Supervision & Scope of Practice

Supervision levels, explained

Direct supervision

The supervising dentist must be physically present in the treatment room while the procedure is performed.

Indirect supervision

The supervising dentist must authorize the procedure and be physically present in the office (though not necessarily the treatment room) while it is performed.

General supervision

The supervising dentist authorizes the procedure in advance based on a prior examination, but does not need to be present in the office while it is performed.

Collaborative practice

The hygienist may practice under a written collaborative agreement with a dentist, without the dentist's direct or on-site supervision.

Direct access

The hygienist may assess a patient's need for care, initiate treatment, and maintain an ongoing provider–patient relationship without prior dentist authorization or examination.

Unsupervised / independent practice

The hygienist may perform the procedure with no dentist supervision requirement at all, including in settings the hygienist operates independently.