For years, dental assistants have worked on the frontlines of patient care—polishing teeth, taking radiographs, assisting with procedures, and helping practices run smoothly. But a recent move by the American Dental Association (ADA) could redefine our roles entirely: the ADA now supports allowing qualified dental assistants to perform scaling procedures.
This announcement, backed by new legislation and pilot programs in multiple states, is more than just policy talk. It’s the beginning of a career evolution for thousands of dental assistants across the country. If you're passionate about growing in your role, expanding your skills, and contributing to accessible oral care, keep reading—this could impact your future in a major way.
What’s Happening? ADA Endorses Dental Assistants Performing Scaling
In April 2025, the ADA endorsed a legislative model known as the Dental Access Model Act. This initiative supports the creation of a new mid-level provider role—called the Oral Preventive Assistant (OPA)—which would allow dental assistants to perform certain preventive services, including scaling and plaque removal, under the supervision of a dentist or dental hygienist.
The idea is simple: if dental assistants are trained and certified to perform these services safely, they can help fill critical care gaps in communities struggling with staffing shortages—especially in rural and underserved areas.
Arizona Becomes the First to Pass It Into Law
Arizona made history in April 2025 by passing Senate Bill 1124, officially creating the Oral Preventive Assistant (OPA) certification. Under this law, dental assistants in Arizona who complete state-approved training are allowed to:
- Remove plaque and stains using hand or ultrasonic scalers
- Work on patients with healthy gums or mild gingivitis
- Perform these duties under the direct supervision of a dentist or hygienist
This is a big deal. For the first time, dental assistants in Arizona can legally perform scaling—an opportunity that was previously out of reach.
The Requirements to Become an OPA in Arizona
To qualify for this new role, dental assistants must:
- Complete at least 120 hours of board-approved instruction
- Be certified in CPR, coronal polishing, and radiography
- Either hold national DANB certification or have graduated from a CODA-accredited dental assisting program
The training ensures assistants are fully prepared to provide safe, effective preventive care.
Why the ADA Is Pushing for This Change
So why is the ADA supporting this change now?
The dental industry is facing serious workforce shortages—especially among dental hygienists. Many practices are struggling to meet demand for preventive care, which directly impacts patient outcomes. By training and certifying dental assistants to take on additional duties, the ADA believes we can:
- Expand access to preventive care for more patients
- Support dental teams in busy or understaffed practices
- Create new career pathways for hardworking assistants
It’s part of a larger vision to strengthen the dental workforce and reduce the number of patients who go without basic preventive services.
Not Everyone Supports the Change: ADHA Voices Opposition
While many dental assistants are celebrating this advancement, not everyone agrees with the ADA's proposal. The American Dental Hygienists’ Association (ADHA) has come out strongly against it, citing concerns over:
- Patient safety
- The complexity of scaling procedures
- The need for more extensive training and clinical experience
The ADHA argues that scaling is a core skill of hygienists, who spend years mastering it through in-depth coursework and clinical rotations. They worry that fast-tracked training programs for assistants could compromise care quality.
This opposition has sparked debate within the dental field—and may slow adoption in some states.
What Other States Are Doing
Arizona may be the first to pass official legislation, but they’re not alone. Several states are exploring similar changes:
- Kansas and Illinois allow dental assistants to perform limited scaling tasks, particularly for pediatric Medicaid patients.
- Missouri launched a pilot program in 2024 to test the impact of OPAs in real-world clinical settings.
- Other states, like Texas and Georgia, are reportedly considering similar legislation in 2025.
This is not a one-off event. It’s a national movement, and more opportunities may be coming your way soon.
What This Means for Your Career
If you're a dental assistant, this is your moment. Whether or not you live in Arizona, it's time to start thinking about how you want to grow in your role.
Here’s how scaling privileges can benefit you:
- Career advancement: You’ll be able to take on new, higher-level responsibilities.
- Increased earning potential: With more duties comes the possibility of better compensation.
- More job opportunities: Practices in need of preventive care support may start looking specifically for certified OPAs.
- Greater impact: You’ll help more patients stay healthy by expanding access to preventive care.
What You Can Do Next
Whether your state has passed legislation or not, here are a few smart moves to prepare for what’s ahead:
1. Stay Informed
Follow updates from your state dental board, the ADA, and professional networks like Dental Assistants ROCK or the Dental Assistants Network. Changes may be coming faster than you think.
2. Start Building Your Skills
Even before laws pass in your state, you can begin building a strong foundation in:
- Infection control
- Coronal polishing
- Radiography
- Continuing education in preventive care
These credentials may be required in future training programs.
3. Talk to Your Employer
Bring the topic up at your next team meeting. Ask your dentist if they’re aware of the changes happening in other states and whether they’d support your professional development if similar laws pass in your area.
4. Join the Movement
Be part of the national conversation. Share your thoughts, ask questions, and support fellow dental assistants as we navigate this exciting shift together.
Final Thoughts: A New Era for Dental Assistants
The ADA’s support for scaling privileges represents a major shift in how the dental field values and utilizes dental assistants. For too long, assistants have been under-recognized despite being the backbone of the operatory.
Now, with proper training and certification, we’re being invited to play a bigger role in patient care—and that’s something to celebrate.
Change takes time, and there will be debate. But if this movement continues, the future of dental assisting is looking brighter, more respected, and more rewarding than ever before.
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Don’t foolishly think DA will be fairly compensated. The ADA supports this because dentists want to bill prophies out without paying an educated, licensed hygienist wage. This article failed to review the prerequisites and college degree that has been the standard to become a hygienist-because it’s never just cleaning teeth above the gum line. Never. There is a dentist shortage. Will the ADA advocate fast-tracking foreign trained dentists to practice in the US ans an dentist and removing the education/degree components to become a dentist? Nursing shortage. Shall we removed the college degree there next? Some areas in the US demonstrate access to care, largely due to cost, lack of coverage, poor reimbursements, lack of Medicaid providers. Address those rare regions in the US. Do not lower educational standards across the entire country. Attend a CODA-accredited dental hygiene program if you wish to expand your career. DAs will never be valued appropriately for providing supragingival care. They will be taken advantage if, as typical, and periodontal disease progression will develop in the public because this policy will be abused and corners will be cut. I have not spoken to a single DA who wants this added to their plethora of demanding duties. Can you imagine the loss of revenue if a dentist needs to cease their scheduled procedures to train, scale subgingival on each patient…(yes, pedo needs subgingival instrumentation 90% of the time!), perio stage and grade adults, intra/extra oral cancer screenings, etc.? They will lose money beyond their wildest dreams. Turnover will continue so they’ll be in “training/supervising” mode endlessly. More likely it will become an “anything goes model” they create when they realize its not working as hoped and perio disease starts catching up to their patients. Hygienists value assistants and admire their versatility in that assisting/restorative role. For those interested in preventative-go to hygiene university/college programs for best patient outcomes and your best respect & compensation from these dentists, corporations, business owners.
ReplyDeleteI have so many days when not a single one of my patients would rightfully qualify to see an OPA, but we all know they will. In the article it says “possibility “ of higher compensation. None of the 5 DA’s I work with would want to do it. Why would they? More responsibility and more back breaking work for a couple more bucks an hour? They say no thanks! Also a lot of hygienists don’t get the respect they deserve, why would this garner any more respect for a DA? Just one more way to take advantage of them because we all know it’s all about the money in the end.
ReplyDeleteThis is just wrong on so many levels. One, assistants have a major staffing shortage and are overworked as it is!!! They have so many responsibilities within the office the last thing they need added onto to them is this task. Sweet Jesus stop piling on more work. They work their butts off on the restorative side, add in stocking rooms, ordering supplies, doing sterile, helping the front, helping hygiene. There is no way dentists will fairly increase salaries to compensate them!!! Two, almost NO patients fall into the category that would allow them to be seen by an OPA. Over 75% of Americans have some form of disease (that requires care from a registered dental hygienist) and even “healthy” mouths have calculus present below the gingival margin that again….requires care from a registered dental hygienist. We need to be concerned about patient safety and long term oral health.
ReplyDeleteAs soon as they passed coronal polishing years ago, dentists began taking advantage of dental assistants by illegally charging out their polishing as prophies. And so it continues, a new generation, a higher level of taking advantage of professional minded dental assistants by putting them in situations they are not qualified for to save a Dr a few bucks. What a shame. I hope the ADAA is not falling for this. I have proudly maintained my CDA for 30+ years and have the utmost respect for dental assisting as a profession. But this does not help dental assistants! Standardized education, qualifications and clear scope of practice would elevate dental assisting across the board. This just adds more confusion and chaos to the what can you do in each state what qualifications do you need endless quagmire that is dental assisting. Dentists aren’t helping you! They are using you, and in the end, patients will suffer, dental assistants will not be any more respected and it won’t really help anyone. As my dental assisting instructor said “if I wanted to scale teeth, I’d go to hygiene school”!
ReplyDeleteI know insurance is the cause for this debacle. My dad was a dentist. I worked for him from the age of 12. At 14 I got my x-ray license through a university. At 16 I sat for the state exams and got my RDA--because I had OTJ training for at least two years. At 18 my coronal polishing certificate. Dad expected near perfection. Of himself and me. I went on to hygiene school and wanted to continue into dentistry. He didn't want to pay for it, but instead of saying so, told me, "I am anxious for you to get on with your life." It didn't take much to discourage me...
ReplyDeleteI've been a hygienist now for 41 years.
It's monotonous.
For "excitement" I start in a different spot of the mouth just to change things up.
I do dental volunteer work to provide purpose to my life.
...and I always elect to be a dental assistant at those free dental clinic events.
Because it offers more variety. I like it. It's not so hard on my hands, shoulder and arm. And, I just like it!
If an assistant wants to pursue this OPA role I have a few pointers. Take these as genuine recommendations to make your additional responsibilities easier (as if you don't have enough on your shoulders already).
1. Disclose first. Use 2-Tone. This will help you *see* where you need to polish well..
2. Polish *FIRST* and do it with coarse polishing paste. Use GENEROUS amounts of it, and with intermittent pressure, lifting up and down to get more paste into the cup.
3. As you polish, push the paste aggressively into the embrasures, forcing it under the papilla. You will see plaque ooze out the other side if you are doing the facials first. Don't be a whimpy polisher. Really work on the interproximal areas.
4. Polish *right over the calculus.* There is always live plaque on the dead, hardened calculus, and it's acting like Post-it glue to keep it tenacious. So polish that gunk off, really well, and Voila! the calculus will become brittle, popping off more easily.
5. Floss out the grit from under the gums. It will dull your instruments quickly if you only rinse. Plus, I use the floss to see where open contacts are, and then I check for pockets in that zone. I can feel if there is sub-G calc with the floss. I watch for bleeding. I use it "diagnostically." DO NOT USE GLIDE. It will not "grab" the grit, it will not grab the plaque. It's worthless. Disclose and see what I mean. It literally takes NOTHING off the teeth. Instead, daily use will burnish the plaque onto the teeth. Ugh!
ReplyDelete6. Learn how to sharpen your instruments--well. Do NOT over-angulate the blade, turning the face of the scaler to a 90 degree angle to the stone. Your instrument will never work if you do that. I just corrected SEVERAL scalers at an office I was temping at to day that were WORTHLESS until sharpened.
7. I spent $4,000 on my ergo loupes & light last year. I didn't use them for 12 months, but about 4 times because I didn't realize the lenses could be dialed to focus like binoculars! I took them to convention and learned why I was having problems using them. Today I used them all day...and the ability to see the edge of my scaler get sharper as I was sharpening it was FANTASTIC! Loupes are very pricey, but Amazon has $30 loupes that will help you to a better job--even when you think you don't need them. I read reviews and learned many dentists buy and use them while their own are being repaired. I've also given them out as gifts at my dental clinics in Africa to the hygienists who come to help that live in Kenya. They love them.
8. Use the air-water syringe to dry the teeth you have just scaled to see where you missed. There is going to be stuff show up a chalky white color that you never dreamed you didn't scale off. That's calculus. Scale again, and...
9. then polish one last time. They will be SO CLEAN--patients will LOVE IT!
10. Do not become arrogant. I have people in Africa who are trained as "community oral health officers." They can do simple fillings, dental cleanings, and extractions. They are really good at ext's, do not like to do dental cleanings, and SUCK at any and all dental work!! WHY? Because they are fully trained like dentists are. But they want to be called Clinicians, by George! They strut around like proud peacocks, refusing to help a dentist if he needs assistance, refusing to do hygiene treatment, and even refusing to help each other. The level of ARROGANCE if galling!!!! The DENTISTS however--*never* display such disgusting behavior. They know what they know, and they don't have to stick their chest out and REMIND you they are "CLINICIANS!" Gag.
Don't. Just DON'T. Don't be like that if you get the training as an OAP. Just do your job, be helpful where needed, and never forget it's about the patients.
**Correction**. Point #10 "....Because they are NOT fully trained like dentists are."
ReplyDelete