The document discusses the roles and classifications of dental auxiliaries. It notes that dental auxiliaries assist dentists and take on tasks that require less skill, helping to improve access to dental care. Dental auxiliaries discussed include dental assistants, hygienists, technicians, and other roles with varying levels of training and supervision. The use of auxiliaries benefits communities by improving coverage of preventive services and increasing the productivity and efficiency of dental care delivery.

2. DENTAL
AUXILIARIES

3. ⁕ Socrates, in defining the ideal state, gives as a
prerequisite that men should divide the labor, certain
men becoming expert in certain fields, others in other
fields, and all working as a team for the common
good.

4. ⁕ Some task actually require more than two hands
⁕ Other tasks are more quickly or better performed if
one worker confines himself to part of the task,
leaving other parts to other workers.
⁕ A final reason lies in the different levels of
knowledge attainable within one field by opportunity
for training.
Reasons for division of Labour

5. ⁕ Certain parts of task require top-level skill and knowledge. In
dentistry these are the so called “professional services.”
⁕ Other parts of the task require less skill and knowledge.
These may safely be delegated to auxiliary personnel.
⁕ Society benefits from this sort division of labour in that
training time for professional personnel can be conserved.
⁕ Since large tasks, and particularly community-wide tasks, are
those where division of labour and teamwork are most
needed.

6. DENTAL AUXILIARY
⁕ Dental auxiliary is a person who is given responsibility by a
dentist so that he or she can help the dentist render dental
care, but who is not himself or herself qualified with a dental
degree.
⁕ The duties undertaken by dental auxiliaries range from
simple tasks such as sorting instruments to relatively
complex procedures which form part of the treatment of
patients.

7. AUXILIARIES
Non-Operating
Auxiliaries
Operating
Auxiliary
Clinical Laboratory
CLASSIFICATION BY WHO (1967)

8. AUXILIARIES
Non-Operating
Auxiliaries
Operating
Auxiliaries
REVISED CLASSIFICATION
Dental surgery assistant
Dental secretary/receptionist
Dental laboratory technician
Dental health educator
School dental nurse
Dental therapist
Dental hygienist
Expanded function
dental auxiliary

9. ⁕ Non-operating auxiliary who assists the dentist or dental
hygienist in treating patients, but is not legally permitted to
treat the patient independently.
⁕ Also known as Dental assistant, Chair side dental
assistant, Dental nurse
DENTAL SURGERY ASSISTANT

10. DUTIES OF DENTAL ASSISTANT
1) Reception of the patient
2) Preparation of the patient for any treatment
3) Provision of all necessary facilities such as mouthwashes
and napkins.
4) Sterilization, care and preparation of instruments.
5) Preparation and mixing of restorative materials including
both filling and impression materials.

11. 6) Care of the patient after treatment until he or she leaves
7) Presentation of the documents to the surgeon for his
completion and filing of these documents.
8) Assistance with X-ray work and the 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 anaesthetics.

12. Four-handed Dentistry

13. ⁕ Assists the dentist with his secretarial work and patient
reception duties
DENTAL SECRETARY/ RECEPTIONIST

14. DENTAL LABORATORY TECHNICIAN
⁕ Non–operating auxiliary who fulfils the prescriptions provided
by dentists regarding the extra oral construction and repair of
oral appliances and bridge-work.
⁕ Also known as Dental Mechanics

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

16. The DCI has prescribed that,
1. The course of studies should extend over a period of two
academic years and lead to the qualification of dental
mechanic certificate.
2. The candidate should be at least 15 years of age at the time of
admission or within 3 months of it and should be medically fit.
3. The candidate must have passed at least matriculation
examination of a recognized university taking science subject
or an equivalent recognized qualification.

17. ⁕ Dental laboratory technicians who are permitted to fabricate
dentures directly for patients without a dentists’ prescription.
⁕ ADA defines denturism as fitting and dispensing of dentures
illegally to the public.
⁕ Tasmania, a state in Australia – first place where technicians
are legally permitted to provide a prosthetic service.
DENTURIST

18. DENTAL HEALTH EDUCATOR
⁕ A person who instructs in the prevention of dental disease
and who may also be permitted to apply preventive agents
intra-orally.
⁕ Sweden - 2 additional weeks of training is given, after which
auxiliaries are allowed to conduct fluoride mouthrinsing
programs to groups of school children.
⁕ Not allowed to take any intra oral procedures

19. SCHOOL DENTAL NURSE
• Who is permitted to diagnose dental disease and to plan
and carry out certain specified preventive and treatment
measure, including some operating procedures in the
treatment of dental caries and periodontal disease in
defined groups of people, usually school children.

20. • Dental Nurse Scheme: Wellington, New Zealand in 1921-
because of extensive dental disease found in army recruits
during World War I
• T A Hunter – founder of New Zealand Dental Association,
pioneered in establishment of first school for them – THE
DOMINION TRAINING SCHOOL FOR DENTAL NURSES
• Training period – 2 years for both reversible and irreversible
procedures.

21. • Upon completion of course – school dental nurse is
assigned a school and employed by the government – for
dental care of 450-700 school children.
• If more than 100 school children per school – then a
dental clinic is present in the school.
• School dental nurse is treated as a member of the staff

22. Functions
1. Oral examination
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

23. 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.Referral of patient to private practitioners for more complex
services

24. DENTAL THERAPIST
⁕ Permitted to carry out the prescription of a supervising
dentist, certain specified preventive and treatment
measures including the preparation of cavities and
restoration of teeth
⁕ Training for two years.
⁕ Both reversible and irreversible procedures

25. 1. Clinical caries diagnosis
2. Cavity preparation
3. Vital pulpotomies under rubber dam in deciduous
teeth
4. Extraction of deciduous teeth under local anesthesia.
Duties

26. DENTAL HYGIENIST
• Is an operating auxiliary licensed and registered to
practice dental hygiene under the laws of the appropriate
state, province, territory or nation.
• Work under the supervision of the dentist

27. Duties
1. Oral prophylaxis
2. Instructions in oral hygiene
3. Topical application of fluorides and sealants
4. Screening or preliminary examination of patients

28. EXPANDED FUNCTION DENTAL
AUXILIARY (EFDA)
⁕ Who has received further training in duties related to the direct
treatment of patients, though still working under the direct
supervision of a dentist.
⁕ Undertake reversible procedures which could be either corrected
or redone without undue harm to the patients health.

29. Duties
1) Placing and removing rubber dams, matrix bands and
temporary restorations
2) Condensing and carving amalgam restoration in previously
prepared teeth
3) Placing of acrylic restorations in previously prepared teeth
4) Applying the final finish and polish to the previously listed
restorations.

30. Four levels of training and qualification were recognized
1. Certified dental assistant
2. Preventive dental assistant
3. Dental hygienist
4. Dental hygienist with expanded duties.

31. ⁕ Training course: 8 months.
⁕ The assistant was taught traditional chair side duties. The
only intraoral duty was exposing radiographs.
Certified Dental Assistant

32. ⁕ The trainee had to be certified dental assistant
⁕ Full time courses were 3-6 weeks
Duties
1) Polish coronal surfaces of teeth without instrumentation
2) Make impressions for study models
3) Topical applications
4) Placing and removing rubber dams
5) Maintain a patients oral hygiene
Preventive Dental Assistant

33. • Training course: 8 months
Duties:
1) Preliminary examination of the oral cavity
2) Complete oral prophylaxis
3) Apply and remove a periodontal packs
4) Apply fissure sealants
Dental Hygienist

34. • Training: 4 months
Duties:
1) Removing sutures
2) Placing, finishing and polishing restorations of amalgam
and resin.
3) Placing and removing matrix bands
4) Placing cavity liners and temporary restorations
Dental Hygienist with Expanded Duties:

35. 5) Fitting and removing orthodontic bands
6) Separating of teeth prior to banding by a dentist
7) Cementing temporary crowns previously fitted by a
dentist
8) Retracting gingiva for impression making

36. FRONTIER AUXILIARIES
⁕ In developed countries – dentist is in urban centres
⁕ Nurses and formal dental assistants go to the distant areas
⁕ Provide valuable service with minimum of training.
⁕ Simple dental prophylaxis, dental health education, dental first –
aid, Fluoride rinse programs, simple denture repair.
⁕ 1981 – one week training conducted in Alaska and sent to areas
40 or more miles from the nearest dentist.

37. • Training period: 2 years
Duties
• Dental prophylaxis
• Cavity preparation and fillings of primary and permanent teeth
• Extractions under local anesthesia
• Drainage of dental abscesses
• Early recognition of more serious dental conditions
DENTAL LICENTIATE

38. DENTAL AIDE
⁕ This type of auxiliary personnel preforms duties which include,
elementary first-aid procedures for the relief of pain, including:
⁕ Extraction of teeth under local anesthesia
⁕ Control of hemorrhage
⁕ Recognition of dental disease

39. ⁕ General Supervision
⁕ Indirect Supervision
⁕ Direct Supervision
⁕ Personal Supervision
DEGREES OF SUPERVISION OF
AUXILIARIES

40. 1. General supervision: The dentist diagnoses and plans
the treatment of a patient and authorizes the auxiliary to carry
out the treatment.
2. Indirect supervision: The dentist diagnoses and plans
the treatment but he authorizes the auxiliary to carry out the
treatment in the field (eg. school premises) while the dentist
remains in the dental office.

41. 3. Direct supervision: Similar to general supervision, the
dentist diagnoses and plans the treatment of a patient and
authorizes the auxiliary to carry out the treatment but before
the dismissal of the patient, the dentist evaluates the
procedure performed by the auxiliary.
4. Personal supervision: The dentist himself performs
the treatment but authorizes the auxiliary to provide
supportive assistance.

42. • With rapid population growth and increase demand for dental
care more and more dentists are required but this is an
expensive process.
• Training of auxiliary is more economical, less time consuming
and fewer burdens to the society.
• More oral health services to the community-more improvement.
• More productivity of dental care services.
• Better coverage of Preventive Services to individual patients
and groups.
Benefits of using Auxiliaries

43. CONCLUSION
⁕ India needs a longer positive approach in creating and
expanding dental auxiliaries systems to meet the demands.
⁕ The dental auxiliary present in India are dental hygienist,
laboratory technician and dental surgery assistants, which have
been recognized by Ministry of Health; Government of India
and certificate courses recognized by Dental Council of India.