I would like to make a few comments after proudly caring for patients as a  registered dental hygienist for twenty-six years.  The key to keeping a type I perio patient from progressing is  thorough debridement of the accretions that are ,undoubtly, both supra and subgingival. When treatment is rendered in an inflamed and diseased environment the tissue is fragile and can be easily damaged without careful instrumentation.  I have witnessed doctors (in my tweny -six year career) who failed to recognize calculus on radiographs and who did not know how to properly adapt the curets to the tooth and root surface.  Is it any wonder why hygineists fear that the quality of treatment will be negatively impacted with such a consideration?  It seems that a large volume of the commenting dentists thought it grand idea to have DAII take a "week-end warrior" course and do what an RDH studied and logged hours in the clinic for 2-4 years to be licensed to do.  I agree that there are a variety of stages of disease that we are involved with treating and I think most RDHs enjoy working with early, moderate and advanced disease stages.   A huge factor is also educating that patient in proper home-care technique.  This is not the "cookie-cutter" type of instruction, but must be tailored to the needs of each patient. I do not think that there is a hygienist out there who has not worked on  military personnel who were under-diagnosed and under-treated (for years) in the military under the care of technicians.  Several new community college programs have begun in VA in the past few years.  We, the VDHA, are hearing from hygienists who cannot find work.  Why would we want to short-change the citizens of the commonwealth by creating a substandard means of treating patients while their are RDHs out there hoping for an opportunity to provide care for patients and  in public health settings who have been educated in accredited institutions and are eager to join the dental workforce.  Numerous doctors made reference to this process saving people money on treatment.  I sincerely doubt that the fee for services rendered would have a sliding fee for the patients whose cleanings were performed by an assistant.  This type of care would provide a false sense of security for those patients who have been used to the quality of treatment performed by a registered dental hygienist.  I strongly oppose including scaling as a duty to be taught as a part of the curriculum of the DAII.  Most sincerely, Maureen M. Glick, RDH,BS