A prophylaxis is for the prevention of gum disease.  Every hygienist I know always cleans above AND under gum lines. Health history, BP readings, perio probing, oral cancer screenings etc are all done during regular prophy or recare  appts. Patients NEED to be told if they have gum problems EVERY time they have a recare appt (prophy.) and be told how and why it happens! Education!! They also need to know what to do about it and shown HOW to clean their own teeth at home and not just be given a pamphlet. None of this will happen if dentists are allowed to “train” their assistants to “clean” teeth above the gumline.  How will they have the time to even attempt this? Periodontal disease will skyrocket in the next decade or two and lawsuits will happen in the future…guaranteed!  Patients who have really had their teeth cleaned properly will indeed notice the difference between a 15-20 minute supragingival “prophy” by just a dental assistant and a 45-60 minute prophylaxis by a licensed dental hygienist!  A lot of dentists are pushing this for financial gain because their hygienist refuses to do a 20 minute prophy appt or will not see 16 or so patients in 8 hours. (Double hygiene) when there are no breaks all day!!! Hygienists are getting burnt out. After Covid and being the highest at risk health professional being 6 inches away from many patients ALL day long no longer wanted to work.  While everyone else in the office gets a full lunch break, has time to go to the bathroom, has time to write (type) notes and gets full benefits (medical, vacation, scrubs, CEs etc) and overtime while the hygienist usually doesn’t, it’s no wonder so many are choosing to temp instead of working for one office all the time! It’s depressing to read all the hygiene FB pages conversations about the poor working conditions in some dental practices. It never used to be like this when I started out and hygienists were respected and part of a professional team. Dentistry is shooting itself in the foot and will reap the consequences and the public will suffer from inadequate dental care and end needing more periodontal treatment. It’s called malpractice!