Dental Hygienist Requirements in Illinois: Scope of Practice & Direct Access
Dental Hygienists in Illinois are regulated by the Illinois Board of Dentistry. The ADHA records a direct-access provision for Illinois — Public Health Dental Hygienist (225 ILCS 25/18.1) — the rule that decides whether a dental hygienist there can work without a dentist on site; see below for what it covers.
Verify before you rely on this
At a glance
ADHA Direct Access chart
Direct access
Yes
Since 2015
Category
Public Health Dental Hygienist
Illinois law
Statute
225 ILCS 25/18.1
ADHA Practice Act chart
Permitted functions
12 of 22
Verified September 2026
Regulated by
Illinois Board of Dentistry
Illinois’s Direct-Access Provision: Public Health Dental Hygienist
A dental hygienist may treat patients in specified public health settings without a dentist first examining the patient and being present during treatment, who are Medicaid-eligible or uninsured and with household incomes not greater that 200% of the federal poverty level.
Provider services: Dental hygienist may provide prophylactic cleanings, apply fluoride, place sealants, and take radiographs. Additional services may be prescribed by the Illinois Department of Financial and Professional Regulation.
Requirements: A licensed dental hygienist must have 2 years of full-time clinical experience or an equivalent of 4,000 hours of clinical experience and have completed 42 hours of additional course work in areas specific to public health dentistry. The dental hygienist must also practice pursuant to a written public health supervision agreement with a dentist.
What a Dental Hygienist Can Do in Illinois: Permitted Functions & Supervision Levels
Illinois's ADHA Practice Act row sits almost entirely at general supervision.
Eleven functions — oral prophylaxis, x-rays, topical anesthesia, fluoride, pit/fissure sealants, scaling and root planing, soft tissue curettage, study cast impressions, placing and removing periodontal dressings, and dental hygiene assessment — are listed at general supervision, meaning a dentist authorizes the service in advance but does not need to be present.
Local anesthesia stands apart at direct supervision, the only function on the Illinois row that requires the dentist to be present while it's performed.
No function is listed at direct access for Illinois.
Ten functions carry no listed supervision level at all: administering nitrous oxide, placing sutures, removing sutures, dental hygiene diagnosis, treatment planning, prescriptive authority, Botox, lasers, vaccines, and dermal fillers.
- Local anesthesia is the only function listed at direct supervision (D) on Illinois's chart, meaning the dentist must be present, while every other listed function sits at general supervision (G).
- Eleven functions, including oral prophylaxis, x-rays, and dental hygiene assessment, are listed at general supervision (G), where a dentist authorizes the service in advance but need not be present.
- Dental hygiene diagnosis, treatment planning, and prescriptive authority carry no listed supervision level for Illinois, which ADHA records as not listed on the chart — a narrower statement than a ban.
- Administering nitrous oxide and using lasers are also not listed on Illinois's chart, alongside Botox, vaccines, and dermal fillers.
- G
- General supervision: dentist needs to authorize prior to services, but need not be present
- D
- Direct supervision: dentist needs to be present
Read the chart the way ADHA means it
Source: ADHA Dental Hygiene Practice Act Overview: Permitted Functions and Supervision Levels by State (8.24.26 update). This document is intended for informational purposes only and does not constitute a legal opinion regarding dental practice in any state. To verify any information, please contact your state's dental board.
Local Anesthesia by Dental Hygienists in Illinois
Illinois authorized hygienists to administer local anesthesia by statute in 2000.
The ADHA chart lists direct supervision, meaning the dentist must be present, for both block and infiltration injections, education from an accredited program, and no separate exam requirement.
The course requirement it records is 24 hours didactic and 8 hours clinical.
Confirm current course and permit requirements with the Illinois Board of Dentistry before enrolling or applying.
- State & Year Implemented
- 2000
- Supervision Required
- Direct
- Block and/or Infiltration
- Both
- Education Required
- Accredited
- Exam Required
- No
- Authorized by Statute or Rule
- Statute
- Legal Requirements for Local Anesthesia Courses
- 24 hrs didactic; 8 hrs clinical
Source: ADHA Local Anesthesia Administration by Dental Hygienists – State Chart (Revised December 2025). This document is intended for informational purposes only and does not constitute a legal opinion regarding dental practice in any state. To verify any information, please contact your state's dental board.
Silver Diamine Fluoride by Dental Hygienists in Illinois
ADHA's silver diamine fluoride entry for Illinois cites the scope-of-practice statute at 225 ILCS 25/18, which covers applying chemical compounds to the teeth or gums as desensitizing agents or to help prevent dental caries or periodontal disease — language that reaches topical fluoride and similar agents without naming SDF itself.
ADHA lists supervision as General.
The entry also cites Illinois Department of Public Health guidance from September 15, 2017 that specifically states SDF may be applied by dental hygienists.
The provision states no training, course, setting, or permit condition beyond the general-supervision requirement.
Scope of practice includes the application to the surfaces of the teeth or gums of chemical compounds designed to be desensitizing agents or effective agents in the prevention of dental caries or periodontal disease. Additionally, IDPH guidance specifically says SDF may be applied by dental hygienists.
Source: ADHA State Specific Information on Silver Diamine Fluoride (Revised September 2025). This document is intended for informational purposes only and does not constitute a legal opinion regarding dental practice in any state. To verify any information, please contact your state's dental board.
What Direct Access Does — and Doesn’t — Cover
Direct access is one dimension of scope, not scope itself. The ADHA’s direct-access chart records whether a dental hygienist can initiate treatment and treat a patient without a dentist present — the function-by-function supervision levels and the local anesthesia rules above come from two separate ADHA charts, and the three do not always line up neatly.
Don’t generalize from a direct-access provision to any other part of scope, and confirm specifics with the Illinois Board of Dentistry.
Frequently Asked Questions
Does a dentist have to supervise a dental hygienist in Illinois?
It's conditional, not unsupervised.
Illinois's 2015 Public Health Dental Hygienist status (225 ILCS 25/18.1) lets a hygienist treat patients without a dentist first examining them or being present during treatment, but only for patients who are Medicaid-eligible or uninsured with household incomes at or below 200% of the federal poverty level, only in specified public health settings, and only under a written public health supervision agreement with a dentist.
The hygienist must also have 2 years of full-time clinical experience (or 4,000 hours) and 42 hours of public-health-specific coursework.
Confirm current details with the Illinois Board of Dentistry.
Who regulates dental hygienists in Illinois?
Dental Hygienists in Illinois are regulated by the Illinois Board of Dentistry.
Scope of practice is set by state law and changes over time, so verify current rules directly with the board before relying on them.
Does a dentist have to be present when an Illinois hygienist gives local anesthesia?
Yes.
Both the ADHA Practice Act chart and the Local Anesthesia chart list local anesthesia in Illinois at direct supervision, meaning the dentist must be present while it's administered.
That's stricter than every other function on Illinois's Practice Act row, which is listed at general supervision, where a dentist authorizes the service in advance but does not need to be present.
Confirm current permit and supervision rules with the Illinois Board of Dentistry.
Does the Illinois chart list dental hygiene diagnosis or prescriptive authority?
No. Dental hygiene diagnosis, treatment planning, and prescriptive authority all carry no listed supervision level on Illinois's ADHA Practice Act row.
ADHA records this as the function not being listed on the chart, a narrower statement than a ban — it does not mean Illinois law bans it outright.
What each term covers under Illinois law is a separate question from what the chart shows, so check with the Illinois Board of Dentistry for how the state defines them.
What does the Illinois chart show for nitrous oxide and lasers?
Administering nitrous oxide and using lasers are both listed as not on the chart for Illinois, the same status as placing sutures, Botox, vaccines, and dermal fillers.
The chart doesn't say whether any of ADHA's footnoted conditions apply to these functions, since the footnote markers didn't survive extraction from the source chart.
Ask the Illinois Board of Dentistry directly if you need to perform one of these functions.
Can a dental hygienist in Illinois apply silver diamine fluoride?
ADHA's entry says yes.
The underlying scope-of-practice statute, 225 ILCS 25/18, covers chemical compounds applied to prevent caries or periodontal disease without naming SDF specifically, but the entry also cites Illinois Department of Public Health guidance from September 15, 2017 stating that SDF may be applied by dental hygienists.
Supervision is listed as General.
Confirm current requirements with the Illinois Board of Dentistry before applying SDF.
What supervision does an Illinois hygienist need to apply SDF?
ADHA lists General supervision for this scope of practice in Illinois, meaning a dentist authorizes the service in advance but does not need to be present while it's applied.
The entry states no additional training, course, or setting requirement beyond that.
Confirm current supervision rules with the Illinois Board of Dentistry.
More Illinois & Dental Hygienist Resources
Sourced from the ADHA Direct Access States chart (Revised February 2025), the ADHA Dental Hygiene Practice Act Overview: Permitted Functions and Supervision Levels by State (8.24.26 update) and the ADHA Local Anesthesia Administration by Dental Hygienists – State Chart (Revised December 2025), and the ADHA State Specific Information on Silver Diamine Fluoride (Revised September 2025). Verified September 2026. This page is general information, not legal advice — confirm current rules with the Illinois Board of Dentistry.