Current state of dental hygienist scope-of-practice rules in the U.S.

Jan 22, 2014

Symbol	Definition
Y	The condition as established by state legislative or regulatory guidelines has been met.
N	The criteria have not been met.
A	The dental hygienist can provide services as he or she determines appropriate without specific authorization or direct dentist supervision (direct access) in at least one setting.
G	A dentist must authorize the dental hygienist's practice but need not be present.
D	Direct dentist supervision of the dental hygienist practice is required.

State	% of residents underserved^b	Can be directly reimbursed by Medicaid^c	Prophylaxis	Fluoride	Pit/fissure sealants
Alabama	24	N	D	D	D
Alaska	10	N	G/A	G/A	G/A
Arizona	15	Y	G/A	G/A	G/A
Arkansas	5	N	G/A	G/A	G/A
California	3	Y	G/A	G/A	G/A
Colorado	7	Y	A	A	A
Connecticut	10	Y	G/A	G/A	G/A
Delaware	22	N	G	G	G
Florida	18	N	G/A	G/A	G/A
Georgia	11	N	D	D	D
Hawaii	11	N	D/G	D/G	D/G
Idaho	18	N	G/A	G/A	G/A
Illinois	13	N	G	G	G
Indiana	4	N	D/G	D/G	D
Iowa	7	N	G/A	G/A	G/A
Kansas	17	N	G/A	G/A	G/A
Kentucky	5	N	G/A	G/A	G/A
Louisiana	24	N	D/G	D/G	D/G
Maine	15	Y	G/A	G/A	G/A
Maryland	5	N	G	G	G
Massachusetts	5	Y	G/A	G/A	G/A
Michigan	5	N	G/A	G/A	G/A
Minnesota	7	Y	G/A	G/A	G/A
Mississippi	36	N	D	D/G	D
Missouri	18	Y	G/A	G/A	G/A
Montana	15	Y	G/A	G/A	G/A
Nebraska	0	Y	G/A	G/A	G/A
Nevada	11	Y	G/A	G/A	G/A
New Hampshire	1	N	G/A	G/A	G/A
New Jersey	0	N	G	G	G
New Mexico	26	Y	G/A	G/A	G
New York	5	N	A	A	A
North Carolina	13	N	D/G	D/G	D/G
North Dakota	8	N	G	G	G
Ohio	8	N	G/A	G/A	G/A
Oklahoma	2	N	A	A	A
Oregon	17	Y	G/A	G/A	G/A
Pennsylvania	10	N	G/A	G	G/A
Rhode Island	10	N	G/A	G/A	G/A
South Carolina	21	N	G/A	G/A	G/A
South Dakota	13	N	G/A	G/A	G/A
Tennessee	20	N	G	G/A	G/A
Texas	9	N	G/A	G/A	G/A
Utah	13	N	G	G	G
Vermont	0	N	G/A	G/A	G/A
Virginia	8	N	G/A	G/A	G/A
Washington	10	Y	G/A	G/A	G/A
West Virginia	11	N	G/A	A	G
Wisconsin	9	Y	G/A	G	G/A
Wyoming	7	N	G	G	D
Totals		Y = 15	D = 3	D = 2	D = 5
		N = 35	G = 8	G = 9	G = 8
			A = 3	A = 4	A = 3
			G/A = 32	G/A = 30	G/A = 31
			D/G = 4	D/G = 5	D/G = 3

Data courtesy of the "The Role of Dental Hygienists in Providing Access to Oral Health Care" report by the National Governers Association, January 6, 2014.
^a American Dental Hygienists' Association, "Dental Hygiene Practice Act Overview: Permitted Functions and Supervision Levels by State," accessed November 12, 2013; and American Dental Hygienist's Association, "Direct Access States."
^b The total state population divided by estimated underserved population in each state. Data provided by the Health Resources and Services Adminisatration (HRSA), April 2013.
^c State Medicaid dental hygienist reimbursement policies were obtained from the study, "States Which Directly Reimburse Dental Hygienists for Services under the Medicaid Program," conducted by the American Dental Hygienists' Association, 2010.