1. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Essentials of Dental Assisting, 4e Introduction to Dental Assisting Chapter 1

2. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Introduction Dentistry has a long and fascinating history. From the earliest of times, humans have been plagued by dental disease. Many of the remarkable techniques in modern dentistry can be traced to the very earliest of times in every culture.

3. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Early Times The Egyptians  Hesi-Re was the earliest dentist whose name is known. He practiced in 3000 BC and was called “Chief of the Toothers.”  Egyptian pharaohs were known to have suffered from periodontal (gum) disease. Radiographs of mummies confirm this fact.

4. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Early Times The Greeks  Hippocrates (460-377 BC) earned the title of Father of Medicine.  Aristotle (384-322 BC), the great philosopher, referred to teeth in many of his writings.  Diocles of Carystus, Physician of Aristotle’s time. Recommended “rubbing the teeth and gums “ as oral hygiene instructions

5. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.  By 2000 B.C. the Chinese were practicing dentistry.  Around the 2nd century A.D. the Chinese developed a silver amalgam paste for fillings. (more than 1000 years before dentists in the west).  T’ing and Yu Shu described the entire process of swallowing in the eleventh century. The Early Times The Chinese

6. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Early Times The Romans  Several Roman physicians wrote extensively about dentistry. Many people still believed in the theory of the toothworm being responsible for toothaches. Romans were skilled in restoring decayed teeth with gold crowns. They had a high regard for oral hygiene.

7. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Dr. Green Vardiman Black  Known worldwide as G.V. Black, he earned the title of the “grand old man of dentistry.”  He standardized the rules of cavity preparation and fillings.  He developed the principle of “extension for prevention.”  He taught in dental schools, became a dean, and wrote more than 500 articles and several books.

8. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Wilhelm Conrad Roentgen (1845-1923)  A Bavarian physicist who discovered x-rays in 1895.  His discovery revolutionized diagnostic capabilities and forever changed the practice of dentistry.

9. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-1 Roentgen discovered the early potential of a radiograph beam in 1895. (Courtesy Eastman-Kodak, Rochester, NY.)

10. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Horace Wells (1815-1848)  Dr. Wells was the dentist credited with the discovery of inhalation anesthesia in 1844.  This was one of the most important medical discoveries of all time.  He realized the potential for pain-free dentistry by using nitrous oxide.

11. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Lucy B. Hobbs-Taylor  Denied admission to a dental college, Lucy B. Hobbs-Taylor went to work for a dentist, who trained her in his office to become a dentist.  Later opened her own dental practice in Cincinnati and then opened a dental office in Iowa.  Admitted to the Ohio College of Dental Surgery. She was the first woman to graduate from a dental school.

12. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. History of Dental Assisting  C. Edmund Kells, a dentist in New Orleans, was credited with using the first dental assistant. – She was a “lady in attendance,” making it respectable for women patients to go into a dental office unaccompanied.  Dr. Kells soon realized that this lady could be a valuable asset, and by 1900, he was working with both a chairside dental assistant and a secretarial assistant.

13. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-9 C. Edmund Kells and his “working unit,” about 1900. Assistant on the left is keeping cold air on the cavity while assistant on the right mixes materials and “secretary” records details. (From Kells CE: The dentist’s own book, St. Louis, 1925, Mosby.)

14. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Introduction A highly skilled dental assistant is a vital member of the dental healthcare team. Dental assisting is a career that requires dedication, personal responsibility, integrity, and a commitment to continuing education.

15. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Introduction-cont’d Becoming a dental assistant is more than acquiring the knowledge and developing the skills, it is about becoming a professional person Professionalism is an attitude that is apparent in everything you say and do, in and out of the dental office.

16. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Characteristics of a Professional Dental Assistant  Professional Appearance – Good grooming – Good health – Appropriate dress

17. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Roles of the Chairside Dental Assistant  Primary responsibilities in this role include but are not limited to the following: – Seating and preparing for patients – Charting – Instituting infection control procedures – Mixing and passing dental materials – Assisting the dentist during procedures – Ensuring patient comfort – Exposing and processing radiographs

18. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Roles of the Chairside Assistant Pouring and trimming models; performing other laboratory procedures Pouring and trimming models; performing other laboratory procedures Providing patient education Providing patient education Providing postoperative instructions to patients Providing postoperative instructions to patients Overseeing inventory control and ordering dental supplies Overseeing inventory control and ordering dental supplies Ensuring compliance with OSHA regulations Ensuring compliance with OSHA regulations

19. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Roles of the Expanded Function Assistant  Delegation of the following functions varies among states, depending on the individual state’s dental practice act: – Placing dental sealants – Taking impressions – Fabricating temporary crowns and bridges – Placing retraction cord – Applying fluoride – Applying topical anesthetic – Placing and removing dental dams – Placing and removing matrices and wedges

20. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Roles of the Expanded Function Assistant Applying liners, varnishes, and bases Applying liners, varnishes, and bases Placing, carving, and finishing amalgam or composite restorations Placing, carving, and finishing amalgam or composite restorations Removing sutures Removing sutures Placing and removing periodontal dressings Placing and removing periodontal dressings Performing additional functions as specified in the dental practice act of the state in which the dental assistant is employed. Performing additional functions as specified in the dental practice act of the state in which the dental assistant is employed.  It is important to be aware of the laws of the state in which you practice.

21. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Introduction A team is people working together for a common purpose. In dentistry, the purpose, or mission, of the team is to provide quality oral health care for the people of the community. The dentist is legally responsible for the care of the patient and the supervision of all other members of the team.

22. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Members of the Dental Healthcare Team  Dentist (General/Specialist)  Dental Laboratory Technician  Dental Hygienist  Dental Assistant – On-the-job trained – Formal education

23. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Dentist  Before going into practice, all dentists must pass a written national board examination.  Dentists are required to take a clinical board examination in the state in which they choose to practice.  Dentists have a variety of practice options available to them.  Most dentists are members of their professional organization, the American Dental Association (ADA).

24. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The General Dentist  A college degree (4-year pre-dental)  Undergraduate dental education (4 years with emphasis on basic sciences first 2 years, and clinical sciences the last 2 years)  Graduates of these programs must pass a written national exam and a clinical state board exam in order to practice.

25. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Dental Specialists  Education as a general dentist  Master’s degree program in the specialty ranging from 2 to 6 years depending on the area of specialty.  Some programs offer a PhD for another 2 years of education and post-doctoral education.

26. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Dental Specialties  Dental Public Health  Endodontics  Oral and Maxillofacial Radiology  Oral and Maxillofacial Surgery  Oral Pathology  Orthodontics  Pediatric Dentistry  Periodontics  Prosthodontics

27. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Dental Hygienist  The dental hygienist (RDH) is a licensed professional with specialized clinical and educational skills.  The minimal education required for a dental hygienist is two academic years of college study in an ADA- accredited dental hygiene program. Dental hygiene is also offered in bachelor and master's degree programs.  The RDH is required to work under the supervision of a licensed dentist.

28. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-3 Dental hygienist performing an oral prophylaxis.

29. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Dental Assistant  The duties assigned to the dental assistant are determined by the regulations of the dental practice act of the state.  The dental assistant is trained to assume many activities that are not required of the dentist.  The educational program for a dental assistant must include didactic, laboratory, and clinical content.

30. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Roles of the Dental Assistant  Clinical dental assistants are directly involved in patient care in the following roles: – Chairside assistant – Circulating assistant – Sterilization assistant

31. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-4 Dentist and chairside dental assistant working together.

32. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-5 Circulating dental assistant provides an extra pair of hands as needed in six-handed dentistry.

33. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-7 Expanded functions dental assistant removing excess cement. (Courtesy Pamela Landry, RDA.)

34. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-8 The patient is greeted by the business assistant before meeting the dental hygienist. (Courtesy Dr. Peter Pang, Sonoma, CA.)

35. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. The Dental Laboratory Technician  The dental laboratory technician may legally perform only those tasks specified by the written prescription of the dentist.  Individuals who wish to become a certified dental technician (CDT) must pass a written examination.  Dental technicians may be members of their professional organization, the American Dental Laboratory Technician Association (ADLTA).

36. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Dental Laboratory Technician- cont’d. 2 year educational program (voluntary) 2 year educational program (voluntary) Take and pass national exam to earn the credential of CDT (Certified Dental Technician) Take and pass national exam to earn the credential of CDT (Certified Dental Technician) Majority of lab techs are trained through apprenticeship Majority of lab techs are trained through apprenticeship

37. Copyright © 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved. Fig. 1-9 Dental laboratory technician fabricating a crown.