I’ve been hearing the same concern from dental practice leaders across the country: the schedule stays full, but the team doesn’t. In August 2026, new developments in Nevada and Tennessee show how practices may respond: by training dental assistants to take on more carefully defined duties.
The American Dental Association recently reaffirmed support for Nevada’s proposal to expand certain dental assistant responsibilities. At the same time, Tennessee continues to build multiple pathways for dental assistant registration, certification, and expanded-function training.
Together, these developments point to a larger workforce shift. Dental assistants aren’t simply filling gaps at chairside anymore. With the right education, supervision, and state approval, they may help practices deliver preventive care, support hygienists, and keep more appointments moving.
What changed in Nevada?
On August 4, 2026, ADA News reported that the ADA reaffirmed its strong support for a Nevada proposal involving an oral preventive assistant, or OPA-style, model.
The proposal would allow properly trained dental assistants to perform certain preventive services, including limited scaling duties. The final scope depends on Nevada’s regulatory process, so practices should not treat the proposal as a blanket authorization.
The model generally centers on services such as:
• Supragingival scaling for appropriate patients
• Coronal polishing
• Oral hygiene instruction
• Topical fluoride application
• Documentation of preventive findings, where permitted
The key phrase remains properly trained. An OPA-style role does not mean every dental assistant can perform every hygiene procedure. It also does not replace the dentist’s responsibility for diagno sis, treatment planning, supervision, or patient safety.
The ADA emphasized that state dental boards remain the primary licensing and regulatory authorities for dental professionals.
Important: Expanded dental assistant duties vary by state. Before changing job descriptions or assigning procedures, confirm the current rules with your state dental board and compliance advisors.
Why practices are paying attention
Nevada’s workforce data explains why this conversation has gained momentum.
According to the ADA News report, Nevada State Board of Dental Examiners President Ronald West said that seven out of 10 dentists surveyed reported longer patient wait times because of the dental hygiene shortage. Nearly half of surveyed offices reported at least one vacant dental hygiene position.
The report also cited an approximately 20% decline in licensed dental hygienists in Nevada since 2020, while the number of dentists remained steady or increased.
That creates a familiar problem for practice owners. A dentist may have open operatories, available patients, and treatment demand. But without enough hygienists, preventive appointments get delayed or canceled.
An expanded-duty dental assistant may help absorb selected preventive tasks under the required supervision. That gives hygienists more time to focus on periodontal disease treatment and complex patient needs.
The Nevada Dental Association described the concept as a “force multiplier” for hygienists. In practical terms, the goal is not to push hygienists aside. It’s to help the entire team use its skills more effectively.
Tennessee is building more ways into the profession
Nevada has captured the headlines, but Tennessee offers another important part of the workforce story: expanding access to training.
The Tennessee Board of Dentistry maintains approved dental assistant educational programs across technical colleges, community colleges, and private training providers.
These programs include different formats, such as:
• Traditional certificate programs
• Accelerated courses
• Evening and weekend options
• Community college degree pathways
• Programs designed for working adults
Tennessee also maintains an official list of approved dental assistant certification courses.
Depending on the program and state requirements, certification pathways may include radiology, nitrous oxide monitoring, coronal polishing, and other expanded functions.
The University of Tennessee Health Science Center’s EFDA program provides another example. Its board-authorized continuing education courses cover expanded restorative and prosthodontic functions for eligible dental hygienists and registered dental assistants.
This matters because practices need more than one way to hire. Some offices need an experienced dental assistant today. Others may want to train an entry-level employee over time. A broader education pipeline gives employers more options.
Expanded duties are a workforce strategy: not a shortcut
When a practice talks about expanded duties, the conversation should start with workflow, not procedures.
Ask where the current bottleneck lives.
Is the hygienist spending too much time on routine preventive services? Is the dentist waiting for radiographs, room turnover, or patient education? Are assistants leaving because they see no path for growth?
A thoughtful workforce plan might include:
1. Map the current workflow.
Track where appointments slow down and which responsibilities overlap.
2. Review state-specific rules.
Confirm what dental assistants may perform, under what supervision, and with which credentials. 3. Identify the right training pathway.
Compare board-approved courses, national credentials, and in-office competency development. 4. Build clear role boundaries.
Document what the assistant may do and what remains reserved for the dentist or hygienist. 5. Measure the effect.
Watch wait times, appointment capacity, team stress, patient feedback, and clinical quality.
This approach helps practices avoid a common mistake: hiring one person and expecting that person to solve a broken system.
What this means for hiring dental hygienists
Expanded-duty assistants won’t eliminate the need to hire dental hygienists. In many practices, the opposite may happen.
When hygienists spend less time on tasks that another qualified team member can handle, their work becomes more focused. They can dedicate more time to periodontal care, patient education, risk assessment, and treatment coordination.
That can make the position more attractive.
A practice that offers a clear team structure may also compete better for hygienists. Candidates often want manageable workloads, clinical support, and a workplace where responsibilities make sense.
If your practice has struggled to fill a hygiene opening, consider reviewing the entire team design before simply reposting the job. A qualified dental staffing agency can help you evaluate whether you need:
• A full-time hygienist
• A part-time hygienist
• A temporary or locum tenens hygienist
• An expanded-duty dental assistant
• A lead assistant with training responsibilities
• A combination of roles
The benefits and the guardrails
A well-designed expanded-duty model may help practices:
• Increase preventive appointment capacity
• Reduce pressure on dental hygienists
• Improve room utilization
• Support patient access in underserved communities
• Create career pathways for dental assistants
• Strengthen employee retention
• Reduce dependence on emergency hiring
• Improve coordination across the dental team
But the model needs guardrails.
Before assigning expanded duties, confirm:
• The assistant’s registration or license status
• Required education and certification
• Permitted supervision level
• Patient eligibility
• Documentation requirements
• Infection control expectations
• Practice liability coverage
• Dentist and hygienist oversight
• State-specific restrictions
A job title alone does not establish clinical authority. Credentials and current regulations do.
How practice leaders can prepare in 2026
You don’t need to wait for a new law in your state to improve your workforce plan.
Start with a simple team review. Talk with your assistants and hygienists about the tasks that consume the most time. Ask which skills employees want to develop. Then compare those needs with your state’s approved education pathways.
For practice managers, this conversation can also support retention. An assistant who sees a clear route toward advanced certification may feel more invested in the practice.
For owners and DSOs, the same approach can support scalability. A consistent training and staffing framework makes it easier to open locations, cover absences, and maintain patient access across multiple offices.
The bigger workforce lesson
The 2026 conversation around dental assistants reflects a broader reality: dental practices need flexible, team-based solutions.
Some practices will recruit additional hygienists. Others will invest in training. Many will need both.
Expanded-duty assistants should not replace clinical judgment or professional standards. They can, however, become an important part of a carefully supervised workforce strategy: especially when practices pair them with strong hiring, credentialing, onboarding, and retention plans.
The most successful practices won’t ask one role to carry the entire workload. They’ll build a team where each professional can work at the top of their training and legal scope.
Frequently asked questions
What is an expanded-duty dental assistant?
An expanded-duty dental assistant has completed additional education or certification that allows them to perform specific procedures beyond a standard dental assistant scope, subject to state law and supervision requirements.
What is an oral preventive assistant?
An oral preventive assistant, or OPA, is an expanded-function dental assistant trained to provide selected preventive services. These may include supragingival scaling, coronal polishing, fluoride application, and oral hygiene instruction for appropriate patients.
Can a dental assistant replace a dental hygienist?
No. Expanded-duty assistants do not automatically replace dental hygienists. Their permitted duties, training, and supervision differ by state. The model is designed to support the dental team.
Why is the ADA supporting Nevada’s proposal?
The ADA stated that Nevada’s proposal is well researched, includes patient safeguards, aligns with longstanding ADA policy, and responds to workforce needs identified by Nevada dental organizations and regulators.
Is Tennessee expanding dental assistant training?
Tennessee offers multiple approved educational programs and certification courses for dental assistants. These include pathways for registration and additional certifications, depending on the program and Board of Dentistry requirements.
How can a practice hire a qualified dental assistant?
Begin by defining the role, verifying state requirements, and identifying the credentials needed. A specialized dental staffing partner can help source, screen, and match candidates to your practice.
The dental assistant role is changing, but the goal remains familiar: help more patients receive timely, safe, coordinated care.
Nevada’s proposed OPA-style model and Tennessee’s growing training pathways show how states are testing new ways to strengthen the dental workforce. For practice leaders, the next step is to review your staffing plan now: not after another hygienist resigns or your schedule develops a three-month backlog.
If you need help hiring a dental assistant, finding a dental hygienist, or building a stronger clinical team, RSMC Services can help. We provide specialized dental recruitment and staffing support, including dental specialists, locum tenens coverage, and executive search.
Ready to put more dependable talent on your schedule? Call +1 650-447-1527 or email ca reers@rsmcservices.com. Feel free to reach out to the RSMC Team.