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It Takes a Team

Author: Kimberly Bland, CDA, EFDA, M.Ed./Thursday, December 4, 2014/Categories: 24/7 Articles

Team \tēm\: a group of people with a strong sense of mutual commitment who function synergistically using a full set of complementary skills in order to accomplish a task, complete a job, or realize a goal.

From the late 1800’s up through the mid-20th century we recognized a small team of individuals as our total oral healthcare experts: the family dentist and his dental assistant later joined by the dental hygienist and the dental laboratory technologist served all the needs of the dental consumer. Then time marched on and our knowledge of the human body and disease processes began to increase. Suddenly we realized that premium oral healthcare should be multifaceted. Patients’ needs became more complex as knowledge and technology related to oral healthcare expanded. With enlightenment we saw the emergence of dental specialties such as oral and maxillofacial surgery, periodontics, endodontics, orthodontics, prosthodontics, and pedodontics. Today, dental practitioners are continuing to meet the intricate needs of the dental consumer by further narrowing the scope of practice to such sciences as oral implantology, cosmetic dentistry, dental sleep medicine, and oral and maxillofacial radiology.

Through the evolution of these many facets of oral healthcare, there has been one constant: dental assistants. Practitioners, regardless of their specialization, cannot practice alone. A well-skilled, multi-tasking dental assistant is a necessity in order to meet the needs of the patient and the practice. Today, dental assistants are doing more than just comforting patients, suctioning mouths, and setting-up/tearing down treatment areas. Dental assistants with advanced training are now charged with performing many of the complex tasks that would otherwise prevent the dentist from seeing others in need. Expanded functions dental assistants in many states are placing and finishing restorations, fabricating provisional restorations, packing retraction cord, making impressions, and placing soft relines in dentures. They are assisting in preventive procedures by polishing teeth, applying fluoride, and placing sealants while others are working competently in orthodontic settings sizing, securing, and un-securing archwires, preparing teeth for brackets, and cementing molar bands. This is in addition to performing other traditional duties such as assisting in dental and surgical procedures, exposing dental radiographs, providing patient education, and performing infection control services.

The dental assistant is an enduring member of the dental team regardless of the team’s narrow focus. For oral healthcare of the 21st century, not just any dental assistant will do. Dentists are demanding the skills of highly specialized assistants and prefer to employ team members who come to the practice with prior formal training and all required state credentials. It is becoming less common for dentists to offer on-the-job training to individuals without prior dental education or at least a minimal amount of dental experience. Today’s dentist does not have the time to be an educator.

While a dental assistant’s advanced intraoral and laboratory skills are of great value to today’s high-volume practitioner, the age of communication has enlightened the patient with a concern over safety. Recently, and most paramount to the dental consumer, is the concern with regards to dental infection control practices. It has become evident to the ADAA that due to the threat of emerging communicable diseases that are potentially fatal, dental assistants, who are the infection control specialists in the oral healthcare setting, must have advanced knowledge of the disease process and in the prevention of disease transmission in the oral care environment. Sadly, formal training in advanced concepts of infection control is still not a requisite in most states; thus a disparity in the standard of care continues to exist from practice to practice. While a few states are now considering a rigorous formal training requirement for those who perform infection control procedures in oral healthcare settings, it has come to the attention of the American Dental Assistants Association that more can be done to ensure quality oral healthcare services are safely delivered to the dental consumer.

In late 2013, the ultimate dental team emerged. The American Dental Assistants Association approached the Dental Assisting National Board (DANB,) the Organization for Safety, Asepsis, and Prevention (OSAP,) and the American Dental Education Association (ADEA) in order to form an alliance with the purpose to begin the process of developing a standardized curriculum for infection control education. A secondary goal was to propose a means of formal competency assessment or credentialing of oral healthcare professionals responsible for performing infection control procedures in oral healthcare settings. Very quickly other organizations communicated their interest in participating with the “Founding Four” in this significant endeavor. Currently, this Infection Control Consortium benefits from the added participation of representatives from the American Dental Association (ADA,) the Academy of General Dentistry (AGD,) the Centers for Disease Control and Prevention (CDC,) and the American Association of Dental Boards (AADB.) Each of the organizations agree that it is important for oral healthcare workers responsible for performing infection control procedures to be educated in a core curriculum of infection control principles based upon relevant Occupational Safety and Health Administration (OSHA) regulations, Centers for Disease Control and Prevention (CDC) guidelines, and other relevant national standards. It is the ultimate goal for this infection control consortium is to enhance the protection of the public and the dental team.

Based upon that premise, the ADAA encourages immediate action. ADAA advocates all Dental Assistants adhere to current Centers for Disease Control recommendations, Occupational Safety and Health Administration Standards, and state regulations with documented proficiency in dental infection control protocols. We maintain this be demonstrated by passing the Dental Assisting National Board's Infection Control Examination. ADAA further advocates the adoption of standardized mandatory federal and state requirements for dental infection control training and credentialing of oral healthcare workers. All dental assistants and dental assistant students are sincerely encouraged to join the ADAA team in order to advance the practice of dental assisting toward the highest standards of performance obtainable. Together, as a team, we share in the responsibility for quality oral health care delivery to all.

There is no doubt that in the 21st century, dentistry remains a team-based profession. Quality oral healthcare continues to require the services of many highly-skilled and knowledgeable individuals as one lone practitioner, single-handedly, cannot be everything to everyone. For the team to be successful, each member must function with a level of interdependence and share in accountability, demonstrating a devotion to success. To assure the team functions synergistically with a strong sense of mutual commitment, a full set of complementary skills must be possessed by each team member. As dental assistants, we are an integral part of the dental team sharing in the responsibility for the delivery of quality oral healthcare to all. The team is only as strong as its weakest member; therefore it is up to us to assure strength in our own skill, knowledge, and commitment to excellence, for those are the premium qualities necessary for the team’s goal to be realized.

Kimberly Bland, CDA, EFDA, M.Ed.
President, American Dental Assistants Association

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