I am opposed to adding scaling of periodontal type I patients by dental assistants.  Although the previous comments include the dentist as doing the diagnosis, who will be doing the full mouth periodontal assessment prior to the diagnosis? 

Dentists do not routinely do full mouth probing with attachment levels nor have the expertise of locating deposits on a regular basis.  These skills are best done by dental hygienists who devote many years to perfecting these skills.  My fear is that patients' periodontal disease may be underevaluated.  Even children have subgingival calculus and periodontal disease beyond type I.

Dentists will not be available to devote time  away from their production and patients to routinely provide the assessment and diagnose necessary to each appointment and to accurately assess disease or health.  In addition these assistants will likely be supervised by a dentist on site who will be expected to check the outcomes.  Who is doing the restorations and crown preparations if the dentist will be busy providing the above?  My guess is that dentists will not be available prior to the treatment.

Removal or debridement of periodontal tissues is not the same as removal of cement from crowns but often involves removal of deposits that are  continuous from the gumline to below the gumline.  Partial removal of deposits may result in serious adverse periodontal infections.   These clinicians need a precise working knowledge of oral anatomy both supra - and subgingivally, advanced instrumentation skills, assessment and treatment planning skills as well as the ability to reevaluate the treatment outcomes. Even in a relatively healthy situation, isolated problems can exist.  This recognition takes time and expertise.

We do not need a robot who can only remove deposits but a clinician who can make decisions about the patients' status and treatment.  The dental hygiene curriculum provides all of this. I have been a dental hygiene educator for 20 years and understand the level of education necessary to provide these services.  No quicky course can prepare the dental assistant to provide for the patients' periodontal needs and protect the public.

I encourage decision-makers to look for ways to improve access to periodontal therapies that do not include this addition.  This is not a wise answer to the problem and has the potential to cause new problems and liabilities.

Jeanne M. Anderson, RDH. BSDH