Missouri Dental Hygienists Take Periodontal EFDA Rule to Court

The Missouri Dental Hygienists’ Association (MDHA) has filed a lawsuit against the Missouri Dental Board regarding passage of the Periodontal Expanded Function Dental Assistant (EFDA) rule, which enables dental assistants to perform tasks typically performed by dentists or dental hygienists such as supragingival scaling and periodontal charting. The MDHA strongly opposes Rule 20 CSR 2110-2.120, which passed by a 4-to-3 vote of the Missouri Dental Board on May 14, 2026. The rule was published in the Missouri Register in September, and the public comment period was opened.

The rule was based on a pilot program overseen by the Missouri Dental Board that legislators decided to let expire. The initial program was approved in 2022 by the General Assembly who allowed the law that prohibits dental assistants from performing dentists’ and dental hygienists’ duties to be waived temporarily in an effort to improve access to care. The program expired on August 28, 2026, and was not renewed by the legislature.

Results from the pilot program did not show increased access to care for vulnerable patients. The newly passed rule also allows dental assistants who participated in the pilot program to automatically receive the Periodontal EFDA permit. The rule also does not require that patients be told a dental assistant is performing these duties instead of a dentist or dental hygienist.

The MDHA asserts that the Dental Board has acted outside of its authority by implementing these changes. The lawsuit asks that the rule be deemed invalid and the Dental Board be prevented from granting permits for the Periodontal EFDA. Public comment is currently open through October 15. Click here to read more.