Dental auxillaries


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Dental auxillaries

  2. 2. 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
  3. 3. 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
  4. 4. 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
  6. 6. 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
  8. 8. DENTAL SECRETARY/RECEPTIONIST This is a person who assists dentist with secretarial works and patient reception duties
  9. 9. 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”
  10. 10. 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.
  12. 12. 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
  13. 13. 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.
  14. 14. Dental Therapist
  15. 15. 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
  17. 17. 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
  18. 18. 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
  19. 19. 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
  20. 20. 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
  21. 21. 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
  22. 22. 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
  23. 23. 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
  24. 24. 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