1. Dr Hidayathulla Shaikh

2.  At the end of the lecture student should be able to –  Discuss duties of dental hygienist  Explain duties of EFDA  Enumerate new auxiliary types  Discuss degree of supervision of auxiliaries.

3. 3) Dental Hygienist  Is an operating auxiliary licensed and registered to practice dentistry.  Dental hygienist works under the supervision of dentist.  Dr Alfred Fones trained Mrs. Irene Newman on the procedures of dental prophylaxis, and in 1906 she became the first dental hygienist.  The countries which includes hygienist work are USA, UK, Canada, India, Nigeria, China, Japan, Korea and Poland.

4. Duties of dental hygienist  Cleaning of mouth and teeth with particular attention to calculus and stains.  Topical application of fluorides, sealants and other prophylactic solutions.  Screening and preliminary examination of individuals or groups to refer them to dentist.  Instructions on oral hygiene.  Resource work in the field of dental health.

5. 4) Expanded Function Dental Auxiliary (EFDA)  They have been also referred as expanded function dental assistant, expanded function dental hygienist, technotherapist.  An EFDA is an dental assistant or hygienist who has received further training in duties related to the direct treatment of patients.  Though still working under the direct supervision of the dentist.  The first large scale application of EFDA were made in Philadelphia.

6. Duties of EFDA  Placing and removing rubber dams  Placing and removing temporary restorations  Placing and removing matrix bands  Condensing and carving amalgam restorations in previously prepared teeth.  Applying the final finish and polish to the previously done restorations.

7. Frontier Auxiliaries  In developed countries, dentist remains in the urban areas and large part of country side still requires his treatment.  In such cases nurses and former dental assistants provides valuable services with minimum training.  Dental prophylaxis, health education, dental first aid done and patients referred to nearest dentist.  In 1981, one week training program was conducted for frontier auxiliaries in Alaskan 2 years later larger number of simple dental problems had been solved.

8. New Auxiliary types  The expert committee on auxiliary dental personnel of the WHO suggested 2 new types a) The dental licentiate b) The dental aide. o These new auxiliaries are particularly useful in some countries, having acute dentist shortage with no facilities for training dentists.

9. Degrees of supervision of Auxiliaries  ADA in 1975 defined 4 degrees of supervision of auxiliaries.  The ultimate responsibility was assumed by the licensed dentist. 1) General supervision  The dentist has authorized the procedures and they are being carried out in accordance with the diagnosis and treatment plan.

10. 2) Indirect supervision  The dentist is in the dental office, authorizes the procedure and remains in the dental office.  While the procedures are being performed by the auxiliary. 3) Direct supervision  The dentist is in the dental office, personally diagnosis the condition to be treated.  Personally authorizes the procedure and  Before the dismissal of the patient evaluated the performance of the dental auxiliary

11. 4) Personal supervision  The dentist is personally operating on the patient.  And authorizes auxiliary to aid treatment by concurrently performing supportive procedures.