Ontario has officially directed the College of Dental Hygienists of Ontario (CDHO) to begin expanding the scope of practice for registered dental hygienists, allowing them to prescribe radiographs, serve as Radiation Protection Officers, and prescribe and administer local anesthesia by injection. For dental practice owners in Toronto and across the GTA, this is one of the most significant regulatory developments of 2026 — and it will reshape staffing models, workflow design, and patient access to care.
As of August 2026, the Ontario government's directive to the CDHO represents the formal start of a regulatory process that has been debated in the province for over a decade. Ontario dental hygienists have long operated under a narrower scope than their counterparts in British Columbia, Alberta, and several other provinces. This directive begins to close that gap — and dental practice owners need to understand what is changing, what is not changing, and how to prepare.
What the Scope Expansion Includes
The Ontario government has directed the CDHO to develop the regulatory framework for three specific scope-of-practice enhancements:
- Prescribing radiographs: Registered dental hygienists would be authorized to prescribe (order) dental radiographs based on their clinical assessment, without requiring a dentist's prescription for each set of films or digital images.
- Serving as Radiation Protection Officer (RPO): Dental hygienists would be eligible to serve as the designated RPO for a dental facility, a role currently restricted to dentists in most Ontario practice settings.
- Prescribing and administering local anesthesia by injection: This is the most clinically significant expansion. Dental hygienists would be authorized to administer local anesthetic injections in the orofacial complex — a procedure currently outside their authorized acts in Ontario.
These changes align Ontario with provinces like British Columbia, where dental hygienists already practice with an expanded scope that includes local anesthesia administration and independent radiograph prescribing.
Why Ontario Is Expanding Scope Now
The timing is not accidental. Several converging pressures have pushed the Ontario government toward action:
Workforce Shortage
Ontario faces a well-documented dental workforce shortage that has worsened since the launch of the Canadian Dental Care Plan (CDCP) in 2024. With nearly 6 million Canadians now enrolled in the federal program, demand for dental services has surged — but the supply of dental professionals has not kept pace. Expanding the scope of hygienists allows practices to deliver more care without needing to hire additional dentists, who are increasingly difficult to recruit outside of major urban centres.
Access to Care in Underserved Areas
Northern and rural Ontario communities have struggled with dental access for years. Independent dental hygiene practices — already permitted in Ontario under certain conditions — can serve long-term care facilities, community health centres, and remote settings. But without the ability to prescribe radiographs or administer local anesthesia, hygienists in these settings hit a clinical ceiling that forces patients to travel to a dentist for basic procedures.
Interprovincial Alignment
British Columbia, Alberta, Saskatchewan, and Manitoba already allow dental hygienists to administer local anesthesia. Ontario's current restrictions create an interprovincial inconsistency that complicates labour mobility and limits the pool of hygienists willing to relocate to Ontario from provinces where they practise with a broader scope.
Pro Tip: If you are struggling to recruit dental hygienists for your GTA practice, the scope expansion could be a differentiator. Once implemented, advertising positions that include the expanded scope may attract candidates from British Columbia and Alberta who are currently reluctant to move to a province where their practice range narrows.
What This Means for Dental Practice Owners
Workflow Efficiency Gains
The most immediate impact will be on daily workflow. Currently, in many Ontario dental practices, the hygienist must wait for the dentist to prescribe radiographs during a new patient appointment or a recall visit where imaging is indicated. This creates bottlenecks — the dentist is with another patient, the hygienist waits, the schedule slips. Allowing hygienists to prescribe their own radiographs based on clinical assessment removes that dependency.
Similarly, local anesthesia authorization means that a dental hygienist performing deep scaling or root planing on a patient who needs freezing will no longer require the dentist to step in for the injection. This frees the dentist's time for procedures only they can perform — and keeps the hygiene schedule running on time.
Staffing Model Flexibility
For practices in Markham, Vaughan, Mississauga, and other GTA suburbs that operate with multiple hygiene operatories, the scope expansion could allow a leaner dentist-to-hygienist ratio during certain appointment types. This is not about reducing clinical oversight — it is about deploying each professional's skills where they add the most value.
Compensation Implications
Ontario dental hygienist compensation has already been climbing due to the CDCP-driven demand surge. Expanded scope will likely accelerate this trend. Hygienists authorized to administer local anesthesia and prescribe radiographs bring more clinical value to the practice, and their compensation expectations will reflect that. Practice owners should budget for upward pressure on hygienist wages in 2027 and beyond.
Pro Tip: Start conversations with your hygiene team now about their interest in expanded-scope certification. Early adopters will need additional training — likely a certification course in local anesthesia administration, similar to those already offered in British Columbia through programs at the University of British Columbia and the BC Dental Hygienists' Association. Ontario will likely develop its own accredited programs, and your team members who enroll early will be practice-ready when the regulatory framework is finalized.
What Is NOT Changing
The scope expansion is significant but bounded. Ontario dental hygienists will not be authorized to:
- Diagnose dental disease. Diagnosis remains a controlled act restricted to dentists and physicians.
- Prescribe medications beyond local anesthetics (e.g., antibiotics, analgesics).
- Perform restorative procedures, extractions, or surgical interventions.
- Supervise dental assistants in roles that require dentist oversight under the Dentistry Act.
The Royal College of Dental Surgeons of Ontario (RCDSO) retains regulatory authority over dentists, and the expanded hygienist scope does not diminish the dentist's role as the primary diagnostician and treatment planner in general dental practice.
Timeline and Implementation
The government's directive to the CDHO initiates a regulatory process, not an immediate change. The College must:
- Develop competency standards for each expanded act — what training, certification, or examination is required.
- Draft regulatory amendments for public consultation.
- Publish and finalize the regulations after the consultation period.
- Establish continuing education requirements for hygienists seeking the expanded authorizations.
Based on precedent from other Ontario health professions' scope expansions, this process typically takes 12–24 months from directive to implementation. Practice owners should plan for expanded-scope hygienists to begin practising under the new authorities in late 2027 or 2028.
The Ontario Dental Hygienists' Association Response
According to the Ontario Dental Hygienists' Association (ODHA), the organization has welcomed the government's announcement as a positive step toward recognizing the full competencies of registered dental hygienists. The ODHA has been advocating for scope expansion for years, citing the interprovincial disparities and the growing evidence that dental hygienists can safely and effectively perform these procedures when appropriately trained.
What Practice Owners Should Do Now
- Audit your current workflow. Identify how often hygienists wait for dentist-prescribed radiographs or dentist-administered anesthesia. Quantify the time lost — it directly maps to scheduling inefficiency.
- Budget for compensation adjustments. Expanded scope means expanded expectations and expanded pay. Factor this into your 2027 staffing budget now rather than reacting after the fact.
- Monitor CDHO communications. The College will publish consultation papers as the regulatory framework develops. Participating in the consultation gives you a voice in how the rules are written.
- Discuss training opportunities with your team. Hygienists who invest in local anesthesia certification early — even through out-of-province programs — will be better positioned when Ontario's regulations come into effect.
- Evaluate your insurance coverage. Confirm with your professional liability insurer that your policy will cover hygienists performing expanded-scope acts once authorized. Update your coverage proactively.
Pro Tip: Ontario's CDHO will publish draft regulations for public consultation before anything becomes final. Set a calendar reminder to check cdho.org quarterly for consultation notices. Your feedback — especially from a practice owner perspective — helps shape practical, workable regulations.
Frequently Asked Questions
Q: When will Ontario dental hygienists be able to administer local anesthesia?
The Ontario government has directed the CDHO to develop the regulatory framework, but the expanded scope is not yet in effect. Based on typical regulatory timelines for health professions scope changes in Ontario, implementation is expected in late 2027 or 2028, following competency standard development, regulatory drafting, and public consultation.
Q: Will dental hygienists need additional certification for the expanded scope?
Yes. The CDHO will establish competency standards for each expanded act, which will likely include a certification course in local anesthesia administration and possibly a practical examination. Similar programs already exist in British Columbia and Alberta and can serve as models for the Ontario framework.
Q: Does the scope expansion affect independent dental hygiene practices in Ontario?
Significantly. Independent dental hygiene practices in Ontario — which operate without a dentist on-site — have been limited by the inability to prescribe radiographs or administer local anesthesia. The expanded scope removes those barriers, potentially allowing independent practices to serve a broader range of patient needs, particularly in long-term care facilities, community health centres, and underserved communities across the province.