DENTAL AUXILIARY

DENTAL AUXILIARY

Ø    DENTIST

A dentist is a person licensed to practice dentistry under the law of the appropriate state, province, territory or nation. Dentist must satisfy certain qualifications such as,

·        Completion of an approved period of professional education in n approved institution.

·        Demonstration of competence.

After being trained for 4 years, followed by one year of paid rotating internship, the student is conferred the degree of bachelor of dental surgery (BDS). The student has to register with the dental council of India (DCI) through the state dental council. He/she can then practice dentistry or can pursue post graduation in a specialty of his/her choice of subject, leading to a master’s degree – master of dental surgery (MDS). The revised BDS course regulations given by the DCI wide notification dated 25^th July 2007 States that the undergraduate dental training program leading to BDS degree shall be of 5 years duration with no internship program.

Ø    DENTAL ANCILLARY

A dental auxiliary is a person who is given responsibility by a dentist so 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.

Ø    CLASSIFICATION BY WHO(1967)

·        Non-Operating auxiliaries

a)     Clinical: this is the person who assists the professional (dentist) in his clinical work but does not carry out any independent procedures in the oral cavity.

b)    Laboratory: this is a person who assists the professional by carrying out certain technical laboratory procedures.

·        Operating auxiliary

This Is A Person Who, Not Being A Profession Is Permitted To Carry Out Certain Treatment Procedures In The Mouth Under The Direction And Supervision Of A Professional.

REVISED CLASIFICATION:

1)     Non-operating auxiliaries

-         Dental Surgery Assistant.

-         Dental Secretary Receptionist.

-         Dental laboratory technician.

-         Dental health educator.

2)     Operating Auxiliaries

-         School Dental Nurse.

-         Dental Therapist

-         Dental Hygienist.

-         Expanded function dental auxiliaries.

Ø    DENTAL SURGERY ASSISTANT:-

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 patient independently. A dental assistant may only work under the supervision of a licensed dentist, carrying out duties prescribed by the dentist or by a dental hygeienist employed by the dentist.

The category of auxiliary personnel has been called by various names in different countries assistant, chairside dental assistant and dental nurse.

Ø    FOUR – HANDED DENTISTRY

The term four handed dentistry is given to the art of seating both the dentist and the dental assistant in such a way that both are within easy reach of the patients’ mouth. The patient is in a fully supine position. The assistant will hand the dentist, the particular instrument he needs. She will also perform additional tasks such as retraction or aspiration. Dentists who do not expect too much from their assistants prefer to train them on the job. Training courses do exist, extending over a period of one year to two year.

Ø    THE DUTIES THE DENTAL ASSISTANTS ARE

·        Reception of the patient.

·        Preparation of the patient for any treatment he or she may need.

·        Preparation and provision of all necessary facilities such as mouthwashes and napkins.

·        Sterilization, care and preparation of instruments.

·        Preparation and mixing of restorative materials including both filling and impression materials.

·        Preparation of the surgery for the next patient.

·        Presentation of documents to the dental surgeon for his completion and filling of these.

·        Assistance with x-ray work and the processing and mounting of x-ray.

·        Instruction of the patient, where necessary, in the correct use of the toothbrush.

Ø    DENTAL SECRETARY / RECEPTIONIST

This is a person who assists the dentist with his secretarial work and patient reception duties.

Ø    DENTAL LABORATORY TECHNICIAN

A dental laboratory technician is a non-operating auxiliary who fulfills the prescriptions provided by dentists regarding the extra oral construction and repair of oral appliances and bridge work.

          These categories of personnel have also been known a dental mechanics. As per the Indian dentist Act of 1948, dental mechanic is a Peron who makes or repairs dentures and dental appliances.

Ø    DUTIES

Casting f models from impressions made by the dentist.

Fabrication of dentures, splints, orthodontic appliances, inlays, crowns and special trays.

Dental mechanic is a person, who makes or repairs detail appliances and dentures including, inlay, crown a bridge work. He shall restrict his activities to purely mechanical laboratory work at the instance of the registered dental surgeon. He shall not do nay chair side work.

Ø    DENTURIST

Is a term applied to those dental laboratory technicians who are permitted to fabricate dentures directly for patients without a dentist’s prescription. They may be licensed or registered.

Tasmania, a state in Australia, was the first palce where technicians were legally permitted to provide a prosthetic service. Denmark uses the term “Denturist” to describe a special category of dental technician who sits at an examination, to enable him to prescribe, make and fit removable dentures without supervision.

The who expert committee on auxiliary dental personnel (1959) has recommended that only qualified dentists may work directly on patients.

Ø    DENTAL HEALTH EDUCATOR

This is a person who instructs in the prevention of dental disease an who may also be permitted to apply preventive agents intra orally.

Ø    SCHOOL DENTAL NURSE

This is an operating auxiliary, who is permitted to diagnose dental disease and to plan a carry out certain specified preventive and treatment measure, including some operative procedures in the treatment of dental caries and periodontal disease in defined groups of people, usually school children.

Interest in an organized plan to improve dental conditions among children in New Zealand first become evident in 1905.

The dental nurse Scheme was established in Wellington new Zealand in 1921 due to the extensive dental disease found in army, recruits during world war I. the man who recruits during world war the man who influenced its formation was T.A. hunter , a founder of the new Zealand dental association and a pioneer in the establishment of a dental school in new Zealand. The name of the school where they were trained was “ The Dominion training school for dental nurses.

Upon completion of training, each school dental nurse is assigned to a school where she is employed by the government to provide regular dental care for between 450 and 700 children.

Ø    DUTIES:

·        Oral examination.

·        Prophylaxis

·        Topical fluoride application

·        Advice on dietary fluoride supplements.

·        Administration of local anesthetic.

·        Cavity preparation and placement of amalgam filing in primary and permanent teeth.

·        Pulp capping

·        Extraction of primary teeth.

·        Individual patient instruction in tooth brushing and oral hygiene.

·        Classroom and parent-teacher dental health education.

Ø    DENTAL THERAPIST

This is an operating auxiliary, who is permitted to carry out to the prescription of a supervising dentist, certain specified preventive and treatment measures including the preparation of cavities and restoration of teeth.

The training of dental therapists is for about a period of two years involving both the reversible and irreversible procedures. The functions of a therapist vary. Their duties include.

·        Clinical Caries diagnosis.

·        Cavity preparation in deciduous and permanent teeth.

·        Vital pulpotomies under rubber dam in deciduous teeth.

·        Extraction of deciduous teeth under local anaesthesia.

They have little training in interpretation of X-rays. They often take radiographs at the request of the supervising dentist. They are not trained to provide endodontic care.

Apart from Australia and United Kingdom, other countries using the services of therapists include hongkong, Singapore, Vietnam and lanzania.

Ø    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. The dental hygienist work under the supervision of dentists.

Dental hygienist is a person, not being a dentist or a medical practitioner, who does oral prophylaxis, gives instructions in oral hygiene & preventive dentistry, assists the dental surgeon in chairside work and manages the office. He/she shall work under the supervision of the dental surgeon. –the dental council of India.

Ø    DUTIES:-

·        Cleaning of mouths and teeth with, particular attention to calculus and stains.

·        Topical application of fluorides, sealants and other prophylactic solutions.

·        Screening or preliminary examination of patients as individuals or in groups, such as school children or industrial employees, so that they may be referred to a dentist for treatment.

·        Instruction in oral hygiene.

·        Resource work in the field of dental health.

Ø    EXPANDED FUNCTION DENTAL AUXILIARY (EFDA)

They have been referred to as expanded function dental assistant, expanded function dental hygienist, expanded function auxiliary, technotherapist, expanded duty dental auxiliary.

Ø    DUTIES:-

·        Placing and removing rubber dams.

·        Placing and removing temporary restorations.

·        Placing and removing matrix bands.

·        Condensing and carving amalgam restoration in previously prepared teeth.

·        Placing of acrylic restorations in previously prepared teeth.

·        Applying the final finish and polish to the previously listed restorations.

Ø    Four level of training and qualification were recognized

·        Certified dental assistant

·        Preventive dental assistant

·        Dental hygienist

·        Dental hygienist with expanded duties

Ø    CERTIFICATE DENTAL ASSISTANT

The training course is of 8 months duration. The assistant was thought traditional chairside duties. The only intraoral duty was exposing radiographs.

Ø    PREVENTIVE DENTAL ASSISTAN:

The trainee had to be a certified dental assistant. Full time courses were of three to six weeks lengths. They were permitted to:

·        Polish the coronal portions of teeth without instrumentation.

·        Make impressions for study models.

·        Topically apply caries preventive agents.

·        Place and remove rubber dams.

·        Maintain a patient’s oral hygiene.

Ø    DENTAL HYGIENIST

A student had to be a certified or preventive dental assistant. The eight month training program allowed them to,

·        Carry out scaling

·        Conduct a preliminary examination of the oral cavity including taking a case history, a periodontal examination and recording clinical findings.

·        Provide a complete prophylaxis including scaling, root planning and polishing of fillings.

·        Apply and remove a periodontal pack.

·        Apply fissures sealants

Ø    DENTAL HYGIENIST WITH EXPANDED DUTIES:

Training of 4 months duration was given to dental hygienists who had at least one year’s practical experience. They were allowed to carry out,

·        Removing sutures.

·        Placing, finishing and polishing restorations o amalgam and resin.

·        Placing and removing matrix bands.

·        Fitting and removing orthodontic bands.

·        Retracting gingival or impression making.

·        Placing cavity liners.

·        Filling and removing orthodontic bands.

·        Separating of teeth prior to banding by a dentist.

·        Cementing temporary crowns previously fitted by a dentist.

·        Placing temporary fillings.

NEW AUXILIARY TYPES:

The expert committee on auxiliary dental personnel of the WHO (1959) has suggested two new types of dental auxiliaries.

·        The dental licentiate

·        The dental aide

Ø    DENTAL LICENTIATE

He is a semi-independent operator, trained for 2 years to perform.

·        Dental prophylaxis.

·        Cavity preparations and fillings of primary and permanent teeth.

·        Extractions under local anesthesia.

·        Drainage of dental abscesses.

·        Treatment of the most prevalent diseases of supporting tissues of the teeth.

·        Early recognition of more serious dental condition.

Ø    DENTAL AIDE

This type of auxiliary personnel performs duties which include, elementary first-aid procedures for the relief of pain, including:

·        Extraction of teeth under local anesthesia

·        Control of hemorrhage.

·        Recognition of dental disease which is important enough to justify transportation of the patient to a center where proper dental care is available.

They would operate only within a salaried health organization and be under supervision, the closer the better, particularly at first. The formal training extends from 4 to 6 months, followed by a period of field training under direct and constant supervision.

Ø    DEGREES OF SUPERISION OF AUSXILIARIES

ADA (1975) defined four degrees of supervision of auxiliaries, with the assumption that ultimate responsibility was assumed by the licensed dentist.

·        General Supervision:

The dentist has authorized the procedures and they are being carried out in accordance with the diagnosis and treatment plan completed by the dentist.

·        Indirect Supervision:

The dentist is in the dental office, authorizes the procedure and remains in the dental office while the procedures are being performed by the auxiliary.

·        Direct Supervision:

The dentist is in the dental office, personally diagnoses the condition to be treated, personally authorized the procedure and before dismissal of the patient, evaluates the performance of the dental auxiliary.

·        Personal Supervision:

The dentist is personally operating on a patient and authorizes the auxiliary to aid treatment by concurrently performing supportive procedures.

DENTAL AUXILIARY