I strongly oppose expanding the scope of practice to allow dental assistants to perform procedures that require the periodontal assessment and clinical judgment traditionally provided by a licensed dental hygienist. There is a significant difference between simply removing supragingival deposits and providing comprehensive periodontal care. Dental hygienists receive formal education in periodontal disease, anatomy, histology, microbiology, radiographic interpretation, instrumentation, patient assessment, infection control, and the recognition of disease processes. That education is what allows a hygienist to determine what is clinically appropriate for an individual patient rather than simply performing a task. I believe expanding duties into areas traditionally performed by hygienists in an effort to address a perceived “hygienist shortage” risks overlooking the real issue: retaining experienced hygienists in ethical, patient-centered practices.

If we are truly experiencing a shortage of hygienists, I believe we should be asking why so many experienced hygienists are leaving clinical practice or seeking smaller offices where they feel their professional judgment is respected. Increasing the number of people performing pieces of the hygienist’s job does not necessarily solve the underlying workforce problem. In fact, it could further devalue the education and expertise of licensed hygienists while allowing practices to increase patient volume and production. Rather than lowering the educational threshold for periodontal care, I believe the profession should focus on improving working conditions, protecting clinical autonomy, addressing production-driven treatment pressures, and creating environments where experienced hygienists want to remain. Patient safety and quality of care should remain the priority—not simply finding a less expensive way to perform more procedures.