As a dental hygienist who has provided dental hygiene care for over 37 years as well as teaching clinical skills to dental hygiene students for 13 years I know that having dental assistants scale teeth is NOT a good and safe idea. Quality of care for residents of Virginia will not be maintained and dentists will open themselves up to potential lawsuits. I have personally seen countless cases of periodontal disease associated with crowns around which all cement was not removed, therefore harboring microorganisms. I have witnessed dental assistants attempting to remove cement following posterior teeth crown deliveries with an anterior sickle scaler (by the way, a technique taught by the DDS). No wonder cement remained on the proximal surfaces!!! Properly educated, tested and licensed dental hygienists are uniquely qualified to provide preventive and therapeutic periodontal care. I have teamed with wonderfully talented dental assistants who assist their dentists with patient care, but they are not qualified to scale teeth, not even supragingivally. Is the DDS going to evaluate the patient as to location of deposits and gingival health prior to assigning the patient to a dental assistant II or a hygienist? Of course not, the DDS is busy with his or her own patients. Assuming that all child patients have only supragingival deposits is also not an ethical practice. All patients are unique and deserve to be cared for appropriately. I have removed rings of black calculus from posterior teeth of children. I have cared for children with demineralized surfaces which should only be instrumented lightly and then have fluoride varnish applied to remineralize them.  Would a dental assistant know the difference to choose the proper care in these instances? As to a supposed shortage of RDH's in Virginia, I believe the situation is rather an unequal distribution. Hygienists should be offered incentives to locate to under-served areas and assistants or high school graduates be encouraged to attend an accredited hygiene program and then return to their communities to practice. In communities where care has not been available , patients need skilled clinicians to remove years of calculus accumulation, to educate as to proper home care and to control periodontal disease.....NOT  a minimally trained dental assistant to remove supragingival calculus. What is the Board of Dentistry thinking???