1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 5: Patient Care: Dental

2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists 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

3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) The Middle Ages, the Renaissance, and the 17 th 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

4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) Course Work –Anatomy & physiology –Biochemistry –Microbiology –Laboratory techniques –Pharmacology –Histology

7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) Licensure –Required by all states –Requires: Graduation from accredited dental school Passing of written & practical exam

8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) Specialties –Orthodontics –Oral & maxillofacial surgery –Pediatric dentistry –Periodontics –Prosthodontics –Endodontics –Dental public health –Oral & maxillofacial pathology –Oral & maxillofacial radiology

10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentists (cont’d) 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

13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental 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

14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) Course Work –Basic science –Dental science –Dental hygiene science

16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) Licensure –Required in all states –Requires: Graduation from accredited program Passing written exam & clinical board exam –Renewal required periodically (continuing education)

17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) 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

18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) Personal Characteristics –Detail oriented –Manual dexterity –Efficient –Well-organized –Good people skills –Patient –Flexible

19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) Employment Opportunities and Trends –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

20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Hygienists (cont’d) 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

21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental 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)

22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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

23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) 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

24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) 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

25. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) 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

26. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) Personal Characteristics –Reliable –Comfortable working under supervision –Work well with others –Good communication skills –Manual dexterity

27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) Employment Opportunities and Trends –>295,000 jobs in 2008 –36% growth between 2008 & 2018 –More than one-third work part-time

28. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dental Assistants (cont’d) 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