Direct access is defined by the American Dental Hygienists Association 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.
The map below shows the range of direct access requirements for dental hygienists by state, D.C. and territory.