MN Jurisprudence Delegated Duties
Perform preliminary charting of the oral cavity and surrounding structures to include case
histories, perform initial and periodic examinations and assessments to determine periodontal
status, and formulate a dental hygiene treatment plan in coordination with a dentist's
treatment plan -
DH-general supervision
Complete preliminary charting of the oral cavity and surrounding structures with the
exception of periodontal probing and assessment of the periodontal structure -
LDA- general supervision
Make referrals to dentists, physicians, and other practitioners in consultation with a dentist -
DH-general
Obtain informed consent within scope of practice -
DH and LDA- general
Take vital signs such as pulse and blood pressure -
DH and LDA- general
Take photographs extraorally or intraorally -
DH and LDA- general
Take radiographs -
DH and LDA- general
Perform mechanical polishing to clinical crowns not including instrumentation -
DH- general
LDA- indirect
Complete debridement, prophylaxis, and NSPT -
DH-general
Place subgingival medicaments -
DH-general
Salivary analysis -
DH-general
Nutritional counseling -
DH-general
Administer local anesthesia -
DH- general
Administer nitrous oxide inhalation analgesia -
DH- general
1|Page
, LDA- direct
Monitor a patient who has been induced by a dentist into nitrous oxide inhalation analgesia -
DH-general
LDA-indirect
Take impressions and bite registration -
DH and LDA- general
Fabrication and delivery of custom fitted trays -
DH-general
Etch appropriate enamel surfaces, apply, and adjust pit and fissure sealants -
DH-general
LDA-indirect
Remove marginal overhangs -
DH-general
Place and remove rubber dam -
LDA- indirect
place and remove isolation devices or materials for restorative purposes -
DH- general
Place and remove matrix bands -
LDA- direct
Place and remove matrix systems and wedges -
DH- general
Fabrication, placement, replacement, cementation, and adjustment or temporary crowns or
restorations -
DH- general
Fabricate, cement, and adjust temporary crown/restorations extraorally or intraorally -
LDA- direct
Place temporary fillings (not including temporization of inlays, onlays, crowns, and bridges).
-
LDA- general
Recement intact temporary restorations -
LDA- general
Remove temporary crowns or restorations with hand instruments only -
DH- general
LDA- direct
Remove excess cement from inlays, crowns, bridges, or orthodontic appliances -
2|Page
Perform preliminary charting of the oral cavity and surrounding structures to include case
histories, perform initial and periodic examinations and assessments to determine periodontal
status, and formulate a dental hygiene treatment plan in coordination with a dentist's
treatment plan -
DH-general supervision
Complete preliminary charting of the oral cavity and surrounding structures with the
exception of periodontal probing and assessment of the periodontal structure -
LDA- general supervision
Make referrals to dentists, physicians, and other practitioners in consultation with a dentist -
DH-general
Obtain informed consent within scope of practice -
DH and LDA- general
Take vital signs such as pulse and blood pressure -
DH and LDA- general
Take photographs extraorally or intraorally -
DH and LDA- general
Take radiographs -
DH and LDA- general
Perform mechanical polishing to clinical crowns not including instrumentation -
DH- general
LDA- indirect
Complete debridement, prophylaxis, and NSPT -
DH-general
Place subgingival medicaments -
DH-general
Salivary analysis -
DH-general
Nutritional counseling -
DH-general
Administer local anesthesia -
DH- general
Administer nitrous oxide inhalation analgesia -
DH- general
1|Page
, LDA- direct
Monitor a patient who has been induced by a dentist into nitrous oxide inhalation analgesia -
DH-general
LDA-indirect
Take impressions and bite registration -
DH and LDA- general
Fabrication and delivery of custom fitted trays -
DH-general
Etch appropriate enamel surfaces, apply, and adjust pit and fissure sealants -
DH-general
LDA-indirect
Remove marginal overhangs -
DH-general
Place and remove rubber dam -
LDA- indirect
place and remove isolation devices or materials for restorative purposes -
DH- general
Place and remove matrix bands -
LDA- direct
Place and remove matrix systems and wedges -
DH- general
Fabrication, placement, replacement, cementation, and adjustment or temporary crowns or
restorations -
DH- general
Fabricate, cement, and adjust temporary crown/restorations extraorally or intraorally -
LDA- direct
Place temporary fillings (not including temporization of inlays, onlays, crowns, and bridges).
-
LDA- general
Recement intact temporary restorations -
LDA- general
Remove temporary crowns or restorations with hand instruments only -
DH- general
LDA- direct
Remove excess cement from inlays, crowns, bridges, or orthodontic appliances -
2|Page
