Chapter 5: Patient Care: Dental

Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 5: Patient Care: DentalChapter 5: Patient Care: Dental


DentistsDentists

• Early History

– Ancient Egypt

• Hesi-Re (died in 2600 BC): first dentist known to historians

– Ancient Romans

• Promoted oral hygiene

• Used tooth-cleaning powders & toothpicks

– Ancient India & Islamic countries

• Physicians or surgeons performed dentistry


Dentists (cont’d)Dentists (cont’d)

• The Middle Ages, the Renaissance, and the 17th Century

– Medieval Europe

• Monks provided dental care

• Barbers were surgical assistants

• Catholic Church forbade monks to practice medical/dental care

• Barbers became dental care providers

• Barber-surgeons extracted teeth

– Renaissance: renewed study of human anatomy, including dental



• Dentistry in the U.S.

– Colonial America: physicians provide dental care

• Tooth-drawers, surgeon-dentists, barbers, & blacksmiths extracted teeth

• Advertisements of services in newspapers (Paul Revere)

– 1840: first dental college established, in Baltimore

– 1859: American Dental Association formed

– By 1880: 28 dental schools established

– 1928: creation of national exam



• Education

– 4-year accredited dental school is standard

– 58 accredited programs in U.S.

– Requirements for entering dental school:

• At least 2 years of college education (most have bachelor’s)

• Passing the Dental Admission Test (DAT)

– Diagnosing & treating tooth & gum disease in first 2 years

– Treatment of patients under supervision in last 2 years

– Schools award DDS or DMD degree



• Course Work

– Anatomy & physiology

– Biochemistry

– Microbiology

– Laboratory techniques

– Pharmacology

– Histology



• Licensure

– Required by all states

– Requires:

• Graduation from accredited dental school

• Passing of written & practical exam



• General Duties

– Examine a patient’s teeth, gums, & mouth

– Interpret an x-ray

– Formulate a plan of treatment

– Administer an anesthetic

– Fill a cavity

– Apply a crown

– Perform a root canal

– Extract a tooth

– Apply braces

– Insert a dental implant



• Specialties

– Orthodontics

– Oral & maxillofacial surgery

– Pediatric dentistry

– Periodontics

– Prosthodontics

– Endodontics

– Dental public health

– Oral & maxillofacial pathology

– Oral & maxillofacial radiology



• Personal Characteristics

– Self-discipline

– Strong work ethic

– Good problem-solving skills

– Attention to detail

– Patience

– Thoroughness

– Focus

– Manual dexterity

– Communication skills

– Genial personality

– Positive attitude



• Employment Opportunities and Trends

– 16% growth from 2008 to 2018

– In demand due to:

• Population growth

• Preventive care for younger people

• Increasing dental coverage among private insurance companies

• Rising popularity of cosmetic dental services



• Professional Organization: ADA

– >157,000 members

– Advocates for dental profession & oral health

– Monitors policy issues in Congress, state legislatures, regulatory agencies, & foreign governments

– Establishes standards for & accredits dental education programs

– Issues Dental Admission Test and National Board Dental Examinations

– Develops standards for dental products & testing them

– Conducts scientific research


Dental HygienistsDental Hygienists

• History of the Profession

– 1890: publication of Microorganisms of the Human Mouth by Willoughby D. Miller

– 1896: Alfred C. Fones integrated oral hygiene into practice

– 1913: Fones opened first oral hygiene school

– 1916: first university program started at Columbia University

– 1923: formation of American Dental Hygienists’ Association (ADHA)

– 1951: all states required licensure

– 1952: accreditation of schools begun

– 1962: first national board exam administered


Dental Hygienists (cont’d)Dental Hygienists (cont’d)

• Education

– Most programs offer associate’s degree

– Some offer certificate, bachelor’s degree, or master’s degree

– Entrance requirements: HS diploma or equivalent

– Academic classes & supervised clinical instruction



• Course Work

– Basic science

– Dental science

– Dental hygiene science



• Licensure

– Required in all states

– Requires:

• Graduation from accredited program

• Passing written exam & clinical board exam

– Renewal required periodically (continuing education)



• Work Responsibilities

– Clean teeth

– Remove plaque & other materials from teeth & below gum line

– Polish teeth

– Examine mouth for tooth decay & gum disease

– Take x-rays

– Apply fluoride treatments, sealants, & other materials

– Make casts of patients’ teeth




– Detail oriented


– Efficient

– Well-organized

– Good people skills

– Patient

– Flexible




– Rapid growth: 36% between 2008 & 2018

– Ranks first among all occupations requiring associate’s degree

– Job growth due to:

• Increase demand for dental services due to expanding population

• Aging population

• Growing focus on preventive care



• Professional Organization: ADHA

– Three-tier structure: national, state, local

– Monitors legislation & federal activities

– Represents profession before Congress

– Advocates on issues of scope of practice, education, & licensing

– Promotes dental hygiene education & research through fellowships & grants

– Offers continuing education programs, networking, employment assistance program


Dental AssistantsDental Assistants

• History of the Profession

– C. Edmund Kells, dentist

• Founder of dental assisting

• Hired female assistant in 1885, starting a trend

– Milestones in the American Dental Assistants Association (ADAA)

• 1921: Juliette Southard started ADAA

• 1930: educational guidelines & training developed

• 1944: standards & a competency exam developed

• 1946: first 140-hour training course adopted

• 1948: certifying board established (DANB)


Dental Assistants (cont’d)Dental Assistants (cont’d)

• Education

– Some trained on the job; most trained in programs

– Programs:

• At community/junior colleges, trade schools, technical institutes, & the military

• Most last 1 year & award certificate or diploma

• Some last 2 years & award associate’s degree

• Require HS diploma

• Include clinical practice with a dentist



• Course Work

– Oral & written communication

– Oral health education

– Anatomy and physiology

– Microbiology

– Oral pathology

– Nutrition

– Pharmacology

– Dental materials

– Chairside assisting

– Dental radiology

– Psychology

– Practice management



• Regulation, Licensure, and Certification

– States regulate duties

– Licensure or registration for expanded functions in some states

– Licensure requires completing accredited program, passing exam

– Continuing education required for renewal of license

– Two certification credentials offered by DANB:

• Certified Dental Association (CDA)

• Certified Orthodontic Association (COA)

– Two specialty areas: radiation health & safety and infection control



• Work Responsibilities

– Open office & daily routine

– Prepare dental treatment room

– Set up instrument trays

– Seat patient

– Take & develop x-rays

– Hand instruments to dentist

– Instruct patients in oral hygiene

– Clean & polish removable appliances

– Complete health history records

– Prepare bank deposits




– Reliable

– Comfortable working under supervision

– Work well with others

– Good communication skills





– >295,000 jobs in 2008

– 36% growth between 2008 & 2018

– More than one-third work part-time



• Professional Organization: ADAA

– Largest professional organization representing dental assistants

– DANB: certifying board of ADAA

– Credentials recognized or required in 37 states

– Provides home-study continuing education classes

Documents

Chapter 5: Patient Care: Dental