As a practicing Registered Dental Hygienist for 46 years, I must express extreme concern for the proposal to allow Dental Assistants to perform supragingival scaling procedures. While supragingival calculus is unattractive and irritating, the real danger to our patient’s periodontal health is subgingival calculus and virtually every adult patient has subgingival deposits as do countless children. 

 

There are some serious questions here that need to be answered. Since most patients do have subgingival calculus, how many patients with only supragingival calculus would be left for the Dental Assistant II to treat? Who would first determine whether a patient had any subgingival calculus? Would it be the dentist who would be providing the “direct supervision”? How long before a DA II would decide (without adequate training) that he/she was qualified to begin to scale subgingivally? 

 

As to “direct supervision” – ah, the very idea is worrisome. Most dentists I know have precious little time for anything approaching direct supervision. An inadequate, incomplete “cleaning” will promote disease of the gingival tissues and, consequently, lead to inflammation throughout the body. This inflammation can lead to increased cardiovascular risk factors and compromised overall health.

 

The population of Virginia deserves your protection. Isn’t the mission of the Virginia Board of Dentistry the delivery of safe and competent health care by licensed, qualified health care professionals? Supragingival scaling is not competent health care. It is at best a compromise to provide inadequate care to some who have little care; at worst it is malpractice.

 

Licensed, skilled, well-educated, professional Dental Hygienists are already trained to provide optimum care for patients.  They are passionate about their profession and understand their responsibility to the citizens of Virginia. They know that continuing education is necessary and the constant upgrading of their skills is essential. Dental Hygienists embrace these opportunities for improvement.

 

If Dental Hygienists are in short supply, the answer is to provide schools to educate more Dental Hygienists, not compromise Virginia’s standards. Please do not allow minimally trained personnel to provide substandard care. Vote no to DA II scaling.