Dental Hygienists Can Perform Certain Procedures Without Direct Supervision Under NJ Statute

The New Jersey legislature approved a statute allowing dental hygienists to perform certain procedures without a dentist being physically present in the office. The NJDA issued an advisory with key provisions of the statute which is as follows.

• It is in the sole discretion of the dentist to allow or not allow dental hygienists to practice when the dentist is not physically present in the office.
• The general supervision of dental hygienists (known as “supervision” under the NJ Statutes) in a dental office must be authorized in writing (see sample below) by the dentist who assumes full professional responsibility whether or not the dentist is physically present.
• A dental hygienist practicing under general supervision must hold current certifications in basic or advanced cardiac life support.
• Dental hygienists may perform hygiene services only on patients of record.
• No more than three dental hygienists may be supervised by any one dentist at a time.
• Proper emergency equipment, as may be required by the New Jersey State Board of Dentistry, must be readily available in the dental office that allows the general supervision of dental hygienists. (Note: At present, none are required.)
• Dental hygienists may take radiographs under general supervision if allowed in writing by the dentist.
• It is our understanding that Dental hygienists are permitted to administer local anesthesia in the form of topical agents only. They may not perform other anesthetic procedures such as injections, or administer nitrous oxide. The application of the topical anesthetics should be used judiciously.
• Within the scope of their practice, dental hygienists may treat patients at any appropriately equipped school, clinic or institution, including nursing homes, veterans’ clinics, hospitals, prisons and facilities that treat persons with developmental disabilities.
• Dental hygienists cannot perform intra-oral services in a school setting on a person except for administering preventative measures, such as the application of fluorides, sealants and other recognized topical agents designed to prevent oral disease or discomfort, unless the dental hygienist reasonably believes that the person has been examined by a dentist within the immediately preceding 365-days.
• Only a New Jersey licensed dentist may diagnose, treat or perform any surgical or irreversible procedures pertaining to the dental condition of the treatment of a person and bill or receive payment for dental services.
• The law clarifies that dental hygienists may not own an independent office or practice.

See a Sample Written Work Order Allowing General Supervision in Dental Office below.

Unless and until altered or revoked by me in writing, at all times when I am not physically present in the office, I hereby authorize any dental hygienist employed by my office who holds a current certification in Basic or Advanced Cardiac Life Support by an association approved by the New Jersey State Board of Dentistry to perform, upon an existing patient of record only, any service a dental hygienist is allowed by law to perform. However, when a dentist is not physically present in the office, a dental hygienist cannot, under any circumstance, (1) administer local anesthesia, (2) monitor a patient to whom nitrous oxide has been administered or (3) perform any other anesthetic procedure except as may be designated by the State Board.

Contact our dental accountant, Harlene Stevens, CPA on (973) 298-8500 or hstevens@nisivoccia.com for additional information or if you have any questions regarding this or other dental practice management topics.