ADA reaffirms support for Nevada proposal to expand dental assistant duties
The ADA is reaffirming its support for a Nevada proposal that would allow properly trained dental assistants to perform certain scaling duties, telling the Nevada State Board of Dental Examiners that the measure is consistent with longstanding ADA policy and recent developments in other states.
In a July follow-up letter to the board, the ADA reiterated its strong support for proposed changes to Nevada Administrative Code 631.220, building on comments it submitted in April backing the Nevada Dental Association’s oral preventive assistant proposal.
“We believe the Nevada Dental Association’s proposal before this board to be thorough, well-researched, and responsive to the needs of patients and providers in Nevada,” the ADA wrote. “Still further, this proposal is consistent with ADA policy dating back to 1996.”
The ADA told the board that additional states have continued moving forward with similar workforce models since its April comments. According to the letter, the Missouri Dental Board voted in May to promulgate a rule creating a periodontal expanded-function dental assistant following review of the state’s oral preventive assistant pilot program. The ADA also noted that two Arizona schools have announced plans to begin enrolling students in oral preventive assistant training programs this fall and that, as of July 1, Virginia’s law allowing trained dental assistants to perform supragingival scaling and coronal polishing has taken effect.
The letter also addressed recent public misinformation of the Nevada proposal.
“Recent public statements opposing the proposal before the board, suggesting that minimally-trained assistants would be allowed to perform procedures inappropriately, are inconsistent with similar laws passed in Arizona and Virginia, and with the curriculum developed by the Missouri Dental Association for the successful pilot in that state,” the ADA wrote.
The association added that those statements are inconsistent with the Nevada Dental Association’s proposal, which it said “is in-line with actions taken in other states and, we are confident, will safely benefit Nevadans seeking care.”
The ADA also reaffirmed its longstanding position that “state boards of dentistry in each state, territory, or jurisdiction of the United States are the sole licensure and regulating authorities for all dentists and allied dental personnel,” adding that it believes state boards are “appropriately attentive to any patient safety concerns that come before them.”
“After reviewing the Nevada Dental Association’s survey results and hearing firsthand the anecdotal evidence of a shortage from many fellow dentists, the extent of Nevada’s dental hygiene workforce shortage is clear,” said Nevada State Board of Dental Examiners President Ronald West, D.M.D. “Seven out of 10 dentists report that the shortage has contributed to longer patient wait times, while nearly half of the dental offices surveyed reported at least one vacant dental hygiene position.”
Dr. West said Nevada has experienced an approximately 20% decline in the number of licensed dental hygienists since 2020 while the number of dentists has remained steady and gradually increased. He said the state’s existing dental hygiene education programs cannot currently produce enough graduates to meet workforce demand and called on educational leaders, policymakers and industry stakeholders to pursue long-term solutions to strengthen the dental hygiene workforce.
Nevada Dental Association President Aimee Abittan, D.M.D., said the organization has been working for several years to address what she described as a growing workforce crisis.
“As an association, we have been working to address the critical shortage of dental hygienists for several years,” Dr. Abittan said. “This is one of the most challenging and urgent issues facing our members, and the shortage continues to deepen both in our state and across the country.”
According to Dr. Abittan, the board’s review found Nevada has only 0.8 dental hygienists for every general dentist, well below what the association considers an ideal ratio, and the state's educational pipeline is not producing enough graduates to meet demand.
"In response, we proposed a model similar to the Oral Preventive Assistant (OPA) programs operating in Arizona, Kansas, Missouri, and Illinois," Dr. Abittan said. "Our goal is to create an auxiliary role that acts as a force multiplier for our dental hygienists, allowing them to focus their time and expertise where they are needed most: treating periodontal disease."
She added that the proposal incorporates patient safeguards and is based on models already in use elsewhere.
“We are pursuing the safest model we can find. In the states that have enacted OPAs, there have been zero reports of adverse effects. A pilot study from Missouri also had no incidents, injuries, nor patient complaints. We simply cannot carry on with the status quo,” she said. “Our dental practices are grossly understaffed, and we must find solutions to meet the needs of our patients.”
