Dental hygienists are essential elements of the dental team, and provide important services for the oral health care system in the United States. State laws regulate the oral health treatments that can or cannot be performed by dental hygienists. It also states under what supervision the treatments can be performed, and other requirements, such as licenses or education level. The dental hygiene scope of practice varies from state to state. To understand those differences, we must first understand how each level of supervisions is defined. Direct supervision level means a licensed dentist must be present when the treatment is preformed. In California and Michigan the services that may be performed by hygienist under direct supervision are the same. These services include administering local anesthesia, soft tissue curettage and administering N20. General supervision requires the dentist to authorize prior to the services being rendered, but they are not required to be present. General supervision often goes hand in hand with direct access supervision, which allows dental hygienists to provide treatment as she or he sees appropriate without specific authorization. Under general supervision and/or direct access, California and Michigan allow the same duties as well. Those duties are the oral prophylaxis, x-rays, topical anesthesia, fluoride, pit and fissure sealants, root planning, study model impressions, suture removal and DH diagnosis. In both states dental hygienists are able to preform most of the treatment within the dental hygiene scope of practice independently, with no or very limited supervision by a licensed dentist. A study performed by American Dental Hygienists' Association showed that this had no negative affect on the quality of public health. In fact, in conclusion to their study, the researchers state that, “under the circumstances … and the methods used to assess theen quality of care, the study showed that independent dental hygienist practice did not increase the risk to the health and safety of the public.”1
Pending legislation California:
Senate bill 694 was introduced to the senate on march 29th, 2011 by senator Padilla and coauthor senator Emmerson and senator Price.. This bill was sponsored by the children’s partnership funded by the PEW Charitable trust foundation. Senate Bill 694s to is an purposed addition to Section 104766 to, to add Article 2.5 (commencing with Section 104767) to Chapter 3 of Part 3 of Division 103 of, and to repeal Section 104767.1 of, the Health and Safety Code, relating to dental care. 2 “This bill would create a study of a variety of avenues for creating new categories of dental auxiliaries to enhance workforce providing oral health care to children and specifically includes hygienists in the study.”3