There is a critical need for additional training or certification for RDH's to adequately perform the duties required for remote supervison.  In my clinical experience, only about 20% of the RDHs I have hired have the diagnostic/examination skills required when seeing a patient without a licenced dentist present.

Apparently, current hygiene training programs in Virginia are failing to teach basic dental diseases, diagnoses, and treatment to their students.  Hygienists should be able to recognize decay and periapical pathosis clinically and on radiographs, know how to reconize pulpitis and cracked teeth, and easily identify an abcessed tooth through observation of a fistula or a sudden increase in a periodontal pocket from a previous visit.

My experience has found the majority of hygienists in the Commonwealth lacking in these basic skills.  Two hours of CE will not cover this lack of training.   A better idea would be a proctered online test of clinical diagnostic skills.  Therefore the RDH's that have these skills would not be penalized.  Should a hygienist fail the test, they should have their license put on probabtion until they take an 8 hour CE class at their expense and pass the proctered online test.

Dentists in Virginia have for too long had to put up with very poor performing dental hygienists that do not meet the standards of their training.  They demand top pay and fail to regularly perform periodontal exams, recognize dental problems and work with the DDS to take needed radiographs and diagnostic records, and way too many don't understand dental disease and treatment in order to educated our patients.  

Dentristry in Virginia is under extreme stress with lagging, low reimbursement from insurance companies, a severe shortage of licensed hygienists outside of the urban areas and outside of a 45 mile radius of a dental hygiene schools.  Well trained and good performing dental hygienists are vitally needed to help dentists keep their patients cared for and to help keep general practices financially viable.

I believe the Board would be surprised if they sent out a survey to general dentists about the skills and quality of the hygienists availble here in Virginia.  Having practiced 30 years in the Commonwealth, I have unfortunately seen the quality and quantity of RDH's continue to decline, forcing dentists to compromise the quality of care offered to their patients.