The employment of dental nurses.

The term “(school) dental nurse” has come to refer t o auxiliaries who cut and restore cavities in children’s teeth after a training period of about two years. 2o 75 5x 7y The nurses’ responsibilities vary with the country, but invariably they inject local anesthetics; prepare cavities and place restorative materials; and extract primary teeth and, in some instances, permanent teeth. 27 74 v 74 The preparation of cavities and extraction of teeth are among features which distinguish dental nurses from “expanded-duty dental auxiliaries,” who merely restore cavities prepared by dentists. Perhaps no dental personnel have faced more opposition from dentists than dental nurses.2o274454X’ Even in New Zealand, where nurses were introduced in 1921 with support from the New Zealand Dental Association, initial opposition from sectors of the profession was obvious. IX “ Possibly the strongest resistance has been expressed in the United States. In 1949, the Massachusetts Legislature approved a five-year experiment with dental nurses, but after little more than a year, the enabling legislation was repealed following opposition from organized den t i~ t ry .~3 The American Dental Association proclaimed in 1949 that programs to teach people to treat children’s teeth should not be less rigorous and time-consuming than for dentists.’ The Association called for a study into the effects of all programs employing dental nurses, wherever they might be established.4 Since then, the Association has been steadfast in opposing the preparation of cavities in teeth by auxiliaries.9 Nonetheless, approximatley 30 countries use dental nurses. 2h 5xln this review, factors that should be considered when deciding whether t o introduce dental nurses are discussed, together with pertinent literature. Although data exist on the dental nurses’ productivity and quality of restorative care, other aspects such as effects on dentists’job satisfaction o r on the public’s access to care have not been evaluated statistically and are open t o conjecture.