What procedure is a Dental Hygienist not allowed to perform under any level of supervision?

A Dental Hygienist is not permitted to elevate a soft tissue flap under any level of supervision due to the invasive nature of this procedure. Elevating a soft tissue flap involves surgical manipulation of the tissues, which requires a higher level of training, typically reserved for licensed dentists. This action falls outside the scope of practice allowed for dental hygienists, as it can pose significant risks and complications that a hygienist may not be adequately trained to manage.

In contrast, taking diagnostic impressions, luxating teeth, and adjusting occlusal surfaces may be performed by dental hygienists under specific supervision guidelines and conditions set by the Dental Hygiene Practice Act in Washington State. For instance, while taking impressions is generally permissible under supervision, and luxating (or slightly moving) teeth is often a part of non-surgical periodontal procedures, they all fall within the boundaries of acceptable practices for a hygienist when properly directed. Adjusting occlusal surfaces is also a procedure a hygienist can carry out based on their education and specific supervision requirements.

Thus, understanding the explicit limitations imposed by practice acts and regulations helps clarify why elevating a soft tissue flap is strictly off-limits for dental hygienists in any supervisory context.