Expanding services by dental auxiliaries; why? where? how?

The economic and educational affluence of recent years has produced a heightened public awareness of the correlation between personal health and general well-being. Coincidently the development of the ideal concept of individual right to comprehensive professional health services is beginning t o put stress on systems for delivering health care. The preventive measures from public health have not caused a decrease in the need for dental services, but merely have changed the character of the need. The results of fluoridation of communal drinking water, for example, now are becoming apparent and are turning the attention of both the public and the profession from restoration of cavities to the more sophisticated and productive professional services that maintain total oral health throughout a lifetime.' Increased pressures on the dental profession by continued development and expansion of private and governmentally supported plans of prepayment also have increased the demand for dental services. Better training, equipment, and increased operational efficiency are, without doubt enhancing the productivity of individual dentists. Increasing numbers of graduates from more dental schools also will boost the productivity of the profession. But these gains will keep pace with neither the nced nor the demand for dental care." Added demands on the Nation's dental force make progressively more difficult its ability t o meet the population's needs for adequate dental care. Based on the time required for treatment, the Bureau of State Services of the Public Health Service estimated that a dental force five times the present size would have t o work for a year, full-time, t o meet the accumulated backlog of dental needs in this country. The provision of adequate dental care t o the people of this country, hence, will demand much more effective utilization of auxiliary personnel. More effective utilization of auxiliary personnel, in turn, will become the most significant factor in helping the dental profession meet the increasing demand for dental care." The practice of dentistry encompasses two specific fields of operation: (1) prevention, and (2) restoration and rehabilitation. The dental hygienist, by virtue of her training. practices a preventive phase of dentistry. To remove her from that task and expand her duties in restorative treatment would defeat the purpose of her education and disrupt the efficiency of dental hygiene practiced in her office. It seems reasonable to contend, therefore, that any expansion of delegated personnel must be through the dental assistant. The dental assistant already is oriented t o restorative procedures. A relatively uncomplicated, and a much more direct approach to the problems of her training and, subsequently, her functions in dental practice * A resume of a Table Clinic presented April 1, 1969, a t The University of Michigan, School of ____