The Fight Over Expanded Practice for Dental Assistants Moves to Nevada
As more states consider adding the American Dental Association’s “oral preventive assistant,” dental hygienists assert patient care will suffer and suggest moving the profession toward self-governance.
The Nevada legislature is again considering a change to Nevada Administrative Code 631.220 that would allow dental assistants to perform some scaling procedures, which is currently under the purview of dental hygienists. A similar piece of legislation, Senate Bill 495, was shot down in March 2025 when dental hygienists and patients alike opposed it.
The American Dental Association asserts that allowing dental assistants, who would undergo additional training, to provide scaling to patients would help dental practices across the state address a decline in the number of licensed dental hygienists.
The changes to the code were suggested by the Nevada Dental Association, and they are similar to other states, including Missouri and Arizona, that are considering the addition of the “oral preventive assistant” (OPA).
The OPA is designed as an expanded-function dental assistant with additional education and clinical training in preventive care. The OPA model generally focuses on limited preventive procedures performed under specified levels of dentist or dental hygienist supervision. The goal is to add another member to the dental team who can provide basic preventive services while allowing dental hygienists and dentists to concentrate on patients with more complex needs.
The proposal has met strong opposition from organized dental hygiene. The American Dental Hygienists’ Association (ADHA) has stated that it strongly opposes the OPA model, arguing that dental hygiene procedures should be performed by qualified, licensed professionals who have completed established educational and competency requirements. The Nevada Dental Hygienists’ Association (NDHA) likewise has made advancing dental hygiene practice and pursuing self-regulation key objectives of the organization. On August 18, the ADHA published a white paper “Dental Hygiene Governance: An Ethical and Economic Imperative” that calls for dental hygiene self-governance.
The issue has become particularly relevant as dental boards consider expanding the duties of dental assistants. From the perspective of organized dental hygiene, the concern extends beyond the OPA model itself. Dental hygienists argue that decisions affecting dental hygiene education, licensure, and scope of practice should be made by regulators with appropriate dental hygiene expertise rather than by boards dominated by another profession.
