Why is it that the bottom line is always about money?  Let's face it.  The dentists want this because it will save them money.  Not because it benefits the patients.  Why not just train Hygienists to do dentistry? That would save the patients lots of money.  How does cheap inadequate care ever help anyone? This decision not only affects Virginia, but the rest of the world is watching.The best  idea to address the shortage is to increase the number of Hygienists in your area. Why don't you encourage enrollment in DH schools, create better access to existing DH schools, open new schools and offer incentives to potential students?  More Hygienists will even out the pay scale and patient care will not suffer.  That's your solution, not decreased quality of care.