I am a registered dental hygienist (RDH) and I oppose any effort by the Board of Dentistry to allow an "expanded duty dental assistant" to perform supragingival scaling (scaling above the gum line). Only a licensed dental hygienist or dentist is qualified to determine the need for and perform an oral prophylaxis (dental cleaning). Patients will have a false sense of security if they believe that supragingival scaling is appropriate care.

Registered Dental Hygienists receive a similar amount of education as Registered Nurses.  Can you imagine the Medical Board considering delegating the duties of a nurse to an assistant with no required training other than what they have learned by observing? Can you imagine the Board of Education creating “expanded duty teachers aids” to fill a shortage in teachers?”  The public deserve to continue receiving quality care. In addition to years of studying oral anatomy and related topics such as pharmacology, pathology, and microbiology, a dental hygienist spends years practicing  the correct use of dental instruments. This is followed by State and National Board exams to demonstrate competency. This training process will not be possible in an office setting and our patients will suffer. Patients should not be used as “Guinea Pigs”.

Dental Hygienists are also trained to identify and treat Periodontal Disease (80% of the population is affected by periodontal disease). Supragingival scaling is not appropriate care for this infection. Periodontal Disease has been linked to Heart Disease, Diabetes, Stroke, and pre-term low birth weight babies.Our patient's total health and well being is being compromised when subgingival (under the gums) plaque and calculus is not being removed at each oral prophylaxis (dental cleaning) appointment.

The Dental Board should be protecting the public from substandard care NOT greatly lowering the standard of care and placing the public at risk for poor oral and total health. Although the Dental Board claims that their motivation for this Regulatory Action is to increase access to care, they are only achieving poor care. Consider the analogy to a Teacher versus a “expanded duty teachers aid” ---LOWERING EDUCATIONAL REQUIREMENTS and  REMOVING THE NEED FOR A LICENSE is UNACCEPTABLE in any field, especially for health professionals.

Sincerely,

Patricia Sorey, RDH

I strongly oppose any effort by the Board of Dentistry to allow an "expanded duty dental assistant" to perform supragingival scaling. In order to remove supragingival calculus  you must go subgingivally beneath the deposit with a scaller or currette. It is impossible for the "expanded duty dental assistant" to stay above the gumline in order to properly remove supragingival calculus! By only removing supragingival calculus and leaving subgingival calculus the patient is at risk for a periodontal abscess and periodontal disease. If this regulation is passed as stated the Board of Dentistry will be placing the public at risk for periodontal disease which is linked to Heart Disease, Stroke, Diabetes, and preterm low birthweight babies.

I started working in the dental field as a dental assistant at 18 years of age. The dentist trained me on the job as a dental assistant. I than went on to ODU and graduated with a Bachelor of Science in Dental Hygiene. After four  years of formal training, I still was not allowed to scale until I passed my National Dental Hygiene Board Exam, and Dental Hygiene Clinical Examination. I cannot imagine being trained on the job how to scale. It would be impossible. When I first started dental hygiene school  I did not even know what calculus looked like, much less how to use a scaler to remove it. In clinic we first had to learn how to use each instument on a plastic set of teeth. Once that was mastered than we started practicing on each other. The final step in our training was practicing on the public. The public which knew we were a dental hygiene school and paid lower fees to help us with our practice. I could not imagine deceiving patients in our public practices with "expanded duty dental assistants". The patients are paying and expecting to receive high quality care. They have no idea they are receiving substandard care which in turn could harm their overall health. I cannot believe dentist knowing this would want to physically harm their patients. Please consider all the patients you could be harming if not killing if this regulation is passed.

Sincerely

Ruth Hughes, RDH