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

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 underservedb Can be directly reimbursed by Medicaidc 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.
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