Arizona’s Oral Preventive Assistant Debate: Expanding Access or Lowering the Bar?

Arizona’s effort to address ongoing dental workforce shortages has placed the newly created role of oral preventive assistant (OPA) at the center of a growing policy debate. Originally established under Senate Bill 1124 and signed into law in April 2025, the OPA role allows dental assistants to perform limited preventive services, including supragingival scaling and polishing, after completing 120 hours of board-approved training. The intent was to expand access to basic dental care, particularly in rural and underserved communities.

However, new proposals now under discussion, including House Bill 2326, seek to further reduce or restructure these requirements, prompting strong opposition from organized dental hygiene groups. The Arizona Dental Hygienists’ Association (AzDHA) argues that the Arizona Board of Dentistry is moving to weaken safeguards that were carefully negotiated with the Arizona Dental Association during the creation of the role.

One proposed revision would reduce required hands-on clinical training from 120 hours to just 30 hours, replacing the remaining 90 hours with didactic instruction. Another change would expand eligibility pathways, allowing dental assistants to qualify through private post-secondary educational programs rather than accredited dental assisting programs or national board certification. Opponents argue that these changes erode quality controls and open the door to underprepared providers performing procedures that require advanced clinical judgment.

Dental hygienists point out that traditional hygiene programs require close to 3,000 hours of education and clinical training, including extensive instruction in periodontal assessment and disease recognition. While OPAs are limited to treating “healthy” patients or those with gingivitis, critics warn that missed subgingival calculus or early periodontal diseases could lead to delayed diagnosis, worsening oral health outcomes, and increased liability for practices.

Supporters of the legislation counter that OPAs are not intended to replace dental hygienists but to complement existing teams. By delegating routine preventive care, dentists and dental hygienists can focus on more complex treatment needs. The Arizona Dental Association has emphasized that workforce shortages have persisted for more than a decade and were intensified by the pandemic, making alternative care models increasingly necessary.

Similar roles already exist in other states, including Kansas and Illinois, and Missouri launched an OPA pilot program in late 2024. Still, Arizona’s proposed reductions in training requirements have made this iteration particularly contentious.

As lawmakers weigh access against accountability, the debate highlights a central question facing dentistry nationwide: how to expand care delivery without compromising patient safety or professional standards.