CURRENT
EVENTS
Keep up to date on what is happening here in Missouri.
1. Have you heard about the pilot programs that the Missouri Dental Board have approved? Click the button below to learn about the current Nursing Home Pilot Project with Telehealth and the proposed Oral Preventive Assistant "OPA" Pilot Project.
Proposed “Periodontal EFDA” Rule Update
On May 14, 2026, the Missouri Dental Board voted 4–3 to move forward with the proposed “Periodontal EFDA” rule, formerly referred to as the OPA-EFDA proposal.
The Missouri Dental Hygienists’ Association (MDHA) maintains that the Missouri Dental Board does not have statutory authority to permanently create this position through administrative rulemaking without legislative authorization. MDHA retained administrative law attorney Chris Pieper to represent the Association’s position before the Board.
MDHA believes the proposed rule raises serious concerns regarding:
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Patient safety
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Education and training standards
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Scope of practice
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Clinical assessment responsibilities
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Statutory authority
Missouri law currently limits scaling and removal of hard and soft deposits from teeth and comprehensive periodontal charting to licensed dentists and licensed dental hygienists. The proposed rule would also allow “Periodontal EFDAs” to complete periodontal charting and supragingival scaling, which is currently performed by licensed dentists and licensed dental hygienists.
The original OPA-EFDA project was established as a temporary pilot project by the Missouri Legislature, with findings intended to be reported back to legislators and the Missouri Dental Board. MDHA maintains that major scope-of-practice changes should proceed through the legislative process.
The proposal now moves into Missouri’s formal rulemaking process, including review by the Joint Committee on Administrative Rules (JCAR).
MDHA will continue providing updates and guidance as this process progresses.
MDHA Legislative Legal Fund
MDHA has established a Legislative Legal Fund to support continued legal advocacy and representation regarding this issue. Please, consider donating to help cover legal fees.
Expanded Public Health Settings Update
In separate action, the Missouri Dental Board unanimously approved a proposed rule expanding the public health settings where dental hygienists may practice without dentist supervision under Section 332.311, RSMo.
Potential expanded settings include:
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Public and private schools
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Missouri Special Olympics
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Additional nonprofit and community health settings
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Mental health Settings
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State Courts Administrator
The Missouri Dental Hygienists’ Association maintains that the Board does not have legal authority to expand duties beyond the existing pilot project and has retained legal counsel to represent the Association. Our attorney’s letters outlining these concerns, including the pilot project’s failure to meet stated goals, has been submitted to the Board.
2. The Dentist and Dental Hygienist Compact bills
Passage of this legislation is anticipated by MDHA in 2026.
3. Local Anesthesia Under General Supervision — Passage Update
The proposed rule change allowing dental hygienists to administer local anesthesia under general supervision was finalized on October 1, 2024, and published in the Missouri Register. The rule officially took effect on November 30, 2024.
While this is an exciting step forward, there are still several actions that must take place before implementation in the office.
Read below for the final rule wording and review the American Society of Anesthesiologists (ASA) Classifications, which will guide the enforcement of this change.
4. School Expansion:
Over the past several years, COVID-19 significantly impacted Missouri’s oral-health workforce, and recovery remains incomplete. According to the Missouri Department of Health and Senior Services, the state experienced a 5–12% reduction in dental assistants and a 5–8% reduction in dental hygienists.
Compounding this workforce loss, Missouri has seen a substantial decline in dental hygiene education capacity. Since 2016, four of the state’s ten dental hygiene program sites have closed. These closures include two distance-education sites in Rolla and Sikeston, Missouri (2018), which served critical rural areas; the Missouri College site in St. Louis (2016); and a distance-education site at Hillyard Technical College in St. Joseph, which partnered with North Central Missouri College in Trenton (2020). As a result, Missouri began losing graduates as early as 2016, reaching a deficit of approximately 60 dental hygiene graduates per year by 2020. Over the past five years, this equates to a loss of more than 300 potential dental hygiene graduates statewide.
In response, the Missouri Dental Hygienists’ Association (MDHA) engaged with dental hygiene programs across the state, providing workforce data and manpower projections to support program expansion where feasible. These efforts have yielded measurable progress:
1. Concorde Career College now admits a new cohort every eight months and has increased class size from 24 to 32 students per cohort.
2. St. Louis Community College expanded its longstanding Forest Park program by opening an additional site at Florissant Valley in fall 2025, doubling student capacity from 32 to 64. This expansion was made possible through Proposition R, a voter-approved property tax levy passed in 2021.
3. State Fair Community College opened an additional site in Columbia using grant funding, enrolling 10 new students in 2025, in addition to its Sedalia cohort of 10–12 students admitted every other year. Planned clinic expansions at the Sedalia site, including additional operatories, are expected to increase total enrollment capacity to 24 students per class across both locations.
4. Ozark Technical College is exploring expansion of its dental hygiene program through a distance education site at Jordan Valley Community Health Center, potentially adding 8 students in Fall 2026, with possible funding support from the Delta Dental Foundation of Missouri.
5. Missouri Southern State University plans to petition its Board of Regents in April 2026 to expand its dental hygiene program, with an estimated $2 million needed to support clinic and program growth.
Quick Takeaway
Missouri currently graduates approximately 250–260 dental hygienists per year; with recent and proposed program expansions, this could increase by ~65–70 additional graduates annually, bringing the potential total to approximately 315–330 graduates per year (pending full implementation and funding).
Increasing the number of graduates from accredited dental hygiene programs remains one of the most effective and sustainable strategies to address Missouri’s dental hygiene workforce shortage. Even if an OPA-EFDA bill were introduced and passed, the demand for licensed dental hygienists would persist. Expanding educational capacity is essential to ensuring access to safe, high-quality preventive oral-health care for Missourians.