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Virginia Administrative Code
Title 18. Professional And Occupational Licensing
Agency 60. Board of Dentistry
Chapter 21. Regulations Governing the Practice of Dentistry
12/21/2024

18VAC60-21-120. Requirements for direction and general supervision.

A. In all instances and on the basis of diagnosis, a licensed dentist assumes ultimate responsibility for determining with the patient or the patient's representative the specific treatment the patient will receive, which aspects of treatment will be delegated to qualified personnel, and the direction required for such treatment, in accordance with this chapter and the Code of Virginia.

B. Dental hygienists acting within the scope of a license issued by the board under § 54.1-2722 or 54.1-2725 of the Code of Virginia who teach dental hygiene in a CODA accredited program are exempt from this section.

C. Duties delegated to a dental hygienist under indirect supervision shall only be performed when the dentist is present in the facility and examines the patient during the time services are being provided.

D. Duties that are delegated to a dental hygienist under general supervision shall only be performed if the following requirements are met:

1. The treatment to be provided shall be ordered by a dentist licensed in Virginia and shall be entered in writing in the record. The services noted on the original order shall be rendered within a specific time period, not to exceed 10 months from the date the dentist last performed a periodic examination of the patient. Upon expiration of the order, the dentist shall have examined the patient before writing a new order for treatment under general supervision.

2. The patient or a responsible adult shall be informed prior to the appointment that a dentist may not be present, that only topical oral anesthetics can be administered to manage pain, and that only those services prescribed by the dentist will be provided.

3. Written basic emergency procedures shall be established and in place, and the hygienist shall be capable of implementing those procedures.

E. An order for treatment under general supervision shall not preclude the use of another level of supervision when, in the professional judgment of the dentist, such level of supervision is necessary to meet the individual needs of the patient.

Statutory Authority

§ 54.1-2400 of the Code of Virginia.

Historical Notes

Derived from Virginia Register Volume 32, Issue 5, eff. December 2, 2015; amended, Virginia Register Volume 41, Issue 2, eff. October 24, 2024.

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