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General ✔✔The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises. Indirect ✔✔The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel. Direct ✔✔The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel
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General ✔✔The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises.
Indirect ✔✔The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel.
Direct ✔✔The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorizes the procedure, and before dismissal of the patient, evaluates the performance of the allied dental personnel.
Personal ✔✔The dentist is personally operating on a patient and authorizes the allied dental personnel to aid in treatment by concurrently performing supportive procedures.
DH General Supervision ✔✔Perform preliminary charting of the oral cavity and surrounding structures to include case histories,
perform initial and periodic examinations and assessments to determine periodontal status, and
formulate a dental hygiene treatment plan in coordination with a dentist's treatment plan.
LDA General Supervision ✔✔Complete preliminary charting of the oral cavity and surrounding structures with the exception of
periodontal probing and assessment of the periodontal structure.
DH/LDA General Supervision ✔✔Obtain informed consent within scope of practice.
DH/LDA General Supervision ✔✔Take photographs extraorally or intraorally.
DH/LDA General Supervision ✔✔Take vital signs such as pulse rate and blood pressure as directed by a dentist.
DH General Supervision ✔✔Make referrals to dentists, physicians, and other practitioners in consultation with a dentist.
DH General Supervision ✔✔Complete prophylaxis to include scaling, root planing, polishing of restorations.
DH/LDA Direct Supervision ✔✔Remove bond material from teeth with rotary instruments after removal of orthodontic appliances.
DH General Supervision
LDA Indirect Supervision ✔✔Etch appropriate enamel surfaces, apply and adjust pit and fissure sealants.
DH General Supervision ✔✔Administer local anesthesia.
DH General Supervision
LDA Direct Supervision ✔✔Administer nitrous oxide inhalation analgesia pursuant to the rule provisions.
DH General Supervision
LDA Indirect Supervision ✔✔Monitor a patient who has been induced by a dentist into nitrous oxide-oxygen relative analgesia.
DH/LDA Indirect Supervision ✔✔Perform restorative procedures limited to: placing, contouring, and adjusting amalgam
restorations and glass ionomers; adapting and cementing stainless steel crowns; and placing,
contouring, and adjusting class I, II, & V supragingival composite restorations on primary and
permanent teeth.
DH General Supervision ✔✔Remove marginal overhangs.
DH/LDA Direct Supervision ✔✔Place and remove matrix bands.
DH/LDA Direct Supervision ✔✔Fabricate, cement, and adjust temporary restorations extraorally or intraorally.
DH/LDA Direct Supervision ✔✔Remove temporary restorations with hand instruments only.
DH/LDA Direct Supervision ✔✔Etch appropriate enamel surfaces before bonding of orthodontic appliances by a dentist.
DH General Supervision
LDA Indirect Supervision ✔✔Place and remove rubber dam.
DH General Supervision
LDA Indirect Supervision ✔✔Preselect orthodontic bands.
DH/LDA General Supervision ✔✔Place and remove elastic orthodontic separators.
DH/LDA Direct Supervision ✔✔Attach prefit and preadjusted orthodontic appliances.
DH General Supervision
LDA Indirect Superversion ✔✔Remove and replace ligature ties and arch wires on orthodontic appliances.
DH/LDA Direct Supervision ✔✔Remove fixed orthodontic bands and brackets.
DH/LDA General Supervision ✔✔Deliver vacuum-formed orthodontic retainers.
DH General Supervision
LDA Indirect Supervision ✔✔Remove sutures.
DH General Supervision
LDA Indirect Supervision ✔✔Place and remove periodontal packs.
DH General Supervision
LDA Indirect Supervision ✔✔Dry root canals with paper points.
DH General Supervision
LDA Indirect Supervision ✔✔Place cotton pellets and temporary restorative materials into endodontic openings.
DH/LDA Direct Supervision ✔✔Maintain and remove intravenous lines under supervision of dentist holding a valid general
anesthesia or moderate sedation certificate.
DT/ADT General Supervision ✔✔Apply topical medications such as, but not limited to, topical fluoride and cavity varnishes in appropriate dosages.
DT/ADT General Supervision ✔✔Perform mechanical polishing.
DT/ADT General Supervision ✔✔Etch appropriate enamel surfaces, apply and adjust pit and fissure sealants.
DT/ADT General Supervision ✔✔Placement of temporary restorations.
DT/ADT General Supervision ✔✔Fabrication of soft occlusal guards and athletic mouthguards.
DT/ADT General Supervision ✔✔Pulp vitality testing.
DT/ADT General Supervision ✔✔Administer local anesthesia.
DT/ADT General Supervision ✔✔Administer nitrous oxide inhalation analgesia.
DT/ADT General Supervision ✔✔Take radiographs.
DT/ADT General Supervision ✔✔Application of desensitizing medication or resin.
DT/ADT General Supervision ✔✔Tissue conditioning and soft reline.
DT/ADT General Supervision ✔✔Atraumatic restorative therapy.
DT/ADT General Supervision ✔✔Dressing changes, including dry socket.
DT/ADT General Supervision ✔✔Dispense and administer analgesics, anti‐inflammatories, and antibiotics as permitted by the collaborative management agreement. Advanced
Dental Therapist may provide, dispense and administer.
DT/ADT General Supervision ✔✔Tooth reimplantation.
ADT General Supervision
DT Indirect Supervision ✔✔Stabilization of reimplanted teeth.
DT Indirect Supervision ✔✔Repair of defective prosthetic devices.
ADT General Supervision
DT Indirect Supervision ✔✔Placement of temporary crowns: and preparation and placement of preformed stainless steel and resin crowns.
ADT General Supervision
DT Indirect Supervision ✔✔Provide emergency palliative treatment of dental pain.
ADT General Supervision
DT Indirect Supervision ✔✔Recement permanent crowns.
ADT General Supervision
DT Indirect Supervision ✔✔Extractions of primary teeth.
ADT General Supervision ✔✔Extraction of periodontaly diseased permanent teeth with mobility of +3 to +4 as permitted by the collaborative management agreement. Not to include unerupted, impacted, fractured, or need for sectioning.
ADT General Supervision ✔✔Oral evaluation and assessment of dental disease and the formation of an individualized treatment plan authorized by a collaborating dentist.
ADT General Supervision ✔✔Make appropriate referrals to dentists, physicians, and other practitioners in consultation with the collaborating dentist.
Fundamental ✔✔Activities directly related to the provisions of clinical dental services.
Elective ✔✔activities directly related to, or supportive of the practice of dentistry, dental hygiene or dental assisting.
Clinical subject ✔✔subjects directly related to the provision of dental care and treatment to patients.
Core subject ✔✔areas of knowledge that relate to public safely and professionalism.
Protfolio ✔✔an accumulation of written documentation of professional development activities.