| Action | Registration and practice of dental assistants |
| Stage | NOIRA |
| Comment Period | Ended on 11/12/2008 |
 |
18VAC60-20
I went through and read most of the comments. It was interesting to me the demographics of those in this forum asking for scaling as an expanded duty of the dental assistant II.
Here are many of them:
Centreville
Middleburg
Roanoake
Keysville
Shenandoah
Abingdon
There are 2 out of this group that I would consider rural and perhaps underserved, with that I am confused as to why the rest of you are asking for this. The proposal is for expanded duties because there is a supposed shortage of hygienist’s and an underserved community. Looking at the demographics, each of you have access to a hygiene school nearby and you could easily send your dental assistants to such a school. I agree, dental assistants are very capable with the right training. I was a dental assistant many years ago, and was encouraged by my dentist to go to hygiene school. The RIGHT training is accessible to dental assistants at a school of dental hygiene with appropriate National and State Board Examinations.
Most of us have heard this argument for years. Hygienist’s and dentists have worked hard to enhance the quality of care and access to quality care and improved it over the years. We know the importance of increased quality care. It has even taken a long time to get the community to become aware that periodontal health was important to their overall health. What was key – EDUCATION!!
Looking at the demographics above, I am surprised that you can't seem to find hygienists. Most of us know quality hygienist’s who are looking to work in your practice due to the economical strains. Local temp agencies, the dental hygiene schools, your current hygienist, and your colleagues usually can help you meet your needs.
If this is more a concern about the economics, then consider a course in practice management when earning your ceu’s. I mention this with sincerity and truly no sarcasm is intended. I realize that these are hard and difficult times for our practices and our patients. We are all in this together, and perhaps the board of dentistry needs to survey the impact of the economy on dental businesses. Also, let your employee's know what is going on financially - in a course in practice management, I assure you they will tell you this is key to enhancing your practice. If we know, we can help as a team come up with ways to make it better for all involved. We want our practices to be successful.
I assure you that your hygienist will help you keep your patients, and suddenly implementing this practice of dental assistants with this duty will be of more detriment both in short term (your patient's reaction) and long term (legal issues). As a hygienist, I am fully aware of what my patient's want and demand and they count on your dental team and the State board to protect them as well. There are courses out there that are beneficial in helping all of your team members fully utilize their capabilities that don’t include having the assistant’s perform illegal duties or duties that have the potential to harm the patient or duties that require an already substantiated amount of education.
You are a team, and you need team players and each member of your team should become more aware of his/her roles and duties that help enhance the practice. This will ultimately benefit your patient’s with increased care and education that enhance their health and quality of life, and help your practice meet it’s goals.
I think it would be interesting to note, that recently I had a young adult patient come in who is in the military. She was on 2 weeks leave and wanted desperately to seek a professional cleaning as she felt her cleanings by the military were not up to the standards she once knew as a civilian. If you were to have glanced at her, it would have been easy to assume she was a Class I prophylaxis. Her mandibular anteriors had the expected amount of supragingival calculus, and maxillary 1st molars presented with some deposits as well. She had only slight interproximal bleeding, spot probing was not alarming; regardless, it wasn't indicative of what I would soon discover (to note - she had been more diligent recently with her oral hygiene). She had tenacious subgingival deposits throughout the mandibular arch and some on the maxillary arch; of these included burnished deposits. I have been in practice for many years, and have seen this often. I assure you that first glances and spot probings don’t reveal the full picture, and this is what would be happening because you the dentist may not have the time to really investigate this type of patient for the dental assistant. In my professional opinion this could have easily been mistaken as a Class I patient, and yet, it took an educated amount of skill both in clinical assessment and treatment. I assure you the patient was very appreciative that I took the time to give her the appropriate treatment and educate her on how to improve her oral health that will ultimately affect her overall health.
Sincerely,
Jennifer, RDH