Ontario Dental Assistants – Scope of Practice
LEVEL I CERTIFIED DENTAL ASSISTANT SKILLS (CDA)
- Preparation of the treatment/clinical area.
- Cleaning and sterilization of instruments and hand pieces.
- Passing instruments to the dentist or hygienist (single- and two-handed technique).
- Proper use of High Volume Evacuator within the Oral Cavity.
- Preparation of Restorative Materials.
- Perform simple laboratory procedures such as the pouring and trimming of study models.
- Maintains supplies and equipment (stocks and replenishes supplies).
- Monitors inventory.
- Assesses emergency situations, aware of emergency protocols, knowledge of First Aid and CPR.
- Assists in maintaining emergency drug kits.
- Ability to interpret Material Safety Data Sheets.
- Conducts spore/biological indicator tests.
- Recording data on patients’ record or chart as directed by the DDS.
- Patient and community education on oral health (extra-oral).
- Other extra-oral duties as required by the dentist.
- Instruction in care and maintenance of pre-fitted appliances.
- Expose, process, and mount radiographs as specified by HARP.
- Obtains vital signs.
LEVEL Ⅱ INTRA-ORAL DENTAL ASSISTANT SKILLS (CDA Ⅱ) RCDSO Standard of Practice
Please refer to the RCDSO website for further clarification.
A Level II Dental Assistant is a person who holds the certificate of the National Dental Assisting Examining Board issued on or before December 31, 2002, or who holds a certificate of the National Dental Assisting Examining Board issued after December 31, 2002 provided that the certificate was issued based upon successful completion of its examination(s).
A dentist may give direction to a Level II Dental Assistant to perform any of the following intra-oral procedures:
(1) application and removal of rubber dam;
(2) mechanical polishing of the coronal portion of the teeth, but not including any instrumentation;
(3) taking extra-/intra-oral photographs;
(4) taking alginate impressions of the teeth for study and working models;
(5) taking digital/optical impressions of the teeth for study and working models;
(6) oral hygiene instruction;
(7) dietary counselling relative to dentistry;
(8) fluoride application;
(9) application of materials topically to prepare the surface of the teeth for pit and fissure sealants;
(10) application of pit and fissure sealants;
(11) application of topical anesthetics;
(12) application of desensitizing agents;
(13) polishing restorations;
(14) oral irrigation;
(15) whitening the coronal portion of the teeth using tray-based systems and materials generally available to the public without prescription;
(16) placing and removing restorative matrix bands and wedges;
(17) public health screenings to detect gross abnormalities[5];
(18) removing periodontal dressings that are uncomplicated[6]; and
(19) removing simple interrupted sutures[7].
For the intra-oral procedures numbered (1), (9), (10), (11), (12), (13), (16), (18) and (19) above, the dentist giving direction to a Level II Dental Assistant to perform any of these procedures must be present in the office suite while it is being performed and ensure, prior to the patient’s discharge, that it was performed safely and competently.
For the intra-oral procedures numbered (2), (3), (4), (5) (6), (7), (8), (14), (15) and (17) above, the dentist giving direction to a Level II Dental Assistant to perform any of these procedures may permit the Level II Dental Assistant to perform it unsupervised.
In addition to the intra-oral procedures listed above, a Level II Dental Assistant who has successfully completed a Supplemental Course in Orthodontic Procedures that meets the criteria listed in Appendix 1 may also perform any of the following four intra-oral procedures. The supplemental Orthodontic procedures course or a refresher course must be completed within the last 3 years after such time, regular in office use of the supplemental skills is required.
(1) placing and cementing bands, brackets and passive space-maintaining or orthodontic appliances that have been previously selected, fitted and/or dispensed by a dentist for orthodontic purposes[8];
(2) placing attachments for orthodontic purposes in conjunction with clear aligner therapy;
(3) removing bands, brackets and passive space-maintaining or orthodontic appliances, but not removing cement and/or bonding resin[9]; and
(4) taking non-alginate conventional impressions for working models for the fabrication of space-maintaining or orthodontic appliances.
For the intra-oral procedures numbered (1), (2), (3) and (4) above, the dentist giving direction to a Level II Dental Assistant to perform any of these procedures must be present in the office suite while it is being performed and ensure, prior to the patient’s discharge, that it was performed safely and competently.
In addition to the intra-oral procedures listed above, a Level II Dental Assistant who has successfully completed a Supplemental Course in Restorative Procedures that meets the criteria listed in Appendix 2 may also perform any of the following 5 intra-oral procedures:
(1) taking digital/optical impressions for working models, including prepared teeth[10];
(2) taking non-alginate conventional impressions for working models, including prepared teeth[11];
(3) taking interocclusal records or bite registrations using non-rigid materials;
(4) taking facebow transfer records;
(5) fabricating single unit temporary crowns, including intra-orally, to be fitted and cemented by a dentist[12].
For the intra-oral procedures numbered (1), (2) and (5) above, the dentist giving direction to a Level II Dental Assistant to perform any of these procedures must be present in the office suite while it is being performed and ensure, prior to the patient’s discharge, that it was performed safely and competently.
For the intra-oral procedure numbered (3) and (4) above, the dentist giving direction to a Level II Dental Assistant to perform any of these procedures may permit the Level II Dental Assistant to perform it unsupervised.
DENTAL RECEPTIONIST/FRONT DESK ADMINISTRATIVE ASSISTANTS (CDR)
- Patient reception and dismissal
- Appointment book control and maintain recall system
- Block out times for reserved emergency and new appointments
- Maintaining and controlling business area
- Handle all incoming calls promptly and efficiently
- Patient follow-up treatment calls
- Public relations
- Bookkeeping
- Managing receivables and payables
- Prepare and balance bank deposits on daily basis
- Age and prepare outstanding account statements
- Maintaining financial records
- Incoming mail, invoices, packing slips and statements (forward to appropriate person for verification and/or payment)
- Maintaining file system
- Ordering and receiving supplies
TREATMENT COORDINATOR SKILLS (CDTC)
- Performs required part of consultation
- Reviews medical history and explains office policies and procedures
- Makes a definite financial agreement with each patient/parent in accordance with the financial policies of the office. Prepares financial agreement form for each patient
- Monitors patient progress through each treatment
- Sends the patient records for consultation with appropriate specialists as required
- Co-ordinates goodwill program
- Helps to co-ordinate practice building and public relations efforts with patients, parents and referring professionals
- Print and proofread patient correspondence
- Keeps treatment acceptance rate within practice goals
- Ensures the follow-up of "will-advise" and mail-in referrals
- Educates patients with respect to appointments and financial obligations
PREVENTIVE DENTAL ASSISTANT SKILLS (CPDA)
(Listed with RCDSO prior to January 1, 2000)
- Includes, but not limited to all duties of CERTIFIED Level I Dental Assistants as listed above
- Chairside Dental Assisting (Level I)
- Mechanical polishing of the coronal portion of the teeth
- Placement and removal of rubber dam
- Taking of preliminary impression of teeth for study models
- Topical application of anti-cariogenic agents
- Oral hygiene instruction with an intra-oral component
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