Each state enacts its own laws determining the services dental hygienists can perform, the settings in which they can practice, and the supervision under which they practice. However, the typical restorative services provided by dental hygienists are limited to supportive services where the dentist prepares a tooth for restoration and the dental hygienist places and finishes the restorative material. Typically the dentist must be present while the restorative services are administered.

​

A new trend for dental hygienists working with underserved population groups is to provide “Interim Therapeutic Restorations” also known as (ITR’s), which helps to temporarily stop the progression of decay in a tooth until the patient is able to see a dentist for permanent treatment. In 2006, the American Dental Association (ADA) initiated a pilot project to educate, train and deploy a new dental worker to focus on patient education, disease prevention and patient navigation to work in the community called a
Community Dental Health Coordinator (CDHC).

​

According to the 2012 ADA Statement on CDHC’s, part of their skill set is to have the knowledge and skill to 
temporize dental cavities in preparation for restorative care by a dentist. 

The procedure is done by:

• Using hand instrumentation to remove debris within the tooth to prepare it for a temporary restoration

• Place a temporary restoration such as glass ionomer cement.  This procedure has been called  a “Scoop and Fill”

• As of 2013, the CDHC no longer offers a restorative clinical portion to their program.

 

ITR’s, for caries stabilization are recognized by the ADA Code on Dental Procedures And Nomenclature (CDT) and are endorsed by the American Academy of Pediatric Dentistry (AAPD). Training for placement of ITR’s requires additional didactic and hands on training.  In 2018, the Fresno City College dental hygiene class was the first graduates of the school to receive didactic and clinical training in placing ITRs through their core curriculum. This procedure is now offered as a service in the dental hygiene clinic.

​

CODA Standards for Dental Hygiene Education in CA requires all California dental hygiene programs to add the ITR didactic and clinical instruction to the curriculum to ensure appropriately educated and trained graduates who would be ready to perform this procedure without needing additional education.

​

Restorative Function Education or Certification for dental hygienists may be obtained via:

• The dental hygiene core curriculum in states that authorize restorative functions in their state practice act. 

  • Restorative functions in WA State are required for dental hygiene licensure.

• A restorative expanded functions course. 

The type of restorative functions permitted and requirements for certification are dependent on each states practice act.

​

Dental Hygienists in GA may provide:

• Application of cavity liners and bases.

• Place or remove temporary crowns.

• These functions are permitted by virtue of inclusion in the GA dental assistant scope of practice.

​

RESOURCES:

There is no formal process in place at the Commission on Dental Accreditation (CODA) at this time to recognize or accredit a specific course of study in restorative skills. CODA develops overall standards for and accredits entry‐level dental hygiene education programs, rather than individual classes within a program or continuing education classes.

​

In April 2007, the Idaho Legislature authorized the "Extended Access Restorative Endorsement" for qualified dental hygienists. Idaho also provides for an "Extended Access Dental Hygiene Endorsement." These two endorsements are separate endorsements and vary with duties and supervision requirements.

 

Dental Hygienists Restorative Duties – State Chart

​

​