Oral Health Providers Overview
Dental hygienists are oral health providers working together with a dentist to provide preventive and routine care. Since each state has its own specific regulations regarding the responsibilities of dental hygienists, the range of services performed varies from state to state. The American Dental Hygienists’ Association reports approximately 185,000 dental hygienists working in the U.S. in 2015.
Dental therapists are members of the dental team who provide preventive and restorative dental care, usually for children and adolescents. The precise role varies and depends on the therapist’s education and the various state dental regulations and guidelines. There is a growing professional association for dental therapists, the American Academy of Dental Therapy. There are currently few reliable estimates of the number of professionals serving in this capacity.
Dental hygienists and dental therapists practice in private settings, community-based clinics and rural areas. They all practice under varying levels of supervision by dentists, allowing these providers to meet needs in nontraditional, tribal, school based and community settings.
The information on this site focuses on three areas of scope of practice for Oral Health Providers: dental hygienists with direct access, dental hygienists’ prescriptive authority and responsibilities of dental therapists.
Direct access is defined by the American Dental Hygienists Association (ADHA) as the ability of a dental hygienist to initiate treatment based on their assessment of a patient’s needs without the specific authorization of a dentist, treat the patient without the presence of a dentist, and maintain a provider-patient relationship. Some states require a dental hygienist practicing with direct access to have a collaborative agreement with a dentist that outlines certain policies and procedures including supervision by a dentist. Other states require certain educational and experience requirements before being allowed direct access. In some states dental hygienists are not allowed to have direct access. In addition, there are a number of states that do not require supervision by a dentist when dental hygienists are practicing in direct access settings.
Prescriptive authority refers to whether state policy allows dental hygienists to prescribe medications. In most states dental hygienists do not prescribe medications.
Dental therapists are currently recognized in five states and two territories. Alaska, Maine, Minnesota, Vermont, Washington, American Samoa and the Northern Mariana Islands recognize dental therapists as an additional provider for specified dental services in the dental office or other approved practice sites.
The map on the right shows a comparison of all states and territories for these three areas. Choose a tab to explore different options. For more detailed information, please click on a state or territory.
For information on nurse practitioners and physician assistants, please use the practitioner links below the map.
Interactive map: Select a state to get more information.
- No direct access
Dental hygienist is not allowed to practice with direct access.
- Collaborative agreement or supervision required
Dental hygienists are required to have a collaborative practice agreement with a dentist which outlines procedures the dental hygienist is allowed to do and procedures for consulting with the dentist or some sort of supervision by a dentist
- Educational/practice hours required for direct access
The dental hygienist must meet certain educational and/or practice hours requirements before being allowed direct access.
- No supervision required
Dental hygienists are not required to be supervised in alternative practice settings.