In reading some of the dentist comments, they mention a shortage of hygienists.  Northern Virginia is experiencing a shortage of hygiene positions, not a shortage of hygienists. I know of hygienists who cannot find a job even thru temp agencies, one is a hygienist who moved down here from Michigan due lack of hygiene positions there.  She is a hygienist with a degree from University of Michigan, a masters degree and 30 plus years of experience!

To address the lack of care in rural areas, maybe the answer is to let hygienists work independently of dentists as they do in some of the western states.

Let us not address the lack of dental care in some areas by lowering our patient's standard of care by letting lesser trained assistants do scaling.  If an assistant wants to scale, let them pay the cost of dental hygiene school and licensure.