As an RDH I can assure you about 9/10 patients present with some subgingival calculus (build up under the gum line), even children. Only scaling supragingivaly(above the gum line) is unethical and ineffective in getting patients to periodontal health. This will only harm patients, as they will not know who is “cleaning” their teeth. It took so many hours of supervised education to perform scaling for an RDH, dozens of lectures in learning tooth anatomy to perform scaling as well. We obtained knowledge on tooth anomalies and enamel abnormalities, which scaling improperly on could cause permanent harm to the dentition. Allowing assistants to scale with only training from a dentist in the office is very concerning and will ultimately harm patients.