The dental assistants in an office often have a thirst for knowledge too, obtaining certifications to provide needed services in patient care
BY Jamie Collins, RDH, CDA
A smooth-running office can be the key to a long and fulfilling career for many of us. Dentistry presents challenges in many different ways, but by using the diversified talents of all dental team members, it can be a satisfying career and environment for all.
Whether your dental team has one assistant or 15, everyone can help in the daily operations to facilitate harmony for all. Many hygienists started on the path as an assistant before graduating from a hygiene program. Others have practiced in the dental environment only as a hygienist.
Dental assistants can range in abilities and certifications, depending on the state where they practice, but most states allow assistants to take courses for extra credentials to become an Expanded Duties Dental Assistant (EDDA), or Expanded Functions Dental Assistant (EFDA). These certifications allow assistants to perform such functions as pit and fissure sealants, temporary crowns, radiography, administration of nitrous oxide, orthodontics, and coronal polishing, to name a few. Some states also allow assistants to place restorative materials prior to approval by the dentist.
The Dental Assisting National Board, or DANB, is the organization responsible for providing the national certification exams. An assistant can obtain certifications recognized nationally as a Certified Dental Assistant (CDA), Certified Orthodontic Assistant (COA), Certified Preventive Functions Dental Assistant (CPFDA), or Certified Restorative Functions Dental Assistant (CRFDA). The American Dental Association, Academy of General Dentistry, American Dental Education Association, American Dental Assistants Association, and American Association of Dental Boards support these recognitions.
States individually decide which allowable functions to adopt for assistants who have the formal training. DANB provides a link that allows individuals to research each state's allowable expanded duties at http://www.danb.org. Of course, it depends on the state regulations, but an assistant with expanded duties can be a great asset to the flow of any dental practice.
A Certified Preventive Functions Dental Assistant certification consists of the assistant passing four exam components - coronal polishing, sealants, topical anesthetic, and topical fluoride. All of these functions are beneficial to increasing production in any dental hygiene program. Many times the EDDA steps into my operatory to help with sealants or fluoride while I'm administering anesthetic for the dentist in another operatory. Using an assistant, whether in an accelerated hygiene office or to increase production, allows the hygienist or dentist to move on to the next patient or multitask between patients.
Accelerated hygiene patients are scheduled in overlapping intervals with the help of an assistant who takes radiographs, performs coronal polishing, applies fluoride, and performs the exam with the dentist so the hygienist is able to move from patient to patient for scaling. An experienced EDDA can perform these functions with the education necessary to care for patients and provide home-care education to patients.
Having an expanded duties assistant with the knowledge and skills to step in to polish a patient or who holds a restorative function certification can not only help the schedule in a pinch, but can also greatly increase the production potential of an office. In states where allowed, the EDDA is able to place restorative materials and cure while the dentist provides treatment in another operatory. Granted, the dentist must provide final approval of the restoration prior to releasing the patient, but the dentist's operative time with each patient is decreased and he or she is able to schedule more patients throughout the day, thus increasing potential production.
I know of many offices that use an EDDA in a second operatory to provide child prophies, fluoride, and sealants while the dentist provides restorative treatment in another operatory. At $40 to $60 per sealant, the financial benefits of the EDDA can add up quickly. A DANB Certified Preventive Functions Assistant not only has the knowledge to explain why the treatments are performed, he or she can also relay confidence and knowledge to patients.
Expanded Duties Dental Assistants help the ebb and flow of an office when they place sealants or fabricate a temporary crown, thus freeing the dentist to use more than one operatory or perform hygiene exams. All of us love when the dentist is able to come into our hygiene operatory to perform exams in a timely manner. Before assistants are certified through DANB, they have taken a pathway of either formal education or completed 3,500 hours of work experience in the dental field to qualify for the exam process. In addition, assistants must be able to pass a series of exams to prove competency in the fields of infection control, radiation safety, and general chairside procedures to obtain the credentials of a Certified Dental Assistant.
Not every state recognizes the DANB certifications; some states may require additional training to recognize an assistant as an EDDA. Currently, 38 states recognize or require a DANB exam certification. Other states requiring additional exams that can be administered by DANB are Arizona, Delaware, Maryland, Missouri, New Jersey, New Mexico, Oregon, and Washington.
I had the benefit of starting my career in dentistry at the age of 20 as a formally trained assistant in Oregon. Throughout the early years, I felt knowledge was power, and I was hungry to learn as much as possible. The more I learned and experienced in the dental field, the more I found I really enjoyed the hands-on and creative side of dentistry. I enjoyed when I had the opportunity to polish or place sealants, as well as lending my artistic ability to create temporary crowns or a seven-unit temporary bridge. I was fortunate enough to work for a dentist who allowed me to use my expanded duties to my full potential.
After six years of assisting, I knew I wanted more freedom and a stronger skill set, so I applied to hygiene school. My CDA and EDDA certifications no doubt helped me throughout the clinical skills in hygiene school and beyond. I have taught since 2004, and I encourage my students to broaden the scope of practice beyond the basic skills they learned in school. I practice as a hygienist and often help the dentist with fillings or temporary crowns if needed, skills I learned early in my dentistry career.
I have the privilege of working clinically with a few great assistants, and one was a student of mine 10 years ago! Both hold the CDA and EDDA certifications and are phenomenal at their jobs. I know I can trust their knowledge and abilities. An EDDA can be a wealth of knowledge and assistance in any practice when team members are able to combine their abilities to make the day flow more smoothly. RDH
Jamie Collins, RDH, CDA, resides in Idaho with her husband, Cory, and their four children. She currently works as a full-time hygienist as well as an educator at the College of Western Idaho. In addition, she acts as a content expert and contributor in multiple upcoming textbooks. She can be contacted at [email protected].
