This document discusses the roles and classifications of dental auxiliaries. It defines auxiliaries as non-dentists who assist dentists in providing dental care. Auxiliaries are classified as either non-operating or operating. Non-operating auxiliaries include dental assistants and lab technicians, while operating auxiliaries perform treatments like dental therapists and hygienists. The duties and training of common auxiliaries like dental nurses, hygienists, and expanded function dental assistants are also outlined. The document concludes with descriptions of new proposed auxiliary roles and levels of supervision for auxiliaries.

1. DENTAL AUXILIARIES

2. 2
CONTENTS
• Introduction
• Classification
• Operating Auxiliaries
• Non- operating Auxiliaries
• Frontier Auxiliary
• Degrees of Supervision

3. A dental auxiliary or ancillary
is a person who is given
responsibility by a dentist so
that he/ she can help the
dentist render dental care, but
who is not himself or herself
qualifies with a dental degree.
DEFINITION
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4. NON-OPERATINGAUXILIARIES
1.ClinicalAuxiliary:
This is a person who assists the professional in his clinical work but does not
carry out any independent procedures in the oral cavity.
2.Laboratory Auxiliary:
This is a person who assists the professional by carrying out certain technical
laboratory procedures
OPERATINGAUXILIARIES:
This is 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
CLASSIFICATION (WHO,1967)
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5. Revised classification:
Non operating ancillaries:
• Dental surgery assistant
• Dental secretary/ receptionist
• Dental laboratory technician
• Dental health educator
Operating ancillaries
• School dental nurse
• Dental therapist
• Dental hygienist
• Expanded function dental ancillaries
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6. Dental Surgery Assistant:
Is a person who assists the dentist with his
clinical work but does not independently
carry out any procedures in mouth.
Functions:
• Smooth running of the clinical area.
• Management of instruments,
equipments and materials, including
cleansing, sterilizing and recycling.
• Supplies instruments to the dentist at
chairside as needed.
NON OPERATING ANCILLARIES
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7. Dental LaboratoryTechnician:
• Is a non operating auxiliary who fulfils the prescriptions
provided by dentist regarding the extra oral constructions
and repair of oral appliances and bridge work.
• He undertakes many mechanical tasks like casting of models
from impressions made by the dentist, Include the fabrication
of dentures, splints, orthodontic appliances, inlays and
special trays
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8. Denturists:
• Is a term applied to those dental laboratory technicians who are permitted to
fabricate dentures directly for patients without a dentist’s prescription.
• Several countries (Tasmania, Denmark) have allowed laboratory technicians
to work directly with the public.
• The ADA defines denturism as “ the fitting and dispensing of dentures
illegally to public.”
Demonstrating DentureConstruction-Brisbane 1940 8

9. Duties of Denturists/ Dental technicians
• Working with a dentist in the clinic,
• assisting with treatment by helping to fit attachments at chairside.
• Working with a dentist or a clinical dental technician in the clinic.
Assisting with treatment by
• Taking impressions
• Recording facebows
• Carrying out intra-oral and extra-oral tracing
• Carrying out implant frame assessments
• Recording occlusal registrations
• Tracing cephalographs
• Carrying out intra-oral scanning for CAD/CAM
• Taking intra and extra-oral photographs.
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10. Dental Secretary/Receptionist:
The person who assists the dentists with his secretarial work
and patient reception duties.
Dental Health Educator:
Is a person who instructs in the prevention of dental diseases
and may also be permitted to apply preventive agents
intraorally.
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11. School Dental Nurse
• This type of ancillary was established in
New Zealand in 1923 to deal with a large
amount of dental disease present among
the school children.
• The government made provision for
training young women as school dental
nurses who would provide the bulk of the
treatment in school dental services.
Operating Ancillaries
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12. Saskatchewan Health Dental Plan (SHDP),
• Trained and employed dental therapists/ SDN in school based clinics
to provide basic dental care to all children.
• Only school-based program staffed by dental therapists to ever exist
in North America.
• The program achieved significant success during the course of its
existence from 1974 to 1987. However, it was terminated in 1987
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13. Services( Saskatchewan DHP)
• Diagnosis (radiographs, treatment planning),
• Prevention (oral hygiene instruction, both chair side and classroom,
prophylaxis, topical application of fluorides)
• Restorations (stainless steel crowns, intra-coronal restorations/fillings)
• Oral surgery (extractions of primary and permanent teeth),
pulpotomies and emergency procedures.
• Children would be re-examined on a semi-annual basis.
• Dental health education was considered to be the most important
element of the program.
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14. Duties of School Dental Nurse
• Oral examination
• Prophylaxis
• Topical fluoride application
• Advice on dietary fluoride supplements
• Administration of LA
• Cavity preparation & placement of amalgam filling
• Pulp capping
• Extraction of primary teeth
• Individual patient instruction in tooth brushing & oral hygiene
• Class room & parent-teacher dental health education
• Referral of patient to private practitioners for more complex Services.
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15. DentalTherapist:
Is a person 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.
Duties :
• Clinical caries diagnosis
• Cavity preparation in deciduous
and permanent teeth
• Restorative skills
• Vital pulpotomies
• Extraction of deciduous teeth
• Training period is for 2 years
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16. Dental Hygienist:
• This type of ancillary was first employed in 1906 in USA and in 1913 the
first formal training was established.
• Performs certain specified preventive and treatment measures in the
treatment of periodontal diseases.
• Dr.Alfred C Fones - Father of dental hygiene
• Mrs. Irene Newman-First dental hygienist
Duties:
• Scaling & Polishing of teeth
• Topical application of fluoride
• Provision of dental health education
• In some countries they are permitted to
take radiographs, make impressions for
study models and polish restorations. 16

17. Expanded Function Dental Auxiliaries (EFDA):
• Also known as expanded function dental hygienist, expanded function dental
assistant, expanded function auxiliary, expanded duty dental auxiliary.
• An EFDA is a dental assistant who has received further training in duties related
to direct treatment of patients, though still working under the supervision of
dentist.
• They undertake reversible procedures, which could be either corrected or
redone without undue harm to patient’s health.
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18. • Placing and removing temporary restorations
• Placing and removing matrix bands
• Removing and replacing ligature wires
• Placing and removing rubber dams
• Condensing & carving amalgam restorations in previously
prepared tooth
• Applying final finish & polish to previously listed restorations
• Exposing and developing radiographs
• Removing sutures
Duties of EFDA
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19. Four levels of training:
1. Certified Dental Assistant (CDA)
2. Preventive Dental Assistant (PDA)
3. Dental Hygienist
4. Dental Hygienist with expanded Duties
Certified Dental Assistant (CDA)
The training course for CDA is up to 8 months and he is taught traditional chair
side duties.The only intra-oral duty was exposing radiographs.
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20. Preventive DentalAssistant (PDA)
• The PDA had to be a Certified Dental Assistant.
• Courses up to 3-6 weeks.
Duties:-
• Polish coronal portions of the teeth without instrumentation and take
impressions for study models.
• Topically apply caries preventive agents,
• Place & remove rubber dams
• Maintain a patients oral hygiène
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21. Dental Hygienist with Expanded Duties:
• Eligibility – one year practical as a dental hygienists
• Training – 4 months
Functions
• Removing sutures
• Finishing and Polishing amalgam and resin restorations
• Placing & removing Matrix band
• Retracting gingiva for impression
• Fitting and removing orthodontic bands
• Cementing temporary crowns
• PlacingTemporary restorations
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22. FRONTIER AUXILIARIES
• Nurses and former dental assistants can provide valuable service with
minimum of training in rural areas.
• In 1981 , Alaskan communities 1 week training program was conducted for
frontier auxiliaries.
• Simple prophylaxis, basic dental health education, dental first aid can be
rendered for those with pain and subsequently referred to nearest dentist
• Perform Fluoride rinse programmes & simple denture repair
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23. NewAuxiliaryTypes:
The expert committee on auxiliary dental personnel of the WHO has suggested
two new types of dental auxiliaries:
• The dental licentiate
• The dental aide
Dental Licentiate:
Functions as a semi independent operator.
Functions:
• Oral prophylaxis
• Cavity preparation & fillings of primary & permanent teeth
• Extractions under L.A.
• Drainage of dental abscesses
• Early recognitions of more serious conditions. 23

24. DentalAide:
The duties include, elementary first –aid procedures for the relief of pain
including:
• Extraction of teeth under L.A.
• Control of haemorrhage
• Referral
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25. DEGREES OF SUPERVISION (ADA)
General
Dentist has authorized the procedures and are being carried out in
accordance to the diagnosis and treatment plan of the dentist
Indirect
Dentist authorizes the procedures and remains in dental office while the
procedures are being performed by auxillary
Direct
Dentist does the diagnosis of the condition, personally authorises the
procedure and evaluates the performance before dismissal of the patient
Personal
Dentist is personally operating on a patient and authorises the auxiliary to
aid treatment by concurrently performing supportive procedures 25

26. REFERENCES
• Essentials of Preventive and Community Dentistry- Dr. Soben Peter
• Textbook of Preventive and Community Dentistry - SS Hiremath
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