I am writing as an experienced dental hygienist who has spent my career focused on providing high-quality, patient-centered care.

My concern about permitting dental assistants to perform supragingival scaling is not about protecting a professional title or territory. It is about protecting the patient and the standard of care that patient reasonably believes he or she is receiving.

Scaling is not simply the mechanical removal of visible calculus. A well-educated dental hygienist is continually assessing what we see, feel and hear throughout an appointment. We recognize changes in periodontal health, inflammation, bleeding, recession, deposits that extend below the gingival margin, abnormalities in the oral tissues, and other findings that may indicate a need for further evaluation. That education and clinical judgment are integral to the care—not incidental to it.

I understand the very real workforce and access challenges facing dental practices. But solving a workforce problem by transferring clinical procedures to personnel with substantially less education and clinical training risks lowering the standard of care rather than solving the underlying problem.

It also creates an important concern for patients: Will patients clearly understand who is providing their care, that person’s level of education and training, and the limitations of the procedure being performed? A patient who schedules what they understand to be a preventive dental hygiene appointment should not unknowingly receive a fragmented or lesser level of clinical care.

There are also practical questions about what happens when supragingival calculus is removed but disease or subgingival deposits are present. Who identifies that distinction, at what point in the appointment, and what safeguards ensure that disease is not missed or treatment delayed?

I respectfully urge the Board to consider not only whether an assistant can be trained to operate a hand or ultrasonic scaler, but whether separating that task from the education, assessment skills and clinical judgment of a licensed dental hygienist ultimately serves the patient.

Access to care matters. Workforce shortages matter. But patient safety, informed consent and maintaining a high standard of oral healthcare must remain the priority.

Thank you for considering the perspective of those of us who have spent our careers caring for patients chairside.

Anita Sirianni