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Variation in Dental Hygiene Scope of Practice by State

This infographic, an update from when it was last updated in 2019, illustrates allowable tasks for dental hygienists by each state in the United States, to help planners and policymakers understand the differences in legal scope of practice across states, particularly in public health settings.

Legal scope of practice for dental hygienists differs by state. These scope of practice acts describe the services that dental hygienists can provide and under what conditions they can be provided. Restrictive legal scopes of practice often serve as a barrier to effective and efficient delivery of health services.

* In Colorado, indirect supervision requires only preapproval, not the presence of a dentist.

† In Idaho, provision of sealants and prophylaxis without prior examination by a dentist is permissible for volunteer dental hygienists.

References:

1. Langelier M, Baker B, Continelli T. Development of a New Dental Hygiene Professional Practice Index by State, 2016. Oral Health Workforce Research Center, Center for Health Workforce Studies, University at Albany, School of Public Health; 2016. https://oralhealthworkforce.org/wp-content/uploads/2018/02/OHWRC_Dental_Hygiene_Scope_of_Practice_2016.pdf

2. Langelier M, Continelli T, Moore J, Baker B, Surdu S. Expanded scopes of practice for dental hygienists associated with improved oral health outcomes for adults. Health Affairs. 2016;35(12):2207-2215. doi:10.1377/hlthaff.2016.080

This work is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of an award totaling $450,000 with 0% financed with non-governmental sources. The information presented in this infographic is based on research conducted by the authors and does not necessarily represent the official views of, nor an endorsement, by, HRSA, HHS, or the US government. For more information, please visit HRSA.gov.

The authors wish to thank the American Dental Hygienists’ Association for their assistance with updating this infographic.

This graphic describes the highest level of practice available to a dental hygienist in a state, including dental hygiene therapy. Some provisions highlighted in this infographic may apply only to dental hygienists in collaborative care agreements and/or dental hygienists practicing in specific settings, including but not limited to public health settings and designated Health Professional Shortage Areas. This graphic is for informational purposes only and scope of practice is subject to change. Contact the applicable dental board or your attorney for specific legal advice.

This infographic is the property of the OHWRC and may not be modified in any way. It may be shared publicly in its current form in its entirety, including the attribution stated above.

Last Updated November 2024.

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