Role of the Allied Oral Health Practitioner and Dental Materials

Since 1970 efforts have been made to use allied oral health practitioners (also referred to in the book as dental auxiliaries) in the performance of intraoral tasks to efficiently deliver health care and enhance the productivity of the dentist. Until 1970 only the dental hygienist was allowed to perform intraoral functions in all states. Although laws vary from state to state, virtually every state has modified, updated, and made changes to its state restrictions to allow for the performance of intraoral procedures by all allied oral health practitioners. Currently several states allow for the placement as well as care of restorative and other therapeutic agents in the patient’s mouth. The dental assistant is most directly responsible for the delivery of dental materials within specific guidelines outlined by the dental manufacturer. The dental hygienist’s responsibilities frequently include the care of the restorative material once it has been placed and the application of some therapeutic and preventive agents. All allied oral health practitioners must have a complete understanding of the potential hazards in the manipulation and disposal of materials and must be trained to handle them safely. Background knowledge in the basic principles of dental materials is also essential to an appreciation of the selection of a particular restoration or treatment procedure for individual patient application. It also becomes, in many circumstances, the auxiliary’s role to advise the patient why the dentist has recommended a particular restorative or therapeutic material or what choices the patient may have for a particular circumstance.

Dental materials are classified as preventive, restorative, and therapeutic materials. The search for the perfect material, designed to prevent disease, treat disease, or restore tooth structures, continues to elude the profession. The perfect material would be biocompatible, bond permanently to the tooth structures, be esthetic with the tooth/tissue structures, and repair or regenerate missing tissues.

All of this may seem an overwhelming task given the ever growing variety of available materials, recommendations for their use or disuse, and rapidly developing techniques in manipulation, placement, and care. Professional journals, dental materials manufacturers, and manufacturers’ representatives, Internet links, and other resources can provide invaluable information. The knowledgeable allied oral health practitioner reviews products used and recommended by his or her office to serve as a reliable resource for the patient and the dentist.

Evidence-Based Decision Making

The American Dental Association (ADA) defines evidence-based dentistry as an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, related to the patient’s oral medical history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences. Searches of scientific information identify thousands of citations for materials and techniques used in restoring and treating oral structures. With the wealth of scientific information, evidence-based decision making (EBDM) helps the clinician make decisions on what is relevant to incorporate into practice. In incorporating EBDM into your practice, you should ask these questions: How are decisions made regarding the techniques, technology, and products that you recommend? How do you read the published scientific literature to make sure a product provides a clinical benefit to the patient? Do you give product samples to your patients before trying them yourself? How does your office stay informed about trends in dentistry?

Evidence alone does not replace clinical expertise or input from the patient. EBDM requires an understanding of new concepts and development of new skills. The clinician must be able to incorporate the best research evidence along with his or her clinical expertise and patient preferences. Developing an evidence-based approach to addressing patient problems will greatly increase the potential for success/>