❌ Virginia Dental Hygiene Association (VDHA) Myth: Virginia's primary challenge is retention. Few hygienists remain in, or return to, high-stress, unsupportive work settings- conditions that jeopardize clinician well-being and patient care.

✅ Facts: Dental hygiene is an in-demand, high-wage career.

Compared with nurses, dental hygienists in Virginia earn a higher median hourly wage, are less likely to carry educational debt, are twice as likely to have an associate degree as their highest level of educational attainment, are more likely to work fewer hours per week, and are less likely to be involuntarily unemployed.[1] 

A typical dental hygienist works 30-39 hours a week, treats 6-8 patients in a day of work, and spends more than 90 percent of their time at work in direct patient care and less than 10% percent of their time in administrative work.[2]

95 percent of Virginia hygienists report in their annual state licensure survey being satisfied or very satisfied with their current place of work.[3]

❌ VDHA Myth: Hygienists report poor working conditions, lack of full-time benefits, and stagnant wages over the past five years.

✅ Facts: 95 percent of Virginia hygienists report in their annual state licensure survey being satisfied or very satisfied with their current place of work.[4]

Dental hygienists earn the highest hourly wage of any healthcare profession attainable with a two-year associate’s degree, with an annual median income of $98,880.[5]

Three-quarters of Virginia hygienists report receiving employer-sponsored benefits, which exceeds the population of hygienists who choose to work in one full-time position (56 percent).[1] 

❌ VDHA Myth: 5,306 hygienists are practicing in Virginia; 1,057 are inactive. Approximately 1,000 hygienists are needed to close the access gap. This gap can be narrowed most efficiently by improving retention and re-engaging inactive, fully qualified hygienists.

✅ Facts: This statement is misleading. Of those 1,057 hygienists who maintain a Virginia license but aren’t part of the Virginia workforce, most are practicing as hygienists in other states or in the military/federal government.[1]

Only 122 of those 1,057 reported being voluntarily unemployed, and 107 reported being retired. Seven hygienists out of a workforce of 5,306 reported being involuntarily unemployed. 

The growing hygienist workforce gap has been created by the limited educational pathways to enter into the dental hygiene profession, which are insufficient to meet student, employer or patient demand. 

❌ VDHA Myth: These bills do not address the gap in the dental hygiene workforce because they will not produce any new licensed dental hygienists and could drive licensed hygienists out of the market.

✅ Facts: These bills will allow a pathway for internationally educated dentists to become licensed to practice dental hygiene. Many of those professionals are currently working in dental practices in roles that only utilize a small portion of their professional education. 

This pathway to licensure could also help address challenges in recruiting faculty at Virginia’s existing dental hygiene education programs. 

A decade after a similar role for dental assistants was created in Kansas, the state commissioned a performance audit to understand the impact on access to care and other dental professions. They found that placement rates of graduates of dental hygiene education programs, "haven’t been affected by the existence of dental scaling assistants.”[6] 

❌ VDHA Myth:  Dentists who graduate from dental schools outside the United States have a highly variable global preparation, creating regulatory inconsistency; Commission on Dental Accreditation (CODA) accredited pathways remain the defensible route for role integration. As written, SB282 / HB1036 is missing (CODA) accredited education to bring these dentists up to the US standards of care.

✅ Facts: Dental education is variable in other countries, and many other countries combine the roles of a dentist and dental hygienist in patient care, resulting in dentists with a broad scope of preventive clinical experience. That’s why SB272 /HB1036 allows the Virginia Board of Dentistry discretion to review the educational credentials of applicants as well as requires successful passage of a clinical skills exam as part of an application for licensure. 

❌ VDHA Myth:  SB178 / HB970 "Preventative dental assistant" or "Scaling assistant" concept promotes supra-gingival-only (partial scaling) debridement that is inconsistent with safety/quality norms and risks miscoding/misrepresentation, and potential False Claims Act exposure.

✅ Facts: Other states, including Illinois[7] and Kansas[8], have permitted dental assistants to perform these functions, and they have decades of experience in the Indian Health Service[9] and the military[10]. Dental assistants can only perform this limited scaling procedure under the direct supervision of a dentist. 

Performing this limited dental procedure under direction as part of a dental care team allows dentists and dental hygienists to provide patient care at the top of their licenses. A Johns Hopkins study of a similar role in the Indian Health Service found, that it elevated the care provided by hygienists and dentists, noting, “Programs with periodontal EFDAs showed an increase in periodontal procedures typically performed by dental hygienists and dentists, presumably because periodontal EFDAs were providing more basic services to allow more time for dental hygienists and dentists to perform these advanced services.”[11]

With respect to patient safety, an 8-month IRB-approved study of a similar role in Missouri found no adverse events nor any patient complaints among 1,626 patient visits with dental assistants providing preventive care.[12]

Where we agree: The VDHA says, “Every patient deserves care from a licensed, educated, and accountable provider.”

Under this legislation, every patient receiving a regular dental checkup will receive care from a licensed, educated, and accountable provider. The proposed legislation allows one of the safest procedures that are part of that dental checkup to be delegated under supervision to appropriately educated, experienced dental professionals so that more Virginians can have access to essential dental care. 

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