A. INTRODUCTION
This document provides an updated guideline of the Scope of Practise for dental assistants in a private office setting as recognized by the Manitoba Dental Association.
Although the MDA Oral Health Team Committee worked on this document neither the Manitoba Dental Assistants Association or the Manitoba Dental Therapists Association agree with the final draft. However, the MDA Board has approved this Scope of Practise and it represents their official position as it relates to the delegation of duties by dentists to Registered Dental Assistants.
Having completed a CDA accredited educational program or a program recognized by the Manitoba Dental Association, the individuals identified may perform, under the effective supervision of a dentist licensed by the MDA, those procedures for which a dentist can delegate as outlined in this document. Therefore, a dentist must be physically present in the dental office and available while patient services are being provided by any of these designated oral health team members.
Prior to delegating procedures, it is the responsibility of the employing dentist to ensure that an individual is qualified to perform said procedures and, where applicable, has been registered and/or licensed by the Association.
Individual dentists do not have the authority to delegate intra oral services that are beyond the limits of the scope of practise as outlined in this document. Doing so would constitute a breach of the Bylaws of the Manitoba Dental Association.
B. EDUCATION PROGRAMS AND COURSES
Education programs available to dental assistants can be broadly described as:
- Core programs (ie. full time formal courses),
- Speciality modules (ie. short upgrading courses), or
- Upgrading programs
1. Core Programs
Institutions presently offering training in Core Programs are listed below, followed by the year in which the program was formally recognized as an accredited course of training by the Manitoba Dental Association.
Dental Assisting
- Red River College (1974)
- University College of the North (1979)(UCN)
- CDI (2007)
- Winkler Campus - Red River Collge
Programs accredited by the Commission on Dental Accreditation of Canada (CDAC)
National Dental Assisting Examining Board (NDAEB) certificates for non-accredited programs (July 2001)
Student Practicums
Student practicum's as it relates to the Core Programs and Specialty Modules.
In order to perform intra-oral procedures in a private dental practise as part of an educational practicum arranged by the educational institution, a student must;
- be enrolled in an accredited Level II Dental Assisting program recognized by the Manitoba Dental Association
- have successfully completed the theoretical and pre-clinical components and demonstrated competency in those specific intra-oral procedures that they will be expected to perform
- work under the direct supervision of a licensed dentist
2. Specialty Modules
These Modules are offered to qualified individuals who have received standing in one of the Core Programs. Characteristically, the Modules are of short duration and require self-study in advance of a formal laboratory/clinical session.
Orthodontics for dental assistants
Didactic and practical, designed to prepare Level II dental assistants for work in a orthodontic-oriented office. Upon completion, the individual is able to:
- Place and remove orthodontic separators;
- Fit orthodontic bands prior to cementation;
- Cement orthodontic bands;
- Tie in prepared orthodontic archwires;
- Remove orthodontic archwires;
- Remove excess cement following cementation of orthodontic bands;
- Place direct bonded orthodontic attachments;
- Take orthodontic impressions;
- Take panoramic and cephalometric radiographs; and
- Trace cephalometric radiographs.
3. Upgrading Programs
The following procedures were added to the training of a Level II in 1992-93 at UCN and 1995-96 at Red River College. Individuals graduating prior to these dates may upgrade through either the Advanced skills at Red River College or the Expanded Intra-oral Competencies Upgrading Level II at UCN.
At the completion of either of these courses, the individual is able to:
- Apply topical anaesthetics
- Place treatment liners, bases, and adhesives
- Place and remove matrices and wedges
- Apply topical desensitizing agents
- Remove sutures
- Use an explorer during sealant, coronal polishing procedures and placement of matrices
Independent Study Programs
The following program is designed to provide theoretical knowledge to chairside employees in private offices:
- Northern Alberta Institute of Technology – Edmonton, Alberta
This program is accredited by the Commission on Dental Accreditation of Canada
4. Re-Entering the Workforce
Dental Assistants who have not been employed in private practice or clinical teaching for a period of 5 years or more cannot re-enter the workforce without prior approval of the MDA Registrar.
C. CURRENT SCOPE OF PRACTISE
All MDA recognized programs currently require students to obtain certificates in CPR and first aid procedures prior to graduation. Upon graduation, it is the individual’s responsibility to maintain certificates yearly.
A Level II dental assistant who has completed a specialty module recognized by the Manitoba Dental Association is eligible to perform the duties covered in the module, in addition to those listed on the chart.
OFFICE TRAINED AUXILIARIES
Office trained auxiliaries have no formal educational training but are trained in-office by the dentist to perform extra-oral procedures only. Excluded from the list of extra-oral procedures are:
- Counsel, instruct and demonstrate for the maintenance or improvement of oral health
- Dental hygiene care - Plan in consultation with dentist
- Diet and nutritional counselling as it relates to oral health
- Radiographs—identify information significant to dental hygiene care
- Vital signs - take and record
PUBLIC HEALTH (Educational and Long-term Care)
Dental Assistants may work in a public health setting without effective supervision. They are however limited to the following:
- Develop and deliver community dental health education programs
- Counsel, instruct and demonstrate for the maintenance or improvement of oral health
- Screening: use mirror, tongue depressor & light to record and chart observations. The level of screening will be limited to their education qualifications.
