Dear Hygienists:
You are correct. The Oral Preventive Assistant (OPA) is not the answer to the dental hygienist shortage. It is just one of many angles that dentists and dental associations are working on to address this complex issue, and there is no single solution.
The duties of an OPA are wide-ranging, but none of them replace the procedures performed by a dental hygienist. An OPA is only allowed to remove supragingival calculus, and any remaining calculus is removed by the dentist or dental hygienist, while an examination and periodontal record are performed.
The OPA position is intended to supplement the preventive procedures of the dentist or dental hygienist. Each state has its own rules and regulations, but in many states, including Missouri, dental hygienists can also supervise OPAs.
In some cases, OPAs can be used in conjunction with auxiliary dental hygiene, where the dental hygienist has a dedicated OPA who can remove supragingival calculus before the dental hygienist completes the preventive treatment. In areas where dental hygiene is in short supply, two dental hygienists are often employed simultaneously.
I know of many dentists in offices that can only employ one dental hygienist, sometimes only part-time, who performs most or all of the dental hygiene work. This means that urgent care and/or new patient care cannot be scheduled or is delayed for a long time.
Another situation where an OPA may be used is in a pediatric office where it is very expensive or difficult for the office to hire a dental hygienist to perform child-specific preventive care.
The dentist can use the OPA and then explore and remove any remaining subgingival calculus, which is necessary to legally perform preventive care.
Again, in no case does the OPA replace the knowledge and skills of a dental hygienist. The Missouri curriculum was developed by dentists and dental hygienists to ensure technical skills to remove supragingival calculus…that is, calculus you can see, while subgingival calculus is removed by the supervising dentist or dental hygienist.
OPAs do not provide services such as patient-centered oral hygiene instruction, intraoral or extraoral examinations, dietary or caries risk assessments.
In addition, it is a priority for dentists and dental organizations to support the continued funding and potential expansion of dental hygiene programs across the country.
Dentists have always recognized the importance of dental hygienists and have done everything they can to support their development and practice, especially in Missouri where we have just certified dental hygienists to perform local anesthesia under general supervision.
Finally, please know that dentists consider periodontal health to be just as important as caries. We do not consider the dental foundation we restore so unimportant that we replace the education and standards of dental hygienists with those of general dental assistants (OPAs).
I worked as a dental hygienist for nearly 15 years before returning to school to become a dentist. I understand the requirements of dental education, as do many of my dental colleagues, but I have also experienced it firsthand.
I hope that dental hygienists will recognize that the OPA position is a supportive position, not in opposition to the services provided by dental hygienists, and that dental hygienists will see the true benefit to the patient, and that we are all oral health professionals doing our best to provide services.
I hope the above statement will answer your questions and alleviate some of your concerns. If you have any questions, please feel free to contact me or other dentists who support OPA support services. We work together, not against each other, to serve our patients when they need us most.
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