Can a Dentist Supervise a Nurse Practitioner?

There are several states in which scope of practice laws for APRNs mention dentists. As a nurse practitioner I had never considered that I might work for or be supervised by a dentist. But, it seems others have at least considered this. Working in the emergency department I do treat a number of oral/dental complaints and make my fair share of referrals to dental clinics. Legally, could I work in a dental practice and/or be supervised by a dentist?

Like it or not, in many states, nurse practitioners are required to be "supervised by" or "collaborate with" a physician in order to practice, prescribe or both. These laws can be straightforward or complex depending on the state and conditions required within a collaborative agreement. State laws typically use the word "physician", "MD" or" DO" in describing the individual responsible for supervising the nurse practitioner. A few states, however, also add "dentist". Can a nurse practitioner really be supervised by a dentist? There are several factors to consider in determining the answer to this question. 

How Does the Law Define Physician?

If you're a NP required to collaborate with or be supervised by a physician, the first step is to determine how your state defines the word "physician". In some cases, state law or at least APRN scope of practice laws, define a "physician" to be a MD or DO. Other states include other healthcare professionals like dentists and podiatrists in this mix. Typically, if supervision by a dentist is allowable in APRN scope of practice, states will specifically name this profession. Florida's scope of practice law says, for example, that APRNs may be supervised by "physicians or dentists".

Which APRNs are Allowed Supervision by a Dentist?

Some states write scope of practice laws for each nursing profession separately (i.e. nurse practitioners, CRNAs, nurse midwives). Other states lump these professionals into a single group and write scope of practice legislation for APRNs as a whole, only occasionally singling out each profession. 

It's common for CRNAs to work for or be supervised by dentists given that they provide anesthesia services. So, supervision of a CRNA by a dentist is allowed in most states. In states where APRNs are addressed as a collective group by law it my appear that there is also a path for nurse practitioner supervision by a dentist. For example, in Illinois, the Nurse Practitce Act specifies a written collaborative agreement is entered into by an advanced practice nurse and a "collaborating physician, dentist or podiatric physician".  While this makes it initially appear that a nurse practitioner and dentist can collaborate, further examination of state law indicates that CRNAs are the only APRNs that my have a collaborative agreement with a dentist in Illinois. Some APRNs (CRNAs), but not all, can practice with dental supervision. 

Practice Area Stipulation

If you're still unsure if NPs can be supervised by dentists in your state, legal specifications about practice area or specialty are another aspect to consider. In most states, scope of practice law specifies that the nurse practitioner be supervised by a physician working in the same or in a similar specialty to the NP with whom there is a collaborative agreement. So, unless a nurse practitioner is providing dental services, supervision by a dentist would be inappropriate in these states. 

Dental Practice Act

Not only do nurse practitioners practice under a set of state laws, other healthcare professionals like dentists do as well. So, another place to look for this information would be the Dental Practice Act for your state that specifies how dentists are allowed to practice. Typically, this document will outline supervisory and collaborative agreements for CRNAs and dental hygienists, but not nurse practitioners. 

Overall, though dentists may be mentioned in Nurse Practice Acts and scope of practice law for advanced practice nurses, in most if not every state nurse practitioners cannot be supervised by dentists given one or more of the legal conditions outlined above. 

 

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Comments

Not in Georgia. It has to be an MD or OD.

Margaret