Hello, I have been an RDH for over 2 years now and I strongly oppose the new scaling assistant law, and even MORE strongly oppose it without any definitive regulations and curricula! 

I would like to address a few points that have been highlighted in recent discussion. 

# 1: If the dentists need “relief”, and they’re swamped doing hygiene duties, how will they have time to train adequately? Furthermore, if they want actual RDHs as many state they DO, the answer would have been to work in tandem with the VDHA rather than push hygienists out of the conversation, and belittle our profession on public forums. Not only is it distasteful, it also further damages the DDS-RDH relationship, and reinforces reasons there is a “shortage”. No one wants to be belittled and harassed at work, and spoken to like some of the comments speak to us. 

# 2: When hygienists are mistreated and refuse to work for toxic and dangerous offices, there is a shortage of RDHs, and the public is sold on how we’re a rarity. Now that assistants are feeling uncomfortable scaling, now there is a shortage of assistants I’m hearing about. There is not a shortage of either that exists. There is a shortage of ethical offices, and that has nothing to do with pay. I have temped at over a dozen practices before settling full time, and those with ethical, legal and moral standards are not experiencing a “shortage” whatsoever. The answer to not having enough hygienists is communication and ethics. 

# 3: Ultimately, this bill was passed with false promises. They stated the board would develop regulations for these new “scaling assistants” however now the board of dentistry is deciding to be entirely hands off. Essentially the new rules for becoming a scaling assistant consist of whatever the dentist wants!! That is not a uniform standard of care!! I’ve worked with dozens of doctors who will adamantly state “I wasn’t trained in scaling the way hygienists were”. I have often seen SRP patients that were seen on the DDS side come back to me with radiographic sub calc remaining. I have had veterans come to me post-military following care with a DDS and a “prophy tech” and they need SRP treatment and periodontist intervention. Dentists are not hygienists, neither are assistants. We all have critical yet separate roles. I myself can admit, I cannot perform some DA responsibilities as well as my DA friends and colleagues… and you wouldn’t want me to try!! 

# 4: There is a reason when I solely scale above the gums and neglect periodontal charting, sub scaling, etc it’s considered negligence. As dentists you KNOW the dangers of the bacteria that remains under the gum tissue being left untreated. As dental professionals we KNOW there is not a single patient with absolutely no subgingival buildup of some kind. This is a bill rooted in greed and known negligence of the patients.

# 5: Some patients are intensely medically compromised, need thorough homecare instructions, tobacco cessation, nutritional counseling, head and neck cancer screenings, and more. Hygienists need to know standard of care, bloodborne pathogen standards, how to protect themselves when working with patients with AIDS, HIV, Hepatitis, use of aerosols, etc… and you believe in 120 hours you can adequately train to replace the hygienist’s roles in these situations? You’re comfortable with your families seeing these scaling assistants instead of an RDH? Especially when, as it stands now, there’s no formal training requirements beyond a certificate ChatGPT can create in 2 minutes, and be in the building doing whatever the dentist says is necessary? 

# 6: You want hygienists to work for you, but you’re exceptionally quick to post dehumanizing comments about them, ask them to train assistants (who are already overworked and underpaid) with no formal education on how to care for complex patient cases (even the supragingival portion still requires complex dexterity, adaptation and clinical experience not to mention for patients with diabetes and heart issues that will suffer with bacteria left behind), and you want to sell to the public that we are the ones who have left this profession in such distress that everyone must now risk their families seeing an entirely untrained member of staff?

It’s unethical. As a medical provider, you know it is.

Thank you for your time. I beg you to protect patient safety and standard of care. At bare minimum, demand structured and standardized training of the providers you want to place razor sharp instruments in the hands of. 

Respectfully

-Kat, RDH, CTTS