I have been going to this dentist who lately doesn't seem to be in the office that much. This last visit was in order to have my temporary crown removed and have the permanent one put in. It turned out that he was out of town on vacation. The two dental assistants in the office did the work with one permanently cementing it in. I live in the state of Florida, and I'm wondering if this was legal for a dental assistant to do this. I am rather concerned as to whether it was adjusted properly. Also, I'm having some twinges in that area of my mouth but hoping they will settle down. Wondering if anyone knows for sure whether a dental assistant is allowed to do this in Florida. I don't really want to go back to this dentist because he also doesn't followup on things that well and, like I said, is gone so much. Would appreciate any info. Thanks
Can a dental assistant cement in a permanent crown?
I work in Massachusetts and I don't believe it is legal for any assistant to do anything with a permanent crown such as cementing or adjusting. I am not saying that you need this form but this is the link to a complaint form for the state of Florida - http://www.doh.state.fl.us/mqa/dentistry...
And this is the link to the duties that a assistant can perform - http://www.doh.state.fl.us/mqa/dentistry...
64B5-16.005 Remediable Tasks Delegable to Dental Assistants.
(1)
The following remediable tasks may be performed by a dental assistant who has received formal training and who performs the tasks under direct supervision:
(a)
Removing sutures;
(b)
Placing or removing temporary restorations with non-mechanical hand instruments only;
(c)
Polishing amalgam restorations of the teeth when not for the purpose of changing the existing contour of the tooth and only with the following instruments used with appropriate polishing materials – burnishers, slow-speed hand pieces, rubber cups, and bristle brushes;
(d)
Polishing clinical crowns when not for the purpose of changing the existing contour of the tooth and only with the following instruments used with appropriate polishing materials – slow-speed hand pieces, rubber cups, bristle brushes and porte polishers;
(e)
Removing excess cement from dental restorations and appliances with non-mechanical hand instruments only;
(f)
Cementing temporary crowns and bridges with temporary cement;
(g)
Applying sealants;
(h)
Monitor the administration of the nitrous-oxide oxygen making adjustments only during this administration and turning it off at the completion of the dental procedure;
(i)
Selecting and pre-sizing orthodontic bands, including the selection of the proper size band for a tooth to be banded which does not include or involve any adapting, contouring, trimming, cementing or otherwise modifying the band material such that it would constitute fitting the band;
(j)
Selecting and pre-sizing archwires prescribed by the patient’s dentist so long as the dentist makes all final adjustments to bend, arch form determination, and symmetry prior to final placement;
(k)
Selecting prescribed extra-oral appliances by pre-selection or pre-measurement which does not include final fit adjustment;
(l)
Placing or removing prescribed pre-treatment separators;
(m)
Preparing a tooth surface by applying conditioning agents for orthodontic appliances by conditioning or placing of sealant materials which does not include placing brackets; n) Using appropriate implements for preliminary charting of existing restorations and missing teeth and a visual assessment of existing oral conditions;
(o)
Fabricating temporary crowns or bridges intra-orally which shall not include any adjustment of occlusion to the appliance or existing dentition; and
(p)
Packing and removing retraction cord, so long as it does not contain vasoactive chemicals and is used solely for restorative dental procedures;
(q)
Securing or unsecuring an archwire by attaching or removing the fastening device;
(r)
Removing and recementing properly contoured and fitting loose bands that are not permanently attached to any appliance.
(s)
Inserting or removing dressings from alveolar sockets in post-operative osteitis when the patient is uncomfortable due to the loss of a dressing from an alveolar socket in a diagnosed case of post-operative osteitis;
(t)
Making impressions for study casts which are being made for the purpose of fabricating orthodontic retainers.
(u)
Taking of impressions for and delivery of at-home bleaching trays.
(2)
The following remediable tasks may be performed by a dental assistant who has received formal training and who performs the tasks under indirect supervision:
(a)
Making impressions for study casts which are not being made for the purpose of fabricating any intraoral
appliances, restorations or orthodontic appliances;
(b)
Making impressions to be used for creating opposing models or the fabrication of bleaching stents and surgical stents to be used for the purpose of providing palatal coverage;
(c)
Placing periodontal dressings;
(d)
Removing periodontal or surgical dressings;
(e)
Placing or removing rubber dams;
(f)
Placing or removing matrices;
(g)
Applying cavity liners, varnishes or bases;
(h)
Applying topical fluorides which are approved by the American Dental Association or the Food and Drug Administration; and
(i)
Positioning and exposing dental and carpal radiographic film and sensors.
(3)
The following remediable tasks may be performed by a dental assistant who has received on-the-job training and who performs the tasks under direct supervision:
(a)
Applying topical anesthetics and anti-inflammatory agents which are not applied by aerosol or jet spray and;
(b)
Changing of bleach pellets in the internal bleaching process of non-vital, endodontically treated teeth after the placement of a rubber dam. A dental assistant may not make initial access preparation.
(4)
The following remediable tasks may be performed by a dental assistant who has received on-the-job training and who performs the tasks under indirect supervision:
(a)
Retraction of lips, cheeks and tongue;
(b)
Irrigation and evacuation of debris not to include endodontic irrigation;
(c)
Placement and removal of cotton rolls; and
(d)
Taking and recording a patient’s blood pressure, pulse rate, respiration rate, case history and oral temperature.
(e)
Removing excess cement from orthodontic appliances with non-mechanical hand instruments only.
(5)
The following remediable tasks may be performed by a dental assistant who has received on-the-job training and who performs the tasks under general supervision:
(a)
Instructing patients in oral hygiene care and supervising oral hygiene care.
(b)
Provide educational programs, faculty or staff programs, and other educational services which do not involve diagnosis or treatment of dental conditions.
(c)
Fabricating temporary crowns or bridges in a laboratory.
Specific Authority 466.004(4), 466.024(3) FS. Law Implemented 466.024 FS. History–New 1-18-89, Amended 11-16-89, 3-25-90, 9-5-91, 2-1-93, Formerly 21G-16.005, Amended 3-30-94, Formerly 61F5-16.005, Amended 1-9-95, 9-27-95, 6-12-97, Formerly 59Q-16.005, Amended 1-8-01, 4-22-03, 7-13-05.
You might want to give the dentist the ability to address this issue, it is possible that he or she may be unaware...
Good luck
Reply:yes , the last one i had done was done better by a dental asst, then the dentist. it fits well and does not even hurt.
Reply:My last two were done that way - one was good, the other not.
Reply:I don't know about Florida, but in my state nothing permenant can be done by an assistant. No removal of tooth structure, nothing that can't be undone.
Call your local dental society for details.
Reply:The twinge that you are talking about sounds like you may be biting on that tooth hard. The bite may need to be adjusted. I am a Dental Asst in a specialty practice. I hope that this helps. I would also request that the dentist make the adjustment.
Reply:In some states, they can. I do not know the particulars for FL, but I doubt they could do this without the dentist being present in the office. I know that in PA, where they are about as liberal as any state, the dentist has to be present to verify that the crown fits properly and that the bite is adjusted properly. As assistant can not do this.
Reply:You might want to discuss this with this dentist and allow him to take a radiograph, check the bite and do a visual exam of this crowned tooth to assure it was seated properly since you feel it might not be and are having these "twinges." Although some dental assistants and hygienist excel and are highly capable of performing these extended duties, they are never allowed to do so without the dentist being in direct supervision and on the premises.
Reply:Not really sure about Florida law but I do know that I have had three crowns cemented and re-cemented, and it is not always the dentist who does the cementing. However, I live in Cali so don't know how much this will help.
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