Just because the Bureau of Indian Affairs and the military use dental assistants to do scaling, doesn't mean that they are giving quality care.  They tend to look at the cheapest way to deal with situations.  As a civilian, paying the full price for my dental care, I want to be sure that I am getting quality care.  When you consider the time spent, and the courses, and the exams that dental hygienists need to go through  in order to become certified, you can understand their expecting to be well paid for their work.  If there is a shortage of hygienists,then more schools need to offer the courses.  If we are going to be honest, we need to admit that using dental assistants to do work that a hygienist does now,is not going to reduce my cost in going to the dentist.  It will only add to his bottom line and I see no benefit to me, the patient.RX