A Workforce Solutions Update

The AAO and the California Association of Orthodontists (CAO) worked with AAO California lobbyists Mel Assagai and Caliph Assagai of California Policy Solutions(supported through the AAO Component Legal Support Fund) to address a Dental Board of California (DBC) proposal that could have significantly altered how orthodontic assistants are educated and trained in the state. This effort alleviated immediate threats to currently accepted in-office orthodontic assistant training.

Over the past year the DBC explored potential regulatory changes that would shift orthodontic assistant education toward a formal accreditation model, moving oversight away from the Board’s existing framework and into external educational accrediting bodies. While framed as a regulatory update, the proposal raised concerns that it could limit or eliminate the in-office training pathway and impose additional costs and barriers without a demonstrated benefit to patient safety or quality of care.

In California, in-office training has long allowed orthodontists to educate and train orthodontic assistants directly within their practices, supporting workforce flexibility, access to care, and practice sustainability. Preserving this pathway is particularly important as orthodontic offices continue to navigate ongoing staffing challenges and increased demand for care.

AAO and CAO engaged early and consistently in the DBC stakeholder process to ensure the perspective of practicing orthodontists was represented, and to convey the importance of preserving in-office orthodontic assistant training, protecting existing education pathways and avoiding new barriers to workforce entry.

CAO organized approximately 20 orthodontists to participate directly, including attending and providing testimony at the stakeholder meeting. Throughout the process, AAO/CAO members and AAO National Advocacy Network leadership in California emphasized the importance of preserving in-office orthodontic assistant training, protecting existing education pathways that have served the profession for decades, and avoiding new barriers to workforce entry.

They also stressed that, if changes were ever considered, they should align with the Registered Dental Assistant work-experience pathway, which allows on-the-job training without mandatory coursework.

These concerns were shared by a broad range of stakeholders, including educators, dental practices, the California Dental Association, and other professional organizations. The proposal was scheduled for consideration at the DBC’s November 6, 2025, meeting, but the Board ultimately chose not to move forward due to unresolved issues and lack of stakeholder consensus for the changes that were proposed but not supported by the AAO/CAO.

This outcome reflects the value of early, coordinated advocacy and active grassroots member engagement. While this proposal has been paused, regulatory discussions related to workforce education and training are ongoing. AAO and CAO will continue to monitor developments, engage with regulators, and advocate for policies that support orthodontic practices and protect proven training pathways.

Thank you to all AAO/CAO members who have been engaged on this important issue and continue to work with the DBC to ensure any changes to current pathways for hiring and training dental assistants are not at the detriment of orthodontists or their patients who seek care. The continued leadership and engagement from the CAO Board is also greatly appreciated, including Dr. Jeffrey Kwong, President of the California Association of Orthodontists, Dr. Mark Rashidi, Immediate Past President of the California Association of Orthodontists, Dr. Sheetal Patil, California Association Board Members and Component Advocacy Liaison, AAO National Advocacy Network volunteers (see below), and Jennifer Bennett, Executive Director of the California Association of Orthodontists.

We look forward to more discussions and advocacy on these issues and other AAO/CAO priorities during the upcoming 5th annual Lobby Day events (March 24 and 25) for orthodontists in Sacramento.

Grassroots leadership and engagement from AAO/CAO members are essential in this ongoing initiative and the key to our success. We are also grateful for the leadership of our National Advocacy Network (NAN) members in California. Their dedication and persistence have been instrumental in advancing this effort.

Dr. Sheetal Patil – Component Advocacy Liaison (CAL)
Dr. Paul Kasrovi – AAOPAC Captain
Dr. Maya Giannetti – CAL Team – State Regulatory Captain
Dr. Greg Pavlos – CAL Team – Media Advocacy Captain
Dr. Hap Dougherty – CAL Team – State Legislative Captain
Dr. So Hee Kim – CAL Team – Digital Advocacy Captain
Dr. Rebecca Long – CAL Team – Resident Captain

If you are interested in advancing similar workforce solutions in your state or province, get involved with the AAO National Advocacy Network. Workforce solutions supported by AAO advocacy efforts have seen recent success or are underway in several locations with NAN grassroots support, including Michigan, Ontario, Maryland, and North Dakota.

As the AAO continues advancing policy priorities in Washington, D.C. and across the states, consider supporting advocacy efforts by making a contribution at AAOPAC.org (using the email address associated with your AAO membership).  Your voice and grassroots engagement make the difference!