In the Air Force I developed programs to train dental assistants to scale teeth.  No military patients were ever harmed by allowing trained dental assistants to scale teeth.  I believe that dental assistants in Virginia could be trained to scale teeth. The training program would be shorter than the present Dental Hygiene programs.  This would alleviate the severe shortage of dental hygienists and serve the unmet needs of dental patients in the Commonweatlh and increase ACCESS TO CARE.  Since the average hourly wage of hygienists in Virginia is approaching $50 per hour, it is becoming increasingly difficult to employ them just to treat relatively periodontally healthy patients who just need preventive care like oral hygiene counseling, light scaling and polishing of their teeth.  Dental Assistants with advanced training in scaling could provide these preventive services and prophylaxis much more economically.  Hygienists could then be utilized to provide advanced services to patients with more periodontal needs rather than wasting their talents doing light scaling and prophylaxis.  Current trends on the West Coast include allowing hygienists to use dental lasers and other advanced modalities to treat the more difficult cases.  Some hygienists have been allowed to practice independently (including a friend of mine in Colorado).  I believe that this is the agenda of the national and state hygienist associations and maybe it is time for Virginia to consider this alternative. If hygienists are allowed to set up their own practices, it is even more urgent that Dental Assistant II training be started to replace hygienists in "dentist" practices.