3. INTRODUCTION
A dental auxiliary is a person who is given
responsibility a dentist so that he or she can
help the dentist to render dental care, but who
is not himself qualified with dental degree
Soben Peter
Their duties may range from simple procedures
like sorting the instruments to relatively
complex procedures which form part of
treatment
4. Classifications
A. Classification by WHO (1967)
i.
Non operating auxiliaries
a. Clinical
it’s a person who assists dentist in his clinical work but
doesn’t carry out any independent procedures in oral cavity.
b. Laboratory
it’s a person who assists the dentist by carrying out certain
laboratory procedures
ii. Operating auxiliaries
it’s 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
5. B. Revised classication
i.
a.
b.
c.
d.
ii.
a.
b.
c.
d.
Non-operating auxiliaries
Dental surgery assistant
Dental secretary/ receptionist
Dental laboratory technician
Dental health educator
Operating auxiliaries
School dental nurse
Dental therapist
Dental hygienist
Expanded function dental auxiliaries
7. DENTAL SURGERY ASSISTANT
A dental assistant may work under supervision of a licensed dentist carrying
out duties prescribed by dentist or by a dental hygienist employed by dentist
Duties
a) Reception of patient
b) Preparation of patient for any treatment he may need
c) Preparation of provision of all necessary facilities such as mouth washes
and napkins
d) Sterilisation, care and preparation of instruments
e) Preparation and mixing of restorative materials including both filling and
impression materials
f) Care of patient after treatment until he/she leaves including clearing of
instruments and preparation of instruments for reuse
g) Preparation of surgery for next patient
h) Presentation of documents to the dental surgeon for his completion and
filing of those
i) Assistance with x-ray work and the processing and mounting of x-rays
j) Instruction of patient, where necessary in the correct use of tooth brush
k) After care of patient who have had general anesthesia
10. DENTAL LABORATORY TECHNICIAN/DENTAL MECHANIC
A dental laboratory technician is a non-operating auxiliary who fulfils
the prescriptions provided by dentist regarding the extra oral
construction and repair of oral appliance and bridge work
Qualification prescribed DCI for dental mechanic
• Should have completed training of 2 years
• Candidate should be 15 years of age at the time of admission or
within 3 months of it and should be medically fit
• The candidate must have passed matriculation examination of
recognised university taking science subject or an equivalent
recognised qualification.
DENTURIST
it’s a term applied to those dental laboratory technician who are
permitted to fabricate dentures directly for patients without
prescription of dentist
ADA defines Denturism “as the fitting and dispensing of dentures
illegally to the public”
11.
12. DENTAL HEALTH EDUCATOR
This is a person who instructs in the prevention of
dental disease and who may also be permitted to
apply preventive agents intra orally, but they are
not allowed to take up any intra oral procedures.
14. SCHOOL DENTAL NURSE
This is a operating auxiliary who is permitted to diagnose dental disease and to plan
and carry out certain specified preventive and treatment measures including some
operative procedures in the dental care and periodontal disease in defined group of
people usually school children.
They are mainly confined to New Zealand but now some other countries like
Malaysia, South Vietnam, Thailand, Hong Kong, Australia have also recognised their
services and are being employed
Duties
• Oral examination
• Prophylaxis
• Topical fluoride application
• Advice on dietary fluoride supplements
• Administration of local anesthetic
• Cavity preparation and placement of amalgam filling 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
• Referral of patient to private practitioner for more complex services like extraction
of permanent teeth and orthodontic treatment
15. 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 preparations of cavities and restoration of teeth.
Duties
• Clinical caries diagnosis
• Cavity preparation in deciduous and permanent teeth
• Vital pulpotomies under rubber dam in deciduous
teeth
• Extraction of deciduous teeth under local anesthesia
The training is for a period of 2 years involving both
reversible as well as irreversible procedures. Their service
is mainly utilised in Australia and UK.
17. DENTAL HYGIENIST
This is an operting auxiliary licensed and registered to practise dental hygiene under
the laws of appropriate state, province, territory or nation.
DCI defines dental hygienist as “a person, not being a dentist or a medical
practitioner, who does oral prophylaxis gives instruction in oral hygiene and preventive
dentistry, assists the dental surgeon in chair side work and manages the office. He/she
shall work under the supervision of dental surgeon”
Criteria laid down by DCI for the course
• The course of studies should extend over a two academic years and lead to
qualification of dental hygienist
• The candidate should be at least 15 years of age at the time of admission or within
3 months of it and medically fit.
• The candidate must have passed at least matriculation examination of a
recognised university taking science subject or an equivalent qualification.
Duties
• Cleansing of mouth and teeth with particular attention to calculus and stains
• Topical application of fluorides, sealents and other prophylactic solutions
• Screening of preliminary examination of patient such as individuals or I
groups, such as school children or industrial employees, so that it may be referred
to a dentist for treatment
• Instruction for oral hygiene
• Resource work in field of dental health
Other countries where dental hygienist are accepted include
USA, UK, Canada, Nigeria, China, Japan, Korea and Poland
19. EXPANDED FUNCTION DENTAL
AUXILIARIES
An EFDA is also referred expanded function dental assistant, expanded
function dental hygienist, expanded function auxiliary techno
therapist, expanded function duty dental auxiliary.
An EFDA is a dental assistant or dental hygienist in some cases who has
received further training in duties related to the direct treatment of patients
though still working under the supervision of a dentist
Duties
• Placing and removing of rubber dams
• Placing and removing temporary restorations
• Placing and removing matrix bands
• Condensing and carving amalgam restorations in previously placed teeth
• Placing of acrylic restorations in previously prepared teeth
• Applying the final finish and polish to the previously listed restoration
Four levels of training and qualification were recognised
1. Certified dental assistant
2. Preventive dental assistant
3. Dental hygienist
4. Dental hygienist with expanded duties
20. 1. CERTIFIED DENTAL ASSISTANT
Training course is of 8 months duration. The assistant was taught traditional
chair side duties
2. PREVENTIVE DENTAL ASSISTANT
Trainee should be certified dental assistant. Fulltime courses were of 3-6
weeks length. They’re permitted to
• Polish the coronal portions of teeth without instrumentation
• Make impressions for study models
• Topically apply caries preventive agents
• Place and remove rubber dam
• Maintain a patient’s oral hygiene
3. DENTAL HYGIENIST
The student has to be a certified dental assistant . Fulltime courses were of 36 weeks lengths. They’re allowed to carry out
• Scaling
• Conduct a preliminary examination of the oral cavity including taking case
history, periodontal examination and recording clinical findings
• Provide a complete prophylaxis including scaling , root planing and
polishing of fillings
• Apply and remove a periodontal pack
• Apply fissure sealent
21. 4. 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’re allowed to carry out
• Removing sutures
• Placing, finishing and polishing restorations of
amalgam and resin
• Placing and removing matrix bands
• Placing cavity liners
• Retracting gingiva for impression making
• Fitting and removing orthodontic bands
• Separating of teeth prior to banding by a dentist
• Cementing temporary crowns previously fitted by a
dentist
• Placing temporary fillings
22. Frontier auxiliaries
It refers to the community of nurses and former
dental assistants who are provided training to work
in rural areas which are distant from public or
private dental clinics
They’re trained to provide services like
• Simple dental procedures
• Basic dental health education
• Organising fluoride rinse programmes
• Simple denture repairs
• First aid can be rendered in case with pain
23. NEW AUXILIARIES TYPE
The expert committee on auxiliary dental
personnel of WHO(1959) has suggested two
new types of dental auxiliaries
Dental licentiate
Dental aide
24. Dental licentiate
This is a semi independent operator trained for 2 years to
perform
• Dental prophylaxis
• Cavity preparation and fillings of primary and
permanent teeth
• Extraction under local anaesthesia
• Drainage of abscess
• Treatment of the most prevalent disease of supporting
tissues of teeth
• Early recognition of more serious dental conditions
They work mainly in rural or frontier areas. They’re
responsible to the Chief of the regional or local health
services
25. Dental aide
They perform duties which include elementary first
aid procedures for the relief of pain, including
• Extraction of teeth under local anaesthesia
• Control of haemorraghe
• Recognition of dental disease which is important
enough to justify transportation of patient to a
centre where proper dental care is available
They receive a training of 4-6 months followed by a
period of field training under direct and constant
supervision. They operate only within a salaried
health organistion and be under supervision
26. DEGREE OF SUPERVISION OF
AUXILIARIES
ADA(1975) defined four degrees of supervision of auxiliaries with the
assumption that ultimate responsibility was assumed by the licensed dentist.
1. General supervision
The dentist has authorised the procedures and they’re being carried out in
accordance with diagnosis and treatment
2. Indirect supervision
the dentist is in the dental office, authorises the procedures and remain in
the dental office while the procedures are being performed by auxiliary
3. Direct supervision
the dentist is in the office personally diagnoses the condition to be
treated, personally authorises the procedures and before dismissal of the
patient evaluate the perfomance of the dental auxiliary.
4. Personal supervision
the dentist is personally operated on a patient and authorise the auxiliary to
aid treatment by concurrently performing supportive measures
