Dental Auxiliaries DEPARTMENT OF COMMUNITY DENTISTRY Contents Introduction

Dental Auxiliaries DEPARTMENT OF COMMUNITY DENTISTRY

Contents Introduction Classification Non-operating Auxiliaries Operating Auxiliaries Degrees of supervision Conclusion DEPARTMENT OF COMMUNITY DENTISTRY

Dental Auxiliary / Ancillary Auxiliary -- “being helpful, subsidiary” Definition: “a person who is given responsibility by a dentist so that he or she can help the dentist render dental care, but who is not himself or herself qualified with a dental degree. The duties undertaken by dental ancillaries range from simple tasks such as sorting instruments to relatively complex procedures which form part of the treatment of patients. ” (SLACK) DEPARTMENT OF COMMUNITY DENTISTRY

Classification WHO (New Delhi, 1967) A) Non-operating auxiliaries 1) Clinical: assists the professional (dentist) in his clinical work but does not carry out any independent procedures in the oral cavity 2) Laboratory: assists the professional by carrying out certain technical laboratory procedures B) Operating auxiliary a person who, not being a professional, is permitted to carry out certain treatment procedures in the mouth under the direction and supervision of a professional DEPARTMENT OF COMMUNITY DENTISTRY

Revised Classification A) Non-operating ancillaries - Dental Surgery Assistant - Dental Secretary / Receptionist - Dental Laboratory Technician - Dental Health Educator B) Operating ancillaries - School Dental Nurse (New Zealand type) - Dental Therapist - Dental Hygienist - Expanded Function Dental Ancillaries (EFDA) DEPARTMENT OF COMMUNITY DENTISTRY

Dental Surgery Assistant Also called Dental Assistant, Chairside Dental Assistant, Dental Nurse, etc. A dental assistant is a non-operating auxiliary who assists the dentist or dental hygienist in treating patients, but who is not legally permitted to treat patients independently. DEPARTMENT OF COMMUNITY DENTISTRY

first hired by Dr. C Edmund Kells of New Orleans – 1885 as a “Lady in Attendance” trained to work at the chairside during World War – II (1939 -1945) significant change in 1960 s when four-handed sit-down dentistry evolved DEPARTMENT OF COMMUNITY DENTISTRY

training given on job or courses available for 1 -2 years Duties ü patient reception ü patient preparation ü sterilization, care, preparation of instruments ü preparation and provision of facilities, napkins ü preparation and mixing of restorative & impression materials ü care of patients after treatment DEPARTMENT OF COMMUNITY DENTISTRY

ü preparation of the surgery for the next patient ü presentation of documents ü assistance with X-ray work ü instruction of the patient ü aftercare of patients – general anesthetics Advantages - increased efficiency - shorter appointment periods, time saved - improved quality of service - increased income DEPARTMENT OF COMMUNITY DENTISTRY

Dental Secretary / Receptionist assists with secretarial work and patient reception duties DEPARTMENT OF COMMUNITY DENTISTRY

Dental Laboratory Technician fulfills the prescriptions provided by dentists regarding extraoral construction and repair of oral appliances and bridgework also called Dental Mechanics in India, most are employed in government service Training apprenticeship formal training period – 2 years (India) DEPARTMENT OF COMMUNITY DENTISTRY

Functions - casting models from impressions - fabrication of splints, dentures, orthodontic appliances, inlays, crowns, special trays Denturists - are permitted in some states in the USA and elsewhere to fabricate dentures directly for patients without a dentists’ prescription - may be licensed or registered DEPARTMENT OF COMMUNITY DENTISTRY

formed out of a desire for autonomy among laboratory technicians their craft is called “Denturism” USA, Denmark, Tasmania DEPARTMENT OF COMMUNITY DENTISTRY

Dental Health Educator ü instructs in prevention of dental disease ü may be permitted to apply preventive agents intra-orally In Sweden X not allowed to undertake any intra-oral procedures ü allowed to conduct fluoride mouthrinsing DEPARTMENT OF COMMUNITY DENTISTRY

School Dental Nurse ü permitted to diagnose dental disease, to plan and carry out certain specified preventive and treatment measures including some operative procedures in the treatment of dental caries and periodontal disease in defined groups of people, usually school children. ü school-based salaried service ü stimulus was shortage in the number of dentists during World War – I DEPARTMENT OF COMMUNITY DENTISTRY

ü started in 1921 – Wellington, New Zealand, army recruits ü idea was put forward by T. A. Hunter ü trained at Dominion Training School for Dental Nurses - for 2 years - reversible & irreversible procedures - after training, assigned to schools – provide regular dental care for 450 -700 children at nearly 6 -month intervals - under supervision of District Principal Dental Officer, Dental Nurse Inspector DEPARTMENT OF COMMUNITY DENTISTRY

Duties ü oral examination ü prophylaxis ü topical fluoride application, advice on dietary fluoride supplements ü administration of local anesthetic ü cavity preparation & placement of amalgam restorations in primary & permanent teeth ü pulp capping, extraction of primary teeth ü individual patient instruction in tooth brushing & oral hygiene ü classroom & parent dental health education ü referral DEPARTMENT OF COMMUNITY DENTISTRY

Dental Therapist ü carries out to the prescription of a supervising dentist, certain specified preventive and treatment measures including the preparation of cavities and restoration of teeth X permitted to diagnose and plan dental care training – 2 years reversible & irreversible procedures DEPARTMENT OF COMMUNITY DENTISTRY

Duties ü clinical caries diagnosis ü cavity preparation - deciduous & permanent teeth ü material handling & restorative skills ü vital pulpotomies under rubber dam in deciduous teeth ü extraction of primary teeth ü taking radiographs ü may perform emergency first aid ü preventive services in some countries Services available in Australia, England, Hong Kong, Vietnam and Tanzania DEPARTMENT OF COMMUNITY DENTISTRY

Dental Hygienist A dental hygienist is an operating auxiliary licensed and registered to practice dental hygiene under the laws of the appropriate state, province, territory or nation. supervision of dentist licensed DEPARTMENT OF COMMUNITY DENTISTRY

idea put forward by C. M. Wright in 1902 put into practice by Dr. Alfred C. Fones of Bridgeport, Connecticut --- 1905, trained Mrs. Irene Newman in Dental Prophylaxis first training school in 1913 (course duration -- 7 months) present course duration – 2 years in countries like --- USA, Canada, India, China, Japan DEPARTMENT OF COMMUNITY DENTISTRY

Duties ü oral prophylaxis ü topical fluoride application ü screening of patients, Instructions in oral hygiene ü resource-work, dietary evaluation ü history-taking, root planing, removing overhangs ü making impressions, recording jaw relations Independent Contractual Practice of Dental Hygiene started by Linda Krol (1976) ü independent practice – USA, Sweden DEPARTMENT OF COMMUNITY DENTISTRY

Expanded Function Dental Auxiliary (E. F. D. A. ) also called Expanded Duty Dental Auxiliary, Technotherapist mostly hygienists or assistants with additional training impetus to utilization -- shortage of dental personnel in the 1960 s ü undertake reversible procedures X prepare cavities DEPARTMENT OF COMMUNITY DENTISTRY

An EFDA is a dental assistant or a dental hygienist in some cases, who had received further training in duties related to the direct treatment of patients, though still working under the direct supervision of a dentist. Duties ü placing and removing rubber dams and matrix bands ü placing and removing temporary restorations ü condensing & carving amalgam restorations ü placing of acrylic restorations ü final finish of restorations, topical fluorides In some places, • make impressions, etch teeth for bonding, do sealant application DEPARTMENT OF COMMUNITY DENTISTRY

Frontier Auxiliaries provide care to areas too far from dental care facilities usually nurses, dental assistants Duties ü dental prophylaxis ü basic dental health education ü dental first aid ü referral ü fluoride-rinse programmes tried and evaluated in Alaskan communities, Africa DEPARTMENT OF COMMUNITY DENTISTRY

NEW AUXILIARY TYPES – WHO Dental licentiate Dental aide DEPARTMENT OF COMMUNITY DENTISTRY

Dental Licentiate semi-independent operator, trained for 2 years responsible to the chief of the regional or local health service works in rural or frontier areas, remote supervision Duties ü dental prophylaxis ü cavity preparations and restorations ü extractions under L. A. ü drainage of dental abscesses ü early recognition of more serious dental conditions DEPARTMENT OF COMMUNITY DENTISTRY

Dental Aide WHO - 1959 ü elementary first-aid ü extraction of teeth ü control of hemorrhage ü recognition of serious dental conditions - formal training for 4 -6 months followed by field training - direct supervision DEPARTMENT OF COMMUNITY DENTISTRY

Degrees of Supervision ADA (1975) l General l Indirect l Direct l Personal DEPARTMENT OF COMMUNITY DENTISTRY