Dental Manpower Question and Answers

Dental Manpower

Question 1. Write short note on dental auxiliary.
Or
Write in brief on dental auxiliary.
Or
Define dental auxiliary. Classify and describe the different types of dental auxiliary.
Or
Classify dental auxiliary.
Answer. Dental auxiliary is a person who is given responsibility by a dentist so that he or she can help the dentist render dental care, but who is not himself or herself qualified with a dental degree.

WHO Classification (1967)

• Non-operating auxiliaries.
  • Clinical.
  • Laboratory.
• Operating auxiliaries.

Nonoperating Auxiliaries

• Clinical: This is the person who assists the dentist inhis clinical work but does not carry-out independently procedure in the oral cavity.
• Nonclinical: This is a person who assists the dentist by carrying out certain technical laboratory procedures.

Read And Learn More: Public Health Dentistry Question And Answers

Operating Auxiliaries

This is a person who not being a professional is permitted to carry-out certain treatment procedure in the mouth under the direction and supervision of a professional.

Revised Classification

Nonoperating

• Dental surgery assistant
• Dental secretary/receptionist
• Dental laboratory or technician
• Dental health educator.

Operating Auxiliaries

• School dental nurse
• Dental hygienist
• Dental therapist
• Expanded functional dental auxiliary.
• Besides the above mentioned classification, new auxiliary types are given by expert committee on auxiliary dental personnel of WHO (1959). These are:
• The Dental licentiate.
• The Dental Aide.

Nonoperating Auxiliaries

• Dental surgery assistant:
  • This is a person who assist the dentist in treating patient but who is not legally permitted to treat independently.
• Dental secretaries or receptionist:
  • This is a person who assists with his secretarial work and patient reception duties.
• Dental laboratory technician:
  • A nonoperating auxiliary who fulfills the prescription provided by dentist regarding the extraoral constriction and repair of oral application and bridgework.
  • Denturist: It is a term applied to those dental lab technicians who are permitted in US, Canada, Denmark to fabricate denture prescription. They may be licensed or registered.
• Dental health educator:
  • This is the person who instructs in the prevention of dental disease and who may also be permitted to apply preventive agents intraorally.

Operating Auxiliaries

• School dental nurse:
  School dental nurse is a person who is permitted todiagnose dental disease and to plan and carry out certain specified preventive and treatment measure, including some operative procedure in the treatment of dental caries and periodontal disease in defended group of people, usually school children.
• Dental hygienist:
  • This is a person who is permitted to carry out to the prescription of a supervising dentist, certain specified preventive and treatment measures, including the perforation of cavities and restoration of teeth.
  • The dental hygienist is an operating auxiliary licensed and registered to practice dental hygiene under the laws.
• Dental therapist
  • It is an operating auxiliary which is permitted to carry out prescription of supervising dentist. This includes the various specified preventive and treatment measures which includes preparation of cavity and restoration of teeth.
  • Training of dental therapist is for the period of 2 years which involves reversible and irreversible procedures.
  • Duties of dental therapist are:
    • Diagnosis of clinical caries.
    • Preparation of cavity in deciduous and permanent teeth.
    • Vital pulpotomies under rubber dam in deciduous teeth.
    • Extraction of deciduous teeth under local anesthesia.
• Expanded functional dental auxiliary (EFDA):
• An EFDA is a dental assistant or a dental hygienist in some cases, who has received further training in duties related to the direct treatment of patients, though still working under the direct supervision of the dentist.

New Auxiliary Types

• Dental Licentiate
  • He is a semi-independent operator and is trained for the two years for its performance.
  • He should provide his service in rural areas.
  • Following are the functions performed by dental licentiate:
    • Dental prophylaxis
    • Cavity preparations and fillings of primary and permanent teeth.
    • Extractions to be performed under local anesthesia.
    • Drainage of dental abscess
    • Treatment of prevalent diseases to supporting structures of teeth
    • Early recognition of serious dental conditions.
• Dental Aide
  • This auxiliary perform duties which consists of first aid procedures in relief of pain.
  • They provide their services in salaried health organization.
  • Training of dental aide extends from 4 to 6 months.
  • Functions performed by dental aide are:
    • Extraction of teeth under local anesthesia.
    • Hemorrhage control
    • Recognition of dental disease, so that patient is transported to appropriate dental center.

Question 2. Define dental auxiliary. Describe the role of dental auxiliary in dental care delivery.
Answer. Dental auxiliary is a person who is given responsibility by the a dentist so that he or she can help the dentist render dental care, but who is not himself or herself qualified with a dental degree.

Role of Dental Auxiliary in Dental Care Delivery

Nonoperating

• Dental surgery assistant
• Dental secretary/receptionist
• Dental laboratory or technician
• Dental health educator.

Operating Auxiliaries

• School dental nurse
• Dental hygienist
• Dental therapist
• Expanded functional dental auxiliary.

Besides the above mentioned classification new auxiliary types are given by expert committee on auxiliary dental personnel of WHO (1959). These are:

• The Dental Licentiate.
• The Dental Aide.

Role of Dental Surgery Assistant

• Reception of patient
• Patient preparation for any treatment
• Preparation and provision of facilities, i.e. mouthwashes, napkins, etc.
• Care, preparation and sterilization of instruments.
• Preparation as well as mixing of restorative materials, i.e. filling and impression materials.
• Care of patient after treatment till the patient leave. It also includes clearing of instruments and preparation of instruments for reuse.
• Preparation of surgery for patient.
• Present documentation to dental surgeon for his completion and filing.
• Provide assistance with work of X-ray as well as processing and mounting of X-rays.
• Provide instructions to patient
• Aftercare of persons who had general anesthetics.

Role of Dental Secretary

• Assist dentist with secretarial work.
• Provide reception duties.
• Role of dental laboratory technician models casting from the impressions made by dentist.
• Denture fabrication
• Fabrication of orthodontic appliances
• Fabrication of inlay, crowns and special trays.

Role of Dental Health Educator

• Instruct the patient for prevention of dental disease.
• Apply preventive agents intra–orally.

Role of School Dental Nurse

• Oral examination
• Prophylaxis
• Topical fluoride application
• Administration of local anesthesia
• Advice on dietary fluoride supplements
• Cavity preparation and placement of amalgam and silicate fillings in primary and permanent teeth.
• Pulp capping
• Extraction of primary teeth only
• Classroom and parent-teacher dental health education
• Individual patient instruction in tooth brushing and oral hygiene
• Referral of more complex cases to dentist.

Role of Dental Therapist

• Diagnosis of clinical caries.
• Preparation of cavity in deciduous and permanent teeth.
• Vital pulpotomies under rubber dam in deciduous teeth.
• Extraction of deciduous teeth under local anesthesia.

Role of Dental Hygienist

• Cleansing of mouth and teeth with particular attention to calculus and stains.
• Topical application of fluorides, sealants and other prophylactic solutions.
• Screening or preliminary examination of patient as individuals or in groups, such as school children or industrial employees.
• Instruction in oral hygiene.
• Resource works in the field of dental health.

Role of Expanded Function Dental Auxiliary

• Placement and removing of rubber dam.
• Placement and removing of temporary restoration.
• Placement and removal of matrix bands.
• Condensing as well as carving of amalgam restoration in previously prepared teeth.
• Placing of acrylic restoration in previously prepared teeth.
• Applying final finish as well as polishing of above mentioned restorations.

Role of Dental Licentiate

• Dental prophylaxis
• Cavity preparations and fillings of primary and permanent teeth.
• Extractions to be performed under local anesthesia.
• Drainage of dental abscess
• Treatment of prevalent diseases to supporting structures of teeth
• Early recognition of serious dental conditions.

Role of Dental Aide

• Extraction of teeth under local anesthesia.
• Hemorrhage control
• Recognition of dental disease, so that patient is transported to appropriate dental center.

Question 3. Write short note on dental hygienist.
Answer. “Dental hygienist is a person, not being a dentist or a medical practitioner; who does oral prophylaxis, gives instructions in oral hygiene and preventive dentistry, assist the dental surgeon in chair side work and manages the office. He/she shall work under the supervision of dental surgeon”.The Dental Council of India.

• A dental hygienist is an operating auxiliary licensed and registered to practice dental hygiene under the law of appropriate state, province, territory or nation.
• Dental hygienist work under the supervision of dentist.
• Dental Council of India has prescribed:
  • Course of study for dental hygienist should extend over a period of 2 academic years and then qualification of dental hygienist is given.
  • Minimum age for candidate is 15 years at the time of admission or under 3 months of it and should be medically fit.
• Candidate should pass at least matriculation examination of recognized university taking science as subject or the equivalent recognized qualification.
• The usual functions of dental hygienist are:
  • Cleansing of mouth and teeth with particular attention to calculus and stains.
  • Topical application of fluorides, sealants and other prophylactic solutions.
  • Screening or preliminary examination of patient as individuals or in groups, such as school children or industrial employees.
  • Instruction in oral hygiene.
  • Resource works in the field of dental health.

Question 4. Write short note on dental manpower.
Answer. Dental manpower, include dental surgeon and dental auxiliary for facilitating the provision of dental services is the need of the hour.

• It requires continuous monitory and evaluation. WHO has suggested following framework in formulating planes.
• Analysis of existing situation:
  • Dental health need and demands for service.
  • Dental health manpower supply.
  • Utilization of dental health manpower.
• Policy formulation:
  • Dental health manpower planning
  • Incentives and controls
  • Level of decision-making.

Analysis of Existing Situation

• Dental health needs and demands for services:
  • The number of dental personal, required to meet the needs of a given population will depend upon:
    • Whether the dentist works with or without auxiliaries.
    • How the dentist is remunerated.
    • Preventive measures use.
    • Interval between recall of people for maintenance of dental care.
  • The information of utilization of dental services is to set by number of problems, which should be
    • Source of data
    • Sampling problem
    • Frequency
    • Difficulty to recall
    • Blaming the deviant
    • Type of service.
• Dental health manpower supply:
  • The most community used approach to gauging dental manpower supply is dentist: population ratio.
  • The better the ratio the more likelihood demand for dental care can be met.
• Utilization of dental health manpower:
• The pattern of utilization of dental health manpower varies with social, economic and demographic variable.

Policy Formulation

• Dental health manpower planning:
  • It is the process of estimating the quantity of manpower and there varying types of knowledge and skills needed to bring about planned alteration in dental health system so that chances of improvement in dental health of population are optimal.
• Incentives and control:
  • The incentives offered by the types of work and particular professional carrier and the control imposed upon dental health workers together play an important role in achieving desire dental health objectives.
• Levels of decision-making:
  • Decisions must be made in all steps of dental health and manpower planning.
  • The implementation of dental health manpower plan requires political, financial and administrative support and administrative machinery for formulation, preparation and implementation of plans.
  • However the final decision to implement the plan remains in the hands of government.

Question 5. Write short note on four-handed dentistry.
Answer. When the dentist and the dental assistant working together it is called as four-handed dentistry.

• The four handed dentistry given to the art of seating both the dentist and dental assistant in such a way that both are within easy reach of patient’s mouth.
• Patient is in a fully supine position.
• Assistant will hand the dentist the particular instrument he needs.
• Assistant will also perform additional tasks, such asretraction or aspiration.
• Dentist can thus keep his hands and eyes in the field of operation and works with less fatigue and greater efficiency.

Question 6. Define dental manpower. Discuss current status of dental manpower in India with inferences to implication of dental healthcare services.
Answer.

Current Status of Dental Manpower in India with Interferences to Implication of Dental Healthcare Services

• India consists of 308 dental institutions which provide BDS degree and 241 dental institutions providing MDS degree.
• In year 2004 the dentist to population ratio in India was 1:30,000.
• Due to the geographic imbalance between dental collages
• There is great variation in ratio in rural and urban areas.
• In urban areas in India the dentist to population ratio is 1:10,000 and in rural areas it is 1:2.5 lakhs.
• Almost three fourth of total number of dentist get clustered in urban areas, which houses only one – fourth of country’s population which is in great contrast to physician population ratio which was 1:2400 in year 2000 and 1:1855 in year 2004.
• In 1990 registered hygienists were 3,000 while the registered laboratory technicians were 5,000 in India.
• As per the registration one can make that one hygienist serve to seven dentists and one laboratory technician provide service to four dentists, while the ideal ratio is 1:1.

Question 7. Define and classify dental auxiliaries. Explain the New Zealand school dental nurse.
Or
Define dental auxiliary. Classify dental auxiliaries. Write in detail about school dental nurse.
Or
Define dental auxiliary. Classify dental auxiliaries. Describe the functions of school dental nurse.
Or
Write short note on school dental nurse.
Or
Define dental auxiliary. Classify them. Write in detail about the duties of school dental nurse.
Answer.

New Zealand School Dental Nurse

• The New Zealand dental nurse scheme was first established in Wellington town of New Zealand in the year 1921.
• This scheme was introduced, because of the extensive dental disease which is found in army recruits at the time of world war I.
• TA Hunter was the man who was responsible for the formation of New Zealand School dental nurse.
• The school where the nurses were trained was named as “The dominion Training School for Dental Nurses”.
• Training of nurses were extended to the time duration of two years for covering the reversible and irreversible procedures.
• After the training completion each nurse is allocated to a school where she gets employment by the government to look after 450–700 children.
• In New Zealand, dental nurses are present predominantly in school based salary service and they provide care for the children at 6 month intervals.
• New Zealand dental nurses remain in the general supervision of district principal dental officer.
• This system works very well in New Zealand.

Duties of New Zealand School Dental Nurse/Functions

• Oral examination
• Prophylaxis
• Topical fluoride application
• Administration of local anesthesia
• Advice on dietary fluoride supplements
• Cavity preparation and placement of amalgam and silicate fillings in primary and permanent teeth.
• Pulp capping
• Extraction of primary teeth only
• Classroom and parent–teacher dental health education
• Individual patient instruction in toothbrushing and oral hygiene
• Referral of more complex cases to dentist.

Question 8. Write in brief on operating dental auxiliaries.
Or
Define dental auxiliary. Describe in detail the operating dental auxiliary.
Answer.

Operating dental auxiliaries are:

• School dental nurse.
• Dental therapist.
• Dental hygienist.
• Expanded function dental auxiliary.

School Dental Nurse

• School dental nurse is a person who is permitted to diagnose dental disease and to plan and carry out certain specified preventive and treatment measure, including some operative procedures in the treatment of dental caries and periodontal disease in defended group of people, usually school children.

Dental Therapist

• It is an operating auxiliary which is permitted to carry out prescription of supervising dentist. This includes the various specified preventive and treatment measures which includes preparation of cavity and restoration of teeth.
• They are likely to New Zealand type school dental nurse but there role is somewhat different i.e. they are not permitted to diagnose and plan out dental care.
• They are permitted to work which is based on written treatment plans devised by the supervising dentist.
• Operative procedures which they carry out are same like school dental nurse which include the administration of local infiltration analgesia.
• The directing dentist is always responsible for determining degree of supervision required in each of the individual case, according to capacity and experience of therapist concerned.
• Training of dental therapist is for the period of 2 years which involves reversible and irreversible procedures.
• Duties of dental therapist are:
  • Diagnosis of clinical caries.
  • Preparation of cavity in deciduous and permanent teeth.
  • Vital pulpotomies under rubber dam in deciduous teeth.
  • Extraction of deciduous teeth under local anesthesia.
  • They often can take radiographs on request of supervising dentist.

Expanded Function Dental Auxiliary (EFDA)

• They have been referred to as expanded function dental assistant, expanded function dental hygienist, expanded function auxiliary, expanded duty dental auxiliary.
• EFDA is a dental assistant or dental hygienist who has received further training in duties related to direct treatment of patients, though still working under the direct supervision of dentist.
• EFDA undertake reversible procedures, which can either be corrected or redone without undue harm to patient’s health.
• Duties of EFDA are:
  • Placement and removing of rubber dam.
  • Placement and removing of temporary restoration.
  • Placement and removal of matrix bands.
  • Condensing as well as carving of amalgam restoration in previously prepared teeth.
  • Placing of acrylic restoration in previously prepared teeth.
  • Applying final finish as well as polishing of above mentioned restorations.
• EFDA seats the patient, performs initial inspection and then with X-rays available, call the dentist. Dentist examine the patient, , make diagnosis and create a treatment plan. Dentist gives local anesthesia, prepare cavities, insert pulp protection and the cement bases. EFDA helps dentist in four handed relationship.
• EFDA seen as well as participate in all the discussions and surgical procedures on the case EFDA now completes the restoration. If any problem occur, dentist can be called for consultation.

Question 9. Write notes on duties and responsibilities of dental hygienist.
Answer. Following are the duties and responsibilities of dental hygienist:

• Cleansing of mouth and teeth with particular attention to calculus and stains.
• Topical application of fluorides, sealants and other prophylactic solutions.
• Screening or preliminary examination of patient as individuals or in groups, such as school children or industrial employees.
• Instruction in oral hygiene.
• Resource works in the field of dental health.

Question 10. Write short note on utilization of manpower.
Answer. Utilization is the actual attendance by the members of the public at oral health care facilities to receive care.

• In regions where adequate dental manpower is available yet the utilization of oral healthcare services is low thereby widening the oral health differences across the social economic classes.
• Various factors like demographic, behavioral, socioeconomic, cultural, and epidemiogical, etc., contribute to people’s decision to either forgo care or seek professional assistance for dental problems
• The utilization of dental services was found to be influenced by the sociodemographic characteristics of the population like age, education, occupation, etc.
• Certain myths that proved to be a hurdle in utilization of dental services prevailed in the study population like tooth loss is an extension of old age, eating tobacco prevented caries, dental diseases can be cured by medicines alone, tooth extraction leads to loss of vision, and oral prophylaxis causes loosening of teeth.

Question 11. Write short note on Denturist.
Answer. Denturist is the term given to the dental laboratory technicians who are permitted to fabricate the dentures for patient without the prescription of dentist.

• Denturist can be licensed or registered.
• Desire for autonomy among dental laboratory technicians lead to the formation of denturists and their craft is known as denturism.
• Several countries have allowed laboratory technicians to work directly with public.
• Denmark uses the term denturist to describe specialcategory of dental technician who sits at an examination, to enable him to prescribe, make and fit removable dentures without supervision.
• In state of Maine, denturists are permitted to take impression and fit dentures but under the directions of a dentist.
• American dental association has vigorously opposed the denturist movement at the political level. Principal argument of association is that denturists are unqualified to treat patients and poor quality care and actual harm could result to patients.
• Some of the duties of denturist are:
  • Measure patient’s jaw to determine size and shape of dentures required.
  • Make impression of patient’s teeth, gums and jaws.
  • Construct dentures or direct other workers to construct dentures.
  • Fit and modify new dentures
  • Repair the dentures
  • Reline and rebase the dentures
  • Fabricate mouth protectors, antisnoring prosthesisand removable prosthesis on implants
  • May prepare partial dentures.