dental assistant dental assistant dental assistants are members of the dental team. they support a dental operator (such as a dentist or other treating dental auxiliary) in providing more efficient dental treatment. dental assistants are distinguished from other groups of dental auxiliaries (such as dental therapists, dental hygienists and dental technicians) by differing training, roles and patient scopes. dental assistant on the right supporting a dental operator on the left, during a procedure. history the first dental assistant infection control was very different in historical dentistry when compared to dentistry nowadays in 2018. dental assistants and dentists did not wear all or if any personal protection equipment when practicing. we can see that the dentist, in this case on the left, is not wearing a mask, gloves or eye protection (apart from his glasses). additionally, the dental assistant on the right, is also not wearing any gloves, mask or eye protection. c. edmund kells, a pioneering dentist operating from new orleans, enlisted the first dental assistant. the dental field was initially dominated by males, but after this first addition of a female, it was then acceptable for women to seek dental treatment without their husbands. this led to dental assistants of that era also being known as "ladies in attendance". thanks to the addition of women to dentistry, the profession flourished with more and more women seeking treatment and more patients overall receiving care. the first association it was not until almost four decades later that in 1923 the first dental assistant association was founded by juliette southard, named the american dental assistant association and it is still in practise now. it began with just five members, now reaching more than 10,000. roles the dental assistant's role is often thought to be to support the dental operator by typically passing instruments during clinical procedures. however, in fact, their role extends much further to include: providing patients help with their oral hygiene skills, preparing the patient for treatment, sterilising instruments, assisting during general anaesthetic dental procedures, positioning suction devices, exposing dental radiographs, taking dental impressions, recording patient notes and administration roles such as scheduling appointments. infection control it was customary for oral health care workers and dental assistants in the 1980s to practice oral health care without wearing gloves, masks or eye protection. this was at a crucial time due to the human immunodeficiency virus (hiv) spreading rapidly at a global rate. however, in 2018 gloves, masks and eye protection have become part of the standard infection control guidelines which has been implemented in all oral health care settings as a means of preventing the spread of infectious disease. infection control in oral health care not only protects the patient but it also protects the oral health care workers. this includes: dentists, dental specialists, oral health therapists, dental hygienists and dental assistants. dental assistants play a crucial role in maintaining high levels of infection control in the oral health care setting. the dental assistant is the major link between oral health care workers and the patient. to perform infection control responsibilities well, the dental assistant must have the appropriate education, training and work experience. examples of infection control protocols that the dental assistant needs to follow in an oral health setting include: hand hygiene hand hygiene aims to reduce the number of microorganisms on hands. antimicrobial agents such as alcohol-based hand rub or antimicrobial soap and water are effective agents to remove most antimicrobial bacteria on hands in dental settings. personal protective equipment (ppe) gloves, gown, hair net and eye protection are essential barrier protection items that enable the dental assistant to reduce the transmission of infectious diseases to themselves, other dental co-workers and patients. gloves and masks need to be disposed after each patient, eyewear can be disposable or reusable and gowns need to be replaced if visibly soiled. lastly, footwear must include leather closed toe shoes; this minimises the risk of sharps injury. surgical procedures and aseptic technique it is crucial to wear sterile gloves when the dental assistant is assisting in surgery with the oral health care clinician. hand hygiene using antimicrobial soap and water is imperial to maintaining adequate infection control in this setting, as this minimises the risk of infection. management of sharps injury it is crucial that sharp instruments which include: needles, scalers, scalpels, burs, orthodontics bands and endodontic files need to be handled with care and appropriate techniques to minimise any potential sharps injury. sharps also need to be disposed accordingly into the sharps containers, separate from other disposable bins. the dental assistant needs to be aware of what is required to go into the sharps containers and what is not. this minimises the chance of spreading infectious diseases. container for medical sharps and infectious waste - typically found in dental surgeries. management of clinical waste it is imperative that when performing change over, that the dental assistant is able to distinguish the difference between medical related waste compared to contaminated waste. contaminated waste needs to be placed in a leak proof thick yellow bag with a biohazard symbol label. environment the dental assistant should put on utility gloves when cleaning working surfaces during the changeover between patients. each person in the dental office needs to have his or her own pair/s of utility gloves. they must also be able to distinguish between clean and dirty zones as this minimises the spread of infectious diseases between co-workers and patients. additionally, plastic barriers are placed on: instruments such as; hand pieces connected to the chair, overhead lights, amalgamators, x-ray machines, mixing materials and other miscellaneous dental instruments, materials or appliances. one of the roles that the dental assistant participates in is changing these plastic barriers after each patient has left that surgery. this ensures that the surgery is set up ready for the next patient. these infection control procedures and protocols not only apply to the dental assistant, but to all co-workers in the oral health care setting. however, the dental assistant is the major connection between the patient and the oral health care clinician. therefore, it is imperative that they follow these guidelines to minimise the risk of spreading possible infectious diseases to co-workers, patients and themselves. sterilisation, disinfectant and antiseptic dental assistants play a large role in ensuring that the reusable dental instruments used daily in dental practices are sterilised adequately after each use. sterilisation is an essential part of the infection control protocol. this can be defined as free of all life forms where the elimination of considerable number of the most heat resistant spores (bacterial and mycotic) is the basic criteria sterilisation. sterilisation process consists of autoclaving where moist heat kills bacteria by denaturation of high protein- containing bacteria at 250f (121 °c) for 15 to 20 minutes or 270 f for 3 minutes. biological monitors and process indicators are 2 methods used to ensure the effectiveness of sterilization process. biological monitor (spore test) where bacterial spores are placed in strips or envelops along with the instruments. this method shows that the microorganisms have been eradicated and must be conducted weekly. process indicators; where the load has reached a certain temperature, the indicators change their colour. dry heat sterilization which requires a higher temperature and longer time (1–2 hours) than steam autoclave, therefore, only glass or metal objects can be steamed by dry heat. chemiclave by using ethylene oxide at relatively low temperature for 2–3 hours. cold/ chemical test which can be done by soaking instruments (heat- sensitive) in a specific chemical solution such as 2% glutaraldehyde for 10 hours in order to kill bacterial spores. however, this method does not destroy hepatitis viruses and spores. disinfectant is also one of the major roles of dental assistant where chemicals applied to inanimate surfaces such as lab tops, counter tops, headrests, light handles, etc. this is to make sure that germicide and/or microbiostatic are achieved. antiseptic chemical agents similar to disinfectants but they may be applied safely to living tissue, is another task for dental assistant where alcohol is the most commonly used. health promotion dental assistants make a difference in the community by participating in health promotion activities and programs. these programs may take place at schools, preschools, immunisation events or at maternal health clinics. dental operators may also be supported by dental assistants during pre-school or school screenings. dental assistants can extend their scope to provide oral health promotion to patients in australia by completing the certificate iv in dental assisting (oral health promotion). the dental assistant will have the ability to implement an individualised oral health promotion program and oral hygiene program. after the appropriate training the dental assistant may; health promotion for good oral health. residential aged care and dental assistants engaging in recreational activities - its not always about teeth. promote the dental team concept in achieving good oral health and promoting good oral hygiene habits assist in making dental treatment accessible and affordable to the community perform health promotion activities by promoting good oral health to the community support and educate on oral health promotion to allied health professionals dental assistants help other dental and allied health professionals in health promotion. these dental assistants implement oral health programs by providing resources and presentation promoting oral health messages to several target groups and community settings. these settings include: residential aged care facilities special needs schools early childhood services culturally diverse communities community sport clubs dental assistant can educate the community and schools by advising on: oral diseases diet analysis and counselling oral hygiene strategies preventive strategies care of fixed & removable prosthesis and fixed appliances smoking cessation preventing sports injuries radiography currently in australia, dental assistants are not required to be registered under the dental board of australia. however, dental assistants who have attained their certificate iv in dental assisting – dental radiography must hold a current license with the relative state or territory radiation authority. dental assistants that decide to take on further study into their certificate iv in dental assisting - dental radiography, have an advantage of exposing patients to radiation also known as an x-ray, with regards to oral health care. the dental assistant will take training to further their practical and theoretical skills relevant to the role of the dental radiographer. dental radiography - pictures of intra oral radiographs of the whole mouth.upon successful completion of the training program dependent on the course structure, the dental assistant may: expose intra-oral radiographs that ensures an optimum radiographic image. process, mount and file intra-oral radiographs. able to identify technical faults and their causes. be able to demonstrate an understanding of potential hazards of exposure to radiation and to practice high standards of radiation therapy. to recognise normal anatomy. maintain infection control throughout all practical procedures. potential future roles aging population school screening where children are screened for dental decay or gum disease or other abnormalities of the mouth.looking to the future of dentistry and oral health, the roles for dental assistants are ever-changing and expanding. with the increase in an ageing population, it will become more and more commonplace for dental assistants to be employed to support dental operators with providing oral health promotion and treatment within residential care facilities. increasing demand to match new dental graduates the number of newly graduated dentists and dental auxiliaries is increasing and with that the need for dental assistants. according to the bureau of labor statistics of america the rate of employed dental assistants will likely increase by 18% in the ten years between 2014 and 2024. with an increase in dental assistants comes the possibility of extension in the dental assistant roles and scope. as seen in some states of the united states of america, dental assistants are able to perform some simple fillings with the supervision of a practising dentist. by allowing dental assistants to extend their scope alongside the appropriate training, the workload of the other members of the dental team is lessened and increases efficiency of the dental clinic management. this may have the potential to reach other countries in the future as the need for dental and oral health treatments increase. variations around the world dental assistant roles can vary depending on different country qualifications and regulations. below are examples of dental assisting roles which the dental assistant is able to