Dear VA BOD Members, 

  As a past member of the BOD I am fully aware of how much time & energies you spend on matters of Dentistry with respect to legislation, licensure & disciplinary procedures.  I commend you for your dedication.  

I am asking that you not include Scaling as one of the many new Dental Procedures to be included in the list for the "new position" of Dental Assistant II. The dental assistant has always worked very closely with the dentist in the restorative field of dentistry.  The many "new" restorative duties that have been proposed are exciting & will add to the overall performance of the dental team. However, adding Scaling on Perio I patients should not be one of those duties.  As defined, a Perio I Patient would require Scaling of 3mm. or less Subgingivally.  Those duties are currently part of the Dental Hygienist Role on the Dental Team (a preventive Procedure) which the Dental Hygienist has spent 2 - 4 years in Training.  There are NO States in the United States that currently allow a Dental Asst. to scale subgingivally to 3mm.  If the purpose of this proposal is to provide care to a greater number of patients, then why has it never been practiced in any state?  Why would Virginia want to be the first state to try this? 

A program would be required to train the Dental Assistant II to treat the Perio I Patient (subgingivally scale 3mm or less.)  It has been mentioned that a model for this training program already exists with the "Indian Health Services".  Is this the standard of care that we want for the citizens in Virginia?  I fear that the quality of care would be greatly compromised.

I do not know how this proposal originated with the DA II (Scaling Subgingivally 3mm or less).  There are no other states that allow this.  I believe there are only two states that even allow a Dental Asst. to scale Supramarginally (above the gum).  If having "expanded duty dental assistants" perform even supramarginal scaling is suppose to be so successful, then why are there so few states that allow this practice?  I ask that you not include scaling as an expanded duty for the Dental Assistant II.

I know that as members of the Board you sacrifice a good deal of your time to the Commonwealth.  I commend you for your dedication.  

Sincerely,

Trudy Levitin RDH