TAKE NOTE! Two years ago, the MDA published a workforce issue with information on the OPA Pilot Project, the MDA EFDA program, other workforce initiatives happening across our state and expanding dental hygiene programs. Those programs have provided updates we’re sharing with you in this issue. You can read those starting on page 29 of this issue.
OPA OFFERS A SOLUTION
The OPA is one solution and is proving that this upskilled worker is a valuable part of the dental team. With the fi nal promulgation of rules towards the end of 2024, the trained OPAs began to work within the seven clinical pilot sites providing supragingival scaling and care on healthy and gingivitis patients. In doing so, the dental offi ces — through a team eff ort between the dentist, the RDH, the 16 OPAs and the offi ce administrators — began to collect data to conform with the outlined specifi cations of the project.
The pilot clinical study, which measures the performance of OPA EFDAs, has demon- strated excellent outcomes as evaluated by both patients and clinical supervisors. Details of the performance evaluations are reported to the Missouri Dental Board (MDB), which can be found online, but some key takeaways are as follows:
As of July 3, 2025:
• 440 evaluations had been collected from patients treated by OPA EFDAs. The average evaluation of OPA EFDA care by patients was 9.7/10.
• Supervising dentists were required to submit a performance review of OPA EFDAs using eight scales that mirror the educational objectives of their cur- riculum. The performance evaluation scores average for all OPAs ranged from 8.3 to 10, with an average global score of 9.3/10.
• The study will conclude in October 2025 with fi nal reporting to the MDB and a full analysis conducted by the ADA Health Policy Institute.
Additionally, some of the comments from OPA sites include:
• “We are excited to integrate OPAs into our team. We’ve had trouble recruiting hygienists to our location. Our plan is to pair an OPA with every hygienist to serve more patients better.” — Dr. Robert Thompson (Chief Operating Offi cer,
IRB: PATIENT PROTECTION, DATA INTEGRITY, BIAS CONTROL
Prior to the clinical trial, the MDA submitted the entire OPA EFDA study protocol to an Institutional Review Board registered with the U.S. Department of Health and Human Services Offi ce for Human Research Protections. Registered IRBs are mandated to review human study constructs, ensure adequate safety protocols are in place to protect participants, review the study hypotheses and metrics to ensure there is a high likelihood the study will collect data necessary to confi rm or deny hypotheses, examine for and recommend corrections for study biases if they exist, and determine if the study meets all federal guidelines applicable to human studies. The OPA study was reviewed and approved by the IRB as safe, soundly constructed and in compliance with all federal regulations. The MDA felt it was important this pilot project have IRB approval to remove the concern of any bias within the project and protect the patients served through it.
Pine Lawn Dental Management LLC, St. Louis)
• “The OPA has been an invaluable addition to our clinic, particularly in supporting our hygienists and expand- ing patient access to care. By assisting with tasks such as periodontal charting, patient education and preventative pro-
cedures, the OPA enables our hygienists to concentrate on delivering specialized clinical care for patients with more com- plex periodontal needs. This collabora- tive model improves workfl ow, allows our hygienists to practice at the top of their scope and increases the number of patients we can serve. Because the OPA works directly alongside a hygienist or dentist, this approach enhances access without compromising the quality of care.” — Shannon Covington, RDH (Director of Dental Training and De- velopment, Compass Health Network, Wentzville)
CONTINUING MOMENTUM
The MDA will work to codify this into law, allowing dentists to delegate care to this oral health care worker as a part of their dental team. While we have had naysayers, more so, we have had overwhelming support for the OPA. We also continue to receive comments from doctors expressing their dire need for this and their confi dence in the EFDA pro- gram: that the OPA, as a type of EFDA, can be integrated as a valuable, critical member of their teams.
For those who are skeptical, I will restate that we absolutely can’t sit back and not create a pathway for communities and dental teams to progress toward bringing more access to oral healthcare for Missourians. For those who are critical, just look at the pilot report- ing currently: It’s working! It is being shown an OPA EFDA can provide great care under direct supervision and be an asset to their team — not only to the approval of their su- pervising dentists and hygienists, but to the patients for whom they are providing care. Is the OPA the only solution to workforce issues? Absolutely not. Yet it is clear and proven that EFDA training is the most cost- eff ective way to leverage the existing dental workforce and increase productive capac- ity and access. One EFDA can increase the productive capacity of a dentist or hygienist by 15 to 25 percent.
CONTINUED NEXT PAGE ISSUE 3 | FALL 2025 | focus 13
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