Tija Hunter, CDA, EFDA, CDIA, MADAA, is an expanded functions dental assistant/office manager in O'Fallon, Mo. She is the director of the Dental Careers Institute, member of the American Dental Assistants Association, where she holds a Master, an independent consultant specializing in team building, assistant training, and office organization. She can be reached at 

Tija Hunter, CDA, EFDA, CDIA, FADAA

	Who says dental assisting is a highly skilled profession?

	Frankly, I do! Not very long ago something called the cell phone changed our lives forever! First, it was a car phone; this thing was huge! It came in a leather bag and was as big as a regular home phone, including a twisted cord. Then they got a little smaller, although they were still huge and bulky, then smaller yet. Cell phones got to be so small that they could hide in the palm of your hand. Now our cell phones are getting bigger. The reason? They are little computers that have made our lives easier? More confusing? Busier? Maybe a little of all three!

More from Tija Hunter: 6 tips to dramatically cut your dental supplies overhead

	Now is one of the most exciting times to be in dentistry, and, as a dental assistant, you have so many opportunities to seize this moment! The technology in dentistry evolves every day. There are so many amazing gadgets and toys on the dental market. CAD/CAM in dentistry came along 30 years ago, but, due to price and ease of use, it’s taken awhile for this phenomenon to catch on. With the technology getting easier and faster, our understanding and better familiarity of computers growing, this CAD/CAM market is bursting at the seams and not slowing down! 3D cone beam and guided implant surgery are becoming more prominent in the general dental setting, along with so much more.

	Enter the dental assistant! What better way to make yourself more valuable than to learn this amazing technology? Oh, wait, your doctor doesn’t have this technology? You’re still processing films on an automatic processor? You won’t be for long! This industry and technology aren'’t going backwards; they're moving forward at an alarming rate. Dental schools all over the nation are now training their students on new technology. Soon, just like those cell phones, every office will be equipped with some brand of 3D imagery and digital impression capabilities.

Ask a dental assistant: Can cold sterile (glutaraldehyde) still be used in a dental office?

	I hear dental assistants are a dime a dozen, but not the good ones! CAD/CAM dental assistants are few and far between. They are highly skilled and needed in the dental office. So what better way to make yourself more valuable than to learn this technology? I have always said, “I want to make myself so valuable that the doctor can’t do without me.” That’s a lofty goal, but if you have mad skills that others don’t have yet, you are valuable to any office seeking a highly skilled trained professional.

	With CAD/CAM growing more and more each day, there is a shortage of trained dental assistants that can image, design, stain, glaze and take care of this very expensive machinery. Be one of the best by learning all you can now! In years to come, CAD/CAM and 3D in the dental office will be commonplace so seize the opportunity now by learning all you can.

	Become a highly skilled trained professional and rock dentistry better than anyone out there!

Related reading: I Use That: SonicFill from Kerr

Articles

With CAD/CAM growing more and more each day, there is a shortage of trained dental assistants that can image, design, stain, glaze and take care of this very expensive machinery.

Who says dental assisting is a highly skilled profession?

CEREC is 30 years old this year, and, to celebrate, Sirona Dental hosted CEREC 30, a Las Vegas celebration. Here's a look at some of the highlights...

	The festivities opened with some of Sirona’s big chiefs and top educators. The company announced the new clinical director of Sirona Dental will be 

	Dr. DiTolla rolled out the new Transcendental Treatment Centers. Leave it to Sirona not to disappoint when it comes to innovation and style! Although available in Europe for some time, this is new to the U.S. market. The centers feature ergonomics second to none, and both operator and patient will love the comfort and simplicity of this unit.

	The transcendental treatment centers are said to be the quintessential fit for clinicians looking to optimize and enhance their practice capabilities with top-of-the-line equipment. Reportedly smartly engineered to embody a look of elegance and unmatched functionality, transcendental treatment centers are designed to stand as the showpiece of any operatory.

	With a history of manufacturing treatment centers since 1956, Sirona has installed more than 150,000 units worldwide since the 1980s and that number continues to steadily grow. Reportedly made with the highest class of materials and designed for optimum expansion and integration, transcendental treatment centers are said to provide clinicians superior flexibility while offering the patient the most pleasant experience possible.

	They also reportedly allow practitioners to seamlessly integrate all components of digital dentistry, including CAD/CAM, implantology and endodontics, into one easy-to-use unit designed to streamline workflow while increasing efficiency. Ergonomically built to ensure optimum patient comfort while maximizing clinical proficiency, transcendental treatment centers are said to completely exceed the industry standard for supreme digital practice growth and performance.

	“C30 presents the most advanced technology in digital dentistry and is a befitting forum to introduce our transcendental treatment centers to the US,” said Michael Augins, president of Sirona Dental, Inc. “With the experience and ingenuity that comes from decades of producing top-echelon products and services to the dental world, Sirona’s transcendental treatment centers are a paragon of innovation. Clinicians will be thrilled with the unlimited digital integration potential and state-of-the-art interface capabilities found only in our line of uniquely engineered treatment centers.”

	Specifically, C30 features the new TENEO and INTEGO, two vanguards of the new generation of treatment centers created to transform any practice from ordinary to exceptional and provide users the transcendental experience.

	Additionally, and in partnership with Kappler, C30 attendees reportedly can further enrich their practice configuration with transcendental dental cabinetry, a complement to the treatment centers. GENOVA, COMPONERA, ATHEN, and ATHEN LIGHT transcendental cabinetry units are said to elegantly integrate with TENEO and INTEGO for optimal convenience. Ergonomically designed for the doctor and assistant with dual positional work surfaces to reduce movement and fatigue, transcendental cabinetry reportedly provides increased accessibility to all instruments and consumables, promoting a clutter-free, simplified environment conducive for precise, time-saving operatory procedures.

	The TENEO is designed for the integration of implant and CAD/CAM technology with the ability to run sterile water for implants, and the CEREC wand is right on the unit. It also has the ability to hook up suction and handpiece lines to the built-in cleaning adaptor, flushing the lines. The unit is designed for superior hygiene and was developed with easy to clean features-a dental assistant's dream!! Another great feature is the three-way syringe,with extra heated water and a light.

	Following the treatment center announcement, CEREC 30 attendees went back to the ballroom to finish up the day with a talk by Emmitt Smith and a welcome reception hosted by VITA North America.

	Those who have CEREC should attend these events with their team. The technology and information here can help take your practice to the next level. For those who don’t have a CEREC, this event can help ease their fears and show how to provide quality, same-day dentistry.

	The best part of attending these shows is the people you get to meet. I learn so much talking to people from around the world and sharing stories and information to grow both professionally and personally.

	My room is facing west, so when the sun comes up in the east, it hits the Wynn Hotel (which is right outside my window) and lights up all of Vegas with its mirrored exterior. It’s such a great way to wake up in the morning!

	Day two of CEREC 30 hit the ground running with breakfast and some phenomenal breakout sessions. There’s just one big problem … there are too many great speakers speaking at the same time so it’s hard to choose a class to attend! If you have CEREC or Sirona 3D, you know what I mean … you want to attend them all!

	Before we left for Las Vegas and CEREC 30, my boss had gotten a quote for a new surgical suite from Patterson Dental. It’s something he’s been thinking about for a while and had decided to make the move. When he got here and saw the amazing technology of the Sirona integrated Treatment Centers and the Teneo, he was like a kid in a candy store! After our first class with the amazing Dr. August De Olivera, we went down to the showroom floor to talk details and order the unit. I cannot wait to get this installed in our office! After being in dentistry for 34 years, I can tell you that the technology has taken this industry by storm and, right now, is the best time to be in dentistry!

	After lunch, we had another general session. It featured Fred Joyal, an amazing speaker who promotes marketing and team building. Here’s my advice … don’t ever pass up the opportunity to hear him speak!

	Next, the Venetian came to life when Tony Robbins burst into the room! His energy had the entire crowd up and on their feet jumping around and hollering. Energy creates excitement and Tony does just that! He kept the room alive for 3 hours and he never stops!

	To end the night, it was time for a tailgate party and the award-winning Train in concert to finish off a great day of speakers and nonstop learning. Seeing old friends, meeting new ones, and creating some great memories. It was a great day and a huge success!

	Everyone seems to be moving a little slow today after last night’s Train concert, but the dedicated ones are here and ready for some great breakout sessions. I started my day out in the Clear Correct breakout and it was a packed house! These sessions are one hour in length so there is a lot of ground to cover in that amount of time. All of the ones I attended were awesome!

	My doctor had some questions about Clear Correct so after this session we headed over to the showroom floor to talk about the Clear Correct-CEREC partnership and how to properly scan and submit cases. It was actually a great time to do this because most everyone was in the breakouts and we had them all to ourselves!

	Back to general sessions, Imtiaz Manji was the first speaker. If you have never heard this man speak, please make it a priority! This gentleman is amazingly inspirational and so insightful. When he speaks, people listen. His reputation as a leader and mentor has earned him that right, and he is one of the warmest, most compassionate people you will ever meet. Dr. Mike Skramstad, Dr. Todd Ehrlich, and Dr. Tarun Agarwal all followed suite and ended the last day of CEREC 30.

	This was an amazing event and I would like to thank all the people behind the scenes. These are the ones who have worked for months to make this possible. You see them in their vests working nonstop to make sure everything goes off according to plan and they execute it perfectly.

	This was a somewhat small and intimate venue. I’m told about 6,000 dentists and team members from around the world and that’s what I love about it! It’s all things CEREC. It’s focused on CEREC and 3D-integrated technology from one of the leaders in the dental industry. Sirona has amazing products and they have no trouble showing it off. This meeting is loud and proud. They make you feel like one big family here and they certainly take care of everyone, from speakers, entertainment, classes, food, and vendors. Sirona makes sure everyone walks away from this meeting with a sense of pride … and rightfully so. If you have invested in their products, then you are committed to giving your patients the very best that dentistry has to offer. You have invested in yourself and your practice and you stand out above the rest.

	Sirona isn’t shy about their mission … to take their vision and make it possible to find newer, faster, and better ways for dentist to treat their patients, while always putting the patient first. Their partnership with Patterson Dental means their offices have unsurpassed support for products and services, and that’s something that Patterson prides itself on. Two great companies working together to help dental offices be the best they can be.

	This was a truly an amazing meeting, informative, inspirational, and innovative. It was a meeting like none other.

	Well played Sirona … VERY well played!

The festivities opened with some of Sirona’s big chiefs and top educators. The company announced the new clinical director of Sirona Dental will be Dr. Mike DiTolla.

A complete recap of CEREC 30 in Las Vegas

	A member of the Modern Dental Assistant Editorial Advisory Board shares her thoughts with fellow dental assistants (and sales reps) about the importance of product and technique education.

Hi, this is Tija Hunter, dental assistant and member of the Modern Dental Assistant editorial advisory board. I'm really targeting two audiences in this article and video - the dental assistant and the dental sales representative.

	This profession is all about building great relationships … the relationship between the patient and the doctor, the patient and the front desk team, the hygiene team, and the assisting team … just in the same way we develop relationships with dealer representatives and manufacturer representative. In the dental marketplace, the dental assistant has a huge influence in purchasing for the dental practice. Because of that, dental assistants need to knowledgeable about various products. There will always be 32 teeth and the tooth surfaces never change, but the products and materials we use do! Of course not every product is going to fit your practice today, but knowledge of these products can help your practice grow.

	We always talk about the "wow" patient experiences, and dental assistants play a huge role in that. Dental sales reps need to "wow" dental assistants and their practices with their products. Here’s my advice to the sales reps … give lunch and learns, talk to dental assistants at conventions, and get in that door!

	A sales representative can be the assistant’s best friend and vise versa! Creating a great relationship between dental assistant and sales representative will benefit both parties. It's all about working together!

The importance of education for dental assistants

This profession is all about building great relationships … the relationship between the patient and the doctor, the patient and the front desk team, the hygiene team, and the assisting team …

The importance of education for dental assistants ... and ideas on where to get it [VIDEO]

	I am a social media stalker. I love to keep up with friends and colleagues on 

, visit different group pages, and see what dental assistants are talking about. What is it that makes us tick? What are the issues that concern us most?

Time and time again, I see that there is a huge misunderstanding about what a 

 is and how you go about obtaining that certification. There is also a misunderstanding of exactly what an RDA is, what that entails and how each state differs. Are these state or national certifications? Let’s examine those two valuable designations and help set the record straight.

A CDA or Certified Dental Assistant is a national certification (not state-specific) awarded by the 

. You earn this certification by completing all three components of DANB’s CDA exam. The three components are General Chairside, Infection Control and Radiation Health and Safety. There are three pathways to be eligible to obtain CDA certification. All the information I’m about to give you can also be found on the DANB website and it has some great information about other national exams available for dental personnel. It’s important to note that DANB owns the Certified Dental Assistant

 and the CDA® marks, so only those who earn and maintain CDA certification are allowed to use this credential after their names.

Related reading: 5 ways to celebrate dental assistants during Dental Assistants Recognition Week


	1. Graduation from a CODA-accredited dental assisting or dental hygiene program, AND
	2. Current CPR from a DANB-accepted provider

CODA (Commission on Dental Accreditation from the American Dental Association)

-accredited dental assisting or dental hygiene program, you are eligible to sit for the CDA exam. You must also be current in 

Even if you didn’t attend a CODA-accredited program, but you would like to better yourself and further your career, you can still sit for the CDA exam given by DANB but you must adhere to pathway II.


	1. High school graduation or equivalent, AND
	2. Minimum of 3,500 hours of approved work experience, AND
	3. Current CPR from a DANB-accepted provider

DANB notes that the 3,500 hours of experience is about two years of full-time employment. Your current employer must sign off on your application to DANB stating that you have indeed completed the 3,500 hours necessary to take the exam.

From IDS 2015: One dental assistant's perspective on the show and dental assisting around the world

DANB's CDA exam is given at testing centers around the country. You must apply to take the test first (applications can be found on the DANB website), and then DANB will provide you with a window of time in which to take the test. The three components of the exam can be taken separately or altogether. Taken separately, you will spend a little more money but it allows you to just study that component. Some people find that easier and less stressful. The results or your pass/fail are immediately given to you when you are finished.

Of the three components, there are currently no eligibility requirements for taking the RHS (radiology) or the ICE (infection control) exams. Once you take your first component of the CDA exam, you have five years to complete all three components. Meaning that while you are working towards completing your 3,500 hours, you can go ahead and take the RHS and ICE. When your 3,500 hours are complete, you’re ready to sit for the GC (general chairside) portion of the exam.

There is one last pathway to obtain a CDA…


	1. Former DANB CDA status, or graduation from a CODA-accredited DDS or DMD program or graduation from a dental degree program outside the U.S. or Canada, AND
	2. Current CPR from a DANB-accepted provider

Related reading: Announcing the launch of Modern Dental Assistant

Note that Pathway III is for “former DANB CDAs.” You only hold “CDA status” if you are current in paying your renewal fees, hold current CPR, and receive a minimum of 12 continuing education hours each year. Many times I’ve met assistants who say they are CDA certified, but they have not kept up with the yearly requirements. If you haven’t met your early requirements, you are not a DANB CDA certificant. If you think this credential isn’t important, keep your dues paid and your continuing education requirements current! You simply never know where life is going to take you and you may want them!

Why obtain CDA certification? Out of approximately 300,000 dental assistants across the U.S., only 35,000 currently hold this national certification. Obtaining this status means taking and passing this national exam, and committing yourself to continuing education and a lifetime of learning. It shows you’ve dedicated yourself to this profession and you hold yourself to the highest standards of patient care and educational excellence. Many states require one or more of the components of this exam in order to hold a license or permit through that state. Many federal or government agencies, state institutions, and schools require you to be a current CDA certificant in order to be employed with them. At this very moment, many more states are considering legislation for minimal standards of education and training for dental assistants. The DANB CDA certification is already the gold standard in many states and I believe will be adapted by more states as the need for qualified dental assistants grows and public awareness demands that the dental community hold us to minimal educational requirements.

That’s national, what about state requirements? It seems confusing to me, but each state has its own set of rules. Some states are strict and require licenses and/or permits for radiology and infection control, while some states don’t allow their dental assistants to perform any extra task and have no licensure. For this, DANB has also compiled a list on their website to help sift through the muck and identify what each state requires.

Related reading: Dental assistants, you have the power!

Many states have regulations and rules set into place for dental assistants working within the state to become registered dental assistants (RDAs). An RDA status that is granted in one state is only valid in that state. An RDA status does not move from state to state and what one state may require to obtain RDA status will be completely different in another state.

A Kentucky RDA doesn’t require an exam but does require current certification in CPR that meets or exceeds the guidelines of the 

. In addition, the dental assistant’s employer dentist must register the dental assistant on his or her application for renewal of dental licensure and maintain a personnel file for the registered dental assistant containing the following:

		a copy of proof of having current CPR certification

		a copy of the certificates of completion of the coronal polishing, radiation safety, radiation techniques course and starting IV access lines courses, if the dental assistant has completed these courses

		the licensee's statement attesting to the competency of the dental assistant in the procedures delegated the assistant from the delegated duties list

There are no yearly requirements except for CPR.

A dental assistant in the state of Texas can earn status as an RDA by formally registering with the 

Texas State Board of Dental Examiners (TSBDE)

. To qualify, one must successfully complete a current course in basic life support, successfully complete a mandatory course of training specified by the TSBDE that includes procedures for positioning and exposing dental X-rays, jurisprudence, and infection control, or earn the national DANB CDA certification and complete the Texas Jurisprudence Assessment, and apply to the TSBDE for registration.

From a dental assistant's perspective: Things I wish I could go back and tell my 19-year-old self

The Massachusetts Board of Registration in Dentistry

 published new regulations effective October 10, 2014, related to registration and scope of practice of dental assistants. They have four levels for dental assistants: 

dental assistant trained on the job (OJT)

expanded function dental assistant (EFDA)

. Each of these carries their own criteria and regulations.

Missouri has no radiology or infection control requirements. However, the state requires its assistants to hold either the DANB CDA or sit for the 

 (this exam is also given by DANB and the information is available on its website). Once either of these exams have been taken and passed, the assistant is eligible to take any of the five expanded functions courses that Missouri allows. After passing those courses, the assistant obtains a permit for that expanded function. Missouri doesn’t recognize RDA status.

Wow, doesn’t that make your head spin? In a perfect world, we would all be on the same page. If your state doesn’t hold you to minimal standards, hold yourself accountable for continuing your education in this growing profession. There is no limit to what you can do. Know the laws that pertain to you, work hard to better yourself, and never, ever stop learning!

Related reading: The latest hourly and annual salary numbers for dentists, dental hygienists and dental assistants

 I am a social media stalker. I love to keep up with friends and colleagues on Facebook, visit different group pages, and see what dental assistants are talking about. What is it that makes us tick? What are the issues that concern us most?

Ask a dental assistant: What do all of those credentials mean and how can I obtain them?

At the age of 19, when I began my career in dentistry, I thought that when I became “old” (like 40), I would have to quit assisting. I thought to myself that since I’ve never heard of an “old” assistant, I would have to move to the front desk. Boy was I wrong! There are so many things I wish I could go back and tell my 19-year-old self about what to expect in the future and how to make my career that much better. If given the chance, here are a few things I would tell myself.

I had no idea back then just how important a “good” pair of shoes is. Not just for my feet, but my back and knees too! As dental assistants, we are on our feet all day. Just because shoes cost a lot doesn’t mean they have the support you need to protect your joints from the effects of getting old. Do your research. 

So many times throughout the years, I would hear, “Oh you don’t need continuing education you’re a dental assistant.” I was stupid enough to listen to them! Dental assistants are truly valuable team members and we need to be educated. It doesn’t matter if you were trained on the job or attended a 3-month or 9-month dental assisting program, this career is about lifelong learning! There are so many different avenues you can take in dentistry, but you can’t get anywhere without learning all you can first. 

Those wrinkles creep up on you. This career is demanding on your skin with the constant washing of the hands. I wish I would have known just how important a good facial cleanser and hand lotion would be years down the road and how putting a little effort into my skin then would mean a lot to me now! 

I heard Aretha sing it for years but never gave a thought that she may be singing to me! I remember one job I worked at and, many times, I thought the doctor would talk down to me, but I noticed he didn’t do that with the front desk girl. It took me awhile to realize that’s because she wouldn’t put up with it! Nobody will respect you until you make them respect you. Stand up for yourself because nobody else will. The sooner this lesson is learned, the better off you are. 

This is probably the hardest one to learn. As a young assistant, I had a little boy to care for and I was a single mom. Taking time for me didn’t seem like something I could do. I always gave to my son and my job, so there wasn’t much left for me. I also thought that this meant spending money that I obviously didn’t have. Taking time for me now means spending time with my thoughts, thinking clearly, and giving some thought on where I’d like to be and what I’d like to accomplish, then setting up a game plan on how I intend to get there. The luxury of a pedicure doesn’t cost a lot and the hour that I get to spend all to myself always makes me feel good about me. 

These 33 years since I was my 19-year-old self have flown by. There isn’t much I would change about how I have arrived at my life now, but these few little tweaks would have meant some big changes in the way I saw myself and my future. Lesson learned 

 has been a hot debate on many message boards recently. And, I must admit, I thought 

 outlawed Glutaraldehyde, but the truth is they have only (highly) recommended that we no longer use it. Will it be “outlawed” sometime in the future? I truly believe so and here’s why:

; “In the years since its introduction as a disinfectant/sterilant, glutaraldehyde has been linked with a variety of health effects – ranging from mild to severe – including asthma, breathing difficulties, respiratory irritation and skin rashes.”

They claim the most serious adverse health effect documented among employees exposed to glutaraldehyde vapor is 

, a chronic condition characterized by bronchial hyperresponsiveness. Reactions can be either immediate or delayed, with a latent period ranging from a few weeks to several years from the onset of exposure.

Newly proposed EPA standards will affect dentists

“In addition, a few cross-sectional studies also show that an increased prevalence of irritant symptoms, including itching of the eyes with increased lacrimation (tearing), and rhinitis…”

And in addition to causing respiratory effects, glutaraldehyde acts as a contact allergen, giving rise to contact dermatitis, usually on the hands, but occasionally on the face.

, nosebleeds, sneezing, wheezing, hives, nausea and staining of the hands.

OK, so if that’s not enough to convince you, glutaraoldehyde is also very unstable. Most of us don’t handle it properly. Many of the “test strips” you can get to test the solution really only test to see how diluted the chemical is, not its effectiveness. Most of these are 28-day solutions; sure, your chemical might be great for the first few days, but is it still working on day 20?

Are you using too many chemicals in your dental practice?

Are there other chemicals that you can use? There are a few on the market, but are they as effective? They will all tell you “yes.” I will say, “Why chance it?” Holding yourself to the highest standards of patient care is essential. Infection control is the most important thing we do on a daily basis, so get it right!

The EPA is also concerned with disposal of the chemical after its use. You should never dispose of your glutaraldehyde in the sewer systems without notifying the local sewage treatment plant authority. You should always contact your local water board or regional office of the EPA. I don’t know many offices that do that.

Best practice: If you can autoclave it, do it. If you can’t, throw it away. It’s simply not worth the health risk or the all the problems associated with handling it or disposing of it. We got rid of it in our office a couple of years ago and I will admit, I was unsure at first how we would do without it.  Happy to say, we haven’t missed it.

OSHA and the CDC make these guidelines based on facts, so don’t ignore them. For your safety, the safety of your patients and that of your families, I recommend (as do OSHA, the CDC and the EPA!) to get rid of it! 

 Whether or not to use Glutaraldehyde has been a hot debate on many message boards recently. And, I must admit, I thought OSHA and the CDC outlawed Glutaraldehyde, but the truth is they have only (highly) recommended that we no longer use it. Will it be “outlawed” sometime in the future? I truly believe so and here’s why:

Ask a dental assistant: Can cold sterile (Glutaraldehyde) still be used in a dental office?

	When I became a dental assistant over 33 years ago, I never imagined that one day I would love teaching as much as I do.

	My love of dentistry and my love of teaching allow me to talk to dental assistants all over the country. When you get a room full of assistants together, engaging and talking, you learn so much. One of the subjects that comes up often is laws regarding dental assistants. I find that there is a tremendous lack of knowledge of the law.

What is legal for a dental assistant to do? Do assistants have to be licensed? What is a “registered” dental assistant? Do you have to be a 

(CDA) to do expanded functions and if not, why should I become one?

I find it somewhat frustrating that when this subject is brought up, the information passing through the room is usually wrong. And many times, when someone asks, “how do you know that” or “where did you get that information” a simple, “well that’s what so-and-so said” is the explanation. Patient care, infection control and protecting your patients and yourself should always be your number one priority every single day. So, not knowing the laws, not completely understanding right from wrong and not educating yourself is not only lazy, it’s downright dangerous.

Did you know that there are approximately 300,000 dental assistants in the U.S.? There are approximately 200,000 dentists, and 175,000 dental hygienists. Dental assistants make up the greatest number of the oral healthcare team, yet for the most part we are unregulated and undereducated. It’s for this reason that I believe that there is a lack of knowledge of the law. Assistants, for the most part, just haven’t been taught what it is they are allowed to do. Or, if they have been formally trained, they don’t always keep up with continuing education and changes. Over the years, I have seen some incredible changes in our industry with technology and materials, including 

 guidelines. As the laws change from year to year, keeping up with education is more important than ever before.

due to some unsavory practices; rusty instruments, an autoclave that was never spore tested and proved to be malfunctioning, questionable infection control procedures and assistants who were administering IV’s when it wasn’t allowed by the Oklahoma Board of Dentistry. But did you know his assistants were brought up on felony charges as well? They were arrested, jailed and they are waiting for their fate to be decided. Even if they serve no prison time, the devastation this has caused has severely impacted their lives. They may serve prison time or possibly fined a pretty hefty amount. They had been sent to a course on IV sedation and assumed it was legal for assistants to do. They failed to keep accurate spore test records and their infection control procedures were extremely out of date. Their lack of understanding of the law and current guidelines for infection control has cost them greatly. In this case, their employer may or may not have known the law either.

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Ignorance of the law is no excuse. You can still be held accountable for your actions or lack thereof. No longer can you use the excuse of “well, that’s the way we’ve always done it,” or “that’s the way to they told me to do it when I got here.” It’s your responsibility to know right from wrong and you should never simply take someone’s word for it. The statement that “it’s ok, we’ve always done it that way, no big deal,” is just laziness!

Does your state require dental assistants to have a radiology permit? Some states allow for dental assistants to preform expanded functions. What functions does your state allow and how do you go about becoming certified for these functions? If I am certified in one state, but am moving to another, will that permit/license be valid in my new state? I would love to take all the credit and say that I have done all the research for this but the truth is that the 

 (DANB) has already done it for us. Listed on their website is a state-specific tab where you can search your state and its laws governing dental assistants. Go to the experts who have done the research for you and get the correct information. Never assume that just because it’s always been done that way that is the right way to do it. Do your research and educate yourself.  

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According to DANB.org, there are approximately 36,000 Certified Dental Assistants in the U.S. So out of approximately 300,000, only 12% are certified with a national standard requiring them to achieve 12 hours of CE a year to keep that certification. Many states that require their assistants to be registered dental assistants (RDA) also require licensure or radiology permits. RDAs also have to complete a number of hours each year to keep their certification current.

Not all states have those requirements; some require no continuing education whatsoever. We hear new studies all the time that link our oral health to our overall health yet, the most oral healthcare workers have no minimal standards for education and for the most part are not required to continue their education to keep up with a growing profession. Does that blow anyone else’s mind but mine?

If continuing education isn’t mandatory for your state, YOU should take it upon yourself to get educated. Whether you were formally trained or trained on the job doesn’t really matter. As assistants, we play a vital role in our patient’s care and infection control. What should matter is that you are up-to-date, knowledgeable and completely confident that you are holding yourself and team members to the highest standards for patient care. Doing it the way you’ve always done it doesn’t really cut it anymore. Times, infection control procedures and materials all change. Educate yourself on what the latest and greatest in infection control is and make sure your office is performing to the highest standards.

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I often hear; “it’s not legal but our doctor allows us to do it” or “it’s no big deal, they tell us to do it,” or “yeah, you’re supposed to, but we don’t,” – words that make me cringe. I can only imagine that if you were to talk to those Tulsa dental assistants just one week before the Board of Dentistry questioned them, they might have said the same things. And they aren’t the only assistants serving time in jail: In many cases, depending on the infraction, the state board deems some procedures “practicing dentistry without a license,” which is a felony. When you know you are doing something wrong, then you are and you can be held accountable for your actions. You can also be held accountable for knowing something is wrong and not doing anything about it, i.e. improper infection control procedures, not spore testing your autoclave, knowing team members are doing more than they are allowed by your state, etc.

Are you prepared to go to jail, have felony charges against you or have your mug shot on the evening news or morning paper? If you are told to do something that you know you aren’t supposed to be doing, then don’t do it! If you aren’t sure, then find out. DANB.org will have those answers for you and if you need better clarification, call your state dental board. The greatest asset you have is yourself, so protect yourself and the investment you have made to this profession by educating yourself and knowing what your state laws are.

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I had been a dental assistant for 29 years when I took my 

test to become a Certified Dental Assistant (CDA). Before that, I had always heard things like; “you don’t have to be a CDA to get a job” or “it’s not going to make you any more money, so why do it?” And the one I now hate the most; “oh, you’re just a dental assistant, you don’t need continuing education.” I think back to all those years before I became a CDA and see how much growth I missed out on. I feel like I was held back and not given the chance to better myself. I can only blame myself; I chose to listen to bad advice.

As I stated earlier, approximately only 12% of dental assistants nationwide currently hold a CDA. Those assistants who maintain their CDA are dedicated, educated and passionate about their careers. In most cases you don’t have to be a CDA, but any employer knows the CDA is a national standard for excellence in dental assisting. Having a CDA behind your name sets you apart. And don’t think that just because you took and passed the CDA exam that you don’t have to keep that certification up to date. Each year you must maintain that excellence by obtaining the 12 continuing education credits necessary for renewing your CDA. If you don’t, then you’re not a CDA.

It is my opinion that one day, dental assistants will be held to minimal standards and I believe that the DANB CDA certification will be the gold standard that states will look to. Many states right now that require infection control or radiology permits already use DANB as their go-to resource and I believe that more states will do the same.

And of course, not one of my articles would be complete without me mentioning another amazing tool for growth in yourself and your profession. The 

American Dental Assistant’s Association

 is your own professional organization that speaks for you in terms of legislation, education and professionalism. As a member, you are entitled to countless hours of CE, articles that help you and give you ideas for growth, the opportunity to network with an amazing group of individuals just like yourself who face all the same issues and are there to help you be the best you can be, and so much more. Their Fellowship/Mastership program is nothing short of learning excellence. I can say without hesitation that my career took a major turn for the better by becoming a CDA and a member of the phenomenal organization called the ADAA. These two organizations will give you the tools you need to excel, know the law and be educated. When you take your career more seriously, the people around you and your employer will too.

Do your job and know the law, become involved, get educated and hold yourself to a high standard of patient care. Your patients depend on you; they trust you to be educated and take excellent care of them. Never forget that you are responsible for that care.

 When I became a dental assistant over 33 years ago, I never imagined that one day I would love teaching as much as I do.

Know the law: Dental assistant regulation and education

Working in a dental office is one of the greatest joys in my life. I sincerely love everything about it. Through the years, I have found some common mistakes dental assistants make, including myself. I have found that changing the way dental assistants do things (even just a little) will help you have low stress and a more enjoyable work environment.

I can say this until I’m blue in the face and maybe one day someone will listen. What’s the best way to find a job? Create a 

 resume that is different. For example, don’t make it over two pages (one for cover letter and one for resume), then put it on heavier paper (something with a nice border) and secure it neatly in a see-through binder 

a cover letter. Remember, resumes give the potential employer the facts. Cover letters show your personality. Make them positive and upbeat. Never complain in your cover letter about how you can’t find a job! Get out of that computer chair, get on your scrubs (clean and unwrinkled), pull your hair back, and get ready for your day. Go to every office with a huge smile, be sincere, look the team in that office in the eye, shake hands if you are able to, and ask if you can drop off your resume.

We get hundreds of resumes by fax and e-mail, but they don’t have a face with them. Give potential employers a positive image to remember when they are hiring. Not only does this work, I’ve known several assistants who have been asked to stay for an interview and/or working interview. Since you don’t know who is hiring, go to every office. If you project a positive image, word will get around and you will get a job!

This not only applies to what you say to patients, but your team as well, especially if you are a new hire. One of the best ways to get to know patients and help them relax is to get them to talk about themselves (it’s a trick I learned years ago). They are the subject that they know best, so get them chatting about themselves and they relax more. However, when they ask how you are, keep it positive! Don’t tell them about your bad day, what your ex is up to, or how you don’t get paid enough! If you don’t have anything positive to say, then don’t say it. Most people perceive dental offices as torture dungeons and they are frightened to be there. The last thing they want to hear from the person they want total confidence in is how your day is falling apart or that you don’t want to be there at all.

In the employee lounge, telling your dark secrets will only make you a target for the gossip group, so don’t go there! We all have stresses and struggles in our life, but keep that side of your life to yourself. Use your work as your sanctuary to forget about the problems at home and focus on the vision for the office and your career. You are getting paid to be there and not have your thoughts occupied by your home life.

Establishing office routine ... from an old office

“At Dr. Parker’s office, we did it like this.” “That’s not how we did it at Dr. Smith’s office.” Oh boy! Bottom line, nobody cares how you 

to do it. You’re in a new office and each office has its own mojo going on and does things its own way. Now I’m all open to ideas and trying new ways to make our office flow better, but to just come in and constantly tell everyone Dr. Smith did it like this is only going to make everyone give you the evil eye when you open your mouth.

You’re in a new place, so do things the way they do them. Then, once you’ve learned their system, you can make suggestions. Some of the things that work in one office just won’t in another, so be flexible and positive.

Doctors find this the #1 most annoying problem working chairside. This always aggravated me as well! I think I’m all ready and BAM! I forgot something. Most of the time it was because I was distracted mentally or someone came in and asked me a question.

What I found was that looking over my schedule each morning and getting ready for the day that I needed was a huge help. Then before I bring back my patient, I do a quick walkthrough (in my head) to make sure. When the doctor is focused, keep it going by not having to get up during a procedure because you forgot something. Dentists like nice smooth procedures and your day will be better too!

Successful dental assistants are the epitome of multitaskers! We can juggle an air/water syringe and HVE while opening up a bottle of bond, keeping an eye on the time, reminding the doctor he or she has a hygiene check in room 2, remembering to write bond on the order list, and not letting patients drown in toxic saliva they can’t swallow all with a smile on our face.

Keep yourself, your ops, and the sterilization area all organized. Run through your day in the morning huddle and get yourself ready. I work great making a list of things that need to be done. Crossing things off that list makes me feel accomplished and serves as motivation to rock out my day. If you manage your time well, your day will flow with little stress.

Make your day less stressful and your career will be on track and you will be happier about what you’ve accomplished. Your employer will notice, your team will be motivated, and you’ll help to create a happy workplace.

The top 5 things dental assistants do wrong ... and how to change that

Dentistry has one of the highest overheads of any profession. The rising cost of rent, equipment, lab fees, staff salaries, and numerous other costs can easily take over your bottom line. If you are an insurance-based practice, you can only raise fees so much. Being in network with an insurance company limits what you can charge.

I believe one of the biggest drains in overhead is right in your supply room. Most offices don’t know how to manage their supplies in a cost-effective way. The key to keeping supply costs down isn’t hard it just takes dedication.

Here are some numbers that may shock you. Disposable safety glasses are great. Use them once and throw them away, right? The only problem is they cost about $1 each. If you use three per patient (doctor, assistant, and patient), you’ve just spent $3. How many patients do you see a day? For a large practice that sees 40, 50, or even more patients, that can add up to $100 or more 

Our office used to use disposable bite blocks for the X-ray sensors until I saw how much we were spending. Between our busy hygiene department and taking various PAs, I totaled the cost we spent in one year for disposables and it was well over $1,200. We now use autoclavable ones and, you know what, they work great! More money in my boss’s pocket means more money for CE, more money for bonuses, and a very happy boss!

“Pennies,” you think? Those pennies add up. I’ve named only two products that were costing our office a lot of money. Many professionals claim the average overhead in dentistry for supply cost only is about 7%. That seems fair, but with a little planning, you can cut that to 4 or even 3%. Knowing what to do isn’t hard, but you must have a dedicated person keeping an eye on those supplies. Here are six tips to help you save money.

Look to see what percentage you have spent on average over the last 12 months in supplies, then take your average monthly production and come up with a budget for supplies that makes you comfortable. If you were at 7%, then shoot for 6 or even 5%. If you were at 6%, go for 4! Last month, with more than $150,000 in production, we were able to keep our supply cost just under 3%.

Don’t forget this. It’s huge! Your sales reps are there to help you. If they don’t help you out with free goods, then it’s time to find a new rep! Manufacturers offer them so take advantage of them. Again, they add up!

This is the part that many people don’t get. With a monthly budget, it truly does me no good to have a lot of inventory on the shelf. I don’t like running out of anything and I try to order twice a month so I can split up my budget. This is the part where you have to be very dedicated. Watch what you order in bulk. Too much inventory on our shelves is money sitting around. We go through certain things like suction tips, 3 way tips, and prophy angles, so they are always ordered in bulk. But many things don’t get used as often, so hold off on ordering so much. It may take you a few months to get the hang of it, but try it!

Take a good look at what you are ordering

Talk to your supply rep. I have often sat down to go through products we frequently order and come up with some alternatives. Many times, we find products we actually like better like the gauze I just found that is saving us $11.53 a case! I’m also a negotiator. I find a fair price and ask my rep to match it. Sometimes it’s in free goods and sometimes it’s in cost savings. Many dental supply companies offer a “savings plan” as well. If you purchase mainly through one company, it should offer some sort of savings in addition to what it already offers. It never hurts to ask.

One of the most overlooked and biggest wastes of money are the finance charges you pay on supplies when not paid on time. Statements going out 30/60/90 days will rack up some pretty hefty charges (around 18% on average). Let’s face it, if your balance is sitting there on the books, then even if you keep the cost at 4%, it’s really a lot more than that after all those finance charges. Try looking at what you paid last year in finance charges it’s not pretty! Keep your supply cost down so you can pay it off monthly and save those extra charges.

Go into your operatory and look to see what “extra” supplies your assistant has stashed in there. When you keep extra supplies in the operatories, it gives you a false sense of what you have on hand in the supply room. Since you don’t want to keep a huge inventory, it’s money just sitting there. For instance, we have six operatories. If all six of those operatories have two or three boxes of “extra” gloves (not what is open and in use) stashed in them and my supply room is empty, I may think we need a lot more than I would normally order. This all depends on how busy your practice is and how often you go through supplies. Keeping all supplies in one location can help you get a better handle on how much you need to order and keep on hand.

“Pennies,” you’re still thinking? Go ahead and keep thinking that. Take a long, hard look at your supplies, what’s on the shelf, how much you’re spending, and then look into what you can save. Those “pennies” could be in your pocket.