I am graduated of West Virginia University,  I have practice as hygienist for over 8 yrs.  I have practice in different states.  one of the states I have pratice in  wasPa where expanded assistance went to school for 1-2 yrs , but  the program did not allow any type of scaling , they were train after the  dentist prep the the tooth they were allow to place filling materials., to help the dentist out.   When, I moved to VA  i was so shock that  denal assistance were allow clean childrens' teeth.   After reading the comment , i realize that  almost a lot dentist going say  to yes to dental assistance they are not look out for the best  interest of the pt.  I am afraid dentist would  choose a cost factor, they could pay assistance at lower rate than hygienist , then we will have problem that dentist would rather hired assistance than hygienist.  In northern virginia not really a hygienist shortage.  "Please Board member just image you are the patient in chair instead  of having a train hygienist( who went to college for 2yrs or more)  doing your rountine cleaning having untrain dental assistance placing a scaler in your mouth going underneath your gums.":