Lesson 13

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Lesson 13

  1. 1. Lesson 13 Dentists, Dental Technicians, and Dental Hygienist WORK DESCRIPTION Dentists diagnose, prevent, and treat problems of the teeth and tissues of the mouth. They remove decay and fill cavities, examine x-rays, place protective plastic sealants on children's teeth, straighten teeth, and repair fractured teeth. They perform corrective surgery of the gums and supporting bones to treat gum diseases. Dentists extract teeth and make molds and measurements for dentures to replace missing teeth. Dentists provide instruction in diet, brushing, flossing, the use of fluorides, and other aspects of dental care, as well. They administer anesthetics and write prescriptions for antibiotics and other medications. Dentists use a variety of equipment including X-ray machines, drills, and instruments such as mouth mirrors, probes, forceps, brushes, and scalpels. Dentists in private practice oversee a variety of administrative tasks, including bookkeeping, and buying equipment and supplies. They may employ and supervise dental hygienists, dental assistants, dental laboratory technicians, and receptionists. Most dentists are general practitioners who handle a wide variety of dental needs. Other dentists practice in one of eight specialty areas. Orthodontists, the largest group of specialists, straighten teeth. The next largest group, oral and maxillofacial surgeons, operates on the mouth and jaws. The remainder specializes in pediatric dentistry (dentistry for children); periodontics (treating the gums and the bone supporting the teeth); prosthodontics (making artificial teeth or dentures); endodontics (root canal therapy); dental public health; and oral pathology (studying disease of the mouth). WORKING CONDITIONS Most dentists work four or five days a week. Some dentists work evenings and weekends to meet their patient's needs. Most full-time dentists work about 40 hours a week; some work more. Younger dentists may work fewer hours as they build up their practice, while established dentists often work fewer hours, as they grow older. A considerable number continue in part-time practice beyond the usual retirement age. Most dentists are solo practitioners, that is, they own their own businesses and work alone or with a small staff. Some dentists have partners, and a few work for other dentists as associate dentists. Dentists wear masks, gloves, and safety glasses to protect themselves and their patients from infectious diseases like hepatitis. EMPLOYMENT OPPORTUNITIES There are approximately 200,000 dentists practicing in the United States. About nine out of 10 dentists are in private practice. Others work in private and public hospitals and clinics, and in dental research. 1
  2. 2. TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT All 50 States and the District of Columbia require dentists to be licensed. To qualify for a license in most States, a candidate must graduate from a dental school accredited by the American Dental Association's Commission on Dental Accreditation and pass written and practical examinations. Candidates may fulfill the written part of the State licensing by passing the National Board Dental Examinations. Individual States or regional testing agencies give the written and/or practical examinations. Currently, about 15 States require dentists to obtain a specialty license before practicing as a specialist. Requirements include two to four years of postgraduate education, and, in some cases, completion of a special State examination. Most State licenses permit dentists to engage in both general and specialized practice. Dentists who want to teach or does research usually spend an additional two to five years in advanced dental training in programs operated by dental schools or hospitals. Dental schools require a minimum of two years of college-level pre dental education. However, most dental students have at least a bachelor's degree. Pre-dental education includes courses in both the sciences and humanities. All dental schools require applicants to take the Dental Admissions Test (DAT). They consider scores earn on the DAT, the applicants' overall grade point average (GPA), science courses GPA, and information gathered through recommendations and interviews when selecting students. Dental school generally lasts four academic years. Studies begin with classroom instruction and laboratory work in basic sciences including anatomy, microbiology, biochemistry, and physiology. Beginning courses in clinical sciences, including laboratory technique courses, are provided at this time. During the last two years, students treat patients, usually in dental clinics under the supervision of licensed dentists. Most dental schools award the degree of Doctor of Dental Surgery (D.D.S.). The rest award an equivalent degree, Doctor of Dental Medicine, (D.M.D.). Dentistry requires diagnostic ability and manual skills. Dentists should have good visual memory, excellent judgment of space and shape, and a high degree of manual dexterity, as well as scientific ability. Good business sense, self-discipline, communication skills, and the ability to instill confidence are helpful for success in private practice. Some recent dental school graduates work for established dentists as associates for a year or two in order to gain experience and save money to equip an office of their own. Most dental school graduates, however, purchase an established practice or open a new practice immediately after graduation. Each year about one-fourth to one-third of new graduates enroll in postgraduate training programs to prepare for a dental specialty. JOB OUTLOOK Employment of dentists is expected to grow more slowly than the average for all occupations through the year 2010. Nevertheless, job prospects should continue to improve because the number of dental school graduates has dropped sharply since the early 1980's and is not likely to increase through 2010. Dental school enrollments began dropping in 1979, as it became clear that keen competition for patients had developed. This surplus of dentists is attributable to the very large numbers of dental graduates that resulted from a Federal decision during the 1960's to support expansion of the nation's dental schools. 2
  3. 3. Demand for dental care should grow substantially through 2010. As members of the baby boom generation advance into middle age, a large number will need maintenance on complicated dental work like bridges. In addition, elderly people are more likely to retain their teeth than their predecessors, so they will require much more care than in the past. The younger generation will continue to need preventive checkups despite treatments like fluoridation of the water supply that decrease the incidence of dental caries. Dental care will focus more on prevention, including teaching people how to better care for their teeth. Dentists will increasingly provide care that is aimed at preventing tooth loss--rather than just providing treatments, such as fillings. Improvements in dental technology will allow dentists to provide more effective and less painful treatment to their patients. However, the employment of dentists is not expected to grow as rapidly as the demand for dental services. As their practices expand, dentists are likely to hire more dental hygienists and dental assistants to handle routine services. EARNINGS Median annual earnings of salaried dentists are about $115,000. Earnings vary according to number of years in practice, location, hours worked, and specialty. Self-employed dentists in private practice tend to earn more than salaried dentists. A relatively large proportion of dentists are self-employed. Like other business owners, these dentists must provide their own health insurance, life insurance, and retirement benefits. Questions: What is the job description of a Dentist? How many Dentists practice in the United States? What are the requirements for entering a Dental School program? What abilities must a Dentist possess? What is the job outlook for becoming a Dentist? What are the average earnings of a Dentist? RELATED OCCUPATIONS 3
  4. 4. Dentists examine, diagnose, prevent, and treat diseases and abnormalities. So do clinical psychologists, optometrists, physicians, chiropractors, veterinarians, and podiatrists. ADDITIONAL INFORMATION For information on dentistry as a career and a list of accredited dental schools, contact: American Dental Association, commission on Dental Accreditation, 211 E. Chicabo, Ave., Chicago, IL 60611 American Association of Dental Schools, 1625 Massachusetts Ave., NW., Washington, DC 20036 Dental Assistants WORK DESCRIPTION Dental assistants perform a variety of patient care, office, and laboratory duties. They work at a chair side as dentists examine and treat patients. They make patients as comfortable as possible in the dental chair, prepare them for treatment, and obtain dental records. Assistants hand dentists instruments and materials and keep patients' mouths dry and clear by using suction or other devices. Assistants sterilize and disinfect instruments and equipment; prepare tray setups for dental procedures; provide postoperative instructions; and instruct patients in oral health care. Some dental assistants prepare materials for making impressions and restorations, expose radiographs, and process dental x-ray film as directed by a dentist. They may remove sutures, apply anesthetic and carries-preventive agents to teeth and gums, remove excess cement used in the filling process, and place rubber dams on the teeth to isolate them for individual treatment. Those with laboratory duties make casts of the teeth and mouth from impressions taken by dentists, clean and polish removable appliances, and make temporary crowns. Dental assistants with office duties arrange and confirm appointments, receive patients, keep treatment records, send bills, receive payments, and order dental supplies and materials. WORKING CONDITIONS Dental assistants work in a well-lighted, clean environment. Handling radiographic equipment poses dangers, but they can be minimized with safety procedures. Dental assistants wear gloves and masks to protect themselves from infectious disease like hepatitis and other diseases. Dental assistants, like dentists, work either standing or sitting. Their work area is usually near the dental chair, so that they can arrange instruments, materials, and medication, and hand them to the dentist when needed. Most dental assistants have a 32 to a 40-hour work week that may include work on Saturday or evenings. EMPLOYMENT OPPORTUNITIES Dental assistants hold about 200,000 jobs. Almost one out of three work part-time, sometimes in more than one dentist's office. Almost all dental assistants work in private dental offices. Some work in dental schools, private and government hospitals, State and local public health departments, or in clinics. TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT 4
  5. 5. Most assistants learn their skills' on-the-job, although many are trained in dental assisting programs offered by community and junior colleges, trade schools, and technical institutes. Some assistants are trained in Armed Forces schools. Assistants must be a dentist's third hand, therefore, dentists look for people who are reliable, can work well with others, and have manual dexterity. The American Dental Association's Commission on Dental Accreditation has approved about 250 training programs. Programs include classroom, laboratory, and preclinical instruction in dental assisting skills and related theory. In addition, students gain practical experience in dental schools, clinics, or dental offices. Most programs take one year or less to complete and lead to a certificate or diploma. Two-year programs offered in community and junior colleges lead to an associate degree. All programs require a high school diploma or its equivalent for admission. Some private vocational schools offer four to six-month courses in dental assisting, but the Commission on Dental Accreditation does not accredit these. Certification is available through the Dental Assisting National Board. Certification is an acknowledgment of an assistant's qualifications and professional competence, but usually is not required for employment. In several States that have adopted standards for dental assistants who perform radiological procedures, completion of the certification examination meets those standards. Candidates may qualify to take the certification examination by graduating from an accredited training program or by having two years of full-time experience as a dental assistant. In addition, applicants must have taken a course in cardiopulmonary resuscitation. Without further education, advancement opportunities are limited. Some dental assistants working the front office become office managers. Others, working chair sides, go back to school to become dental hygienists. JOB OUTLOOK Employment of dental assistants is expected to grow faster than the average for all occupations through the year 2010. Population growth, higher incomes, and greater retention of natural teeth by middle-aged and older people will fuel demand for dental services. Also, dentists are likely to employ more assistants, for several reasons. Older dentists, who are less likely to employ assistants, will leave and be replaced by recent graduates, who are more likely to use one or even two assistants. In addition, as dentists' workloads increase, they are expected to hire more assistants to perform routine tasks, so they may use their own time more profitably. Most job openings for dental assistants will arise from the need to replace assistants who leave the occupation. Many assistants leave the job to take on family responsibilities, return to school, or transfer to another occupation. EARNINGS The average weekly salary for a dental assistant working full-time is about $450 per week. The middle 50 percent earn between $384 and $520 a week. According to the American Dental Association, dental assistants who work 32 hours a week or more average about $450 a week; the average hourly earnings for all dental assistants is $12.50. RELATED OCCUPATIONS 5
  6. 6. Workers in other occupations supporting health practitioners include medical assistants, physical therapy assistants, occupational therapy assistants, pharmacy assistants, and veterinary technicians. Questions: What do Dental Assistants do in the dental office? How many Dental Assistants are there in the United States? Where do Dental Assistants learn their skills? Where is certification available for Dental Assistants? What is the job outlook for Dental Assistants? What are the average weekly earnings for Dental Assistants? ADDITIONAL INFORMATION Information about career opportunities, scholarships, accredited dental assistant programs, and requirements for certification is available from: American Dental Assistants Association, 203 N. Lasalle, Suite 1320, Chicago, IL 60601-1225 Commission on Dental Accreditation, American Dental Association, 211 E. Chicago Ave., Suite 1814, Chicago, IL 60611 Dental Hygienists WORK DESCRIPTION Dental hygienists provide preventive dental care and teach patients how to practice good oral hygiene. Hygienists examine patients' teeth and gums, recording the presence of diseases or abnormalities. They remove calculus, stain, and plaque from teeth; apply caries-preventive agents such as fluorides and pit and fissure sealants; take and develop dental x-rays; place temporary fillings and periodontal dressings; remove sutures; and polish and raconteur amalgam restorations. In some States, hygienists administer local anesthetics and nitrous oxide/oxygen analgesia, and place and carve filling materials. Dental hygienists help patients develop and maintain good oral health. For example, they may explain the relationship between diet and oral health, inform patients how to select toothbrushes, and show patients how to floss their teeth. Some hygienists develop and promote community dental health programs that may include teaching how to practice good oral hygiene. Dental hygienists use hand and rotary instruments to clean teeth, x-ray machines to take dental pictures, syringes with needles to administer local anesthetics, and models of teeth to explain oral hygiene. 6
  7. 7. WORKING CONDITIONS Flexible scheduling is a distinctive advantage of this job. Full-time, part-time, evening, and weekend work is widely available. Dentists frequently hire hygienists to work only two or three days a week, so hygienists may hold jobs in more than one dental office. Dental hygienists work in clean, well-lighted offices. Important health safeguards include strict adherence to proper radiological procedures, compliance with recommended aseptic technique, and use of appropriate protective devices when administering nitrous oxide/oxygen analgesia. Dental hygienists wear safety glasses, surgical masks and gloves to protect themselves from infectious disease such as hepatitis and AIDS. The occupation is one of several covered by the Consumer-Patient Radiation Health and Safety Act of 1981, which encourages the States to adopt uniform standards for the training and certification of individuals who perform medical and dental radiological procedures. EMPLOYMENT OPPORTUNITIES Dental hygienists hold about 110,000 jobs. Because multiple job holding is common in this field, the number of jobs greatly exceeds the number of hygienists. About fifty percent of all dental hygienists usually work part-time, less than 35 hours a week. Almost all dental hygienists work in private dental offices. Some work in public health agencies, school systems, hospitals, and clinics. TRAINING, OTHER QUALIFICATIONS, AND ADVANCEMENT Dental hygienists must be licensed by the State in which they practice. To qualify for licensor, a candidate must graduate from an accredited dental hygiene school and pass both a written and a clinical examination. The American Dental Association Joint Commission on National Dental Examinations administers the written examination that is accepted by all States and the District of Columbia. State or regional testing agencies administer the clinical examination. In addition, most States require examinations on legal aspects of dental hygiene practice. Alabama allows candidates to take its examination if they have been trained through a State-regulated on-the-job program in a dentist's office. The Commission on Dental Accreditation accredited about 200 programs in dental hygiene. Although some programs lead to a bachelor's degree, most grant an associate degree. Five universities offer masters' degree programs in dental hygiene. An associate degree is sufficient for practice in a private dental office. A bachelor's or master's degree is usually required for research, teaching, or clinical practice in public or school health programs. About half of the dental hygiene programs prefer applicants who have completed at least one year of college. Some of the bachelor's degree programs require applicants to have completed two years. However, requirements vary from school to school. These schools offer laboratory, clinical, and classroom instruction in subjects such as anatomy, physiology, chemistry, microbiology, pharmacology, nutrition, radiography, histology (the study of tissue structure), periodontology (the study of gum diseases), pathology, dental materials, clinical dental hygiene, and social and behavioral sciences. 7
  8. 8. Dental hygienists should work well with others, particularly patients who may be under stress. Dental hygienists must have manual dexterity because they use dental instruments with little room for error within a patient's mouth. JOB OUTLOOK Employment of dental hygienists is expected to grow much faster than the average for all occupations through the year 2010 in response to increasing demand for dental care. Demand will be stimulated by population growth, greater retention of natural teeth by middle-aged and elderly people and rising real incomes. Additional job openings will result from the need to replace workers who leave the occupation. Dentists are likely to employ more hygienists for several reasons. Older dentists, who are less likely to employ dental hygienists, will leave and be replaced by recent graduates who are more likely to do so. In addition, as dentists' workloads increase, they are expected to hire more hygienists to perform preventive dental care such as cleaning, so they may use their own time more profitably. Enrollments in dental hygiene programs have been on the rise recently after declining during the 1980's. Unless the number increases sharply, however, opportunities are expected to remain very good. EARNINGS Geographic location, employment setting, and education and experience affect earnings of dental hygienists. Dental hygienists who work in private dental offices may be paid on an hourly, daily, salary, or commission basis. According to the American Dental Association, dental hygienists who work 32 hours a week or more average $609 a week, the average hourly earnings for all dental hygienists is $18.50. Benefits vary substantially by practice setting, and may be contingent upon full-time employment. Dental hygienists who work for school systems, public health agencies, the Federal government, or State agencies usually have substantial benefits. Questions: What kinds of procedures are done by Dental Hygienists in the dental office? What are the prerequisites for entrance into a Dental Hygienist program? What is the job outlook for Dental Hygienists? What are the weekly earnings for Dental Hygienists? 8
  9. 9. ADDITIONAL INFORMATION Contact: American Dental Hygienists Association, 444 N. Michigan Ave., Suite 3400, Chicago, IL 60611 9

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