Oral Preventive


The MDA has a page of extensive information on workforce issues, the OPA EFDA development and recent activity.  Access it here.


In April 2023, the Missouri Dental Board passed the allowance of an Oral Preventive Assistant Pilot Project coordinated by the Missouri Department of Health and Senior Services (DHSS) Office of Dental Health (ODH).

The pilot project will examine the use of an Oral Preventive Assistant (OPA) Expanded Function Dental Assistant (EFDA) (herein referred to as OPA EFDA) to deliver preventive care, including supragingival scaling limited to patients who are diagnosed as periodontally healthy or with gingivitis.

The results of the pilot project will be reported to DHSS through ODH and other oral healthcare stakeholders in the state, and with proven safety and efficacy, will be offered for subsequent rule promulgation to allow new delegable duties.

Creating an OPA EFDA position would build on the proven approach of allowing dental assistants, under direct supervision, to assist with restorative, orthodontic, and fixed prosthetic and removable prosthetic care. All OPA EFDA candidates would be required to satisfy the same prerequisite as other assistants wanting to pursue EFDA certification, and must successfully complete all online learning, including module quizzes, prior to matriculation into clinical training.

So there is no misunderstanding, it must be re-stated this is a pilot and at its conclusion (and upon reporting and assessment) legislation still will have to be codified in law for an OPA to work in a dental setting.

What Would an OPA EFDA Do?

Dental assistants who successfully complete all parts of the OPA EFDA curriculum and training (including prework, hands-on clinical sessions and competency exams) will be eligible (within the pilot program at approved clinical sites) to assist dentists and hygienists (under direct supervision) with:

  • Documenting periodontal probe readings and bleeding spots.
  • Supragingival scaling, limited to patients diagnosed as periodontally healthy or with gingivitis.

By performing these and other clinical skills that alleviate the simpler but time-consuming tasks typically associated with a hygienist’s daily workflow, we hope this will allow dental hygienists (and dentists) the time necessary to practice at the top of their scopes to provide care. It should be noted that if a patient is diagnosed as outside of periodontally healthy or with gingivitis, they can only be seen for the initial diagnostic exam and no proposed delegated functions can be performed by an OPA for that patient thereafter.

Overview of OPA EFDA Modules

The OPA EFDA curriculum is a comprehensive suite of educational modules. The opening modules will require assistants to review and reacquaint themselves with fundamental principles. The subsequent modules will prepare assistants for the delegable functions with required hands-on clinical sessions and competency exams. Some modules (such as Modules 10-11) offer additional education and training on procedures already delegable to all dental assistants (no EFDA certification required).

The curriculum workgroup, comprised of practicing dentists and dental faculty, has consulted existing, similar curriculum from Indian Health Services, among other texts and sources. The curriculum will be presented to the Missouri Dental Board at its October meeting, for review and approval to formally commence the pilot. As with all EFDA curriculum, the workgroup will continue to review and update the curriculum, especially as the pilot provides information and feedback.

  • Introductory Modules – Overview/Introduction; Infection Control; Positioning
  • Module 1 – Anatomy, Physiology and Morphology
  • Module 2 – Periodontal Etiology and Classification
  • Module 3 – Armamentarium
  • Module 4 – Maintenance and Sterilization
  • Module 5 – Oral Hygiene Instructions
  • Module 6 – Patient Assessment and Data Collection
  • Module 7 – Imaging & Evaluation
  • Module 8 – Using a Periodontal Probe, Principles & Techniques (proposed delegable functions)
    • Initial diagnostic periodontal probing depth and bleeding spot recording.
    • Recall periodontal probing depth and bleeding spot recording on patients who have been classified healthy or with gingivitis.
  • Module 9 – Supragingival Scaling (proposed delegable functions)
    • Use supragingival hand and ultrasonic scalers on healthy or gingivitis patients.
    • Initial supragingival gross debridement in preparation for periodontal evaluation.
  • Module 10 – Coronal Polishing
  • Module 11 – Placement of Sealants and Fluoride Varnish; Silver Diamine Fluoride Overview