Oral Health Providers Overview

Dental hygienists are oral health providers working together with a dentist to provide preventive and routine care. Since each state has its own specific regulations regarding the responsibilities of dental hygienists, the range of services performed varies from state to state. As of May 2018, the Bureau of Labor Statistics reports approximately 215,000 dental hygienists working in the U.S.

Dental therapists are primary care oral health professionals able to conduct assessments and provide preventive, restorative and limited surgical care. The precise role varies and depends on the therapist’s education and the various state dental regulations and guidelines. There is a growing professional association for dental therapists, the American Academy of Dental Therapy. There are currently few reliable estimates of the number of professionals serving in this capacity.

Dental hygienists and dental therapists practice in private settings, community-based clinics and rural areas. They all practice under varying levels of supervision by dentists, allowing these providers to meet needs in nontraditional, tribal, school-based and community settings.

The maps on the right show a comparison of all states and territories for the following three policy areas:

1) dental hygienists with direct access
2) states allowing dental therapy
3) states allowing teledentistry

Choose a tab to explore different options. For more detailed information, please click on a state or territory.

Direct access is defined by the American Dental Hygienists Association (ADHA) as the ability of a dental hygienist to initiate treatment based on her or his assessment of a patient’s needs without the specific authorization of a dentist, treat the patient without the presence of a dentist and maintain a provider-patient relationship.

Some states require a dental hygienist practicing with direct access to have a collaborative agreement with a dentist that outlines certain policies and procedures including supervision by a dentist. Other states require certain educational and experience requirements before being allowed direct access. In some states, dental hygienists are not allowed to have direct access. In addition, there are a number of states that do not require supervision by a dentist when dental hygienists are practicing in direct access settings.

Dental therapists are currently recognized in 13 states and two territories as an additional provider for specified dental services in the dental office or other approved practice sites. These professionals typically work with rural and underserved populations to improve access to needed dental services.

Teledentistry uses technology to provide and support dental care services remotely. The policies are wide-ranging and can cover services such as face-to-face consultation via video conference (live video), sharing images and records among providers (store-and-forward) and monitoring patients. Teledentistry can also act as an educational tool for dental professionals. Some states offer reimbursement for teledentistry services, either through Medicaid and/or private payers.