Scope Shift or Staffing Solution? California’s AB 1952 Ignites Debate
California’s AB 1952 would allow internationally trained dentists to become licensed dental hygienists without completing a CODA-accredited dental hygiene program. While supporters cite workforce shortages, dental hygienists argue the proposal sidesteps established educational standards and professional safeguards.
A new bill introduced in Sacramento is stirring vigorous debate across California operatories. Assembly Bill 1952, authored by Assemblymember Marc Berman and sponsored by the California Dental Association (CDA), proposes a streamlined pathway for internationally trained dentists to obtain licensure as dental hygienists without completing a Commission on Dental Accreditation (CODA)-accredited dental hygiene program. In fact, the bill would authorize the Dental Hygiene Board to license an applicant who has completed a degree from a nonaccredited dental school if the diploma is equivalent to a doctor of dental surgery or doctor of dental medicine degree. The bill would require applicants to demonstrate academic equivalency; pass examinations; complete coursework on the dental practice act, infection control, gingival soft tissue curettage, nitrous oxide-oxygen analgesia, and local anesthesia; and meet competency-based criteria under the Dental Hygiene Board of California. Similar legislation has already passed in Virginia and Florida.
Supporters frame the measure as a pragmatic response to a growing workforce shortage. California faces more than 570 federally designated Dental Health Professional Shortage Areas, and projections suggest access gaps will widen by 2030. However, the California Dental Hygienists’ Association (CDHA) does not believe there is a statewide shortage of dental hygienists. The CDA cited workforce shortages and a pathway for internationally trained dentists as justification for its proposal, but provided only county-level dentist-to-hygienist ratios based on a 1:1 assumption. CDHA maintains that this ratio is flawed, as dental hygienists commonly work for more than one dentist; a more accurate estimate suggests approximately two dental hygienists per dentist.
Dental hygienists are pushing back. Their central concern is that bypassing CODA-accredited hygiene education dilutes the integrity of the profession. Dental hygiene curricula emphasize preventive care, periodontal instrumentation protocols, patient education methodology, and scope-specific clinical calibration, which are distinct from dental training models. In addition, the bill does not require the internationally trained dentists/hygienists to practice in underserved areas.
Workgroup discussions have floated alternative guardrails, including national and regional exam passage, credential evaluation services, proof of licensure and work history, English proficiency testing, and structured refresher programs. Even so, many dental hygienists maintain that equivalency cannot substitute for discipline-specific education. Click here to read more.
