By Lancette VanGuilder, BS, RDH, PHEDH, CEAS, FADHA
January 28, 2026

In 2025, Nevada dental hygienists faced a serious threat to patient safety and professional standards. A bill originating from the Governor’s Office proposed allowing anyone to be ‘on-the-job-trained’ to become a licensed dental hygienist, bypassing accredited education – a model often referred to as the “Alabama Model” or “Military Model.”

Nevada hygienists and advocates from across the country stood up to the legislation. And we won.

What made this moment historic was not only the outcome but how it happened. Nevada did not start from scratch. The profession responded with years of preparation, trusted relationships and coordinated advocacy. The result is a clear, repeatable roadmap that can help other states counter Oral Preventive Assistant (OPA) language and harmful legislation while protecting the public. (Learn more about Oral Preventive Assistants here.)

Below are 10 lessons – hard-earned, practical and actionable – for every state.

Lesson 1: Build Relationships Before You Need Them

Start now by introducing yourself to lawmakers in your district. Email, call, and/or meet with them in person. Share patient stories and dental images, show them dental hygiene instruments, and demonstrate what disease prevention looks like in practice. Attend their fundraisers to mix and meet with those who can advocate on your behalf, and offer yourself and your expertise as a resource.

Every legislator should know the dental hygienists in their district by name. Relationships built early create trust when it matters most, so reach out and build those connections now, before you need to ask for their help.

Lesson 2: Strong Associations Win Fights

Successful legislative sessions are built on local, state, and national leaders continuing to show up, session after session, walking legislative halls, meeting one-on-one, and educating lawmakers about prevention. In Nevada, dental hygiene leaders have spent the last two decades writing, lobbying, and advocating for bills in favor of self-regulation, prescriptive authority, lasers, independent public health practice, dental therapy, and autonomy to increase access to care. They were neither stagnant nor complacent. They had strong leaders, intentional mentoring, progressive policies, a legislative agenda and a respected lobby team in place long before a threat materialized. So, when the on-the-job-trained dental hygienist proposal surfaced, legislators already recognized that the legislation was problematic, making one-on-one meetings with policymakers possible because those strong relationships had already been established.

Lesson 3: Call ADHA – Immediately

When concerning legislation is being introduced or begins gaining traction, the first step should be to schedule a meeting with the ADHA advocacy team to assess the language, risks and strategic response.

The very first call Nevada made went to ADHA. That call mattered.

No state should fight alone, and Nevada did not. With ADHA staff and leadership engaged, the response became swift, strategic and powerful. Here is what that coordinated national-state response looked like:

• National partners, including the Academy of General Dentistry and the American Academy of Oral Medicine, came to the table
• VoterVOICE campaigns were launched
• Thousands of letters of testimony flooded committees
• Social media campaigns were activated and amplified
• Social influencers shared the information
• Media outlets were contacted
• Phone calls to the Governor’s Office were so frequent they threatened to shut down the line

National + state alignment changes outcomes.

Lesson 4: Educate Lawmakers Like Patients

Lawmakers are just people. Many have not seen a dental hygienist in years, or ever, though some are fiercely loyal to their hygienists. Be patient with them, educate them, and connect on a personal level.

Hosting an oral health day at the legislature can be a fantastic way to educate and connect with policymakers. Dental hygienists, educators, entrepreneurs, mobile and public health dental hygienists, and dental hygiene students in Nevada used this pathway to bring together experience and voices. They brought typodonts, ultrasonic scalers, and hand instruments to the capitol, and explained periodontal disease in terms anyone could understand. Students and new graduates spoke openly about their concerns: their careers, their student loan debt, and their futures.

Education works when we show up and teach.

Lesson 5: Boots on the Ground Matter

Online advocacy is powerful, but it’s not the most important tool in your kit.

The Nevada Dental Hygienists’ Association (NDHA) showed up day after day in Carson City: outside offices, outside hearing rooms, even outside restrooms, catching brief moments with decision-makers. Meetings were scheduled and rescheduled. Flyers, folders, and business cards were given. Local volunteers kept showing up daily, even until midnight on the session’s final day.

Do not rely on others to be the voice of the profession. Do not assume someone else will take care of it. Social media does not change laws; people showing up in person or submitting official, written testimony to the legislature influences policy.

Visibility matters. Presence matters.

Lesson 6: You Cannot Do This Alone

When hygienists need to be at work and cannot be there in person, trust your association’s lobbyist. Lean on your paid staff and their relationships. Your state lobbyist can bring in additional stakeholders, speak on your behalf, and meet with other lobbyists. Ensure they understand your legislative agenda and what is expected of them.

Effective advocacy is a team sport.

Lesson 7: It Will Get Hard – Do Not Quit

This work is hard, and you cannot take setbacks personally.

Leaders who put themselves out there may face attacks. Harassment may come through social media or email; opponents may even contact your employer to intimidate and silence you.

Dental hygienists must continue to stand up for equality and patient safety.

Lesson 8: Do not Compromise Patient Protection

When controversial laws are proposed and dental hygienists oppose them, supporters may respond with compromises. When compromises weaken protections, undermine college-level education, and put the public at risk, say NO.

No public harm.
No language that diminishes expertise.
No fear-based policymaking.

Standing firm protects patients and the profession.

Lesson 9: Use ADHA’s Model Legislation

Now is the time to step up, go on the offense, and shift the mindset. Stop waiting for what we don’t want and start fighting for what we do. And here is the good news: you do not have to start from scratch.

ADHA already has model legislation ready for states to adapt—legislation that:

• Recognizes dental hygienists as primary prevention providers
• Promotes autonomy
• Honors education, skill sets, and clinical judgment
• Places hygienists in every setting where health happens
  

Imagine if all states advanced proactive legislation together. That would not be a ripple; it would be a tsunami.

Lesson 10: Lean on ADHA – Fully

Use advocacy resources on the ADHA website. Donate to the Advocacy Fund, so states can be supported when challenges arise. Schedule calls with ADHA staff to prepare before OPA language appears and to plan proactive legislation in your state.

ADHA is here for students, graduates, clinicians, educators and leaders.

The Bigger Picture

OPA legislation, or versions of it, has surfaced three times in Nevada, has passed in a few states, and is emerging in many states in 2026. This fight is coming to your state if it hasn’t already.

Nevada isn’t the only success story. Washington and Kentucky have also defeated these efforts through strategy, preparation, unity and leadership.

There has never been a better time to be a dental hygienist. In our greatest challenges lie our greatest opportunities. We can work together to build a healthcare system that truly serves the public and recognizes dental hygienists as the prevention specialists who are essential to that system.

This moment calls on every state to rise together, proactively shaping policy, protecting patients, and advancing dental hygiene nationwide. What comes next depends on all of us: every state, every association, and every dental hygienist choosing to lead rather than react.

This is our national call to action.
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Lancette VanGuilder, BS, RDH, PHEDH, CEAS, FADHA, is the 2025-2026 President of ADHA. A clinical dental hygienist based in Reno, Nevada, she owns an independent mobile practice, serves as clinical director of Sierra Sleep, Airway & Wellness Center, and founded Hygienist for Health, a national CE company. A past president of the Nevada Dental Hygienists’ Association, Lancette was on the ground during the 2025 legislative session that inspired this article. She is a recipient of the ADHA Award for Excellence and a long-time advocate for scope of practice expansion and equitable access to care.