The issue of expanding Dental Assistant II duties to include supragingival scaling is a delicate matter and not to be taken lightly by any parties involved: dentists, dental hygienists, dental assistants, and the most importantly the patient.  There are many variables to consider.  As a dental hygienist I analyze periodontium with medical, clinical, radiographic, nutritional, and social factors revealed via the patient assessment to provide a dental hygiene diagnosis.  This DH Dx ultimately allows us to provide oral hygiene instruction, implement treatment, and provide evaluation for the patient.  Many patients present with at least gingivitis-think of the adolescent who rarely flosses or the pregnant mother with bleeding gums or even your regular recall patient who may have localized gingivitis.  These persons need an individual who can take all the data presented and use it to provide the best care for the patient.  This includes what kind of instruments should be used, keeping instruments correctly sharpened to provide the most efficient scaling for operator and patient comfort, analyzing the teeth and surrounding tissues to bring to the attention to the patient as well as the attending dentists any concerns.  Simply providing supragingival scaling does not entail these responsibilities.  I understand the DA II will be attending an accredited DA program and completing a certain amount of training but this particular expanded duty will only address the supragingival calculus involved and not the patient needs.  A patient who comes to a dental office expects a certain standard of care.  Will they be told they are not having a RDH perform the services?  Will the dentists perform perio evaluation initially and then provide OHI?  I feel there may be patients who walk away with false assumptions of their "teeth being clean" when the issue is the health of their gingiva and the health of their teeth and body in relation to their gingiva.  I do believe there are access to care issues.  I feel more incentives for RDHs to provide services to decreased access to care populations or increased dental hygiene programs might be great alternatives but expanded duty supragingival scaling by DA II is not the answer. 

P.S.  Reducing operating costs while increasing a practice's profitability only lowers standard of care and ultimately the patient suffers. If you ask me we are heading in the wrong direction.