Dentists always want to know what their hygienists are allowed to do while they are not in the office. In California, direct supervision requires the dentist to be in the office, and one of the things that requires direct supervision is placement of subgingival topical anesthetic. So the placement of PFG gel in the sulcus (formerly Profound, Steven’s Pharmacy), for example, would need me in the building. Having the patient rinse with DYC (formerly Cyclone, Steven’s Pharmacy) topical rinse, however, does not. Score one for DYC rinse.

My assistant, Jennifer, is an RDAEF, and the list of extended functions has been increased for 2010. Existing RDAEFs (like Jennifer) will need to attend a dental school based board approved CE program to perform these new functions, but check out the list of what they can do above and beyond a standard RDA license. These all require direct supervision:

• Cord retraction of gingival tissue for impression procedures
• Size and fit endodontic master points and accessory points
• Cement endodontic master points and accessory points
• Take final impressions for permanent indirect restorations
• Take final impressions for tooth-borne removable prosthesis
• Place, contour, finish and adjust all direct restorations
• Adjust and cement permanent indirect restorations

Wow! That is pretty progressive, and I would be interested to hear your feelings on this list.

Will these changes be implemented in your state soon? Do you like the idea of assistants being able to do so much? Much like our training in dental school, their license makes them a safe beginner, and it will take a lot of on-the-job training before they can complete these duties with a high level of confidence.