; Remove Sutures 

Administer N20; DH Diagnosis/ Assessment; 


ID Prophylaxis; X‐Rays; Local Anesthesia; Topical 


Planing; Remove Perio Dressings; Remove 

Sutures 

Administer N20; Study Cast Impressions 

Soft Tissue Curettage; Place Perio Dressings; 





present. 




present. Except for administering local anesthesia, 

General Supervision Levels (dentist needs to 

authorize prior to services, but need not be present) 

allowed for public health settings 





Registered dental hygienists (RDHs) can provide 

services in hospitals, long term care facility, public 

health facility, health or migrant clinic or other board 

approved setting if dentist affiliated with setting 

authorizes 

services. 


present. 





Must earn CPR (up to 4 hrs) and 15 hrs 

must be “clinical science” 


must earn 20 hours every two years and 

be current in CPR. 


must earn 24 hours every 2 years and be 

current in CPR 

RDHs must be an employee of the 

facility or obtain extended care 

permit. ECP requires 1,000 hours 

experience in last 2 years 

IL Prophylaxis; X‐Rays; Topical Anesthesia; General Supervision Levels required; dentist needs to For licensure renewal, a dental hygienist



Remove Perio Dressings; Remove Sutures 

Local Anesthesia; Administer N20 

Place Perio Dressings; Place Sutures; DH 


IN Local Anesthesia; Topical Anesthesia; Fluoride; 

Root Planing; Study Cast Impressions; Place 

Perio Dressings; Remove Perio Dressings; 


Prophylaxis; X‐Rays; Pit/ Fissure Sealants 



Planning 

IA Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants; Root Planing; DH 

Diagnosis/ Assessment 




present. 




present. 


present, but for dental hygienists in public settings, 







Registered dental hygienists (RDHs) may provide 

services based on standing orders and a written 

agreement with a dentist in schools, Head Start 

settings, nursing facilities FQHCs (Federally Qualified 

Health Centers), public health vans, free clinics, 

community centers and public health programs. Only 

General Supervision Level allowed for DH Diagnosis/ 

Assessment and Treatment Planning. 


present. 

must earn 32 hours every three years 

and be current in CPR. 



Must earn CPR (up to 2 hrs credit) and 

2 hours in Ethics. No more than 5 hrs 

practice management. 



Must earn CPR–can claim up to 3 hours. 

Must earn Iowa based child/dependent 

abuse every 5 yrs. 

RDHs must have 3 years clinical 

experience and submit annual report on 

number of patients/services to 

department of health. All dental hygiene 

services (except local anesthesia and 

nitrous) may be provided once to each 

patient. To perform repeat services


Remove Perio Dressings; Remove Sutures; 


Soft Tissue Curettage; Place Sutures 

KS X‐Rays; Pit/ Fissure Sealants; Root Planing; Soft 

Tissue Curettage; Administer N20; Study Cast 


Perio Dressings; Remove Sutures 

Prophylaxis; Topical Anesthesia; Fluoride; DH 



KY Local Anesthesia; Topical Anesthesia; Fluoride; 


Prophylaxis; X‐Rays; Pit/ Fissure Sealants; Root 

Planing; Study Cast Impressions; Place Perio 


Sutures; DH Diagnosis/ Assessment 

Soft Tissue Curettage; Place Sutures; Treatment 

Planning 









Dental hygienist with an extended care permit I or II 

may treat patients in schools, head start programs, 

state correctional institutions, local health 

departments, indigent care clinics, adult care homes, 

hospital long term units, or at the home of 

homebound persons on medical assistance. Only 

General Supervision Level allowed for DH Diagnosis/ 

Assessment and Treatment Planning. 

Direct Supervision Levels required for local 

anesthesia; dentist needs to be present. Placing 

Sutures is not allowed. 


present. 





other than assessment, screening and 

fluoride, dentist must examine. 



Dental hygienist with an extended care 

permit I or II must have 1,800 hours 

experience. CPR required only if RDH 

administers anesthesia. 



CPR required. Approved HIV/AIDS 

course every 10 years.

LA Local Anesthesia; Root Planing; Study Cast 



Prophylaxis; X‐Rays; Topical Anesthesia; 

Fluoride; Pit/ Fissure Sealants 



Planning 

ME Local Anesthesia; Place Perio Dressings 



Tissue Curettage; Study Cast Impressions; 


Administer N20; Place Sutures; DH Diagnosis/ 

Assessment; Treatment Planning 


present. 


anesthesia; dentist needs to be present. For 

hygienists practicing in a public health setting, 






present. 



For a dental hygienist practice in a public or private 

school, hospital or other non-traditional practice 

setting under a public health supervision status 

(granted by the dental board on a case-by-case basis), 

hygienist can provide services as she determines 

appropriate without specific authorization. 



A dental hygienist licensed as an independent 

practice dental hygienist may practice without 

supervision by a dentist in all settings. 


must earn24 hours every two years. CPR 

(required for general supervision) up to 

3 hours credit. No more than 12 hours 

by practice management courses. 



CPR required. 

An Independent Practice Dental 

Hygienist must possess a bachelor's 

degree from a CODA accredited dental 

hygiene program and 2,000 work hours 

of clinical practice in a private dental 

practice during the two years preceding 

the application or possess an associate 

degree from a CODA accredited dental 

hygiene program and 6,000 work hours 

of clinical practice in a private dental 

practice during the six years preceding 

the application. They are also required 

to provide a referral plan to patients in 

need of additional care by a dentist. 

For hygienists practicing in public 

settings, a dental hygienist must apply 

to the board to practice providing

MD Prophylaxis; X‐Rays; Topical Anesthesia; 


Tissue Curettage; Study Cast Impressions; Place 






MA Prophylaxis; X‐Rays; Topical Anesthesia; 







Planning 




anesthesia; dentist needs to be present. 





Public Health Dental Hygienists may provide dental 

hygiene services without the supervision of a dentist 

in public health settings; hygienist can provide 

services as she determines appropriate without 

specific authorization. 


anesthesia; dentist needs to be present. 



such information the board deems 

necessary. The board must take into 

consideration whether the program will 

fulfill an unmet need, whether a 

supervising dentist is available and that 

the appropriate public health guidelines 

and standards of care can be met and 

followed. 



Must be current in CPR, and earn 2 

hours in infection control and abuse and 

neglect. Courses must concern clinical 

knowledge and ability to treat. 



Must earn CPR to administer anesthesia. 

Public Health Dental Hygienists must 

have a minimum of three years full-time 

clinical experience practicing in a public 

health setting and appropriate training 

as determined by the department of 

public health. Prior to providing services, 

a public health dental hygienist must 

have a written collaborative agreement 

with a local or state government agency 

or institution, or licensed dentist that 

states the level of communication 

with the dental hygienist to ensure

MI Prophylaxis; X‐Rays; Topical Anesthesia; 








MN Local Anesthesia; Soft Tissue Curettage; 

Administer N20; Study Cast Impressions; Place 




Dental hygienists, who qualify for recognition as a 

grantee health agency by the Department of 

Community Health may provide dental hygiene 

services for patients who are not assigned by a 

dentist. These hygienists can provide services as she 

determines appropriate without specific 



present. 





patient health and safety. Public health 

dental hygienists shall provide patients 

with a written referral to a dentist and 

an assessment of further dental needs. 


must earn 36 hours every three years. 

CPR required to administer local 

anesthesia. 

The director of community health shall 

designate a person as a grantee 

health agency for a 2-year period if the 

person applies to the department of 

community health on a form provided 

by the department of community health 

and meets all of the following 

requirements: is a public or nonprofit 

entity, or a school or nursing home, that 

administers a program of dental care to 

a dentally underserved population, 

employs or contracts with at least 1 

dentist or 1 dental hygienist, submits a 

program overview indicating the 

approximate population to be served, 

the method by which the service is to be 

provided, the procedures for program 

oversight and direction, and the name 

and license number of the dentist and 

dental hygienist, if applicable, who are 

performing from the Michigan dental 

association or its successor organization. 



be current in CPR. Minimum 15 hrs in


Prophylaxis; X‐Rays; Pit/ Fissure Sealants; 

Fluoride; Root Planing Topical Anesthesia 



MS Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure 

Sealants; Root Planing; Soft Tissue Curettage 

Local Anesthesia; Topical Anesthesia; Administer 



A dental hygienist may be employed or retained by a 

health care facility, program, or nonprofit 

organization to perform dental hygiene services 

without the patient first being examined by a licensed 

dentist if the dental hygienist has entered into a 

collaborative agreement with a licensed dentist that 

designates authorization for the services provided by 

the dental hygienist. 



Direct Supervision Levels; dentist needs to be present 

(Fluoride varnish allowed to be done in public health 

settings by General Supervision Levels). 


“core” courses required. Must complete 

two of the following categories per 

cycle—infection control; record keeping; 

ethics; patient communications; 

management medical emergencies; and 

treatment and diagnosis. Must maintain 

a “portfolio” to record documentation 

of fundamental and elective 

professional development activities, CPR 

certification, and a biennial selfassessments 

(on a board approved 

form) 

Dental hygienists in health care settings 

must have been engaged in the active 

practice of clinical dental hygiene for not 

less than 2,400 hours in the past 18 

months or a career total of 3,000 hours, 

including a minimum of 200 hours of 

clinical practice in two of the past three 

years. Has documented participation in 

courses in infection control and medical 

emergencies within each continuing 

education cycle and maintains current 

certification in advanced or basic 

cardiac life support as recognized by the 

American Heart Association, the 

American Red Cross, or another agency 

that is equivalent to the American Heart 

Association or the American Red Cross. 



CPR, up to 4 hrs, required; 8 hrs for 

advanced CPR.

N20; Study Cast Impressions; Place Perio 

Dressings; Remove Perio Dressings; Place 

Sutures; Remove Sutures; DH Diagnosis/ 


MO Prophylaxis; X‐Rays; Topical Anesthesia; 




Local Anesthesia; Administer N20; Remove Perio 

Dressings 



MT Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root 

Planing; Soft Tissue Curettage; Administer N20 

X‐Rays; Local Anesthesia; Topical Anesthesia; 





NE Prophylaxis; Fluoride; Pit/ Fissure Sealants 




Dental hygienists may provide services without 

supervision in public health settings to Medicaid 

eligible children; hygienist can provide services as she 




present. 





For hygienists with a limited access permit from the 

board, hygienist can provide services as she 






anesthesia. 





The Department of Health may authorize an 



CPR required. Not less than 25 hrs must 

be directly related to updating and 

maintaining skills and knowledge in 

treatment, health and safety of patient. 

Public Health Dental Hygienists must 

have 3 years experience. Direct 

Medicaid reimbursement allowed. 



and be current in CPR. 

Limited access permit hygienists must 

earn 2400 hours experience in the last 3 

years; 3000 hours over career with 350 

hours each of the last 2 years. Additional 

12 hours CE every 2 year; liability 

insurance. 



be current in CPR (up to 4 hours.)

X‐Rays; Local Anesthesia; Topical Anesthesia; 






NV Prophylaxis; Local Anesthesia; Topical 

Anesthesia; Fluoride; Pit/ Fissure Sealants; Study 

Cast Impressions; Place Perio Dressings; Remove 

Perio Dressings; Remove Sutures; DH Diagnosis/ 

Assessment; Treatment Planning; Soft Tissue 

Curettage; 

X‐Rays; Root Planing; Administer N20; Place 

Sutures 

NH Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root 

Planing 

unsupervised Registered Dental Hygienist (RDH) to 

provide public health related services in a public 

health setting or a healthcare or related facility; 

hygienist can provide services as she determines 

appropriate without specific authorization. 




anesthesia. 





For registered dental hygienists (RDHs) with Public 

Health Endorsements, hygienist can provide services 

as she determines appropriate without specific 

authorization. General supervision always required 

for soft tissue cutterage. 

Direct Supervision Levels required for x-rays, root 

planning; and administering N20. RDHs, allowed to 

perform these tasks (general supervision for x-rays; 

where general supervision is allowed; no 

authorization needed for root planning and 

administering N20); placing sutures is not allowed to 

be done by a dental hygienist. 



Under public health supervision, dental hygienists 

may provide procedures authorized by a dentist in a 

public or private school, hospital or institution, or 

residence of a homebound patient provided the 

dentist reviews patient records once in a 12 month 

RDHs must have 3000 hours experience 

in at least 4 of last 5 years; professional 

liability insurance. 


must earn 15 hours every year and be 

current in CPR. 

No special requirements for RDH Public 

Health Endorsements. 



Must be current in CPR (up to 3 hours 

per year) and may only take subjects 

related to practice. 

No special requirements for public

X‐Rays; Topical Anesthesia; Study Cast 

Impressions; Remove Perio Dressings; Remove 

Sutures 


Soft Tissue Curettage; Place Perio Dressings; 



NJ Local Anesthesia; Topical Anesthesia; Administer 

N20; Study Cast Impressions; Place Perio 


Sutures 

Prophylaxis; X‐Rays; Fluoride; Pit/ Fissure 

Sealants; Root Planing 

Soft Tissue Curettage; Place Sutures; DH 


NM Local Anesthesia; Topical Anesthesia 

Prophylaxis; X‐Rays; Fluoride; DH Diagnosis/ 

Assessment; Pit/ Fissure Sealants; Root Planing 


Remove Perio Dressings 

Place Perio Dressings; Administer N20; Place 

Sutures; Remove Sutures; Treatment Planning 

period. 




anesthesia; dentist needs to be present 




present. 


anesthesia; dentist needs to be present. For 




present. 



For those in Collaborative Practice of Dental Hygiene 

(CPDH), hygienist can provide Prophylaxis,, X‐Rays, 

and Fluoride services as she determines appropriate 

without specific authorization. 



health dental hygienists. 


must earn 20 hours every two years. No 

volunteer work considered for CE. Must 

be current in CPR. Up to 10 hours for 

teaching or research. 



and be current in CPR. Course in 

infection control techniques and 

sterilization procedures. 

CPDHs must have 2400 hours active 

practice in past 18 months or 3000 

hours in 2 of past 3 years. Direct 

Medicaid reimbursement allowed. Each 

collaborative practice agreement must 

contain protocols for care. 

NY Local Anesthesia; Administer N20; Study Cast Direct Supervision Levels; dentist needs to be For licensure renewal, a dental hygienist




Fluoride; Pit/ Fissure Sealants; Root Planing 



NC Prophylaxis; X‐Rays; Local Anesthesia; Topical 

Anesthesia; Fluoride; Root Planing; Study Cast 

Impressions; Remove Perio Dressings; Place 

Sutures; Remove Sutures 

Local Anesthesia; Pit/ Fissure Sealants; Soft 

Tissue Curettage; Administer N20; Place Perio 

Dressings; DH Diagnosis/ Assessment; 


ND Prophylaxis; X‐Rays; Local Anesthesia; Topical 




Perio Dressings; Remove Sutures; Treatment 

Planning 

present. 


present. If a supervising dentist is available for 

consultation, diagnosis and evaluation, and has 

authorized the dental hygienist to perform the 

services, and exercises that degree of supervision 

appropriate to the circumstances, dentist needs to 


In nursing homes a hygienist can perform a complete 

oral examination of a resident and then determine 

treatment priorities; plan for continuing oral hygiene 

and dental care. 



For Registered Dental Hygienists (RDHs) in Public 

Health, dentist needs to authorize prior to services, 

but need not be present. Direct Supervision Levels 

required for local anesthesia; dentist needs to be 

present 






anesthesia; dentist needs to be present. Root Planing 

and Soft Tissue Cutterage, must be done upon direct 

order of a dentist. 


and be current in CPR, (Up to 3 hrs, 41/2 

hrs advanced CPR, up to 12 hrs ACLS or 

PALS). State approved class in infection 

control required every 4 years. Courses 

must be related to 

professional practice, no practice 

management. 

No special requirements needed for 

general supervision dental hygienists. 


must earn six hours every year and be 

current in CPR. 

Public Health RDH needs 

additional requirements IF they work 

under “direction”. 


must earn 16 hours every two years. 2 

hours in CPR infection control required; 

only 3 hours may be non-clinical.


Assessment 

OH Local Anesthesia; Root Planing; Soft Tissue 

Curettage; Administer N20; Study Cast 



Prophylaxis; X‐Rays; Topical Anesthesia; Fluoride 

Pit/ Fissure Sealants 



OK Local Anesthesia; Administer N20; Remove 

Sutures 




Perio Dressings; Remove Perio Dressings 



OR Prophylaxis; X‐Rays; Local Anesthesia; Topical 




Perio Dressings; Remove Sutures; DH Diagnosis/ 


Administer N20; Place Sutures 




present. 






present. 

A dentist may authorize in writing a dental hygienist 

to perform services one time on a patient in a setting 

outside the office prior to any dentist contact/exam if 

the hygienist refers the patient back to the 

authorizing dentist. 





For limited Access Permit (LAP) holders, hygienist can 

provide services as she determines appropriate 

without specific authorization, except for providing 

local anesthesia. Only hygienists with LAP permit may 

provide DH Diagnosis/ Assessment and Treatment 

Planning. 

Direct Supervision Levels; dentist needs to be present 

to administer N20; hygienists may not place sutures. 


must earn 12 hours every two years. Up 

to 4 hrs volunteer service allowed. 

CPR required if in clinical practice. 



and be current in CPR. One course in 

ethics every three years required. 

No more than 3 hours in practice 

Management. 

General supervision dental hygienists 

must have 2 years experience. 


must earn 3 hours must be related to 

medical emergencies in dental office. Up 

to 6 hours for volunteer services; 

community oral health instruction 

authorship of a professional publication, 

participation on dental board, peer 

review, or quality of care review 

procedures, test development for 

clinical dh exam may be earned. 

LAP Hygienists must earn 12 hours of CE

PA Prophylaxis; ; X‐Rays; Local Anesthesia; Pit/ 

Fissure Sealants; Root Planing; Study Cast 

Impressions; Remove Sutures 

Topical Anesthesia; Fluoride 


Perio Dressings; Remove Perio Dressings; Place 


Planning 

RI Local Anesthesia; Study Cast Impressions; Place 




Pit/ Fissure Sealants; Root Planing; DH 

Diagnosis/ Assessment 


Sutures; Treatment Planning 


present. Public health dental hygiene 

Practitioners may provide care in a variety of public 

health settings without the supervision or 

prior authorization of a dentist., except for providing 

local anesthesia, which can only be done under direct 

supervision. 


present. For hygienists with General Supervision 

Levels; dentist needs to authorize prior to services, 

but need not be present. 




present. 



Dental hygienists working under a dentist’s general 

supervision can initiate dental hygiene treatment to 

residents of nursing facilities and can provide services 

as she determines appropriate without specific 

authorization, except Diagnosis/Assessment. 



every two years (in addition to the 24 

hours required for all dental hygienists) 

to renew permit. 2,500 supervised 

experience, liability insurance. 




Public health dental hygiene 

practitioners must have 3,600 hours and 

are required to take five hours of 

continuing education dedicated to 

public health matters during each 

licensure period. Must also have 

expense and liability insurance. 



One hour per year must be earned in 

OSHA Bloodborne Pathogen Standards if 

practicing in dental setting. No 

volunteer work considered for CE.

SC Local Anesthesia; Topical Anesthesia 

Study Cast Impressions; Remove Perio Dressings; 



Prophylaxis; X‐Rays; Fluoride 


Perio Dressings; Place Sutures; DH Diagnosis/ 


SD Administer N20; Local Anesthesia 



Tissue Curettage 




Planning 

TN Local Anesthesia; Root Planing; Soft Tissue 

Curettage; Administer N20; Study Cast 

Impressions; Remove Perio Dressings; Remove 

Sutures 


Pit/ Fissure Sealants 

Place Perio Dressings; Place Sutures; DH 



present. 


present. Dental hygienists employed by or contacted 

through the Department of Health and 

Environment Control may provide services under 

general supervision that does not require 

prior examination by a dentist in settings such as 

schools or nursing homes. 




present. 






present. 








Dental Hygienists in public health 

settings must carry professional liability 

insurance. 


must earn 75 hours every five years and 

be current in CPR (can receive credit). 

One hour every year in dental 

radiography required. Up to 6 hrs for 

volunteer work allowed. 



be current in CPR.

TX Prophylaxis; X‐Rays; Local Anesthesia; Topical 


Planing; Study Cast Impressions; Place Perio 


Sutures 




UT Local Anesthesia; Administer N20 




Perio Dressings; Remove Perio Dressings; Place 

Sutures; Remove Sutures 


VT Local Anesthesia 




Pit/ Fissure Sealants; Root Planing 



A dentist may delegate services for a period of 6 

months without seeing the patient first to a dental 

hygienist practicing in a nursing facility, school based 

health center, or community health center. The 

hygienist must refer the patient to a dentist following 

treatment. The hygienist may not perform a second 

set of services until the patient has been examined by 

a dentist. 




present. 






present. 





Dental hygienists may provide hygiene services in 

public health settings under the supervision of a 


must earn 12 hours every year. OSHA, 

CPR not included in 12 hrs, but are 

required (PALS and ACLS do qualify). No 

volunteer work considered for CE, 

except that licencees may get up 

to 6 hours for providing consultation to 

the dental board. 

Must complete an online (no credit) 

jurisprudence assessment every 3 years. 

Dental Hygienists in public health 

settings must have 2 years practice 

experience 



volunteer work considered for CE. 



volunteer work considered for CE. 

Public Health dental hygienists must 

have three years licensed clinical 

practice experience and in good 

standing in Vermont.



Planning 

VA Local Anesthesia; Administer N20 







WA Local Anesthesia; Soft Tissue Curettage; 

Administer N20; Place Perio Dressings; Remove 





Remove Perio Dressings 

dentist via a general supervision agreement. The 

agreement authorizes the dental hygienist to provide 

services, agreed to between the dentist and the 

dental hygienist. The agreement does not require 

physical presence of the dentist but it stipulates 

that the supervising dentist review all patient 

records. 




present; may only be performed by a hygienist on 

patients 18 or older. 

Virginia Pilot Project seeks to assess the impact 

dental hygienists practicing in an expanded capacity 

under remote supervision have on increasing access 

to dental health care for underserved populations. 

The following Dental Health Professional Shortage 

areas: Cumberland Plateau, Lenowisco and Southside 

counties. Dental hygienist will refer patients without 

a dental provider to a dentist with the goal of 

establishing a dental home. 




present. 



May see patients in “senior centers” if hygienist has a 

written agreement with dentist to provide “off-site” 

supervision. Dental hygienists who are school 


must earn 15 hours every year and be 

current in CPR. Dental hygienists 

allowed to monitor sedation requires 4 

CE hours in CPR every 2 years. 

Hygienists in the Virginia Pilot Program 

must be Employed by Department of 

Health and 2 years experience. 


must earn 15 hours every year and must 

be current CPR at renewal. No volunteer 

work considered for CE. 

Dental hygienists working in senior 

centers must have 2 years experience 

and must collect patient data to submit



WV Local Anesthesia; Place Perio Dressings; Remove 


Prophylaxis; X‐Rays; Topical Anesthesia; Pit/ 

Fissure Sealants; Root Planing; Study Cast 

Impressions; Fluoride 



Planning 

WI Local Anesthesia; Place Perio Dressings; Remove 


endorsed may assess for and apply sealants and 

fluoride varnishes and perform prophylaxis in 

community-based sealant programs carried out in 

schools. Unsupervised practice in hospitals, nursing 

homes, home health agencies, group homes 

(for the elderly, handicapped or youth), state 

institutions under department of health and 

human services, jails, and public health facilities 

provided the hygienist refers patient to a 

dentist for dental treatment and needed care. 




present. 



Dental hygienists, who meet specific requirements, 

may provide dental hygiene services without the 

supervision of a dentist in hospitals, schools, 

correctional facilities, jails, community clinics, long 

term care facilities, nursing homes, home health 

agencies, group homes, state institutions under the 

Department of Health and Human Resources, public 

health facilities, homebound settings and Accredited 

Dental Hygiene Education programs. 




present. 

to health department. 

Dental hygienists working in schools 

must have Sealant/Fluoride Varnish 

Endorsement from Department of 

Health. Hygienist must submit data to 

the Department of Health concerning 

patient demographics, treatment, 

reimbursement, referrals, etc. 

Dental hygienists in health care settings 

must have two years clinical experience 

within the last five years. 



current in CPR. At least 2 hours of 

infection control, tobacco use or oral 

effects substance abuse required. 

Unsupervised dental hygienists must 

have 2 years and 3,000 hours of clinical 

dental hygiene experience; six additional 

continuing education hours this must 

include 3 hours in medical emergencies 

and 3 hours in general public health 

content. The dental hygienist and 

supervising dentist must submit an 

annual report to the West Virginia Board 

of Dental Examiners of services 

rendered. 


must earn 12 hours every two years and



Study Cast Impressions 

Place Sutures; Soft Tissue Curettage; Administer 

N20; DH Diagnosis/ Assessment; Treatment 

Planning 

WY Local Anesthesia; Administer N20; Pit/ Fissure 

Sealants; Place Perio Dressings; Remove Perio 

Dressings 


Fluoride; Root Planing; Study Cast Impressions; 






The statute does not require the presence or 

supervision of a dentist in a public or private school, a 

dental or dental hygiene school or a facility owned by 

a local health department. 




present. 





be current in CPR certification (up to 2 

hrs credit). 2 hours of infection control 

required. 

No special requirements for hygienists in 

a school setting. 

No CE required for licensure renewal of 

a dental hygienist. 

Information about services that can be provided by dental hygienists, as well as the different levels of service was compiled using three separate documents from the American 

Dental Hygienist Association: 

http://www.adha.org/governmental_affairs/downloads/direct_access.pdf 

http://www.adha.org/governmental_affairs/downloads/fiftyone.pdf 

http://www.adha.org/governmental_affairs/downloads/CE.pdf

Dental Hygienist Duties By State – AGD - Academy of General ...

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