States Begin to Adopt New Dental Assisting Role
There is a growing conversation in the United States about expanding the role of dental assistants in the dental practice, and a new role is being adopted in several states. Oral Preventative Assistants (OPA) are dental assistants trained and authorized to do certain preventative tasks including supragingival scaling and polishing. Typically, OPAs are restricted to practicing in underserved dental settings.
A Brief History of OPAs in the United States
The first introduction of an OPA-like dental team member in the United States dates back to 1977. They were initially introduced by the Indian Health Service (IHS) under the title periodontal expanded function dental assistants (EFDA). Much of the current attention directed toward the topic is thanks to Missouri’s ongoing OPA EFDA Pilot Project which takes inspiration from the IHS. Conceived in 2023 and launched in 2025, the OPA EFDA Pilot Project will assess key outcomes related to access to care and quality of care. Kansas, Illinois, and Arizona have also launched, or are launching, their own programs based on the IHS model. At this time, Georgia has no pending legislation that would introduce OPAs.
Missouri’s pilot study brief shares limited information on research into the impact of OPAs. They suggest that IHS data indicates a 6.5% increase in preventative services rendered to patients when comparing similar sized and staffed clinics with and without OPAs/Periodontal EFDAs. Other than internal data, Missouri’s brief cites an IHS collaboration with Johns Hopkins that looked at the program, and some documentation emerging from this collaboration exists. Ultimately, the collaboration found that limited data did not allow them to draw a definitive conclusion about the effect of “alternative dental workforce models…compared to the traditional dental workforce model,” on select indicators.
Are There Differences in State Proposals for Curriculums?
Curriculums vary depending on the state. Arizona is the most recent state to show interest in allowing dental assistants to enter this role with their recently passed bill, SB 1124. Arizona’s bill requires 120 hours of training, CPR certification, coronal polishing and radiography certification, and national board certification or graduation from an accredited program. Missouri’s OPA EFDA Pilot Project modeled their training requirements on the IHS curriculum which includes self-study, 35 hours of in-person curriculum, and the execution of a minimum of 20 satisfactory supragingival debridement, prophylaxis, and oral hygiene consultation visits supervised and graded by a dentist or hygienist.
How does this impact Georgia?
Georgia law currently states that, “No dental assistant shall practice dentistry, dental hygiene, or do any kind of dental work other than those acts, services, procedures, and practices prescribed by rule or regulation of the board (O.C.G.A. § 43-11-81).” No legislation was introduced that would allow for the development of OPAs during the 2025 legislative session, which wrapped up on April 4, 2025. GDA’s government affairs team will continue to monitor developing programs around the country with a critical eye.
How can I get involved?
GDA membership offers numerous opportunities to join in advocating for dentists and their patients. To get more involved in advocating for dentistry in the state of Georgia, consider attending LAW Day, signing up as a contact dentist, or donating to GDAPAC. Every fall, each district holds a legislative reception to give dentists an opportunity to interact directly with their local legislators.
