I would like to voice my opposition to the proposed expansion of Assistant duties.

I note that, among other things, the proposal would have registered / certified Assistants (level 2) would be allowed to have "expanded" duties so that they could provide "reversible" care that is normally performed by dentists or hygienists.

I also note that the local dental associate supports this proposal, except for wanting to have scaling included among the procedures that such a level-2 Assistant will be allowed to perform.

I also note that the local area in which I practice is experiencing a shortage of hygienists, which is having various effects, including causing a sharp spike in the salaries of hygienists.

Despite this shortage, I believe that expanding the duties of registered Assistants will be harmful to the treatment of patients, since more and more dentists will have Assistants provide cleanings / scalings and other duties.  This will confuse patients, upset their expectations and ultimately reduce the care and education of patients as less and less hygienists will be providing those services.

Ultimately, the standard or care will decrease in Virginia as the level of training and education required to provide services currently provided by hygienists and dentists is reduced.  The dental offices that will gain from this will be those that are willing to employ lesser-trained Assistants to provide those services, while the losing offices will be those that try to maintain a staff of highly-trained (and highly compensated) hygienists, in addition to assistant and other staff.

For those who might argue that patients will ultimately decide what is right for them (hygienist versus Assistant level-2), I would say that patients are the least informed among the various parties involved, and they will come to believe that those services which are downgraded to Assistants-2 providing them is the norm and the standard of care.