The Oral Preventive Assistant pilot is one of the most discussed workforce topics in Missouri dentistry. This post explains what the pilot was, using pages from the Missouri Dental Association (MDA) and the Missouri Revisor of Statutes opened on October 26, 2026. The MDA supports the OPA model, so its reports come from an interested party. This post did not open the full pilot report, so treat the figures below as the MDA’s summary.
What was the Oral Preventive Assistant pilot?
It was a small, supervised project to test a new team role. The MDA says the pilot would examine an Oral Preventive Assistant who is an expanded function dental assistant delivering preventive care, including supragingival scaling on healthy patients.
The MDA says the Missouri Office of Dental Health asked the Missouri Dental Board in April 2023 to support the pilot. The MDA describes the cause as a shortage of dental workers, especially hygienists.
What would an OPA be allowed to do?
In the pilot design, the MDA lists three tasks: scaling supragingival calculus, polishing teeth and giving oral hygiene instructions. The MDA says OPAs would work under direct supervision of a dentist or hygienist. They would treat patients who are healthy or have reversible gum inflammation, not patients with advanced gum infections.
The MDA page adds that delegation stays at the dentist’s discretion. A dentist who is not comfortable delegating the task does not have to allow it.
What law allowed the pilot?
RSMo 332.325 lets the Dental Board work with state health offices to approve pilot projects for medically underserved populations. A pilot may need a waiver of some Chapter 332 rules. The statute sets seven conditions for a pilot, shown here in short form.
| Condition in RSMo 332.325 | Plain meaning |
|---|---|
| Stated objective | A specific underserved group is named |
| Finite dates | A start date and an end date |
| New techniques defined | The project says what it tests |
| Limited sites | Specific places and populations only |
| Safety standards | Minimum guidelines protect patients |
| Measurement criteria | The plan defines how outcomes are judged |
| Reporting | Interim and final reports go to the Board |
The statute text on the Revisor page opened for this post shows an expiration date of August 28, 2026. It also requires a final report to the general assembly by December 31, 2025. What that date means for any current activity is a question for the Missouri Dental Board or an attorney.
What did the MDA report from the pilot?
The MDA’s EFDA site reports that the pilot observed more than 1,600 patient visits. It lists these results:
| Measure | MDA-reported result |
|---|---|
| Supervising dentist rating of clinical performance | 9.6 out of 10 average |
| Patient satisfaction | 9.8 out of 10 average |
| Adverse incidents | Zero |
| Patient complaints | None reported |
The MDA also says clinics with more OPA use showed capacity gains. It notes the pilot limited use: only existing full-time employees took part, and OPA duties happened only when staff could be released from other work.
These are summary figures from an advocacy group. A reader who wants the full methods can open the pilot report linked on the MDA page. The wider evidence base on scope of practice changes is still growing.
How does the OPA idea compare with other states?
The MDA page says the idea is not new. It reports that the Indian Health Service introduced an OPA-like role, called the Periodontal EFDA, in 1977. The MDA also says Illinois and Kansas already allow assistants to scale, and that Arizona passed an Oral Preventive Assistant law in 2025. The ADA-crafted Dental Access Model Act, adopted by the American Legislative Exchange Council in 2024, includes oral preventive assistants as one of three parts.
These are the MDA’s descriptions. Each state writes its own rules, and a reader who needs details should open the other states’ statutes. Other groups hold different views on scope changes, and this post did not review their positions.
Where does the rule stand?
The MDA says that as the idea moved from pilot to rulemaking, the role became known as the Periodontal EFDA. Its page states that as of October 2026 the proposed rule continues to move through Missouri’s formal administrative process. The MDA does not give a final date.
Anyone who plans staffing around this role should treat it as unsettled until the Board publishes a final rule. The related post on Missouri EFDA training covers the current EFDA path.
What questions would a practice owner ask?
If a final rule is published, owners will have planning questions. These are prompts for discussion, not advice.
| Question | Why it matters |
|---|---|
| Who may supervise, and at what level? | The pilot used direct supervision, and a final rule may differ |
| What training must a team member finish? | The MDA lists classroom, simulation, written exams and a practicum |
| Which patients qualify? | The pilot limited care to healthy patients or those with reversible gum inflammation |
| How would delegation be documented? | Records protect patients and the practice |
Why do dental leaders follow this topic?
It sits where workforce shortage, team structure and state rules meet. Leaders in organized dentistry follow pilots like this one because they show how a state tests a new role. The guide on dental leadership looks at team design from the owner’s side.
Next step
To see how associations shape rules like these, read the guide to organized dentistry. Contact Dr. Copeland about study club topics. Dr. Jon Copeland, DDS, is a general dentist in Wildwood, Missouri, and a past president of the Missouri Dental Association.
Frequently asked questions
What is an Oral Preventive Assistant?
In Missouri's pilot, an OPA is an expanded function dental assistant trained to deliver limited preventive care for healthy patients. The MDA lists supragingival scaling, polishing and oral hygiene instruction. The MDA also says the role is now called the Periodontal EFDA in the rulemaking process.
Is the OPA role legal in Missouri today?
This post cannot say. The MDA says the proposed Periodontal EFDA rule is still moving through the formal administrative process as of October 2026. The pilot statute carries an expiration date of August 28, 2026. Ask the Missouri Dental Board what applies now.
Who ran the pilot?
The MDA describes a collaboration among the Missouri Dental Board, the Missouri Office of Dental Health and the MDA. The MDA wrote the pilot proposal and says the Office of Dental Health supervised it.
Terms on this page
Sources
- Missouri Dental Association: OPA EFDA Pilot Project, opened October 26, 2026
- Missouri Dental Association (MDA EFDA): Periodontal EFDA (OPA), opened October 26, 2026
- Missouri Revisor of Statutes: RSMo 332.325, opened October 26, 2026
Written by Copeland Consulting Services and checked against the sources above on October 26, 2026. Rules, data and guidance change, so check the linked page before you act on it.