Dental Assistant Training - Expanded Duties/Coronal Polishing

COURSE 4: Curriculum

COURSE 5: Armamenteria

COURSE 6*: Curriculum

Course Overview
This program offers 8 hours of clinical and didactic education required by the Georgia Board of Dentistry for certification in coronal polishing for dental assistants. This course will include:

• Oral anatomy
• Tooth morphology
• Indications, contraindications, risks and complications for coronal polishing
• Ethics and jurisprudence relating to coronal polishing
• Indications for professionally applied topical fluoride agents for caries prevention
• Fluoride delivery methods

The laboratory and clinical activity will include:

• Training in using a slow-speed hand piece
• Principles of coronal polishing
• Operator & patient positioning/ergonomics
• Polishing coronal surfaces of teeth, preferred polishing technique, polishing agents
• Coronal polish on typodonts
• Coronal polish on partner and practical with disclosing solution

Objectives

• State the effect polishing has on the patient, oral environment, teeth, and gingival tissues
• Identify indications for polishing the teeth
• Understand the definition of plaque, types of stain, calculus, and related terminology
• Discuss contraindications for polishing the teeth
• Distinguish between abrasion, abrasive, and polishing
• Understand dental armamentarium - the equipment and instruments used in the delivery of dental care
• Identify abrasive polishing agents commonly used in coronal polishing
• Determine how particle size/shape, speed, and pressure affect abrasiveness
• Recognize different abrasive agents
• Demonstrate use of a slow speed hand piece and prophylaxis angle on a partner in clinic
• Define cumulative trauma disorders and explain how the dental assistant might prevent such injuries

Georgia Board of Dentistry Rule 150-9-.02. Expanded Duties of Dental Assistants describes what an Expanded Duties assistant may do in Georgia, and how an assistant can qualify for Expanded Duties training. This rule is printed here as a courtesy. Visit the Georgia Board of Dentistry web site for pertinent rules regarding the performance of dental assistants in Georgia.

150-9-.02. Expanded Duties of Dental Assistants

1. To meet the requirements of an expanded duty dental assistant, a dental assistant must have a high school diploma, or the equivalent thereof, proof of current CPR certification and a certificate documenting that he or she has successfully completed the course pertaining to the specific duties outlined in that certificate. Only those expanded duties, which are listed on the certificate(s), may be performed by an expanded duty dental assistant. An expanded duty dental assistant certificate may be issued by an accredited dental assisting program, a dental hygiene school, a dental school or a professional association recognized and approved by the Georgia Board of Dentistry to a candidate who has successfully completed the required certificate courses (each of which must be a minimum of four hours) from an accredited dental assisting program, a dental hygiene school, a dental school or professional association recognized and approved by the Georgia Board of Dentistry and met all other requirements of an expanded duty assistant; and completed an examination demonstrating competency in specific duties that is administered by a licensed dentist on behalf of the accredited dental assistant program, dental hygiene school, dental school or professional association recognized and approved by the Georgia Board of Dentistry.
2. Eligibility for taking said courses requires that the candidate meet at least one of the following criteria:
   1. Possess current certification that the candidate is a Certified Dental Assistant.
   2. Be a graduate of a one (1) year accredited dental assisting program or a dental assisting program approved by the Board or be eligible for graduation.
   3. Have been employed as a chair side assistant by a licensed dentist for a continuous six (6) month period within the previous three (3) years. (Note: An expanded duties certificate would be issued to a candidate only upon proper proof of graduation.)
3. The employer of the expanded duty assistant shall have readily available in the dental office a copy of the certificate(s) issued from the sponsor of the accredited course(s) of study to the expanded duty dental assistant. The expanded duties specific to the course(s) taken and in which [a] certificate(s) [has / have] been issued may be delegated to dental assistants, who are performing their duties under the direct supervision of a licensed dentist. The following expanded duties may be delegated to those assistants meeting the educational requirements established by Board Rule 150-9-.02(1) and possessing a certificate(s) of the course(s) taken delineating the duties specific to that course.
   1. Apply desensitizing agents to root surfaces of teeth and prepared dentinal surfaces of teeth prior to cementation of temporary restorations and crowns, bridges, or inlays.
   2. Place cavity liner, base or varnish over unexposed pulp.
   3. Intraoral fabrication of temporary crowns and bridges. All such adjustments must be performed extraorally.
   4. Perform face bow transfer.
   5. Make impressions to be used to repair a damaged prosthesis.
   6. Place periodontal dressing.
   7. Redressing (not initial placement of dressing) and removing dressing from alveolar sockets in post-operative osteitis when the patient is uncomfortable due to the loss of dressing from the alveolar socket in a diagnosed case of post-operative osteitis.
   8. Make impressions with irreversible hydrocolloid to be used to fabricate a night guard (bruxism or muscle relaxation appliance). All adjustments must be performed extraorally. Final adjustment must be made by the dentist.
   9. Monitor the administration of nitrous oxide/oxygen; turn off nitrous oxide/oxygen at the completion of the dental procedure and make adjustments to the level of nitrous oxide/oxygen, but only following the specific instructions of the dentist.
   10. Apply topical anticariogenic agents.
   11. Apply pit and fissure sealants, and primer and bonding agents to etched enamel or dentin; and light-cure with a fiber-optic light source (not to include the use of a laser device).
   12. Packing and removing retraction cord, as prescribed by the dentist, so long as said cord is used solely for restorative dental procedures.
   13. Changing of bleaching agent, following initial applications by the dentist, during the bleaching process of vital and non-vital teeth after the placement of a rubber dam; and applying the fiber-optic light source of a curing light for activation of the bleach (not to include the use of a laser device).
   14. Rebond brackets after a licensed dentist has examined the affected tooth and surrounding gingiva and found no evidence of pathology.
   15. Remove bonded brackets with hand instruments only.
   16. Make impressions for passive orthodontic appliances.
   17. Apply primer and bonding agents to etched enamel or dentin; and light cure with fiber-optic light source (not to include use of a laser device).

PLEASE read this policy before completing the Registration Form and the Affidavit of Eligibility.

Definition of Prophylaxis – Child (D1120)

Removal of plaque, calculus and stains from the tooth structures in the primary and transitional dentition.  It is intended to control local irrational factors.

Requirements for calculus removal

Calculus, if present during a “rubber cup prophy”, must be identified and removed by a Georgia-licensed DMD/DDS or RDH only.

Age of primary dentition

The American Dental Association (ADA) lists the presence of primary teeth from approximately one year to about age twelve.  The Georgia Board of Dentistry recognizes and accepts these basic parameters as the ages when primary teeth are present in a child.

Billing as a Prophylaxis

The prophylaxis, D1120, includes the combined processes of examination (DMD/DDS), calculus removal if present (DMD/DDS/RDH) and coronal polishing, “rubber cup prophy” (Trained DA).

Training in Coronal Polishing (“Rubber Cup Prophy”) for Dental Assistants

A dental assistant with at least one year of prior chairside experience or a graduate of an approved dental assisting program is eligible to attend an 8 hour pre-approved course of study that includes didactic and clinical applications necessary for coronal polishing (“rubber cup prophy”) and shall include:

• Ethics and Georgia jurisprudence related to coronal polishing
• Identify the potential risks, indications and contraindications for coronal polishing
• Understand the definition of plaque, types of stain, calculus, and related terminology
• Dental anatomy and morphology for the proper identification of adult and child dentition
• Principles of coronal polishing including, but not limited to –
  • armamentarium;
  • proper positioning used/ergonomics;
  • preferred polishing technique using a stable fulcrum;
  • abrasive polishing agents commonly used in coronal polishing;
  • polishing coronal surfaces of teeth on a typodont using a slow speed hand piece
• Indications for professionally applied topical fluoride agents for caries prevention
• Fluoride Delivery Methods

GDA EXPANDED DUTIES/CORONAL POLISHING CANCELLATION AND REFUND POLICY:

Due to a large number of no shows and last-minute cancellations, the GDA Board of Trustees passed the following rule regarding expanded duties and coronal polishing cancellations and refunds:

Registration fees may be transferred to another course date one time only if notification is received at least 30 days prior to the scheduled course date. Cancellations or transfers after that time will not be permitted, with the exception of extreme extenuating circumstances. There are no refunds.

Requests for transfer or cancellation must be received in writing. Requests for cancellation between 30 and 15 days prior to the course, will be issued a CREDIT for the cost of the course. The credit is issued to the payer of the course (usually the dentist, but may be the assistant in some cases); the credit is valid for one (1) year from the date of the course for which they were registered. It is the responsibility of the creditor to keep track of when the credit expires AND to notify the GDA when the credit is being redeemed.

Credit may be used for the same assistant at a different course date and location or for another assistant.