Florida Dental Hygienist Supervision Levels: Direct, Indirect, General and No Supervision

Direct supervision requires that a licensed dentist examine the patient, diagnose a condition to be treated, authorize the procedure to be performed, be on the premises while the procedure is performed, and approve the work performed prior to the patient's departure from the premises (Rule 64B5-16.001(4), F.A.C.).

The statute defines direct supervision as supervision whereby a dentist diagnoses the condition to be treated, a dentist authorizes the procedure to be performed, a dentist remains on the premises while the procedures are performed, and a dentist approves the work performed before dismissal of the patient (s. 466.003(9), F.S.).

Dental hygienists may perform the tasks delegable by the dentist under s. 466.024, F.S., and the Board by rule determines whether they are performed under direct, indirect or general supervision (s. 466.023(1), F.S.). The Board's list for hygienists is Rule 64B5-16.006, F.A.C.

Indirect supervision requires that a licensed dentist examine the patient, diagnose a condition to be treated, authorize the procedure to be performed, and be on the premises while the procedure is performed (Rule 64B5-16.001(5), F.A.C.).

The statute defines indirect supervision as supervision whereby a dentist authorizes the procedure and a dentist is on the premises while the procedures are performed (s. 466.003(10), F.S.).

The table below is our summary of the three rule definitions, not official wording: read the definitions above for the exact text.

General supervision requires that a licensed dentist authorizes the procedures to be performed but need not be present when the authorized procedures are being performed. The authorized procedures may also be performed at a place other than the dentist's usual place of practice (Rule 64B5-16.001(6), F.A.C.).

The statute adds that the issuance of a written work authorization to a commercial dental laboratory by a dentist does not constitute general supervision (s. 466.003(11), F.S.).

Any authorization for remediable tasks to be performed under general supervision is valid for a maximum of 24 months; after that, no further treatment under general supervision can be performed without another clinical exam by a Florida licensed dentist (Rule 64B5-16.001(7), F.A.C.).

Examples from the rule:

• Removing calculus deposits, accretions and stains from exposed surfaces of the teeth and from the tooth surfaces within the gingival sulcus (prophylaxis) (Rule 64B5-16.006(7)(a), F.A.C.)
• Polishing clinical crowns of the teeth which is not for the purpose of changing the existing contour of the teeth and only with the following instruments used with appropriate polishing materials: slow-speed hand pieces, bristle brushes, rubber cups, porte polishers and air-abrasive polishers (Rule 64B5-16.006(8)(b), F.A.C.)
• Applying sealants (Rule 64B5-16.006(8)(i), F.A.C.)
• Placing subgingival resorbable chlorhexidine, doxycycline hyclate, or minocycline hydrochloride (Rule 64B5-16.006(8)(l), F.A.C.)

Rule 64B5-16.006, F.A.C. also sets the training: some tasks a dental hygienist may perform by virtue of their training and licensure, without additional training; others may be performed only by a hygienist who has received the training the rule names for that task: training in pre-licensure education, formal training as defined by Rule 64B5-16.002, F.A.C., or on-the-job training.

Without supervision, dental hygienists may perform the remediable tasks specified in ss. 466.023(3), 466.0235 and 466.024(2), F.S., as long as all provisions of the respective statute are met (Rule 64B5-16.001(8), F.A.C.; Rule 64B5-16.006(10)-(11), F.A.C.).

Examples from the statute and the rule:

• Authorized fluoride rinse programs (s. 466.023(3), F.S.; Rule 64B5-16.006(10)(a), F.A.C.)
• Applying fluorides (s. 466.023(3), F.S.)
• Applying fluoride varnishes and silver diamine fluoride (Rule 64B5-16.006(10)(b), F.A.C.)

In a health access setting as defined in s. 466.003, F.S., a dental hygienist may apply topical fluorides, apply dental sealants and remove calculus deposits, accretions and stains without the physical presence, prior examination or authorization of a dentist, among other listed tasks (s. 466.024(2), F.S.). Calculus removal needs medical clearance from a dentist or physician first, and a dentist must examine the patient within 13 months afterwards. The patient must receive a written disclaimer before any of these procedures (s. 466.024(3), F.S.).

A dentist may not delegate irremediable tasks to a dental hygienist or dental assistant, except as provided by law (s. 466.024(1), F.S.). Irremediable tasks are intraoral treatment tasks which, when performed, are irreversible and create unalterable changes within the oral cavity or the contiguous structures or which cause an increased risk to the patient (s. 466.003(12), F.S.).

• Any prescription of drugs or medications requiring the written order or prescription of a licensed dentist or physician, and any diagnosis for treatment or treatment planning: a dentist may not delegate these to anyone other than another licensed dentist (s. 466.024(8), F.S.)
• The use of a laser or laser device of any type is not a remediable task, unless utilized as an assessment device (Rule 64B5-16.001(1), F.A.C.)

Proposed, not in effect: a Notice of Proposed Rule for Rules 64B5-16.005 and 64B5-16.006, F.A.C. (flrules.org notice 31410460, published 9/25/2026, comments until 10/16/2026) would delegate to dental hygienists the authority to use lasers under certain circumstances and for limited purposes. Until it is adopted, the current rule applies. Read the notice on flrules.org (opens in a new tab).