Dental Auxiliary

Dental Auxiliary Dr. Raya Al-Naimi

A dental auxiliary is a person who is given responsibility by a dentist so that he or she can help the dentist to render dental care, but who is not himself qualified with dental degree. Their duties may range from simple procedures like sorting the instruments to relatively complex procedures which form part of treatment.

Classification of Dental Auxiliaries :

• Dental auxiliaries may be classified according to :
1- The training they have received.
2-The task they are expected to undertake
3-The legal restrictions placed upon them.

CLASSIFICATION – WHO (1967)

1. Non Operating Auxiliary:
A) Clinical: A person who assists the dentist in his clinical work but does not carry out any independent procedures in the oral cavity.B) Laboratory: A person who assist the professional (dentist) by carrying out certain technical laboratory procedures
CLASSIFICATION – WHO (1967)
2. Operating Auxiliary: 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.

B. Revised Classification

1-Non-Operating Auxiliaries
a. Dental surgery assistant
b. Dental secretary/ receptionist
c. Dental laboratory technician
d. Dental health educator
2- Operating auxiliaries
a. School dental nurse
b. Dental therapist
c. Dental hygienist
d. Expanded function dental auxiliaries.


A-Dental Surgery Assistant
In 1885 – Dr. C. Edmund Kells of New Orleans
Woman as “lady in attendance”
Help dentist in business office as well as chair.
Perform non – technical work that do not require any or much training to ensure smooth running of the clinic . Dentist can concentrate & devote full attention to care of patient spending more time providing actual dental care
Duties Include (DSA)
1-Reception of patient.
2- Preparation of the patient for any treatment he or she may need.
3-Preparation and provision of all necessary facilities, such as mouthwashes, napkins.
4-Sterilization care and preparation of instruments.
5-Preparation and mixing of restorative materials including tooth filling and impression materials.
6- Care of patients after treatment until he or she leaves, including clearing away of instrument and preparation of instruments for reuse.
7- Preparation of the surgery for the next patient.
8- Presentation of documents to the surgeon for his completion and filling of this. Assistance with extra work and processing and mounting of x-rays.
9-Instruction of the patient, where necessary, in the correct use of the toothbrush.
10-Aftercare of persons who have had general anaesthesia.
There is still great variability in the utilization of dental assistance from office to office and from country to country.

Four Handed Dentistry

It simply means that the dental assistant's two hands are assisting the dentist's two hands, helping to reduce the amount of time a dental exam or procedure may take. Any dental professional will tell you that sitting at chairside all day is very uncomfortable and may result in lower back pain, tendonitis, and/or neuromuscular or musculoskeletal complications.
Four Handed Dentistry is the art of seating both the dentist and dental assistant in such a way that both are within easy reach of the patient’s mouth. Perform additional tasks such as retraction or aspiration. The dentist can thus keep his hands and eyes in the field of operation and work with less fatigue and greater efficiency.


Classification of Motion للاطلاع
Motions can be classified into five categories according to the length of the roll.motion as:
Class I. Movement of the fingers only as when picking up a cotton
Class II. Fingers and wrist motion as used when transferring an instrument to the operator.
Class III. Fingers, wrist, and elbow as when reaching for a handpiece.
Class IV. The entire arm and shoulder as when reaching to change the light position.
Class V. The entire torso as when turning around to reach for equipment from the fixed cabinetry

B-Dental Secretary / Receptionist.

This is a person who assists dentist with secretarial works and patient reception duties.

C- Dental Laboratory Technician / Dental Mechanic

The dental technician, whose main function is the fabrication of appliances, should work according to the prescriptions and under the supervision of the fully qualified dentist.
• Dental laboratory technology is both a science and an art. Since each dental patient's needs are different, the duties of a dental laboratory technician are comprehensive and varied.
• Although dental technicians seldom work directly with patients, except under the direction of a licensed dentist, they are valuable members of the dental care team.
• 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

Duties (DLT)

1-Casting of models from impressions made by the dentist.
2-Fabrication of dentures, splints, orthodontic appliances, inlays, crowns & special trays


DENTURIST
Is 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”
Denturists are now practising in many developed as well as underdeveloped countries.
• Reason behind denturism in developed countries like United States, – low cost of denture to needy people who are old, – no provision for denture in Medicare; – people think dentists are middle person for giving denture.

D-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

OPERATING

A-School Dental Nurse
The New Zealand school dental nurse plan was introduced in 1921
• During World War I (1914-1918) extensive dental disease were observed in army recruits and dentists were in short supply.
• In 1921 first training school for dental nurse was opened in wellington, New Zealand.
In 1923, 29 dental nurses were graduated from the wellington school
• The dental nurse is employed only by the government.
• The dental service offered to children begins at the age of two and one-half years. • When child reaches the age of thirteen he is discharged from the services of dental nurse.

Duties School Dental Nurse

A/ General
• Maintaining a specific group of approximately 500 children in sound dental health and free from dental defects by examining and treating them at six monthly intervals.
• Teaching the principles of oral hygiene, using modern teaching and publicity methods, and gaining the interest and cooperation of the children and their parents in this matter.
B/ Specific
1-Examining patients Orally and charting the dental condition
2-Prophylaxis
3-Topical fluoride application
4-Advice on dietary fluoride supplements
5-Administration of local anesthetic
6-Cavity preparation and placement of amalgam filling in primary and permanent teeth
7-Pulp capping
8-Extraction of primary teeth
9- Individual patient instruction in tooth brushing and oral hygiene
10-Classroom and parent-teacher dental health education
11- Recognizing malocclusion and lesions whose treatment is beyond her scope, and referring them to a dentist.


Training period of nurses A minimum of two calendar years

B- Dental Therapist

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

Duties Dental Therapist

1- Clinical caries diagnosis
2- Cavity preparation in deciduous and permanent teeth
3-Vital pulpotomies under rubber dam in deciduous teeth
4-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 utilized in Australia and UK.

C- Dental Hygienist

This is an operating auxiliary licensed and registered to practice dental hygiene under the laws of appropriate state, province, territory or nation. So a dental hygienist is “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.
Duties
1-Scaling and polishing teeth.
2-Applying fluorides, and other preventive
3-Diagnostic data collection • Desensitization of teeth after scaling and polishing •Radiographs • Bleaching of teeth
4-Occlusal splints • Sealant placement • Preventive appointments. • Photography Educating patients to practice sound dental habits

D- Expanded Function Dental Auxillary

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 EFDA
1-Placing and removing of rubber dams
2-Placing and removing temporary restorations
3-Placing and removing matrix bands.
4-Condensing and carving amalgam restorations in previously cavity prepared teeth
5-Placing of acrylic restorations in previously prepared teeth
6-Applying the final finish and polish to the previously listed restoration