It is beyond comprehension and perplexing as an educator and periodontal practice RDH, that any laws have already been passed to jeopardize the comprehensive care and SAFETY to unknowing Virginia patients.

The dental exam after a dental cleaning is less than 5 minutes. Most ethical Drs ask their RDH's their assessment findings prior to examining the patient. This shared information is critical to proper diagnosis and treatment planning as well as medical considerations. How is a dentist going "to train" an OAP to perio chart, take a concise medical history, evaluate medications for possible treatment interactions, provide home care solutions, scale, and use an ultrasonic "properly" to cause no harm to patients? There will be potential legal implications for the dentist and practice if patients are injured. Misdiagnosed periodontal disease causes tooth loss or chronic disease risk factors. 

With no due disrespect, a General Practice Dentist does not have the formal training and or  education to teach an uneducated, unskilled, staff member to scale. Most dental schools provide a brief overview of SRP for 2 weeks. To further hone periodontal skills, an interested dental student completes a periodontal residency which would enable them to properly teach students. I have worked for many Drs who refuse to do dental prophylaxis due to their inability to accomplish the same goal standards as a RDH. 

Another monumental issue that has NOT been addressed:  just who is going to remove the  subgingival calculus during an OAP appointment? There is no time during the dental exam and.... it is very rare for a patient to have calculus that is perfectly located supra gingivally that is not engaged with the gingival tissue. Periodontal disease is going to increase and if calculus is not removed properly, it will continue to accumulate making it more difficult and tenacious for the next clinician to remove at future appointments. 

DH students undergo a grueling program. Clinically they have 3,000 hrs prior to graduation. Their critical thinking skills are maximized to be able to address all of the above issues as well as emergencies, dental anxiety and increasing mental illness awareness. 

Expanding dental hygiene programs is only one answer. Providing a professional, supportive, nontoxic, nonbullying, workplace is crucial to retaining staff. The burn out rate of hygienists is high due to these factors as well as the physical implications of repetitive motions, poor ergonomic spaces and operator stools. 

In conclusion, Virginia is better than this. Until more reasonable solutions are explored and implemented, dentists need to continue supporting licensed, educated staff to provide quality care.