As a dental hygienist in private practice, it is concerning that scaling may be allowed by an assistant who is not fully trained in the use of scalers.  Even with two full years of training, a new hygienist needs more practice to feel confident in their use.  The possibility for gingival damage is highly likely with less training.  Many patients exhibit multiple stages of gum disease in their mouths - if someone has healthy tissue in the anteriors, but gingivitis in the posteriors, how would that be handled?

There is also the need to have a good background in pharmacology.  With the complicated medical histories we see today, a solid knowledge of drug interactions is critical.  Training in oral pathology is another critical area - how can signs of oral cancer be detected by someone who is not educated in the signs? 

I would urge the state of Virginia to avoid creating this undertrained position.  Patient care is likely to be compromised.  It is unlikely that a currently underserved population will benefit.  The underserved often have advanced dental needs, not just a little calculus.  Please do not lower the standard of care that dentistry can provide by adding this position.

Respectfully,

Karen Siebert, RDH, BS