​​​Dental Assisting Standards and Skills​

1. Identify the types of dental healthcare facilities.
2. Outline the organizational structure of the dental healthcare team.
3. Explain the role of the dental assistant on the dental healthcare team.
4. Explain the legal standards practiced by the dental assistant.
5. Summarize the Dental Practice Act, Health Insurance Portability and Accountability Act (HIPAA) and Patient`s Bill of Rights.
6. Describe the role of the mandated reporter.
7. Identify professional dental assistant organizations and explain state and national licensures and credentialing pathways.
8. Examine ethical and legal issues and the standards for dentalcare professions (e.g., standards of care, facility ethical protocol, and appropriate legal documents, including the American Dental Association (ADA) Principles of Ethics and Code of Conduct).
9. Identify the standards of conduct that the dental assistant must maintain in his or her daily care of patients.
10. Identify regulations associated with Consent (e.g., verbal, written, electronic, implied, and exceptions).
11. Explain strategies to maintain patient dignity and confidentiality.
12. Examine requirements of the Board of Registration in Massachusetts (MA), ethics, and jurisprudence exam for dental assistants.

1. Employ emergency protocols in office/facility including activation of EMS and notification of appropriate personnel.
2. Recognize and assist with medical emergencies in the dental office.
3. Demonstrate cardiopulmonary resuscitation.
4. Demonstrate the operation of the automated external defibrillator.
5. Demonstrate response to a patient with an obstructed airway.
6. Demonstrate preparing the oxygen system.
7. Demonstrate response to the unresponsive patient such as: cerebrovascular accident (stroke), breathing difficulty, allergic reaction, convulsive seizure, diabetic emergency, and chest pain.
8. Recognize and assist with the following emergencies: syncope, anaphylactic shock, asthma attack, hyperventilation, postural hypotension, pregnant patient, and cardiac emergencies.
9. Demonstrate basic life support (CPR) at the minimum accepted standard of practice (e.g., compression, AED, and breathing techniques).
10. Perform standard first aid skills (e.g., hemorrhage, shock, fainting, and choking).
11. Explain CDC Guidelines for Infection Control in the Dental Healthcare Setting.

1. Apply knowledge of tooth morphology and dental anatomy.
2. Identify surfaces, arches, and quadrants using correct terminology.
3. Identify structures and tissues of a tooth.
4. Identify the primary and permanent teeth using the Palmer and Universal methods.
5. Identify the various landmarks of the oral cavity and salivary glands.
6. Identify and label the various landmarks of the face.
7. Identify and label the bones of the cranium, the face, and the landmarks of the maxilla and mandible.
8. Identify parts of the temporomandibular joint and describe how the joint works.
9. List and identify the muscles of mastication, facial expression, the tongue, and the floor of the mouth.
10. List and identify the nerves of the maxilla and the mandible.
11. Identify the arteries and veins of the head and neck.

Skills:

1. Demonstrate appropriate verbal, nonverbal, and written communications skills.
2. Utilize proper medical terminology (spoken and written) to interpret and communicate information, data, and observations.
3. Use medical/dental terms and abbreviations and common prescription abbreviations.
4. Demonstrate answering the phone, apply voice quality, asking and answering questions.
5. Answer, prioritize, and accurately address in-office and phone calls from patients, vendors, and other industry professionals.
6. Describe observation skills used in the workplace.
7. Complete and identify the components of an incident report.
8. Demonstrate the process of scheduling appointments.
9. Explain the importance of responding to patients in a timely, compassionate, and professional manner.
10. Prepare, obtain, and verify patient information for scheduling, registration, and check-in using two forms of patient identification (i.e., state-issued driver’s license, insurance card, photo ID, etc.).
11. Manage patient intake, including recognizing and responding appropriately to dental emergencies and notifying the appropriate facility personnel as needed.
12. Identify ethical considerations regarding confidentiality, maintaining integrity and security of medical records in accordance with state rules and standards of practice.
13. Determine ethical electronic communication in the workplace (appropriate cell phone usage, text messaging, social networking, digital photography, etc.).
14. Demonstrate ethical conduct, compassion, and awareness of cultural and generational differences.
15. List strategies to maintain patient dignity at all times.
16. Demonstrate respect for diverse populations.
17. Interact appropriately with pediatric patients and assist with common pediatric patient needs.
18. Review, record, and update patients’ personal, medical, and dental information.
19. Utilize electronic medical and dental records to maintain patient records (e.g., updating patient charts, retrieving, and relaying information, documenting lab and X-ray reports, progress notes and diagnostic summaries, and submitting electronic prescriptions).
20. Summarize the steps in receiving patient payments.
21. Demonstrate the steps involved in filing insurance claims and demonstrate knowledge of insurance terms and procedure codes.

Skills:

1. Explain procedure to prepare exam room, including supplies and dental instruments for minor surgeries or procedures (e.g., defining a sterile field, applying sterile gloves, preparing sterile instruments for use).
2. Demonstrate basic assessment techniques.
3. Obtain and record vital signs.
4. Demonstrate procedures used to position and drape patients.
5. Explain procedures used with all patients.
6. Demonstrate safe transfer techniques for all patients.
7. Recognize abnormal oral pathology.
8. Assist with basic chair side dental procedures.
9. Prepare the operatory for patient treatment.
10. Demonstrate seating and dismissing the patient.
11. Prepare necessary armamentarium to deliver anesthetic as requested by doctor.
12. Apply or assist topical anesthetic to the injection site.
13. Review medical and dental history.
14. Recognize and review medications, their usage, and contraindications.
15. Demonstrate patient/assistant/operator positions during dental treatment.
16. Assist and record dental screenings, charting of the oral cavity and surrounding structures including restorations, lesions, and periodontal proving depths.
17. Record conditions of the teeth and surrounding periodontium.
18. Demonstrate placing and removing a dental dam.
19. Determine accurate quadrant and single tooth isolations using the appropriate clamps/widgets.
20. Maintain a clear operating field.
21. Demonstrate oral evacuation, achieve moisture control.
22. Perform retraction of lips, cheek, tongue, and other oral tissue parts.
23. Place cotton pellets and temporary restorative materials into endodontic openings.
24. Describe childhood development stages and behavior management techniques.
25. Demonstrate appropriate interaction and assistance with pediatric patients.
26. Identify the oral aids specific to pediatric patients.
27. Assemble hand pieces and rotary instruments and transfer instruments according to industry standards.
28. Demonstrate polishing teeth, after dentist or hygienist has determined that teeth are free of calculus.
29. Provide patient instruction/education as required to follow provider’s treatment plan for various dental procedures, and medications.
30. Provide pre-operative and post-operative care instructions for all dental procedures.

Skills:

1. Explain the properties of dental materials.
2. Demonstrate the manipulation, preparation, and application of impression materials.
3. Demonstrate the manipulation, preparation, and application of gypsum products.
4. Demonstrate the manipulation, preparation, and application of all restorative materials.
5. Demonstrate the preparation and application of abrasives and polishing agents.
6. Demonstrate the manipulation, preparation, and application of sedative/palliative materials.
7. Demonstrate the manipulation, preparation, and application of whitening materials.
8. Demonstrate the preparation and mixing of dental cements, liners, and bases.

Skills:

1. Demonstrate approved methods of measuring and recording patient vital signs, blood pressure, and pulse oximetry (orthostatic, manually, and electric).
2. Assist in anesthesia administration, monitor nitrous oxide analgesia, including patient monitoring, (must hold BLS certification).
3. Collect diagnostic data and record symptoms of temporomandibular joint disorders.
4. Prepare armamentarium and manipulate dental materials for restorative procedures.
5. Demonstrate four-handed dentistry concepts.
6. Assist with amalgam procedures.
7. Assist with composite procedures.
8. Compare and contrast amalgam and composite materials used in dental procedures.
9. Explain uses of a Tofflemire matrix band, place and remove matrix bands.
10. Prepare and assemble prescribed matrices.
11. Prepare armamentarium and manipulate dental materials for prosthodontic procedures.
12. Explain procedure to produce quality impressions using gypsum products.
13. Obtain impressions for study casts and all forms of bite registrations.
14. Fabricate custom impression trays.
15. Assist with fabrication of provisional crowns, placement of a stainless-steel crown, and pulpotomy of a primary tooth.
16. Assist with fixed prosthodontics procedures.
17. Place and remove gingival retraction cord.
18. Assist with removable prosthodontics procedures.
19. Summarize procedures for construction of a full or partial denture.
20. Assist with the adjustment or reline of fixed and removable prosthetics.
21. Polish removable appliances and prostheses.
22. Demonstrate procedure to take impressions for a custom athletic mouth guard.
23. Fabricate Custom Mouth Guard, change case on Custom Mouth Guard.
24. Select and prepare armamentarium and dental materials for preventive procedures.
25. Assist with preventive procedures.
26. Explain the purpose of preventive dentistry.
27. Select appropriate materials for fluoride treatment and identify the modes of fluoride therapy including topical and systemic.
28. Assist with application of abrasives and polishing agents, dental sealants, and whitening materials.
29. Prepare armamentarium and demonstrate rubber cup polishing.
30. Prepare and assist with the application of dental sealants.
31. Describe the clinical indications and contraindications for dental sealants.
32. Evaluate the patient`s oral health care status and habits.
33. Summarize dietary analysis for dental disease control and provide oral hygiene instruction.
34. Assist with Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) technology related to dental materials.
35. Assist with 3-D printing, digital scanning, and other laser technologies used in dental practice.
36. Explain laser technology and related safety concerns.

1. Prepare armamentarium and dental materials for oral/periodontal surgical procedures.
2. Identify specialized instruments used for basic surgical procedures.
3. Demonstrate protocols for the aseptic unwrapping of sterile packaging, scrubbed personnel attire, post-surgical clean up, and proper disposal of hazardous medical waste.
4. Using industry standard procedures, maintain, and operate Autoclaves.
5. Demonstrate how to sterilize instruments, including ultrasonic cleaning, wrap surgical tools, and fold gowns and drapes for sterilization.
6. Assist with implant procedures.
7. Describe the indications for and contraindications to dental implants.
8. Assist with placement and removal of sutures.
9. Perform mixing and placement of surgical dressing.
10. Assist with surgical procedures.
11. Perform a surgical scrub.
12. Perform donning and removal of PPE for surgical procedures.
13. Assist in the monitoring and evaluation of recovering surgical patients.
14. Perform and/or assist with orthodontic procedures, including placing and removing separators, placing arch wires, placing, and removing ligature ties and elastomeric ties.
15. Explain the importance of occlusion, and the development, classifications, and results of malocclusion.
16. Identify oral habits and conditions that affect the dentition.
17. Record symptoms of temporomandibular joint disorders.
18. Prepare for and assist with the collection of diagnostic data.
19. Prepare armamentarium and manipulation of any dental material for orthodontic procedures.
20. Identify various fixed and removable orthodontic appliances and their uses.
21. Demonstrate performing intraoral and extraoral photographs.
22. Prepare armamentarium and manipulate any dental materials for endodontic procedures.
23. Assist during endodontic procedures.
24. Describe surgical endodontic procedures.
25. Assist with pulp vitality testing.

1. Identify and describe the factors affecting X-ray production, including kVp, mA, and exposure time.
2. Describe the characteristics of X-ray radiation.
3. Describe X-ray machine factors that influence radiation safety, (e.g., concepts of filtration, shielding, collimation and Position Indicating Device (PID), cone length).
4. Explain the X-radiation physics principles of primary and scatter (secondary) radiation.
5. Describe protocol for suspected X-ray machine malfunctions.
6. Apply patient safety measures to provide protection from x-radiation.
7. Identify major causes of unnecessary x-radiation exposure.
8. Explain the effects of x-radiation on the human body.
9. Identify ways to reduce x-radiation exposure to patients.
10. Explain the As Low As Reasonably Achievable (ALARA) safety guidelines that determine the frequency of exposure to patients and operators.
11. Identify sources of x-radiation to operators/other staff while exposing radiographs.
12. Identify safety measures to reduce operator x-ray exposure.
13. Explain the principles of x-radiation physics and biology pertaining to operator exposure.
14. Explain the biological effects of radiation exposure and safety precautions needed.
15. Describe techniques for monitoring individual x-radiation exposure.
16. Describe the ALARA principle as related to operator safety.
17. Explain the function of a personal monitoring device.
18. List the characteristic properties of x-ray beam and ionizing radiation.
19. Describe how x-rays are produced.
20. List and describe the possible interactions of x-rays with matter.
21. Identify the component parts of the x-ray machine.
22. Expose and evaluate radiographs.
23. Describe the use and purpose of various intraoral and extraoral radiographs.
24. Select appropriate radiographic image to examine, view, or survey conditions, teeth, or landmarks.
25. Select appropriate equipment for radiographic techniques.
26. Describe the purpose and advantage of accessories for radiographic techniques.
27. Select appropriate film size or digital sensor (sensitivity) depending on patient characteristics and indicated exposure technique.
28. Describe the purpose and advantage of dual (double) film packets.
29. Maintain quality assurance control and appropriate storage of radiograph film.
30. Inspect and evaluate film storage areas for recommended temperature, humidity, radiation protection, and inventory control.
31. Identify and correct errors related to improperly stored, exposed, and unexposed radiographic film.
32. Select patient management techniques before, during, and after radiographic exposure.
33. Address patient concerns about radiation, including patient refusal of radiography.
34. Describe techniques for patient management while exposing radiographs, including patients with special needs.
35. Expose dental films, using various techniques.
36. List factors that influence quality of exposure, including mA settings, and kVp.
37. Compare paralleling and bisecting angle techniques, including advantages and disadvantages of each.
38. Name the parts and functions of a radiograph film packet.
39. Describe the function and maintenance of film cassettes and intensifying screens.
40. Describe techniques for exposing (patient positioning) during panoramic and cephalometric radiographs.
41. Demonstrate basic knowledge of digital radiography.
42. Explain the advantages and disadvantages of digital radiography.
43. Demonstrate proper handling of image receptors.
44. Demonstrate infection control protocol for digital equipment use.
45. Evaluate radiographs images.
46. Identify and correct errors related to exposing intraoral and extraoral radiographs.
47. Identify and correct errors related to exposing extraoral radiographs, including patient positioning errors.
48. Prepare, maintain, and replenish radiographic solutions for manual and automatic processors.
49. Describe functions of processing solutions.
50. Describe procedures for maintaining the integrity of processing solutions and equipment.
51. Process exposed intraoral and extraoral radiographs by use of manual and automatic techniques.
52. Identify optimum conditions and procedures for processing radiographs.
53. Identify and correct errors related to radiographic processing.
54. Identify and correct errors due to improper film handling.
55. Demonstrate and apply infection control for radiographic processing.
56. Store and dispose chemical agents used in radiography procedures according to the local regulatory agency, in compliance with the OSHA Hazard Communication Standard.
57. Implement quality assurance procedures (e.g., daily recording of solution temperatures, dates of solution changes, test film runs, clean and maintain equipment, knowledge of periodic inspections).
58. Mount radiographs using buccal (facial) view.
59. Identify anatomical landmarks that aid in correct image mounting and viewing.
60. Match specific tooth views to specified tooth mount windows.
61. Demonstrate appropriate techniques for image viewing.
62. Identify anatomical structure and dental materials on radiographs, including differentiating between radiolucent and radiopaque.
63. Prepare radiographs for legal requirements, viewing, and duplication.
64. Describe and demonstrate methods for duplicating radiographs.
65. Identify information that must legally appear on all radiographic images.
66. List reasons for exposing and retaining radiographs.