On the surface, from a business perspective, it seems like a reasonable idea to allow Dental Assistants the opportunity to perform scaling procedures on patients.  One could argue that it may lead to lower costs for the patients and insurance companies.  But realistically, substituting Dental Hygienists for lower paying Dental Assistants will not translate into lower costs for the patients or insurance companies.  It will only bring higher profits to the dental practice, which yes, would be good for the practice as it provides more revenue to purchase needed equipment and supplies. As many Dentists have recently written, it could also provide an incentive for career growth for the Dental Assistants.  All valid arguments, but they are overshadowed by more important facts

We all recognize the fact that the patient’s oral health is first and foremost important to the entire Dental Profession; however, Registered Dental Hygienists are the first line of defense in the prevention of tooth decay and periodontal disease, as we provide the most important aspect of preventive care in the patient’s oral health regimen. 

Registered Dental Hygienists must meet certain prerequisites of college/university courses taken towards their degree prior to their acceptance into any accredited Dental Hygiene course.  The Dental Hygiene courses are very stringent and structured, and during their two and a half to four year Dental Hygiene course, they must master many facets of oral hygiene, pathology, pharmacology, radiology, and be able to ascertain how patients medical history is associated with medical risks, and the treatment plans prescribed.  Dental Hygiene programs are administered by a number of colleges and universities across the nation under the auspices of the Board of Dentistry.   Combined with the Clinical Exam, the National Board exam, Ethics exam, mandatory continuous learning courses attended each year, countless of articles read and forums that we are involved in each year – will be lost on Dental Assistants that are going to receive minimal training.  The level of education and experience trade-off will surely impact our profession at the detriment of the patient’s oral health care.

Another fact that should be pointed out, in contrast to a few dentists that have suggested their hygienists can perform more periodontal root planning scaling on a daily basis is that the additional strain and damage to the wrists and fingers from the repetitive motions and pronounced angling, will surely cause many Hygienists to quit the profession much earlier than anticipated.  Causing another shortage of Hygienists in the long run and thereby driving the demand up and salaries as well.

I ask the supporters of this crazy idea, would you want to have toe surgery performed by a dentist who had a few hours training by a medical doctor?   How about a root canal performed by a Dental Assistant or Dental Hygienist, that had minimal on the job training?

Many Dentists that I have talked to concerning this issue has stated that it is a bad idea, as it will lead to lower quality patient care and an increase in risk to the patient’s overall oral health, which ultimately may lead to higher incidents of malpractice cases.