Hygienists > Supervision of Personnel

In all instances, a dentist assumes responsibility for determining, on the basis of diagnosis, the specific treatment patients will receive and which aspects of treatment may be delegated to qualified personnel. A dentist may only delegate to a dental hygienist those services that are within their authorized scope of practice. A dentist may only delegate to a dental assistant those services that are within their authorized scope of practice.

“Direct supervision” means that the dentist is present in the treatment facility, but it is not required that the dentist be physically present in the treatment room. Direct supervision is required for all intraoral services (except suctioning) provided by a registered dental assistant. Direct supervision is also required for a dental hygienist administering local anesthesia or nitrous oxide inhalation analgesia, or for a hygienist providing services to a new patient (except under public health supervision). An exam by the dentist must also take place during an initial visit by a new patient.

“General supervision of a dental assistant” means that a dentist has delegated the services to be provided by a registered dental assistant, which are limited to all extraoral duties, dental radiography, and intraoral suctioning. The dentist need not be present in the facility while these services are being provided.

“General supervision of a dental hygienist” means that a dentist has examined the patient and has prescribed authorized services to be provided by a dental hygienist. The dentist need not be present in the facility while these services are being provided. If a dentist will not be present, the following requirements shall be met:

  1. Patients or their legal guardians must be informed prior to the appointment that no dentist will be present and therefore no examination will be conducted at that appointment.
  2. The hygienist must consent to the arrangement.
  3. Basic emergency procedures must be established and in place and the hygienist must be capable of implementing these procedures.
  4. The treatment to be provided must be prior prescribed by a licensed dentist and must be entered in writing in the patient record.

General supervision shall not preclude the use of direct supervision when in the professional judgment of the dentist such supervision is necessary to meet the individual needs of the patient.

All authorized services provided by a dental hygienist shall be performed under the general, direct, or public health supervision of a dentist currently licensed in the state of Iowa.

Under the general or public health supervision of a dentist, a dental hygienist may provide educational services, assessment, screening, or data collection for the preparation of preliminary written records for evaluation by a licensed dentist. A dentist is not required to examine a patient prior to the provision of these dental hygiene services.

Subsequent examination and monitoring of the patient, including definitive diagnosis and treatment planning, is the responsibility of the dentist and shall be carried out in a reasonable period of time in accordance with the professional judgment of the dentist based upon the individual needs of the patient.

“Personal supervision” means the dentist is physically present in the treatment room to oversee and direct all intraoral or chairside services of the dental assistant trainee and a licensee or registrant is physically present to oversee and direct all extraoral services of the dental assistant.

Public health supervision may be provided to a dental hygienist who has entered into a written public health supervision agreement with a dentist. More information.