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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 AL Services that can be provided: Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure; Sealants; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast; Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning AK Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue; Curettage Supervision Required: Direct Supervision Levels; dentist needs to be present to provide all services. Licensure Renewal/Advanced Hygiene Licensure Requirements: For licensure renewal, a dental hygienist must earn 12 hours every year reported on renewal form. CPR required and 2 hours of infection control every two year.

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; Remove Perio Dressings; Place Sutures; Remove Sutures DH Diagnosis/ Assessment Treatment Planning Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants

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. These procedures are not allowed to be done by a dental hygienist. 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

must approve collaborative agreement.

AZ

Local Anesthesia; Administer N20; Place Perio Dressings; Remove Perio Dressings; Place Sutures;

For licensure renewal, a dental hygienist 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.

Root Planing; Soft Tissue Curettage; Study Cast Impressions; Remove Sutures DH Diagnosis/ Assessment Treatment Planning AR Prophylaxis; XRays; Fluoride; Pit/ Fissure Sealants; Study Cast Impressions Local Anesthesia; Root Planing; Soft Tissue Curettage; Administer N20

General supervision required for all hygienists; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist. General supervision required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required; dentist needs to be present to provide all services.

For licensure renewal, a dental hygienist must earn 40 hours every two years. Must be current in CPR and earn 2 hours infection control.

CA

Topical Anesthesia; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning

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 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 authorize prior to services, but need not be present. 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. Direct Supervision Levels required; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists with 2 years experience may practice without supervision in institutions, public health facilities, group homes and schools.

For licensure renewal, a dental hygienist must earn 25 hours every two years. 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.

CO

Local Anesthesia; Soft Tissue Curettage; Administer N20 Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Study Cast Impressions; DH Diagnosis/ Assessment; Treatment Planning

Dental hygienists do not need to earn any continuing education hours. No special requirements for Independent Practice Dental Hygienists. Direct Medicaid reimbursement allowed.

Local Anesthesia; Root Planing; Soft Tissue Curettage; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Administer N20; Place Sutures CT Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning

Dental hygienists do not need to earn any continuing education hours. 2 years experience required for unsupervised practice in public health

Only General Supervision Level allowed for DH Diagnosis/ Assessment and Treatment Planning. Local Anesthesia Soft Tissue Curettage; Administer N20; Place Sutures Prophylaxis; XRays; 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; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; 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; Treatment Planning FL Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Root Planing; Soft Tissue Curettage; Study Cast Impressions Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

settings. Direct Medicaid reimbursement allowed.

DE

For licensure renewal, a dental hygienist must earn 24 hours every two years. CPR required, but not included in 24 hour CE requirement. Limit on management subjects.

DC

These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present (Fluoride varnish allowed to be done in public health settings only). Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a

For licensure renewal, a dental hygienist must earn 15 hours every two years. Two hours of CPR must be part of 15 hour requirement

For licensure renewal, a dental hygienist must earn 24 hours every two years. 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.

GA

Local Anesthesia; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio; Dressings; Remove Sutures XRays; Local Anesthesia; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures Administer N20; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Remove Perio Dressings; Remove Sutures

dental hygienist. Direct Supervision Levels; dentist needs to be present. For licensure renewal, a dental hygienist must earn 22 hours every two years. Must earn CPR (up to 4 hrs) and 15 hrs must be "clinical science"

These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be 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 These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to For licensure renewal, a dental hygienist For licensure renewal, a dental hygienist must earn 20 hours every two years and be current in CPR.

HI

ID

For licensure renewal, a dental hygienist 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

Administer N20; Study Cast Impressions Soft Tissue Curettage; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Topical Anesthesia;

IL

Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings; Remove Sutures Local Anesthesia; Administer N20 Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia; Fluoride; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Pit/ Fissure Sealants

authorize prior to services, but need not be present.

must earn 32 hours every three years and be current in CPR.

Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.

IN

Direct Supervision Levels; dentist needs to be present, but for dental hygienists in public settings, General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. Direct Supervision Levels; dentist needs to be present.

For licensure renewal, a dental hygienist must earn 14 hours every two years. Must earn CPR (up to 2 hrs credit) and 2 hours in Ethics. No more than 5 hrs practice management.

IA

Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; DH Diagnosis/ Assessment

For licensure renewal, a dental hygienist must earn 30 hours every two years. Must earn CPR­can 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

Local Anesthesia; Administer N20

Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; Treatment Planning Soft Tissue Curettage; Place Sutures KS XRays; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; Topical Anesthesia; Fluoride; DH Diagnosis/ Assessment; Treatment Planning

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

other than assessment, screening and fluoride, dentist must examine.

For licensure renewal, a dental hygienist must earn 30 hours every two years. Dental hygienist with an extended care permit I or II must have 1,800 hours experience. CPR required only if RDH administers anesthesia.

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

Local Anesthesia

KY

Local Anesthesia; Topical Anesthesia; Fluoride; Administer N20 Prophylaxis; XRays; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment Soft Tissue Curettage; Place Sutures; Treatment Planning

For licensure renewal, a dental hygienist must earn 30 hours every two years. CPR required. Approved HIV/AIDS course every 10 years.

These procedures are not allowed to be done by a dental hygienist.

LA

Local Anesthesia; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants

Direct Supervision Levels; dentist needs to be present. Direct Supervision Levels required for local anesthesia; dentist needs to be present. For hygienists practicing in a public health setting, General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be 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. These procedures are not allowed to be done by a dental hygienist. A dental hygienist licensed as an independent practice dental hygienist may practice without supervision by a dentist in all settings.

For licensure renewal, a dental hygienist 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.

ME

Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Place Perio Dressings

For licensure renewal, a dental hygienist must earn 30 hours every two years. 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

Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings; Remove Sutures

Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

MD

Prophylaxis; XRays; 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; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

Direct Supervision Levels required for local anesthesia; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not 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. Direct Supervision Levels required for local anesthesia; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist.

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. For licensure renewal, a dental hygienist must earn 30 hours every two years. 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.

MA

For licensure renewal, a dental hygienist must earn 20 hours every two years. 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

Local Anesthesia Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

MI

Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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 authorization. Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist.

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. For licensure renewal, a dental hygienist 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. For licensure renewal, a dental hygienist must earn 25 hours every two years and be current in CPR. Minimum 15 hrs in

Local Anesthesia; Soft Tissue Curettage; Administer N20 Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

MN

Local Anesthesia; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings;

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

Remove Sutures Prophylaxis; XRays; Pit/ Fissure Sealants; Fluoride; Root Planing Topical Anesthesia

"core" courses required. Must complete two of the following categories per General Supervision Levels required; dentist needs to cycle--infection control; record keeping; authorize prior to services, but need not be present. ethics; patient communications; A dental hygienist may be employed or retained by a management medical emergencies; and health care facility, program, or nonprofit treatment and diagnosis. Must maintain organization to perform dental hygiene services a "portfolio" to record documentation without the patient first being examined by a licensed of fundamental and elective dentist if the dental hygienist has entered into a professional development activities, CPR collaborative agreement with a licensed dentist that certification, and a biennial selfdesignates authorization for the services provided by assessments (on a board approved the dental hygienist. form) These procedures are not allowed to be done by a dental hygienist. 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. For licensure renewal, a dental hygienist must earn 20 hours every two years. CPR, up to 4 hrs, required; 8 hrs for advanced CPR.

Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

MS

Prophylaxis; XRays; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage Local Anesthesia; Topical Anesthesia; Administer

Direct Supervision Levels; dentist needs to be present (Fluoride varnish allowed to be done in public health settings by General Supervision Levels). These procedures are not allowed to be done by a

N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning MO Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Sutures

dental hygienist.

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists may provide services without supervision in public health settings to Medicaid eligible children; hygienist can provide services as she determines appropriate without specific authorization. Direct Supervision Levels; dentist needs to be present. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For hygienists with a limited access permit from the board, hygienist can provide services as she determines appropriate without specific authorization. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. The Department of Health may authorize an

For licensure renewal, a dental hygienist must earn 30 hours every two years. 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.

Local Anesthesia; Administer N20; Remove Perio Dressings Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Administer N20

MT

For licensure renewal, a dental hygienist must earn 36 hours every three years 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.

XRays; Local Anesthesia; Topical Anesthesia; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; Fluoride; Pit/ Fissure Sealants

NE

For licensure renewal, a dental hygienist must earn 30 hours every two years and be current in CPR (up to 4 hours.)

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. XRays; Local Anesthesia; Topical Anesthesia; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning 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; XRays; Root Planing; Administer N20; Place Sutures General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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.

For licensure renewal, a dental hygienist must earn 15 hours every year and be current in CPR. No special requirements for RDH Public Health Endorsements.

NH

Prophylaxis; Fluoride; Pit/ Fissure Sealants; Root Planing

For licensure renewal, a dental hygienist must earn 20 hours every two years. Must be current in CPR (up to 3 hours per year) and may only take subjects related to practice. No special requirements for public

period. XRays; Topical Anesthesia; Study Cast Impressions; Remove Perio Dressings; Remove Sutures Local Anesthesia; Administer N20 Soft Tissue Curettage; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Fluoride; Pit/ Fissure Sealants; Root Planing Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Topical Anesthesia Prophylaxis; XRays; Fluoride; DH Diagnosis/ Assessment; Pit/ Fissure Sealants; Root Planing Soft Tissue Curettage; Study Cast Impressions; Remove Perio Dressings General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia; dentist needs to be present These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.

health dental hygienists.

NJ

Direct Supervision Levels required for local anesthesia; dentist needs to be present. For These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. For those in Collaborative Practice of Dental Hygiene (CPDH), hygienist can provide Prophylaxis,, XRays, and Fluoride services as she determines appropriate without specific authorization. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be

For licensure renewal, a dental hygienist 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.

NM

For licensure renewal, a dental hygienist must earn 45 hours every three years 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. For licensure renewal, a dental hygienist

Place Perio Dressings; Administer N20; Place Sutures; Remove Sutures; Treatment Planning NY Local Anesthesia; Administer N20; Study Cast

Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing

present. Direct Supervision Levels; dentist needs to be 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 authorize prior to services, but need not be present. 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. These procedures are not allowed to be done by a dental hygienist. 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 These procedures are not allowed to be done by a dental hygienist.

must earn 24 hours every three years 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.

NC

Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; 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; Treatment Planning Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; Treatment Planning

For licensure renewal, a dental hygienist must earn six hours every year and be current in CPR. Public Health RDH needs additional requirements IF they work under "direction".

ND

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Direct Supervision Levels required for local anesthesia; dentist needs to be present. Root Planing and Soft Tissue Cutterage, must be done upon direct order of a dentist.

For licensure renewal, a dental hygienist must earn 16 hours every two years. 2 hours in CPR infection control required; only 3 hours may be non-clinical.

OH

Administer N20; Place Sutures; DH Diagnosis/ Assessment Local Anesthesia; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present.

For licensure renewal, a dental hygienist must earn 12 hours every two years. Up to 4 hrs volunteer service allowed. CPR required if in clinical practice.

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be 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. These procedures are not allowed to be done by a dental hygienist. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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.

OK

Local Anesthesia; Administer N20; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning

For licensure renewal, a dental hygienist must earn 30 hours every three years 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. For licensure renewal, a dental hygienist 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

OR

Administer N20; Place Sutures

PA

Prophylaxis; ; XRays; Local Anesthesia; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Remove Sutures

Direct Supervision Levels; dentist needs to be 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. Direct Supervision Levels; dentist needs to be present. For hygienists with General Supervision Levels; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist.

every two years (in addition to the 24 hours required for all dental hygienists) to renew permit. 2,500 supervised experience, liability insurance. For licensure renewal, a dental hygienist must earn 20 hours every two years and be current in CPR. 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.

Topical Anesthesia; Fluoride

RI

Soft Tissue Curettage; Administer N20; Place Perio Dressings; Remove Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants; Root Planing; DH Diagnosis/ Assessment

Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be 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. These procedures are not allowed to be done by a dental hygienist.

For licensure renewal, a dental hygienist must earn 20 hours every two years. One hour per year must be earned in OSHA Bloodborne Pathogen Standards if practicing in dental setting. No volunteer work considered for CE.

Soft Tissue Curettage; Administer N20; Place Sutures; Treatment Planning

SC

Local Anesthesia; Topical Anesthesia Direct Supervision Levels; dentist needs to be Study Cast Impressions; Remove Perio Dressings; present. Remove Sutures Fluoride; Pit/ Fissure Sealants; Root Planing; Prophylaxis; XRays; Fluoride Direct Supervision Levels; dentist needs to be 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. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist.

For licensure renewal, a dental hygienist must earn 14 hours every two years and be current in CPR. Dental Hygienists in public health settings must carry professional liability insurance.

SD

Soft Tissue Curettage; Administer N20; Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Administer N20; Local Anesthesia Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Root Planing; Soft Tissue Curettage; Administer N20; Study Cast Impressions; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants Place Perio Dressings; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

For licensure renewal, a dental hygienist 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.

TN

Direct Supervision Levels; dentist needs to be present.

For licensure renewal, a dental hygienist must earn 30 hours every two years and be current in CPR.

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist.

TX

Prophylaxis; XRays; Local Anesthesia; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present.

For licensure renewal, a dental hygienist 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 For licensure renewal, a dental hygienist must earn 30 hours every two years. No volunteer work considered for CE.

Local Anesthesia; Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning UT Local Anesthesia; Administer N20 Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Soft Tissue Curettage; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Place Sutures; Remove Sutures DH Diagnosis/ Assessment; Treatment Planning VT Local Anesthesia Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride Pit/ Fissure Sealants; Root Planing

These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. Dental hygienists may provide hygiene services in public health settings under the supervision of a

For licensure renewal, a dental hygienist must earn 18 hours every two years. No volunteer work considered for CE. Public Health dental hygienists must have three years licensed clinical practice experience and in good standing in Vermont.

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. Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Administer N20 These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be 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. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be 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 For licensure renewal, a dental hygienist 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.

VA

Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings; Remove Sutures

Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning WA Local Anesthesia; Soft Tissue Curettage; Administer N20; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Place Perio Dressings; Remove Perio Dressings

For licensure renewal, a dental hygienist 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

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. Place Sutures; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Place Perio Dressings; Remove Perio Dressings; Remove Sutures Prophylaxis; XRays; Topical Anesthesia; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions; Fluoride These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be 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. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be 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. For licensure renewal, a dental hygienist must earn 20 hours every two years and current in CPR. At least 2 hours of infection control, tobacco use or oral effects substance abuse required.

WV

Soft Tissue Curettage; Administer N20; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning WI Local Anesthesia; Place Perio Dressings; Remove Perio Dressings; Remove Sutures

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. For licensure renewal, a dental hygienist must earn 12 hours every two years and

Prophylaxis; XRays; Topical Anesthesia; Fluoride; Pit/ Fissure Sealants; Root Planing; Study Cast Impressions

General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. 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. These procedures are not allowed to be done by a dental hygienist. Direct Supervision Levels; dentist needs to be present. General Supervision Levels required; dentist needs to authorize prior to services, but need not be present. These procedures are not allowed to be done by a dental hygienist.

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.

WY

Place Sutures; Soft Tissue Curettage; Administer N20; DH Diagnosis/ Assessment; Treatment Planning Local Anesthesia; Administer N20; Pit/ Fissure Sealants; Place Perio Dressings; Remove Perio Dressings Prophylaxis; XRays; Topical Anesthesia; Fluoride; Root Planing; Study Cast Impressions; Remove Sutures Soft Tissue Curettage; Place Sutures; DH Diagnosis/ Assessment; Treatment Planning

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

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