Dear RDH:
This is in response to Dr. E.J. Neiburger`s letter to you in your last issue, it is regarding dental assistants and expanded duties.
It`s too bad that he hasn`t had the joy of having an employee who he feels cannot be replaced, because they go all out for their career! I`d like to know if he`d mind displaying his letter for his patients as well as employees to see. I`m sure his RDH magazine is not on display. The way I read his point of view is: If patients don`t know any different (about the quality of care), who cares!
It`s too bad if you feel this way, doctor. Don`t delude yourself; your patients will simply find a dentist who cares about even the smallest patients. Licensure does matter. I demand it wherever possible. In Illinois, a new bill unbelievably has passed (SB800) that would allow a dental assistant to coronal polish and monitor nitrous oxide after education.
However, it is not stipulated how much education, two hours, two days, two weeks, a home study? We need to know. Plus, there is no mention of licensure. I`m sorry, but I feel that any one with "hands in the mouth duties," touching blood and saliva, must be licensed! There is no accountability without licensure.
I also find it odd that there is a limit of four dental assistants with these duties. I`m sure this will not impact many offices. But I foresee some pedo offices having four operators going with a quick check by the doctor, who is basically hopping to check four patients before, then back to all four to check and dismiss! This will not improve quality of care, just quantity of care!
Will dentists and insurance companies deduct fees because of cheaper labor? I doubt it. I keep hearing that insurance companies are the ones behind preceptorship, but I know here in Illinois there is a group called DENT IL PAC. The group`s sole purpose is to fund campaigns of its legislators who support its issues, and they are funded by dentists who give to them. Not too long before SB800 was heard, free toothbrush packs were passed out to the legislators. How typical!
If this is the wave of the future, I`m sad. I`m sure no one would go to a nail tech who did not have a license (Isn`t it sad that we place more value on cosmetic procedures?), or a hair colorist that had a two-week lesson on hair bleaching, but no license.
I`m sorry if some feel polishing can be done by anyone. They most likely are the ones scrambling for patients, because no one will return to a practice with such views. Patients are not dumb. They know quality care.
Ten years ago, when I used to temp one day a week, I saw dental assistants with no formal training do such things as wipe air/water syringe tips with alcohol to "clean it" or ultrasonic partials or retainers in the same solution! They would add water to fixer and developer to level them up, even misusing the autoclave.
So to those who see this as the wave of the future, I`m sorry. If anything should be done, it should be for all dental assistants to be certified now for what they do. If coronal polishing is a must, license it with stipulations of continuing education and CPR. I was lucky - when I was a dental assistant, I had a great teacher! Dental assisting is very hard work, and I have worked all modes of the office, so I feel I can speak freely on this issue. So to end this letter, don`t delude yourself, doctor, quality hygienists can treat all patients, not just the perio! And they do know the difference. Kudos to all the dentists who have opposed this bill; there are many out there! Dental hygiene is not just a job "anyone" can do, just ask my patients!
Here`s to quality, pride, and ethics!
Julie Buttacavoli, RDH
Arlington Heights, Illinois
