If a DAII is allowed to do this there must be a list of duties they can use the highspeed for. But to just make a blank statement  that opens up for interpretation as to what they can do with it is a bad idea. I don't believe this is a good idea at the present time as the DAII is still new and there has been no feed back on how they are working out.

A blanket approval of such legislation may prove to be dangerous for patients and without proper training a true disadvantage to the dental practioner, as well as, the dental profession..                                                                                                                                                        

this is a BAD idea with vague guidelines!!! as graduate of a 4 year RDH program I am not licensed to operate a high speed hand piece in the mouth. how does the limited amount of training that the DAII will get make this a safe idea?

In my opnonion this must be more precise. Making a blank statement opens up for interpretation

Kred

Public safety is an issue here.  The dental assistant should not be allowed to use a high speed instrument in the mouth for any purpose.  This is not within the realm of their duties and this allowance would put patients at risk of severe injury.  Unlike dentists, they do not have the education or training. Obviously, this petition has no merit.    

Dental assistants using a high speed instrument?  Are you kidding?  For what possble purpose? Prepping a crown? Removing hard tooth structure?  Performing endodontic therapy?  Dentists, you are going to put the public at great risk.  This is a slam dunk NO!!!

This is rediculous. Hygienist after years of education, taking national and clinical boards,  are not licensed to use a high speed rotary instrument. Dental assistants do not have the educational level to allow them to use something that performs irreversible treatment (tooth sturcture removal).  And lets not forget the dangers of possible patient injury.   Is this a means tof increasing office profits?? 

I can see of no possible reason for DA II's to be operating a high speed handpiece. It is a safety hazard to our patients and an affront to our profession.

Use of the highspeed handpiece correctly, without causing harm to a patient, takes years of instruction and knowledge.  Removal of dental caries may look technically easy, but done correctly, is as difficult as removing a cerebral neoplasm.  Extensive knowledge of anatomy, physiology, biochemistry, microbiology, pathology and more is required.   Hand-eye coordination and psychomotor skill is very challenging, but can be learned in a few years of pre-clinical and clinical instruction.  Knowing how to use a handpiece, and where and when to use it correctly, takes years of education and clinical monitoring.  Even after 4 years of dental school, most graduates are barely able to use a handpiece successfully and without causing harm.  Non-dentists have been trying to classify dentistry as a mechanical trade for years, and will continue to do so.  Dentistry became a reliable and worthwhile profession almost 200 years ago, when science, high-level education and clinical mentoring replaced technicians and tradesmen.  This is another attempt to reverse the advances made by dentistry and medicine for purely financial reasons.  We owe the public the right to have properly educated and trained personnel providing medical and dental care.  If DA2's want to use a high speed handpiece, there are plenty of dental schools waiting for their applications.

Only properly trained and qualified dental professionals should be allowed to operate high speed instruments. I am a Registered Dental Hygienist after 4 years of education as well as passing a national and clinical exam yet I am still not allowed to operate a high speed instrument in a patient's mouth so a DAII is certainly not qualified! Dental assistants do not obtain adequate training to allow them to use something that performs irreversible changes to tooth anatomy, and allowing them to do so will put patients at unnecessary risk to great harm. A definite NO! 

I feel that the use of high speed rotary insturments by a DAII is beyond the scope of educational and training requirements in place for a DAII and will not safely expand the capability of dental practice within the Commonwealth.

Over the past 35 years of practice in Virginia , I have had 2 dental assistants that I would have permitted to use a high speed handpiece to replace/adjust a restoration in my mouth. Back in the day, there were no DA II's, just very experienced and well trained DA's, a couple of whom worked for me, I would be very comfortable letting them do what 1st year dental students do under supervision.

General dentistry,  along with family practice medicine, is not rocket science. As Dr. Elmer Bear, head of oral surgery at MCV used to say, "I could train a monkey to pull teeth. I've been doing it for over 30 years", obviously referring to undergraduate dental students.

Dentists are way too uptight about their training and credentials. Let's face it: dental school is no more than a trade school, as is medicine . Well trained auxillaries can be just as competent in performing the manual skills of of dentistry, with the caveat of he supervision and  diagnostic skills of an experienced, licensed dentist.

High speed handpieces should only be used by trainded operators who by there frequent use are able to properly control the instrument, and what about the insurance ramifications, who shall be paying for the increased premiums.

This is not a skill they have now nor will it become a safe skill for them.  Let's leave it off.

I could see it for removal of bonding material using a gold shank fluted bur after orthodontic brackets have been removed, and correcting high spots on restorations.   What other purposes would this change serve?  Other than for these purposes, dental assistants do not have the skill or training to use a highspeed. 

I am a RDH, and I am strongly opposed to the idea of a DA II operating a high speed handpiece.  Not only do I feel this is unsafe for the poor patients who would be subjected to these untrained individuals "experimenting" on them but the mere fact that anyone would consider it is absurd.  Why not let out children do the same?  They are untrained, also.

As a EFDA/DAII we are licensed to placed fillings start to finish, in order to do that  a high speed hand piece is needed, we have to adj the occuclusion,contour the filling and remove flash, this would be like asking the Dental Hygienist  to clean someone teeth start to finish and not letting them  use a CAVITRON. As of how I am the only DAII in the state of Virginia, to become a EFDA/DAII TAKES YEARS of training and schooling, it's not a little 16weeks class. This is something you are taught/trainned  in your Schooling. I think  the people to sit and write these comments need to learn more about  DAII and all that we do as a DAII/EFDA, when YOU have NEVER worked with a DAII in your office, for I know this because I AM THE ONLY DAII IN THE WHOLE STATE OF VIRGINIA AND HAVE WORKED AS ONE FOR OVER 16 YEARS!  

Thank you,

F. Denice Burnette EFDA, CDA, DAII

I am opposed to this proposed regulation allowing a DAII to use a high-speed handpiece in the mouth. A DAII currently does not have the experience and education necessary to put forth this type of proposal. I will be detrimental to the oral health of Virginians.

I am saddened to think that dentists would relegate the use of high speed handpieces to dental assistants whether a certified dental assistant or not.  Do the doctors realize they will be held liable for any injuries to the patient or damage to tooth structure?  Do the assistants realize they will need to carry their own liability insurance?  Yes, they both can be and will be sued.

Use of high speed handpieces cause permanent removal of tooth structure.  So please do not take this bill lightly. What the assistant does with a high speed handpiece will be irreversible.

The dental assistants will still need direct supervision of a dentist.   I realize the goal may be to offer dental care in underserved areas however, the reality is that this puts all citizens of Virginia at risk for poor dental care and injury.

As the hippocratic oath states:  "First do no harm"

Although I have great respect for the role that each person on the dental team plays to support the oral and systemic health of our patients, I also recognize the limitations of each position.  I do NOT support the use of high speed handpieces intraorally by DAII. Use of the highspeed handpiece requires great skill and control.  This has the potential to put the public we serve at risk.

Using a high speed handpiece is a very dangerous procedure. It should not be delegated to someone other than a licensed dentist.

I am completely against the use of high speed handpieces by DAII's in patients mouths. We train dental students for four years to do this irreversible treatment and no amount of training for a dental assistant will qualify them to be as competent to do these proceedures as a dentist. I feel they should go to Dental School to be trained properly and pass the Board Exam before doing so. If this is put into law the Commonwealths' citizens will be put at risk. I realise access to care is a problem but to have assitants doing this type of treatment is unfair to the public and should be prohibited.

Considering that a high speed handpiece rotates at 400,000 RPMs, four years of training at an accredited dental school should be the minimum requirement for anyone considering performing an irreversible procedure in a person's mouth.  Allowing procedures like this to be undertaken by DA2s belittles the training all dentists go through in order to take on this mighty responsibility.   

Probably not a good idea in most cases and I would be against delegation of this task..

I am strongly opposed to anyone other then a trained dentist, using the high-speed handpiece. I urge the BOD to not consider this request and maintain that irreversible procedures be performed only by the dentist.

I have mixed opinions about this petition.  As a program head at a community college that will eventually offer in-depth Level II courses I  know this is necessary to fulfill the intent of Level II but I am not sure if this is a good idea.  I can understand that removal of flash, contouring/finishing composites, and adjusting occlusion will be needed in the completion of restorations but I am concern about the education/training/skills of the person using the high speed handpiece.  If the Board of Dentistry decides to pass this additional Level II petition then the educational hours for the composite and amalgam modules need to be adjusted to reflect the additonal hours of training and coursework involved.  Public safety is of upmost concern.

This is abserd no dental assistant should be operating any tool as such. If they want to be a RDH then go to school for it. Hygiene requires alot more education than an assiatant can obtain in the programs they are attending 

 Go to dental school if you wana do fillings. No DAII is putting a filling or scaling anything in my mouth or families mouth. 

I was a C.D.A. for over 10 years before  going back to college and recieving my degree in dental hygiene. To allow an assistant to perform such  procedures with no guiildlines is insane.  Even with guildlines it is insane , as a hygienist I view this as malpractice, a definate possible harm to the patients who expect the best dental care possible.To allow a DAII to use a highspeed handpiece in the mouth would be as dangerous as giving your child a loaded gun for a play toy. Please don't destoy the dental profession by allowing this to happen..

Several years ago I was very active in helping to structure the proposals which
lead to the current regulations. The proposals were carefully crafted to both
protect the public and to address access to care in underserved areas of the
state. Many hours were invested by qualified dentists in consultation with
registered hygienists; that is why the regulations are the way they are.
Allowing the use of high speeds by anyone other than a licenced dentist to cut
human tissues constitutes far too great a risk to the public. One of the
published comments from a non-registered user agrees with this but also
includes an exception for "correcting high spots on restorations". The lack of
comprehension displayed here by a lay person is understandable. However, it
also illustrates just how damaging this type of thinking could be. After more
than 40 years spent treating TMJ and occlusal problems I cannot think of a
better way to create problems than to have amateurs adjusting the occlusion.
«
John A Marino, DDS
 

I find this to be absurd and a safety concern, as well.

I am opposed to allowing the use of the high speed handpiece by DAII. The high speed is an instrument which requires careful control which is attained by attending four years of dental school. Improper use can be very detrimental to the patient.

To allow DAII's to use a highspeed handpiece is a horrible idea.  Dentist train for years to gain the skill to use a high speed on patients.  We train on plastic and extracted teeth for two years prior to clinical care, and then only use a handpiece with a rubber dam in place, which gives the patient's some protection.  I strongly oppose this and agree with others who have stated how this belittles the training dentists endure to be able to do their work successfully and not harm their patients. 

I have read the comments that others have left. I wanted it to be clear that Expanded Function Dental Assistant are not your general dental assistant. There is alot of schooling and trainings to be come an Expanded Function Dental Assistant DAII.  In which all of this is new to Virginia. If you look at other states, some EFDA/DAII are licensed to do extraction, yes I said that right, some states allow there EFDA/DAII to finish RCT.  I just want everyone to understand that there's a lot of schooling and trainning that comes with being a EFDA/DAII. We as EFDA/DAII we are taught the Anatomic Features of the ALL teeth, contour, all your line angles, cavity wall, cavosurface angle, pulp capping and so on. A EFDA/DAII and a Dental hygienist are not the same it's too  different license. A person can finish high school and go straight to hygiene school and became a hygienst in 2 yrs, but a person can't finish high school and go straight to EFDA/DAII school you have to become a  Dental Assistant first and then you go back to college to be come a EFDA/DAII. If we looked back 10yrs ago and said about hygienist giving anesthesia people would have thought you where crazy but they have been doing that for years in other states. It's like a dentist said at a CE course why shouldnt they, nurses give shots every day, and he is right it's the same thing.  I would like for everyone to see/know whats all involved in EFDA/DAII. The highspeed handpiece isn't used on tooth surface just filling part only!!! As a EFDA/DAII I am licensed to place and finish fillings but I cann't clean/scale your teeth, but a hygienst can clean/scale your teeth but they aren't licensed to do fillings. That's because it's to different license. I hope this helped some people who maybe didn't understand the EFDA/DAII and all that's involved. For anyone who is thinking about going back to school to get your EFDA/DAII I hope this has helped you . I love being a EFDA/DAII been doing it for over 16 yrs. I love having a patient come in that has broken down teeth and wont smile and being able to restore their teeth back and seeing  them smile when they look at their new tooth/teeth .That makes my day.  Thank you all and have a Blessed week.

I agree with the petition with the following concerns.

If the Board of Directors decides to implement the general consideration of this petition, it would also clearly define more specific operative and educational guidelines.  Further logical limits including oversight parameters would be imperative, as in dental school, for the necessary professional competence needed for this level of dental care delivery.

This has been accomplished before, not only in other U.S. states, but in other countries, very successfully.  Now it is our turn.

As with the delegation of other responsibilities to qualified paradental personnel, this careful examination of skill application will only further expand the dentist's ability to deliver health care more efficiently and effectively.

I have had the privilege of having an expanded duty D.A. II working with me for some time.  She is well experienced, well trained, and very well accepted by our patients.  This D.A. II knows well her limits and stays within them.  Her presence has greatly reduced the work stress factor in our office.

The focus here is not on personal accomplishments but on the quality and effectiveness of the services we render to our patients.  This a positive step in that direction.

I did not take the time to "research" who petitioned for "allowing" dental assistants to use high speed drills  but in view of national data pertaining to the high rates of injuries, infections, and etc. and even deaths in all types of healthcare systems,  I, as a seasoned and expert operating room nurse,  find this type of attempt to expand / delegate more and more "medical tasks"  to UAPs (unlicensed assistive personnel) or even perhaps to licensed staffers who are not medically educated or medically trained (either in medical school or in dental  school) appalling!  

Why not just close down all medical and dental and etc schools since "someone"  believes just "anyone"  can be trained to do anything!  I challenge those who keep attempting to expand unqualified staffers to get on the operating room table  themselves or into the dental chairs and allow themselves to be guinea pigs.......sad........there are more safety regulations pertaining to research annmals then there are to human beings. 

Why is it that it always seems like the "issue" seem like it  is all about "getting" more patients processed faster so the coffers fill up faster and higher?   This issue is analogous to the California NPs (nurse practitioners) and PAs (physician assistants) who recently asked  for "priviledges to perform abortions"........if a woman has an abortion then she should have IT performed by a qualified doctor or surgeon!  

Since, we do not live in an underdeveloped country, I expect our standards to be better. 

My opinions, respectfully

Helen M. French RN,BSN,ADN