Dental Hygienist Requirements in Indiana: Scope of Practice & Direct Access
Dental Hygienists in Indiana are regulated by the Indiana State Board of Dentistry. The ADHA records a direct-access provision for Indiana — Access Practice Agreement (Sec. 1. IC 25-13-1-10) — 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 2018
Category
Access Practice Agreement
Indiana law
Statute
Sec. 1. IC 25-13-1-10
ADHA Practice Act chart
Permitted functions
15 of 22
Verified September 2026
Regulated by
Indiana State Board of Dentistry
Indiana’s Direct-Access Provision: Access Practice Agreement
A dental hygienist may provide preventive dental hygiene services directly to a patient without a prior examination, presence, or authorization of a dentist.
A dental hygienist may practice in any setting or facility that is documented in the dental hygienist's access practice agreement.
Provider services: Dental hygienist may provide preventive dental hygiene services as outlined in the access practice agreement.
Requirements: • Professional licensure • Has at least 2,000 documented clinical hours of dental hygiene services during 2 years of active practice under the direct supervision of a dentist • Obtains a national provider identifier number • Enters into an access practice agreement with a licensed dentist • Maintains liability insurance • Before providing dental hygiene services to a patient under an access practice agreement, the dental hygienist has obtained a signed consent form
What a Dental Hygienist Can Do in Indiana: Permitted Functions & Supervision Levels
Indiana's chart leans toward direct supervision for most of the 22 functions ADHA tracks, meaning the dentist must be present.
Local anesthesia, soft tissue curettage, study cast impressions and using lasers are listed only at direct supervision.
Seven functions — oral prophylaxis, x-rays, topical anesthesia, fluoride, pit/fissure sealants, and placing and removing periodontal dressings — carry two levels, direct supervision or collaborative practice, depending on setting; collaborative practice lets the hygienist work without supervision under a collaborative agreement with a licensed dentist.
Scaling and root planing carries three levels: direct supervision, general supervision, or direct access, depending on setting.
Dental hygiene diagnosis, treatment planning and dental hygiene assessment carry direct supervision or direct access, also depending on setting.
Administering nitrous oxide, placing and removing sutures, prescriptive authority, Botox, vaccines and dermal fillers are not listed on the chart for Indiana.
- Local anesthesia, soft tissue curettage, study cast impressions and using lasers are listed only at direct supervision (D) for Indiana, so the dentist must be present for each.
- Scaling and root planing is the only three-level cell on Indiana's chart (D/G/A) — direct supervision, general supervision, or direct access, depending on setting.
- Seven functions, including oral prophylaxis, x-rays and topical anesthesia, are listed at direct supervision or collaborative practice (D/CP), where collaborative practice lets a hygienist work without supervision under a collaborative agreement with a licensed dentist.
- Dental hygiene diagnosis, treatment planning and dental hygiene assessment are each listed at direct supervision or direct access (D/A) depending on setting, not at one uniform level.
- Administering nitrous oxide, placing and removing sutures, prescriptive authority, Botox, vaccines and dermal fillers carry no supervision level for Indiana on the chart, which ADHA records as not listed.
- D
- Direct supervision: dentist needs to be present
- CP
- Collaborative practice: RDH may practice without supervision, pursuant to a collaborative agreement between the RDH and a licensed dentist
- G
- General supervision: dentist needs to authorize prior to services, but need not be present
- A
- Direct access: hygienists can provide services as s/he determines appropriate without specific authorization
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 Indiana
Indiana authorized dental hygienists to administer local anesthesia in 2008.
The ADHA chart lists direct supervision, meaning the dentist must be present, for both block and infiltration injections.
Education must come from an accredited program, and the chart lists an exam requirement: the NERB local anesthesia exam or an equivalent state or regional exam.
Authorization is by rule, and the course requirement listed is 15 hours didactic and 14 hours clinical, with a permit required.
Confirm current course, permit and exam rules with the Indiana State Board of Dentistry before enrolling or applying.
- State & Year Implemented
- 2008
- Supervision Required
- Direct
- Block and/or Infiltration
- Both
- Education Required
- Accredited
- Exam Required
- Yes – NERB Local anesthesia exam or equivalent state or regional exam
- Authorized by Statute or Rule
- Rules
- Legal Requirements for Local Anesthesia Courses
- 15 hrs didactic; 14 hrs clinical; permit required
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 Indiana
ADHA's silver diamine fluoride document does not name SDF for Indiana.
It cites Section 25-13-1-11, the scope-of-practice provision covering the application of antiseptic sprays, washes, or medicaments for the control or prevention of dental caries, and places SDF under that category.
ADHA lists supervision as direct or through an access practice agreement, the same access practice agreement structure Indiana's direct-access law creates.
The quoted provision attaches one condition: the hygienist applies the medicament as his or her employer dentist may direct, so the employer dentist sets the terms even under an access practice agreement.
No separate training, course, or setting condition appears in the cited language.
Scope of Practice allows dental hygienist to apply and use within the patient's mouth such antiseptic sprays, washes, or medicaments for the control or prevention of dental caries as his or her employer dentist may direct
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 Indiana State Board of Dentistry.
Frequently Asked Questions
Does a dentist have to supervise a dental hygienist in Indiana?
It depends.
Under the 2018 Access Practice Agreement (Sec. 1.
IC 25-13-1-10), a dental hygienist may provide preventive dental hygiene services directly to a patient without a dentist's prior examination, presence, or authorization — but only within an access practice agreement entered into with a licensed dentist.
To qualify, the hygienist needs at least 2,000 documented clinical hours during 2 years of active practice under a dentist's direct supervision, a national provider identifier number, liability insurance, and a signed patient consent form before treating anyone under the agreement.
That's not an unconditional "no supervision needed" — confirm current requirements with the Indiana State Board of Dentistry.
Who regulates dental hygienists in Indiana?
Dental Hygienists in Indiana are regulated by the Indiana State 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.
Can a dental hygienist in Indiana give local anesthesia without a dentist present?
No. The ADHA Practice Act chart lists direct supervision for local anesthesia in Indiana, meaning the dentist must be present.
The Local Anesthesia chart agrees: Indiana authorized both block and infiltration injections in 2008, requires education from an accredited program, and lists an exam requirement, the NERB local anesthesia exam or an equivalent state or regional exam.
That level applies specifically to local anesthesia; several other Indiana hygiene functions instead carry a choice between direct supervision and collaborative practice depending on setting.
Confirm current course and permit rules with the Indiana State Board of Dentistry.
Does Indiana's chart let a hygienist practice without any dentist supervision?
For some functions, yes, under a specific arrangement.
Oral prophylaxis, x-rays, topical anesthesia, fluoride, pit/fissure sealants, and placing and removing periodontal dressings are each listed at direct supervision or collaborative practice (D/CP) depending on setting.
Collaborative practice, per ADHA's legend, lets a hygienist practice without supervision under a collaborative agreement with a licensed dentist — it is not unsupervised practice outright.
Scaling and root planing carries a third listed level, direct access, under the same kind of setting-dependent cell.
Confirm which arrangement applies to a given setting with the Indiana State Board of Dentistry.
Does the Indiana chart list nitrous oxide, prescriptive authority, or cosmetic injectables for hygienists?
No. Administering nitrous oxide, prescriptive authority, Botox, vaccines and dermal fillers all carry a dash on Indiana's ADHA Practice Act chart, along with placing and removing sutures.
A dash means the function is not listed on the chart, a narrower statement than the chart declaring it off-limits.
Some cells elsewhere on the ADHA chart carry footnoted conditions that did not survive extraction, so for anything not listed here, ask the Indiana State Board of Dentistry directly what is and is not currently authorized.
Does ADHA's chart name silver diamine fluoride for Indiana hygienists?
No. ADHA's silver diamine fluoride document cites Section 25-13-1-11, a provision covering the application of antiseptic sprays, washes, or medicaments for the control or prevention of dental caries, and places SDF under that broader category rather than naming it.
The provision conditions the application on direction from the hygienist's employer dentist.
ADHA lists supervision as direct or through an access practice agreement.
Confirm current SDF-specific guidance with the Indiana State Board of Dentistry.
Can an Indiana hygienist apply SDF under an access practice agreement without the dentist directing it?
ADHA lists supervision for this provision as direct or through an access practice agreement, the same access practice agreement structure Indiana's direct-access law creates.
But the quoted provision still conditions the medicament's use on direction from the hygienist's employer dentist, so the agreement does not remove that requirement on its own.
ADHA cites no separate training or course condition beyond that line.
Confirm how the board applies this provision to SDF specifically with the Indiana State Board of Dentistry.
More Indiana & 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 Indiana State Board of Dentistry.