Hiring a Dental Therapist: Where It's Allowed and What They Can Do

In the states that authorize it, a dental therapist is a clinician licensed by the state to perform a defined list of procedures, with the work routed through a supervising dentist.

Maine's statute shows the granularity.

There, a dental therapist may perform listed procedures — including simple cavity preparations and restorations and simple extractions — in limited practice settings, under a written practice agreement and the general supervision of a dentist licensed in Maine.

On the education side, CODA's Accreditation Standards for Dental Therapy Education Programs, adopted February 6, 2015, require at least three academic years of full-time postsecondary instruction or its equivalent.

Arizona's dental therapist license requires graduation from a dental therapy program accredited by — or holding initial accreditation from — the ADA's Commission on Dental Accreditation.

Connecticut builds the credential on a hygiene license instead, defining a dental therapist as a licensed dental hygienist authorized to practice dental therapy under a collaborative agreement.

The worker's side of this role — how you train for it, where the programs are, how it compares chairside — belongs to our career guides: start with the dental hygienist vs dental therapist comparison and the dental therapy programs directory.

This page stays on the employer questions: which states allow the hire, under what conditions, and what to verify.

The first gate is binary: does your state authorize dental therapy at all.

A count from the National Partnership for Dental Therapy, reported by Stateline in July 2024, listed 14 states authorizing dental therapists in at least some settings — Alaska, Arizona, Colorado, Connecticut, Idaho, Maine, Michigan, Minnesota, Nevada, New Mexico, Oregon, Vermont, Washington and Wisconsin.

Treat that list as a starting point, not a verification.

It is a secondary count published in mid-2024: we read the statutes for nine states on it (Arizona, Connecticut, Maine, Michigan, Minnesota, Nevada, Oregon, Vermont and Wisconsin), not for Alaska, Colorado, Idaho, New Mexico or Washington — and the count dates to July 2024, so ask your state dental board where your state stands today before you plan around any of this.

Read the table with the caveat above in mind: authorization is never a blanket green light.

The same statutes that let a therapist practice also decide who supervises them — four cap how many therapists one dentist can oversee, and six of the nine limit practice settings (five with a settings list, Maine through "limited practice settings").

The next two sections take those conditions apart.

Eight of the nine statutes we read route the therapist through a named, licensed dentist; Oregon's, as we read it in an unofficial mirror, covers licensure and education rather than supervision.

Where our facts name the instrument, it is written: Minnesota requires a written collaborative management agreement, Maine and Nevada a written practice agreement, and Arizona a written collaborative practice agreement.

Connecticut, Vermont and Wisconsin name a collaborative or management agreement without our facts specifying the form, and Michigan's verified facts describe supervision without naming an agreement.

Minnesota and Vermont require the agreement to go to the board on a recurring basis — Minnesota annually, Vermont annually and whenever it changes.

• Minnesota: the therapist must sign a written collaborative management agreement with a Minnesota-licensed dentist before providing services. Agreements must be reviewed, updated and submitted to the board annually.
• Maine: the listed procedures are performed under a written practice agreement and the general supervision of a Maine-licensed dentist.
• Vermont: the therapist works under a dentist's general supervision within a collaborative agreement, which the board receives annually and whenever the agreement changes.
• Arizona: the therapist completes 1,000 hours of clinical practice under a dentist's direct supervision before entering a written collaborative practice agreement.
• Nevada: the therapist works under the authorizing dentist's direct supervision until reaching 500, 1,000 or 1,500 clinical hours, depending on prior licensure and hygiene experience.
• Wisconsin: general supervision opens only after at least 2,000 hours under direct or indirect supervision.
• Connecticut: the therapist practices under a collaborative agreement in which the supervising dentist is professionally responsible and legally liable for the therapist's authorized services.
• Michigan: a licensed therapist provides the services the statute lists under a dentist's supervision.

Two operational consequences follow.

First, the hour ladders.

Arizona requires 1,000 hours of clinical practice under a dentist's direct supervision, Nevada keeps the therapist under the authorizing dentist's direct supervision until 500, 1,000 or 1,500 hours, and Wisconsin requires at least 2,000 hours under direct or indirect supervision before general supervision opens — so a new hire's first months run on a supervision schedule, not a solo column on the roster.

Plan coverage around it.

Second, the caps.

A Connecticut dentist may hold collaborative agreements with no more than two dental therapists at once, an Arizona dentist no more than four written collaborative practice agreements, a Wisconsin dentist no more than four collaborative management agreements, and a Minnesota dentist no more than five dental therapists or advanced dental therapists.

The cap binds the supervising dentist, not the practice, so spread agreements across your dentists and confirm with the board how your state counts them.

Supervision labels are defined state by state, and "general supervision" inside a therapy statute can bundle different duties than the same label elsewhere.

Our guide to supervision levels unpacks what direct, indirect and general supervision mean for scheduling.

Six of the nine statutes we read limit where a dental therapist may practice, and five of them set out a settings list, so in those states the list decides the hire before anything else does.

Before you draft a job ad in any of these five states, compare your setting and your patient base against the statute's own list:

• Minnesota: a dental therapist is limited to primarily practicing in settings that serve low-income, uninsured and underserved patients, or in a dental health professional shortage area.
• Arizona: the statute lists the permitted settings, including federally qualified health centers and look-alikes, community health centers, nonprofit practices serving low-income patients, and private practices treating referred community-health-center patients.
• Connecticut: a dental therapist practices in a public health facility under a dentist's general supervision.
• Nevada: a therapist may practice only in listed settings — the statute's examples include hospitals, rural health clinics and FQHC-type facilities — under a written practice agreement with an authorizing dentist.
• Wisconsin: a therapist must practice in a dental health shortage area, or in a setting where at least 50 percent of the patient base consists of Medical Assistance, uninsured or other listed patients.

Wisconsin's patient-base test deserves a second look: one prong is geographic (a dental health shortage area), the other is your payer mix — audit what share of your patient base is Medical Assistance, uninsured or otherwise listed before you assume you qualify.

Maine's statute authorizes its listed procedures in "limited practice settings," with each procedure authorized through a written practice agreement.

For Michigan, Oregon and Vermont, the facts we verified cover supervision and credentialing rather than a settings list — which is not the same as saying any office qualifies.

Read the full statute or call the board before you assume a fee-for-service private practice fits.

CODA accreditation is the credential to check first.

Arizona requires licensure applicants to have graduated from a dental therapy program accredited by — or holding initial accreditation from — the ADA's Commission on Dental Accreditation.

Oregon goes further from January 1, 2025: the education program must be CODA-accredited and approved by the Board.

One caveat there: we read the Oregon rule in an unofficial mirror of the Oregon Revised Statutes, so confirm it against the legislature's own site before relying on it.

The CODA standards behind those statutes were adopted February 6, 2015 and require at least three academic years of full-time postsecondary instruction or its equivalent — so where a CODA-accredited program is the requirement, the person you hire has completed a multi-year clinical program.

Whether a specific program holds CODA accreditation is a factual question you can check directly with CODA and with the licensing board.

Verify in this order: the license itself with the state board that issued it (our guide to license verification covers the lookup habit for dental hires); the program's CODA accreditation; and the supervising agreement your practice must execute — who signs it, what it must contain, and where it is filed.

In Connecticut, where the therapist credential is built on a hygiene license, our guide to hiring a dental hygienist covers the underlying license checks.

Where the hire is allowed, a therapist changes your org chart, not just your operatories.

Two statutes make the point concretely.

In Maine, a dental therapist may be delegated a dentist's responsibility to supervise up to 2 dental hygienists and 3 unlicensed persons in any one practice setting through the written practice agreement.

In Michigan, a therapist may not supervise more than 3 dental assistants and 2 dental hygienists in any 1 practice setting.

If your plan hangs assistants or hygienists off the therapist, check whether your state allows it and up to what numbers.

Write the scope boundaries into your schedules and protocols too.

Minnesota prohibits dental therapists from dispensing or administering narcotic drugs.

Arizona does the same and adds a billing restriction: a therapist there may not independently bill any individual or third-party payor.

Billing is the open question.

Arizona's ban on independent billing bars the therapist from billing any individual or third-party payor on their own — but Medicaid billing rules for dental therapists were not something we could verify state by state for this guide.

Before you build a production model on therapist-provided services, confirm with your state Medicaid program and your payers how those claims are handled.

Put together, the role is state-specific: in five of the nine statutes we read, the settings are pointed at low-income, uninsured and underserved populations, shortage areas, public health and community health facilities, and in the eight whose supervision rules we verified the work runs through a supervising dentist — with a written agreement where the statute requires one.

If your state and setting fit, the remaining work is verification; if they do not, recruiting cannot fix the statute.

For planning the rest of the clinical team around whichever providers your state allows, the dental hiring hub collects our employer guides role by role.