Patient safety & standard of care

Why “above-the-gumline only” is not a safe default

Scaling and polishing are not cosmetic add-ons. They are clinical procedures performed to prevent and control disease.

A “cleaning” that addresses only what’s visible above the gums can:

• create a false sense of completion for patients;
• delay identification of gingival/periodontal disease;
• allow inflammation to progress if subgingival areas are not addressed when indicated.

Public reporting on the Virginia debate quotes concerns that incomplete cleanings can contribute to dysbiosis and progression of inflammation/gum disease. (See Sources.)

Patient transparency matters

If a new assistant role is expanded, patients must be able to understand:

• who provided the clinical procedure;
• what was and wasn’t done;
• what follow-up is recommended.

If people believe they received a full preventive cleaning when they did not, that is not informed consent.

Real-world supervision is variable

Even if a procedure is permitted “under supervision,” the quality of supervision varies across settings. Legislation should not assume perfect conditions—especially when its stated purpose is increased throughput.

Bottom line

Virginia can improve access without weakening standards or confusing patients. We should not normalize partial cleanings as a routine replacement for comprehensive preventive dental care.

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