The ADHA's Practice Act Overview (8.24.26 update) tracks placing and removing periodontal dressings as two separate functions, and in 5 of the 51 jurisdictions it covers, the supervision level for one doesn't match the other.
Both are listed as permitted hygienist scope in most states, with supervision ranging from a dentist physically present to full direct access.
A few jurisdictions don't list one or both functions at all.
Always confirm your exact state's current rule with its dental board.
The short answer
In most of the country, yes — the ADHA's Practice Act Overview (8.24.26 update) lists placing a periodontal dressing as permitted hygienist scope in 47 of the 51 jurisdictions it tracks, and removing one in 49 of 51.
The chart records these as two separate rows, each with its own supervision level.
That separation matters: in 5 states, the level required to place a dressing is not the level required to remove it.
The rest of this article covers both functions side by side, exactly as the chart lists them.
Informational only — confirm with your state board
What a periodontal dressing is — and why placing and removing it are tracked separately
A periodontal dressing (sometimes called a periodontal pack) is a protective material applied over the gum tissue after certain periodontal procedures — such as gum surgery, a gingivectomy, or osseous surgery — to shield the surgical site while it heals, and it's typically removed at a follow-up visit days later.
Placing it and removing it are chairside tasks distinct from scaling and root planing or soft tissue curettage, which treat the tooth and pocket rather than protect a healing surgical wound.
The ADHA chart lists "Place Perio Dressings" and "Remove Perio Dressings" as two separate rows with their own supervision levels — so permission for one doesn't automatically carry over to the other, and in a handful of states, it doesn't.
Reading the supervision levels
The codes come directly from the chart's own legend:
- D — Direct Supervision: the dentist needs to be present.
- ID — Indirect Supervision: the dentist must authorize the procedure and be in the dental office while it's performed.
- G — General Supervision: the dentist authorizes the service beforehand but need not be present.
- A — Direct Access: the hygienist can provide the service based on their own determination, without specific authorization.
- CP — Collaborative Practice: the hygienist may practice without supervision, under a collaborative agreement with a licensed dentist.
- "-" — not listed as a permitted function in the chart. That isn't the same as prohibited — it means the chart records no permitted supervision level for that state, so confirm directly with the board.
Where a state's cell lists more than one letter — like Indiana's D/CP or Hawaii's D/G — those are separate listed settings, never a range and never blended into one answer.
Quote the cell exactly as the chart lists it.
Placing and removing perio dressings, by state
Quoting the chart as written, here is the supervision level listed for each function in every jurisdiction.
General supervision (G) alone is the most common listing for both — 27 of 51 for placing, 26 of 51 for removing.
Direct supervision (D) alone is required in 10 states to place a dressing and 13 states to remove one.
Four jurisdictions — Michigan, Mississippi, North Carolina, and Pennsylvania — show no listed level for placing.
Only Michigan and Pennsylvania show no listed level for removing; Mississippi and North Carolina both list Direct supervision for removal despite not listing placing at all.
In five states the two functions carry different supervision levels outright: Arizona (General to place, Direct to remove), Missouri (General to place, Direct to remove), New Hampshire (Direct to place, General to remove), plus Mississippi and North Carolina above.
New Hampshire is the only one of the five where removal requires less supervision than placing — everywhere else the shift, or the addition of a listed level, runs toward more supervision for removal.
| State | Place perio dressings | Remove perio dressings |
|---|---|---|
| Alabama | D | D |
| Alaska | G | G |
| Arizona | G | D |
| Arkansas | ID | ID |
| California | G/A | G/A |
| Colorado | G | G |
| Connecticut | G/A | G/A |
| Delaware | G | G |
| District of Columbia | G | G |
| Florida | G | G |
| Georgia | D | D |
| Hawaii | D/G | D/G |
| Idaho | G | G |
| Illinois | G | G |
| Indiana | D/CP | D/CP |
| Iowa | G | G |
| Kansas | G | G |
| Kentucky | G | G |
| Louisiana | D | D |
| Maine | A | A |
| Maryland | G | G |
| Massachusetts | G | G |
| Michigan | - | - |
| Minnesota | ID | ID |
| Mississippi | - | D |
| Missouri | G | D |
| Montana | G | G |
| Nebraska | G | G |
| Nevada | G/A | G/A |
| New Hampshire | D | G |
| New Jersey | D | D |
| New Mexico | G | G |
| New York | G | G |
| North Carolina | - | D |
| North Dakota | G | G |
| Ohio | G | G |
| Oklahoma | G | G |
| Oregon | G/A | G/A |
| Pennsylvania | - | - |
| Rhode Island | D | D |
| South Carolina | D | D |
| South Dakota | ID | ID |
| Tennessee | G | G |
| Texas | G | G |
| Utah | G | G |
| Vermont | G | G |
| Virginia | G | G |
| Washington | G | G |
| West Virginia | D | D |
| Wisconsin | D | D |
| Wyoming | D | D |
Source: ADHA Dental Hygiene Practice Act Overview, 8.24.26 update.
Multi-letter cells are separate settings, not a range — quoted here exactly as the chart lists them.
How this compares to the other functions on this chart
Placing and removing perio dressings sit near the more-permissive end of this 22-function chart. Scaling and root planing and x-rays are listed as permitted in all 51 jurisdictions, and local anesthesia is unlisted in only 2.
Removing a dressing (unlisted in 2) is nearly as broad as those; placing one (unlisted in 4) is slightly more restricted, and soft tissue curettage is unlisted in 8.
Both perio-dressing functions are far broader than nitrous oxide (unlisted in 17) or Botox (unlisted in 48).
Don't assume permission for one function on this chart implies permission for another — the ADHA lists each one separately, and this article covers placing and removing perio dressings specifically.
Confirm your state's exact rule
A "-" on this chart means the function isn't listed as permitted in that state's row — it does not mean the state prohibits it outright, only that the chart doesn't record an authorized supervision level there.
Even where a level is listed, confirm exactly what it requires in practice, since practice acts and their interpretation change over time.
Start with your state dental board's practice act, and treat this chart and this article as a snapshot dated to 8.24.26 rather than a permanent rule.
For the rest of what a hygienist can and can't do, see our full breakdown of hygienist scope limits.
This article is general information, not legal or clinical advice. Scope-of-practice and supervision rules vary by state and change over time — confirm current requirements with your state dental board.