DHAW stands watch over the nation’s dental hygiene landscape and collaborates with RDHs in impacted states to share insights and strategy in safeguarding educational and practice standards.

Across the country, coordinated efforts are underway to redefine who may deliver preventive dental services and under what level of education and oversight. These proposals vary by state but share a common theme: reducing formal education requirements for procedures historically performed by licensed dental hygienists. Interstate Dentist and Dental Hygienist Compact continues to be heard. Dental Therapy is also on the legislative agenda.

• In Montana (2023), assistants performing subgingival scaling were decisively defeated. Success came through public education, strong grassroots engagement, and clear messaging about patient safety — emphasizing sharp instruments under tender gum tissue and questioning whether abbreviated training could ensure competency.

  
  

• In contrast, Kansas (1998) authorized supragingival scaling assistants, though little published data exists regarding long-term outcomes. Illinois permits scaling assistants to treat patients age 17 and younger.

• Arizona (2025) passed an Oral Preventive Assistant (OPA) bill after negotiation secured guardrails within the statute before final passage last year. However, legislation introduced in 2026 seeks to weaken the educational standards (reducing hours of training and no restriction of education to institutions accredited by CODA). AZDHA compact billis being opposed by the AZDA and is not likely to be heard.

• Missouri Dental Association completed an OPA pilot project  and is pursuing permanent legislation, citing project data. The Missouri Dental Hygienists’ Association has raised concerns regarding the validity and potential bias of those findings and opposes legislation     formalization of the OPA. MDHA has advanced the interstate compact resoundingly through their House and on to the Senate. 

  
  

• Meanwhile, several states — including Georgia, North Carolina, South Carolina, Texas, Iowa, Indiana, and Nebraska — have signaled interest in pursuing OPA legislation, preceptorship-style models such as the Alabama Dental Hygiene Program (ADHP), or FTD pathways.

• Massachusetts (2024) enacted an FTD pathway requiring successful completion of board examinations. Florida, which has long permitted FTD licensure, has advanced Dental Therapy legislation through its House and into the Senate.

  
  

• OK and MO also have compact bills this session. WV and AZ are facing bills that would prohibit addition of fluoride to community water systems, thus removing this decision from the community that a water system serves.

• On the West Coast, California is considering a pilot program to allow Expanded Function Dental Assistants to administer local anesthetic — authority currently permitted in Oregon and Minnesota.

  
  

DHAW remains connected to hygienists across affected states — sharing intelligence, examining legislative language, evaluating pilot project claims, refining public messaging, and strengthening coordinated advocacy. We learn from both victories and setbacks, ensuring Washington remains informed and prepared.

Note: There are rumors and confusion that ADA no longer supports the Dentist and Dental Hygiene Compact. ADA pulled major financial support for the compact from their budget as they struggle to balance recent financial distress; they have not changed their verbal support of the compact.

Update provided by: Paige Seaborg, BS, RDH

Paige Seaborg, BS, RDH, is a retired Washington State dental hygienist with 46 years of clinical experience, involvement in dental hygiene–related advocacy, and service as a board member of Dental Hygiene Advocates of Washington