Scope of practice for dental hygienists

This page lists the scope of practice for dental hygiene.

The Health Practitioners Competence Assurance Act 2003 (the Act) describes a scope of practice as the health service, that a practitioner registered in that scope of practice is permitted to perform, subject to any conditions for the time being imposed by the responsible authority.

The Council publishes a scope of practice as a Notice in the New Zealand Gazette under section 11 of the Act.

Scope of practice for dental hygiene


The practice of dental hygiene is the prevention and non-surgical treatment of periodontal diseases through the provision of oral health assessment, diagnosis, management and treatment of any disease, disorder or condition of the orofacial complex and associated structures in accordance with this scope of practice and a dental hygienist’s approved education, training, experience and competence.

A dental hygienist guides patients’ personal care to maintain sound oral tissues as an integral part of a patient’s general health.

Dental hygienists practise in a team situation with clinical guidance provided by a practising dentist or dental specialist1. Some aspects of the scope of practice are provided under direct clinical supervision2.

Dental hygiene practice includes:

Provided under clinical guidance

  • obtaining and reassessing medical and dental health histories
  • examination of oral tissues and recognition of abnormalities
  • assessing and provisionally diagnosing disease of periodontal tissues, and appropriate referral
  • obtaining informed consent for dental hygiene care plans
  • providing oral health education, information, promotion and counselling
  • scaling, debridement and prophylaxis of supra and subgingival tooth surfaces
  • applying and dispensing non-prescription preventive agents and fissure sealants
  • applying and dispensing topical agents for the treatment of tooth surface sensitivity and tooth discolouration
  • administering topical local anaesthetic
  • taking impressions, recording occlusal relationships and making study models
  • taking impressions, constructing and fitting mouthguards and bleaching trays
  • taking intra and extra-oral photographs
  • performing postoperative procedures such as removal of sutures and placement and removal of periodontal dressings
  • recontouring and polishing of restorations
  • taking periapical and bitewing radiographs for the purpose of recognising disease of the periodontium
  • taking extra-oral radiographs
  • assisting the dentist or dental specialist in implementing orthodontic treatment plans, prepared by the dentist or dental specialist responsible for the patient’s clinical care outcomes, through performing the following orthodontic procedures:
    • tracing cephalometric radiographs
    • supragingival polishing of teeth (as part of oral hygiene, before bonding and after removal of fixed attachments)
    • providing oral hygiene instruction and advice on the care and maintenance of orthodontic appliances
    • making study models, and fabricating retainers, and undertaking other simple laboratory procedures of an orthodontic nature.

Provided under the direct clinical supervision of a dentist or dental specialist

  • applying prescription preventive agents
  • administering local anaesthetic using dentoalveolar infiltration and inferior dental nerve block techniques
  • assisting the dentist or dental specialist in implementing orthodontic treatment plans, prepared by the dentist or dental specialist responsible for the patient’s clinical care outcomes, through performing the following orthodontic procedures:
    • placing separators
    • sizing of metal bands and their cementation including loose bands during treatment
    • preparation of teeth for the bonding of fixed attachments and fixed retainers
    • indirect bonding of brackets as set up by the dentist or dental specialist
    • placing archwires as formed by the dentist or dental specialist when necessary and replacing ligatures /closing self-ligating brackets
    • removing archwires after removing elastomeric or wire ligatures, or opening self-ligating brackets
    • removing fixed orthodontic attachments and retainers
    • removing adhesives after the removal of fixed attachments using burs in slow speed handpieces where there is minimal potential for the removal of enamel
    • trial fitting of removable appliances. This does not include activation
    • fitting of passive removable retainers
    • bonding preformed fixed retainers.

Practice in this context goes wider than clinical dental hygiene practice to include teaching, research, and management, given that such roles influence clinical practice and public safety. Areas of dental hygiene practice which were not included in a practitioner’s training should not be undertaken unless the practitioner has completed appropriate training and practises to the standards required by the Standards Framework for Oral Health Practitioners.

1 Clinical guidance means the professional support and assistance provided to a dental hygienist by a practising dentist or dental specialist as part of the provision of overall integrated care to the patient group.  Dental hygienists and dentists or dental specialists normally work from the same premises providing a team approach. Clinical guidance may be provided at a distance but appropriate access must be available to ensure that the dentist or dental specialist is able to provide guidance and advice, when required, and maintain general oversight of the clinical care outcomes of the patient group. Dental hygienists are responsible and accountable for their own clinical practice within their scope of practice but the dentist or dental specialist is responsible and accountable for the clinical guidance provided. Further detail on the working relationship between dental hygienists and dentists is set out in the relevant Dental Council Practice Standard.

2 Direct clinical supervision means the clinical supervision provided to a dental hygienist by a practising dentist or dental specialist when the dentist is present on the premises at the time the dental hygiene work is carried out

Prescribed qualifications for the dental hygiene scope of practice.