As a licensed dental hygienist practicing in Arizona for 24 years, I wrote this article in response to Erin Hendricks’ article about my state’s recently passed Oral Prevention Assistant (OPA) bill, which is intended to address workforce shortages. While the author compares the OPA model to the United States Air Force’s Prevention Technician Program, upon closer examination, the analogy breaks down.
The military model operates in a uniquely contained and controlled environment, with the primary goal of ensuring personnel are ready for deployment, rather than providing long-term preventive care or comprehensive oral health management. Military dental clinics serve a captive population, with no choice of healthcare provider, and operate in a fundamentally different system than civilian healthcare facilities. To draw comparisons between the two is to ignore the complex clinical realities and patient autonomy of Arizona dentistry.
In fact, Arizona SB 1124 was never compared to the military model during the legislative process. The bill does not appear to be derived from the Air Force model, and its structure is strikingly similar to a policy outline released by the American Legislative Exchange Council (ALEC) in December 2024—one that appears to prioritize personnel convenience over clinical integrity. While addressing the dental workforce shortage is critical, it must not come at the expense of patient safety, quality of care, or the rigorous professional standards that the dental hygiene industry has long upheld.
One of the most pressing concerns for dental professionals is the scope of practice assigned to dental assistants (OPAs). The bill allows OPAs to perform supragingival scaling and polishing. However, even for periodontally healthy patients, effective prevention often requires subgingival scaling to remove calculus and biofilm—key factors in preventing periodontal disease. By omitting subgingival instrumentation, the scope of practice for OPAs may result in incomplete and clinically ineffective preventive care.
The disparity in education requirements is equally concerning. Licensed dental hygienists (OPAs) receive approximately 120 hours of instruction, a fraction of the nearly 3,000 hours of academic and clinical education required of licensed dental hygienists. Dental hygienist programs are designed to develop precise instrumentation skills, critical thinking, and a deep understanding of systemic health conditions that impact oral care.
Courses in biology, chemistry, microbiology, anatomy, physiology, morphology, periodontology, pharmacology, pathology, radiology, jurisprudence, and infection control enable dental hygienists to review a thorough medical history, identify risk factors, and tailor treatment accordingly—all of which are essential for safe and effective patient care. And only after completing the required curriculum can students demonstrate competency through national and state board examinations.
The idea that limited training and scope of services are sufficient to replace the comprehensive preventive care provided by licensed dental hygienists is deeply troubling. Such a shift could lower the standard of care and mislead patients about the quality of care they are receiving.
Arizona patients deserve comprehensive, evidence-based, and preventive oral health care provided by well-trained professionals. While innovative solutions to the workforce shortage are worth exploring, they must be implemented responsibly and with the health and safety of patients at the forefront. I urge policymakers, the dental profession, and the public to carefully evaluate the long-term impact of this legislation and advocate for standards that protect the health, dignity, and trust of every Arizona patient.
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