At a typical checkup you might see three or four different people. One person cleans your teeth, another takes X-rays, the dentist comes in for a few minutes, and the front desk handles billing. Knowing who does what helps you direct questions to the right person and understand your visit. This guide explains each role, based on descriptions from the American Dental Association (ADA) and the American Dental Hygienists’ Association (ADHA). Exact duties vary by state, because state law sets what each role may do.
The dentist
The ADHA sums up the difference this way: hygienists focus on prevention and education, while dentists diagnose and treat dental problems, perform procedures and do surgeries. The dentist:
- examines your mouth and reviews X-rays and the hygienist’s findings
- makes diagnoses and builds a treatment plan
- performs procedures such as fillings, crowns and extractions
- supervises the clinical team, as state law requires
Some dentists complete extra training and practice as specialists, such as orthodontists, periodontists or oral surgeons. See dental specialists explained.
The dental hygienist
The ADHA describes dental hygienists as licensed oral health professionals who focus on preventing oral health problems. They examine patients for signs of disease, teach good oral care and provide preventive and treatment services.
What hygienists typically do
The ADA lists hygienist duties including:
- screening patients and reviewing health histories, including oral cancer screenings
- taking X-rays
- removing calculus (tartar) and plaque from teeth, which is the cleaning
- applying preventive materials such as fluoride and sealants
- teaching oral hygiene and counseling on nutrition
The ADHA adds that, depending on the state, hygienists may also give anesthesia and use lasers. It says hygienists can make a dental hygiene diagnosis and refer patients to a dentist when needed. They often work with minimal or no supervision.
Training
According to the ADHA, hygienists need at least an associate degree in dental hygiene from an accredited program. Licensure requires passing national and state exams. The ADA’s career guide says hygienists become Registered Dental Hygienists (RDH) by passing the National Board Dental Hygiene Exam and state licensure exams.
The dental assistant
The ADHA says dental assistants focus on chairside support, preparing treatment rooms and administrative tasks. The ADA calls their duties among the most comprehensive and varied in the office. Depending on state rules, they may include:
- assisting the dentist during procedures
- taking and developing X-rays
- asking about medical history and taking blood pressure and pulse
- infection control: preparing and sterilizing instruments and equipment
- helping patients feel comfortable before, during and after treatment
- giving aftercare instructions, for example after a filling or surgery
- teaching brushing, flossing and nutrition
- taking impressions for study models
- scheduling, answering phones, billing and ordering supplies
Training
The ADA notes that requirements vary by state. Some states require or offer registration or licensure. The ADA says most academic dental assisting programs take nine to eleven months. Certification through the Certified Dental Assistant (CDA) exam from the Dental Assisting National Board is available.
Who to ask about what
- Brushing and flossing technique, or why your gums bleed: your hygienist.
- Whether you need a filling or crown, or treatment options and risks: the dentist.
- Aftercare instructions or comfort during a procedure: the dental assistant or dentist.
- Costs, insurance and payment plans: the front desk.
If a hygienist mentions a concern, it’s reasonable to ask whether the dentist will review it during the visit.
How often you’ll see the hygienist
The ADHA says most people should see their hygienist every six months, though some need more frequent care. Your dentist may recommend a different schedule based on your risk. See how often should you see the dentist.
Choosing a practice
A well-run team is part of a good dental experience. Our guide on how to choose a dentist covers what to look for, and you can search for dentists near you.
Frequently asked questions
Is a hygienist the same as a dental assistant?
No. The ADHA says the roles differ in responsibilities, education and scope of practice. Hygienists provide preventive care such as cleanings. Assistants mainly support the dentist and run the office.
Can a hygienist diagnose cavities?
The ADHA says hygienists can assess oral health, make a dental hygiene diagnosis and refer patients to a dentist. Diagnosing and treating dental disease such as cavities is the dentist’s role.
Why do duties differ from office to office?
State laws set what each role may do, so a task done by an assistant in one state may be limited to hygienists or dentists in another.
Sources
- American Dental Hygienists’ Association: Frequently Asked Questions
- ADA: Dental Hygienist career pathway
- ADA: Dental Assistant career pathway
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Dental hygienist” by Barbaricino, via Wikimedia Commons, licensed CC BY 3.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.