Frequently Asked Dental Hygienist Questions

Can hygienists administer medicine or shots of local anesthesia to patients?

The state of Washington became the first state to allow hygienists to administer local anesthesia in 1971. By 2002, nearly all state laws had changed to allow hygienists to administer shots. Hygiene programs’ curriculum had adopted the administration of local anesthesia so when graduates pass their boards, they are able to give patients shots. Those individuals who graduated from dental hygienist schools prior to the local anesthesia education and training being integrated in their state are able to take a relatively short class (typically lasting the course of a weekend) so they too can administer shots.

While they are allowed to administer local anesthesia through proper training, hygienists cannot prescribe any medication to patients. The dentist is able to prescribe medicine through his or her drug enforcement administration (DEA) number. After medication is prescribed by the dentist, the hygienist reviews the medicine usage with the patient.

At what age do children begin getting their teeth cleaned?

Dental Hygienist SchoolChildren can go to the dentist for their first check up as early as age 2. This appointment usually just involves an exam, rather than a cleaning. By age 3, patients are ready for their first cleaning. Bite wing x-rays are typically started at ages 4 or 5.

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At their dental appointments, children’s teeth are assessed for development, cavities, and potential orthodontic needs. Additionally, their teeth are cleaned, polished, flossed, and given a fluoride treatment. Fluoride helps prevent cavities and should be given until children are 16 years of age because their teeth are still developing. Some dentists give their adult patients fluoride treatments, operating under the premise that it may help them develop fewer cavities.  Sealants, which are a coating, are also applied to children’s permanent molars, once they’re in, to seal any grooves on the biting surface. This is also done to prevent cavities.

How can a hygienist tell if a patient has an abnormality with their teeth?  

Many dental offices take part in what is known as “co-diagnosing”.  This means that while the hygienist is cleaning a patient’s teeth, they write down anything that appears abnormal for the dentist to evaluate during his oral exam. This practice leaves a smaller window for error since there are two people assessing rather than just one.

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By law, a hygienist cannot diagnose a cavity because it is not within the limits of their license. However, the hygienist can typically spot a cavity, even though they cannot diagnose it to the patient. Cavities are “soft spots” on a tooth. If the “explorer”, which is the little hook-like instrument, “sticks” in a groove, that likely means there is likely a cavity in that spot. Ideally the teeth should be solid without soft spots. If the patient has been having hot or cold sensitivity to food, sensitivity to sweets, or pain while brushing their teeth, those can be other indicators that a cavity exists.


X-rays are an important tool to discover abnormalities of the teeth, including cavities, because they show the dentist and hygienist the areas they are unable to see, such as the area between each tooth. In assessing an x-ray, if there is a dark shadow, it usually means a cavity is at the root of the tooth, commonly referred to as an abscessed tooth. X-rays are also used to determine if a patient needs a root canal. If the root of the tooth is infected, it is typically caused by a broken tooth or a cavity becoming too large.

Do hygienists assist dentists with filling cavities and other restorative procedures?

Hygienists are responsible for the cleaning and maintenance of the teeth and the dentist restores the teeth back to proper order, whether that entails filling a cavity or other procedure. Dentists oftentimes have dental assistants who assist with the restorative natures of dentistry.

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