What Dentists Are Saying When No One Is Listening

As a longtime dental sales representative in this area, I have spent years in dental offices and have professional relationships with dentists throughout the community. What I am hearing privately is very different from what this legislation might lead the public to believe.

Most of the dentists I speak with do not support allowing dental assistants to perform supragingival scaling, and many have told me they have no intention of using this provision in their practices. They value their hygienists, understand the education and clinical judgment behind dental hygiene, and do not believe this is an appropriate substitute for a licensed dental hygienist.

My concern is who will take advantage of this law.

The greatest incentive will exist in practices where reducing labor costs and increasing patient volume are given greater weight than maintaining the traditional standard of hygiene care. Large corporate practices and other production-driven offices may see an opportunity to replace some hygienist hours with lower-paid dental assistants and increase the number of patients moving through the schedule.

That may improve a spreadsheet. It does not necessarily improve patient care.

I hesitate to call these dentists “bad dentists,” because the real issue is the incentive the law creates. Most conscientious dentists I know will continue using licensed dental hygienists because they recognize their training, judgment, and value. But laws should be written with safeguards for what can happen, not based on the assumption that everyone will voluntarily follow the highest possible standard.

Patients often have no idea which duties legally belong to a hygienist and which may now be delegated to an assistant. They trust the dental office to make those decisions for them. A patient may reasonably believe that the person “cleaning their teeth” is a licensed dental hygienist when that individual is not.

That is where the Board must be especially careful.

The Board cannot change the law the General Assembly passed. But its guidance should make the limits of this new authority unmistakable and ensure that patients are not led to believe that limited training and certification in supragingival scaling is equivalent to the education, licensure, and clinical expertise of a registered dental hygienist.

The dentists who choose not to use this law are not the patients we need to worry about. The patients who receive care in practices that aggressively exploit it are.