I oppose delegating scaling duties to the "DAII".  Lowering the education requirements will compromise the standard and quality of care.

   Hygienists are rigorously educated in the early detection and prevention of periodontal disease and other oral health issues.  As hygienists scale teeth they are also assessing the periodontal and oral health of their patients.  Bleeding, bone loss, recession, exudate, pocket depths, dry mouth, faulty interproximal or subgingival margins, furcation involvement, subgingival decay as well as other concerns are addressed.  With early intervention we can prevent or diminish serious periodontal problems, but this takes knowledge of the process, commitment, refined skills and much practice.

  Proper supervision of the "DAII" performing scaling duties would require a much higher level of supervision.  This would be difficult to implement, time consuming, and defeat the purpose.  The increased time needed to adequately supervise this minimally educated position would potentially decrease the population adequately served.

  Not only do we risk the the patients' oral and periodontal health but there are other health risks involved as well.  There are well documented links to other diseases such as heart disease and diabetes.

  Virginia enjoys a rich legacy of excellence in both in both medicine and dentistry.  Let us maintain our current high standards of quality care.  We need to insure that  when a citizen of  the Commonwealth receives dental services he can continue to expect quality care.

  Let us not undermine what we have worked so hard to achieve.