This proposal is wrong for all parties: patients, assistants, hygienists and doctors.  Foremost, it is dishonest to patients.  As consumers of dental insurance, we work hard to be able to afford our premiums and expect professional service when we go for dental visits.  If patients found out that a "trained" assistance versus a licensed hygienist were doing the cleaning - many would seek their dental care elsewhere (bad for the practice overall).  If patients are not told - they are receiving inadequate care that could lead to future dental problems - again, costly to the patients in the long run.  We are not trying to take away from the important role dental assistants hold in the overall care of patients, but we also do not want to take away from the education and training that hygienists must complete in order to receive their degree and do their job.  We have not seen practices that require hygienists to assist with root canals, fillings, etc.  - so why should we see practices that allow assistants to do a hygienist's job?