In most states, no — a dental hygienist cannot do fillings.
A few states do allow it: a hygienist with additional restorative training can place a filling, but only after the dentist has diagnosed the decay and prepared the tooth.
This "restorative" or expanded-function scope is one of the areas that varies most from state to state, so your state's rules decide what's possible.
Can a hygienist do fillings? The short answer
For most of the country, a dental hygienist cannot do fillings.
A small number of states allow it as an expanded, "restorative" function — but with an important condition: the dentist prepares the tooth first, and the hygienist places and finishes the restoration.
What a hygienist never does, even in those states, is diagnose the cavity or drill out the decay.
That line — placing versus diagnosing and preparing — is the whole reason this scope exists as a narrow, trained-and-permitted add-on.
Restorative scope is narrow and highly state-specific
Does a dental hygienist do fillings as part of the job?
For the typical hygiene job, no. Day to day, a hygienist's clinical work is preventive and periodontal — cleanings, scaling and root planing, sealants, fluoride, x-rays.
Fillings stay on the dentist's side of the operatory.
Placement enters a hygienist's job description only where the state authorizes it and the hygienist completes the restorative training and, usually, holds a permit — and even then the work starts after the dentist has prepped the tooth.
So the question has a two-part answer: the license usually doesn't allow it, and the job usually doesn't include it.
If you want to actually drill and fill, that's dentist or dental therapist territory — our guide to what a dental hygienist can't do draws the full line.
What "restorative functions" actually means
Placing a filling is a multi-step procedure, and restorative scope splits it.
The dentist does the irreversible part: diagnosing the decay, numbing the patient, and removing decay to prepare ("prep") the tooth.
Where it's authorized, the restorative hygienist takes it from there — placing the filling material, then packing, carving, and finishing it to the correct shape and bite.
It's skilled work, but it follows the dentist's diagnosis and preparation rather than replacing them.
The states that allow it — and how far
The scope varies a lot by state.
Colorado, New Jersey, and Washington are the states most often cited for allowing hygienists to place permanent amalgam and composite restorations — and Washington is unusual in requiring restorative competence for initial hygiene licensure and letting hygienists pack, carve, and finish restorations.
Others are narrower: Oregon allows temporary restorations under an expanded-practice permit, and states such as New Mexico, Illinois, New York, and Arizona permit various temporary or interim restorations, often under direct supervision.
The permits are granular where they exist.
Nebraska issues Expanded Function Restorative Level I permits, for simple one-surface restorations, and Level II, for complex multi-surface ones — to licensed hygienists as well as dental assistants, with Level II requiring Level I first.
Alaska's board, meanwhile, issues a restorative function endorsement to licensed dental hygienists who qualify under its statute.
Treat these as examples of the range and verify the current rule for your state.
Restorative hygienist vs. expanded-function assistant
Restorative placement is also performed by expanded-function dental assistants (EFDAs) in many states, which is a common source of confusion.
The functions overlap, but the credential paths differ: an EFDA reaches it from the dental assistant side, while a restorative hygienist adds it on top of the RDH license.
Which title is authorized to place restorations — and under what conditions — depends entirely on the state, so don't assume a rule for one applies to the other.
What training you need
Where restorative functions are allowed, they require board-approved training — didactic plus supervised clinical experience placing and finishing restorations — and usually a specific permit on top of the RDH license.
Washington is the outlier that builds restorative competence into initial licensure.
If restorative work interests you, check whether your state offers the pathway before investing in a course, since not every state has one.
How to confirm your state's rule
The ADHA publishes a state-by-state restorative-duties chart, and your state dental board publishes the practice act and any permit requirements.
Where they differ, the board is the authority.
Some states put these permissions right on the license record.
California's Dental Hygiene Board license lookup, for example, flags which privileges a hygienist holds — local anesthesia, nitrous oxide, and interim therapeutic restorations (RDHs only).
Because this is one of the most state-specific areas of hygiene scope, verify the details for your exact state rather than generalizing from another.
This article is general information, not legal or clinical advice. Scope-of-practice and licensing rules vary by state and change over time — confirm current requirements with your state dental board.