Nevada’s oral health care system is in a bit of a cavity. The numbers tell a story of decay: All 17 counties in Nevada are federally designated as Health Professional Shortage Areas, with 66 specific areas also classified as Dental Care Health Professional Shortage Areas, leaving more than 71 percent of Nevadans without adequate access to care. 

The Nevada State Board of Dental Examiners reports there are about 1,500 licensed hygienists in the state. With at least a third of them working part time or having left the workforce in the past biennium, the active hygiene workforce shrinks significantly, leaving an estimated 30 or so full-time hygienists per 100,000 residents — less than half the national average. Consequently, wait times for routine cleanings can extend months beyond when they’re due, leaving patients unclean and underserved.

Hygienist training programs at Truckee Meadows Community College and College of Southern Nevada produce less than 30 hygienists each year — far too few to meet the state’s critical need. This isn’t just our state’s burden — it’s a national crunch, backed by stark figures. Half of all hygienist jobs in America’s 20 largest cities sit unfilled, while 40 percent of all dental practices are searching for hygienists who simply aren’t there. Hygienist graduation rates aren’t just flat — they’re declining, suppressing any chance of a talent surge. Compounding the strain, nearly a third of hygienists are nearing retirement and 8 percent have already exited the workforce since the pandemic.

The data presents a hard-hitting reality: No army of hygienists is poised to march into Nevada and save the day — not now, not soon. 

Yet, there’s a practical solution within reach — tapping into our own trained and available dental-support workforce. AB334 offers a commonsense solution by allowing expanded function dental assistants (EFDAs), licensed dental providers who work alongside dentists and hygienists, to assist with routine teeth cleanings. EFDAs undergo advanced training beyond standard dental assistant programs and are underutilized in Nevada.

AB334 isn’t a Band-Aid — it’s a simple, scalable fix. Quite literally. The bill would permit EFDAs to use a scaler — a slender, toothpick-like tool for removing plaque from teeth — which offers a simple fix for our teeth-cleaning shortage. While opponents spread baseless fearmongering about safety and training, the truth undermines their false claims — safety remains uncompromised, as EFDAs are already trained and authorized to use an ultrasonic scaler to remove dental cement and bonding agents from teeth. Expanding their scope to include lighter plaque offers a smart solution to boost teeth-cleaning access in Nevada.

This method isn’t untested; the U.S. military has used it for years. Additionally, many states have implemented their own versions of EFDAs for comparable roles. By allowing EFDAs to manage the simpler aspects of routine teeth cleanings, hygienists and dentists can focus on the more complex cases. For rural and low-income Nevadans, who have long lacked adequate care, this promises access to essential services. A system on the verge of collapse can find balance — all with allowing EFDAs to use a toothpick-like instrument anyone can buy at Walmart. 

In government, limited funding is usually cited as the reason a problem can’t be fixed. In this case, AB334 offers a proven, practical solution that can help restore oral health access in Nevada. It’s more than just a bill; it’s a resourceful step toward a healthier state. Legislators should back this bill swiftly, giving Nevadans a reason to smile.

Paul Klein is a lobbyist with TriStrategies, a Nevada government relations and public affairs firm, that represents the Nevada Dental Association.

The Nevada Independent welcomes informed, cogent rebuttals to opinion pieces such as this. Send them to [email protected].