Divide grows over California bill creating RDH pathway for internationally trained dentists

A California bill that would allow internationally trained dentists to become licensed dental hygienists without completing a CODA-accredited hygiene program is drawing support from the California Dental Association and opposition from the California Dental Hygienists’ Association, highlighting a growing divide over workforce shortages and professional standards.

The bill would allow applicants who have earned dental degrees from non-accredited international programs to qualify for licensure as registered dental hygienists without having to complete a Commission on Dental Accreditation (CODA) hygiene program.

Instead, the applicant would be required to successfully complete an examination given by the American Board of Dental Examiners and complete additional coursework in soft-tissue curettage, local anesthesia, and nitrous oxide-oxygen analgesia within two years of submitting an application. The individual must complete a two-unit Dental Practice Act course and an eight-unit infection control course that is approved by the dental board.1

CDA frames bill as solution to hygiene staffing shortages

CDA supports this new bill to help address what it describes as a growing workforce shortage, providing experienced clinicians to fill dental hygiene positions. According to the CDA, California has a substantial pool of international trained dentists, and this bill would help integrate these professionals more efficiently.2

“While the total number of RDHs has increased modestly in recent years, workforce growth has not kept pace with the growing population of dentists,” the CDA said in a press release. “Even with additional RDH educational programs expected to open, such as one in Southern California that CDA supported, the projected graduate numbers will add only incremental capacity over time.”

CDHA raises concerns about training and standards

The CDHA, who is pushing back against the legislation, claims that there are issues with the bill on both a workforce and educational standard. According to the CDHA, the number of RDHs is growing and California has over 800 RDHs annually.3 The association also states that many dental offices don’t provide dental hygiene services or have one dental hygienist working for multiple dentists at once.

A main concern for CDHA is the difference in training between dental and dental hygiene programs; dental hygiene programs focus more on public health, preventive and periodontal care, and patient education. The association argues these are not interchangeable with dental degrees, and that inconsistencies in international educational systems pose significant issues.3

“Allowing foreign dental training to qualify for dental hygiene practice, without completing an approved dental hygiene education pathway, risks creating an uneven standard of preparation, which could directly impact the consistency and quality of care the public receives,” the CDHA said in its opposition.

The group also has concerns about potential financial impact of this bill could have, arguing that this could lead to an increase in fees and regulatory burden for the industry by adding a new licensure pathway. CDHA thinks the bill is underestimating the dental education required for dental hygiene licensure.

As an alternative, CDHA has proposed a restricted dental license for internationally trained dentists while they work toward becoming licensed dentists in California. This license would allow individuals to practice dental hygiene and restorative duties, while under supervision of a licensed dentist.

This bill pathway was modeled on other states that have already  implemented for internationally trained dentist.

Workforce shortages drive broader scope-of-practice debates

AB1952 is currently in committee, and its progress will likely hinge on how lawmakers weigh workforce shortages against concerns about training standards and scope of practice. 

Even as recently as 10 years ago, the dental industry was concerned about an oversupply of hygienists, but that has changed rapidly, with staffing a major issue for practices since 2020. However, there is little consensus about how to move forward. Last year, both Arizona and Virginia passed controversial legislation allowing dental assistants to provide supragingival scaling and polishing under supervision. Both bills generated significant opposition, largely but not exclusively from hygienists.

As the workforce shortage in dentistry continues, the industry is likely to see more legislation and other initiatives to address the issue, but there's little agreement across the community on how exactly this should be done.

References

1. “AB-1952 Dentistry: dental hygienists: licensure.” California State Legislature. February 13, 2026. California Legislative Information. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202520260AB1952

2. “CDA-Sponsored Bill Creates Pathway to RDH Licensure for Internationally Trained Dentists.” California Dental Association. March 5, 2026. CDA Newsroom. https://www.cda.org/newsroom/advocacy/cda-sponsored-bill-creates-pathway-to-rdh-licensure-for-internationally-trained-dentists/

3. “AB 1952 Leave Behind Position Statement.” California Dental Hygienists’ Association. 2026. CDHA. https://cdha.org/Portals/CDHA/AB%201952%20Leave%20Behind%20POSITION%20STATEMENT.pdf