As you may know, 2026 legislative sessions are gearing up to push Oral Preventive Assistant (OPA) policy nationwide as a dangerous shortcut to “fix” dental workforce issues.

OPAs are expanded-function dental assistants with minimal training, often receiving unaccredited and substandard education. Some proposals would even allow them to perform dental hygiene procedures like supragingival scaling or pursue an alternative pathway to licensure through on-the-job training. But scaling and dental hygiene licensure require advanced clinical education, critical assessment skills, and accredited training—none of which OPAs receive.

Supporters claim OPAs will improve access to care by “freeing up” hygienists and dentists to focus on more complex cases. But the Missouri OPA pilot—the only one that exists—shows the exact opposite. The study didn’t increase access, didn’t increase appointment volume, didn’t measure patient outcomes, and didn’t track whether gingivitis patients improved. The pilot also raises serious medical and ethical concerns, with objectives, curriculum, and determinations controlled by organized dentistry, which stands to benefit financially from the model.

Bottom line: OPAs are unaccredited, undertrained, and not equivalent to licensed dental hygienists. Allowing them to perform hygiene duties exposes the public to substandard care and undermines the safety and integrity of the dental hygiene profession. If lawmakers want to address access to care challenges, the answer is empowering hygienists to practice at the top of their scope—not creating unqualified providers.

Lawmakers need to hear directly from the hygienists in their communities. These proposals threaten both the profession and patient safety.

Click the link below to participate in the VoterVoice campaign and tell your state legislators to oppose OPA policies and protect safe, evidence-based care.

-ADHA Leaders