Th 67195

Who would train the assistants?

Aug. 1, 2001
We're looking for a few men and women to train dental assistants on how to become dental hygienists. We dug deep into the talent pool for our suggestions.

We're looking for a few men and women to train dental assistants on how to become dental hygienists. We dug deep into the talent pool for our suggestions.

by T.K.Allen

Several states recently have considered unconventional training methods that allow dental assistants to "become" dental hygienists. In the light of this rush to circumvent traditional dental hygiene education, I've been wondering who would train these assistants, if the customary college instructors were replaced. With a watered-down curriculum, who would be qualified to instruct students in clinical instrumentation? Since two years is too long for dentists to wait for an associate's degree in dental hygiene (makes me wonder how long they courted their spouses), this new form of training must meet these requirements:

  • Take only one year; otherwise, assistants would opt for college and an associate's degree, defeating the purpose of the training
  • Only skim over subjects required for an associate's degree; otherwise, it would be too time-consuming
  • Be done without fanfare; otherwise, patients would know about the reduced training and refuse treatment

Candidates for trainers
I did some brainstorming and came up with a few individuals who might make good instructors (see chart at left). My first two candidates were disqualified for the reasons cited.

Once assistants have gotten what some would call adequate training in clinical instrumentation, someone needs to address the other facets of what they will encounter.

Patients are going to ask questions, especially those who come on a regular basis. Last time they came, this same assistant was working with the doctor to place a restoration. Now, a month later, she's alone, armed with sickles, and just practicing ... on them! What will the assistants say when their disbelieving patients ask what's going on as they search in vain for a degree on the wall? This is where the lawyer comes in. You see, it's all done with semantics and distractions.

If a patient asks if he is the assistant's first patient, she need only tell the truth. (Any self-respecting assistant will practice on her immediate family before tackling a paying patient in the chair.) If asked this question, she should laugh, answer "no," and tell him he's "so funny." He doesn't need to know he is her fifth patient and that she still isn't sure if all the screaming her brother did was an act or not. (Her mother's gums are starting to heal nicely from last week. Her dentist says she should be just fine.) In using this response, no perjury has taken place, and she has said nothing she can be held liable for.

When this same patient comes back 12 months later and asks the assistant what college she went to, again the assistant need not lie. What does "go" really mean, anyway? Did he mean "go" as in attend classes and graduate or "go" as in to travel to a place and be physically present there for any length of time? She probably did go to college. The college was merely the test site, because it had a dental clinic with chairs. But the assistant went there ... to take her state Boards. It's no lie; she went to college, although she was just there for a matter of hours. But the patient need not know that. The lawyer has trained her well.

But how about psychological training? There are going to be times when the assistant/hygienist is going to question the value of her education. She will eventually come in contact with college-trained hygienists. These hygienists have bought the whole pie, not just a slice. The assistants who were offered a raise in pay and an RDH on their nametag in just 12 months will feel slighted.

They will listen to traditionally trained hygienists talk "shop" and won't be able to join in for fear of sounding uneducated. They'll have a hard time understanding some concepts and others will be pretty much foreign to them, having not been covered sufficiently in the program. If this feeling of inadequacy is not dealt with early on, it could lead to remorse, depression, and a feeling of discontent.

Click here to enlarge image

If the assistant/hygienist was coerced into this program by her boss when she really wanted a degree and a college education, resentment may develop into animosity on her part. This may be a problem. If the assistant/ hygienist's boss has paid her way through the program, she may feel indebted to him, although she would really like to leave his employ. This can raise feelings of guilt for wanting to leave her benefactor and feelings of entrapment when she realizes she can't.

College-trained hygienists will be able to move from state to state, but the assistant/hygienists will not have that freedom. They may feel they have been bought and are owned by their dentist/boss. They might feel they would have to get fired to be free of their benefactor's office. Then they'd have that blemish on their professional reputation. Quitting is not an option either. What ingrate would agree to let the dentist pay his or her way and then quit?

All these aspects of the assistant/hygienist's situation will have an effect on her psyche. A trained psychologist must be utilized at the onset of any negative feelings about the program. Rationalization and "looking on the bright side" must be part of the assistant/hygienist's training while she is still in the program, to avoid any emotional or psychological upsets later on. At any rate, a reminder that the assistant/hygienist is now making more money than before should help.

This is just the pondering of an inquisitive trouble-shooter with too much time on his hands. I'm sure the state legislatures will not be swayed by politics, lobbyists, finances, or the Good Ole Boy System I've heard so much about. I hope they'll do the right thing for the people of their states. But if they decide to do otherwise, I hope they consider my suggestions on who could train the assistants ... then come up with something better.