2007 Legislative Update    Read the DANB acknowledgement letter to the CDAA                               By Mr. Orain Ridley, CDAA President-elect     I would like to take this opportunity to thank all of those who participated in the May 10-12, 2007 142nd Annual Charter Oak Dental Meeting. I would also like to reach out and give help and information to those in the private clinics, hospitals and community health centers who maybe unaware of the progress made and future preparation for the success of dental assistant initiative in the state of Connecticut which has been ongoing through the Connecticut Dental Assistant Association (CDAA). The Executive Board of the CDAA is beginning a restructuring of the association and continuing education program of their own. To promote the ability and confidence of all dental auxiliaries in the state, the CDAA is working on the following:      The EFDA (Expanded Function Dental Assistant) concept in Connecticut began being formulated after MUCH discussion in spring of 2005, educators from the ADA – accredited Dental Assisting training programs in Connecticut were approached by the CSDA to review the competencies determined by the dentists to be appropriate tasks to delegate to dental levels of training and supervision with the rationales for each competency.  Curriculum modules have been established to facilitate training EFDA-designed skills once the state accepts these new designations.       The role of the educated, trained and experienced dental assistant can promote “access to care” by allowing the dentist to treat multiple patients during a common time period.  As the dentists work in one operatory, the skilled dental assistant (EFDA) can complete many of these routine and necessary tasks independently.  These competencies are listed as recommended DA levels 1-4 with direct or indirect levels of supervision.       In an attempt to establish criteria for non-traditional settings (ex. community clinics, hospitals and private clinics), other competencies are listed which can become known as categories for expanded function dental assistants (EFDA).  These individuals would complete further training that would qualify them to perform reversible dental procedures on patients in settings where the dentists’ time is limited or, in select situations, where license dentists might not be available.  The EFDA-Certified Dental Assistant would also be able to work in private practice, again allowing the dentists to see more patients during the workday.  Dentists would prescribe all treatment before being completed by the EFDA.  By creating the EFDA category, more patients could be served in more diverse settings.  Examples of these tasks are listed as level 4 and 5, with indirect or general supervision.      The current access to care issues has been compounded by the shortage of dental auxiliary.  The EFDA level for dental auxiliary provided a career ladder through advanced education, skills, and responsibility.  This will foster the retention of skilled dental auxiliary employed in the field.  In turn, this will have beneficial consequences on access to care by expanding the numbers of allied dental personnel.      In a short, the executives will be contacting all area dental clinics to encourage all dental assistants to join the Connecticut Dental Assistant Association.  Membership will enable everyone to become informed of upcoming meetings and to have as much input on this matter of access to care by dental assistants, their dentists and administrators.      The Executive Board of the CDAA has established criteria for dental auxiliaries in the state and this information can be viewed below. Thank you, Oraine Ridley, CDA- CDAA President-elect   At the CDAA meeting on November 29, 2005, EFDA Curriculum Committee member Mr. Gary Jacobs presented the proposed career ladder model,proposed functions to be delegated, and proposed teaching modalities.   DRAFT :    Proposed Definitions Career Levels of Dental Assistants   DA 1 – Dental Assistant Level 1 Performs the most basic dental assisting tasks.  No minimum training or education is needed to perform the task – only verbal instruction Must take and successfully pass the DANB ICE within six months of initial dental assisting employment. Direct supervision by dentist or( registered dental hygienist  in public health clinical setting) at all times.   DA 2 – Dental Assistant Level 2 Performs tasks of low to moderate complexity. Must have successfully passed DANB ICE and DANB RHS. Direct supervision by dentist or dental hygienist except in procedures designated as requiring successful completion of DANB ICE or DANB RHS.   CDA – Certified Dental Assistant Performs tasks for moderate complexity. Required 3500 hours of dental work experience or 2 years of formal dental assisting education program accredited by CED Must have successfully passed and obtained DANB CDA and maintain CDA credential with DANB (which includes mandatory CEUs). Indirect supervision for most duties except where noted otherwise.   EFDA – Expanded Function Dental Assistant Performs the most complex tasks. Requires that a CDA in good standing who has graduated from a specific, advanced education of Expanded Function Dental Assisting from an formal dental assisting education program accredited by CED Must maintain CDA certification with DANB. Indirect or Direct supervision of all EFDA duties with general supervision for CDA duties unless otherwise noted. Additional mandatory continuing education (above required for CDA) on related topics to EFDA function   PROPOSED  DRAFT COMPETENCY LEVELS   Expanded Function under DA level 4 Didactic (Written Test) Laboratory Competency Clinical Competency RESTORATIVE MODULE         √ √ √ 52. Place temporary restorations √ √ √ 58. Place, condense and carve amalgam √ √ √ 59. Place and cure composite resin restorations √ √ √ 61. Place liners and bases √ √ √ 63. Size, fit and place stainless steel crowns √ √ √ PREVENTATIVE/PERIODONTAL/ SURGICAL MODULE       45. Apply topical fluoride √ √ √ 67. Apply pit and fissure sealants √ √ √ 62. Place periodontal dressings √ √ √ 64. Remove periodontal dressings √ √ √ 65. Place post-extraction dressings   √ √ √ 66. Remove post-extraction dressings   √ √ √ ORTHODONTIC MODULE       35. Remove orthodontic wire √ √ √ 60. Size and place orthodontic bands and brackets √ √ √ 43. Adjustment of orthodontic archwire √ √ √ 44. Place orthodontic separators √ √ √ 51b. Removal of cements, orthodontic cement √ √ √ **All institutions offering the Connecticut expanded function educational/certification programs for allied dental must have an existing ADA accredited dental program to be recognized to provide official EFDA certification.       Lois Villa, CDA CDAA Mission Statement for Legislative Objective The main legislative objective for the CDAA is to improve access to dental care for the needs of the people of Connecticut. It is well known that there is a large portion of the population that do not have the ability, funding, or it is difficult, to receive adequate dental care. The CDAA believes that the access of care can be greatly increased by qualified dental assistants that are properly utilized and trained for expanded duties. There is much research that clearly indicates that employment of expanded function dental assistants, with proper training and supervision, can perform selected advanced procedures, which will increase dental productivity without undermining the quality of care, and ensuring  the patient’s safety as well as satisfaction. It is critical that only properly trained dental auxiliary be allowed to perform such expanded functions. Therefore it is the CDAA’s belief that Expanded Function Dental Assistants, EFDA’s, should have the following:   Be certified by the Dental Assistant National Board with a CDA, and, for specific advanced functions, successful completion of formal training in an approved accredited EFDA program