DENTAL ASSISTANTS
Source: U.S. Department of Labor
Bureau of Labor Statistics
[Occupational Outlook Handbook, 2010-11 edition]

NATURE OF THE WORK
Dental assistants perform a variety of patient care, office, and laboratory duties. They sterilize and disinfect instruments and equipment, prepare and lay out the instruments and materials required to treat each patient, and obtain and update patients' dental records. Assistants make patients comfortable in the dental chair and prepare them for treatment. During dental procedures, assistants work alongside the dentist to provide assistance. They hand instruments and materials to dentists and keep patients' mouths dry and clear by using suction hoses or other devices. They also instruct patients on postoperative and general oral healthcare.

Dental assistants may prepare materials for impressions and restorations, and process dental x rays as directed by a dentist. They also may remove sutures, apply topical anesthetics to gums or cavity-preventive agents to teeth, remove excess cement used in the filling process, and place dental dams to isolate teeth for treatment. Many States are expanding dental assistants' duties to include tasks such as coronal polishing and restorative dentistry functions for those assistants who meet specific training and experience requirements.

Dental assistants with laboratory duties make casts of the teeth and mouth from impressions, clean and polish removable appliances, and make temporary crowns. Those with office duties schedule and confirm appointments, receive patients, keep treatment records, send bills, receive payments, and order dental supplies and materials.

Dental assistants must work closely with, and under the supervision of, dentists. (See the statement on dentists elsewhere in the Handbook.) Additionally, dental assistants should not be confused with dental hygienists, who are licensed to perform a different set of clinical tasks.

WORK ENVIRONMENT
Dental assistants work in a well-lighted, clean environment. Their work area is usually near the dental chair so that they can arrange instruments, materials, and medication and hand them to the dentist when needed. Dental assistants must wear gloves, masks, eyewear, and protective clothing to protect themselves and their patients from infectious diseases. Assistants also follow safety procedures to minimize the risks associated with the use of x-ray machines.

Almost half of dental assistants had a 35- to 40-hour workweek in 2008. More than one-third worked part time, or less than 35 hours per week, and many others have variable schedules. Depending on the hours of the dental office where they work, assistants may have to work on Saturdays or evenings. Some dental assistants hold multiple jobs by working at dental offices that are open on different days or by scheduling their work at a second office around the hours they work at their primary office

TRAINING, OTHER QUALIFICATIONS & ADVANCEMENT
Many assistants learn their skills on the job, although an increasing number are trained in dental- assisting programs offered by community and junior colleges, trade schools, technical institutes, or the Armed Forces. Most programs take 1 year to complete. For assistants to perform more advanced functions, or to have the ability to complete radiological procedures, many States require assistants to obtain a license or certification.

EDUCATION & TRAINING
In most States, there are no formal education or training requirements to become an entry-level dental assistant. High school students interested in a career as a dental assistant should take courses in biology, chemistry, health, and office practices. For those wishing to pursue further education, the Commission on Dental Accreditation (CODA) approved 281 dental-assisting training programs in 2009. Programs include classroom, laboratory, and preclinical instruction in dental-assisting skills and related theory. Most programs take close to 1 year to complete and lead to a certificate or diploma. Two-year programs offered in community and junior colleges lead to an associate degree. All programs require a high school diploma or its equivalent, and some require science or computer-related courses for admission. A number of private vocational schools offer 4- to 6-month courses in dental assisting, but the Commission on Dental Accreditation does not accredit these programs.

A large number of dental assistants learn through on-the-job training. In these situations, the employing dentist or other dental assistants in the dental office teach the new assistant dental terminology, the names of the instruments, how to perform daily duties, how to interact with patients, and other things necessary to help keep the dental office running smoothly. While some things can be picked up easily, it may be a few months before new dental assistants are completely knowledgeable about their duties and comfortable doing all their tasks without assistance.

A period of on-the-job training is often required even for those who have completed a dental- assisting program or have some previous experience. Different dentists may have their own styles of doing things that need to be learned before an assistant can be comfortable working with them. Office-specific information, such as where files and instruments are kept, will need to be learned at each new job. Also, as dental technology changes, dental assistants need to stay familiar with the instruments and procedures that they will be using or helping dentists to use. On-the-job training may be sufficient to keep assistants up-to-date on these matters.

LICENSURE & CERTIFICATION
Most States regulate the duties that dental assistants are allowed to perform. Some States require licensure or registration to perform expanded functions or to perform radiological procedures within a dentist’s office. Licensure may include attending an accredited dental assisting program and passing a written or practical examination. Many States also require continuing education to maintain licensure or registration. However, a few States allow dental assistants to perform any function delegated to them by the dentist. Since requirements vary widely by State, it is recommended to contact the appropriate State board directly for specific requirements.

The Certified Dental Assistant (CDA) credential, administered by the Dental Assisting National Board (DANB), is recognized or required in more than 37 States toward meeting various requirements. Candidates may qualify to take the DANB certification examination by graduating from a CODA-accredited dental assisting education program or by having 2 years of full-time, or 4 years of part-time, experience as a dental assistant. In addition, applicants must have current certification in cardiopulmonary resuscitation. For annual recertification, individuals must earn continuing education credits. Other organizations offer registration, most often at the State level.

Individual States have also adopted different standards for dental assistants who perform certain advanced duties. In some States, dental assistants who perform radiological procedures must complete additional training distinct from that required to perform other expanded functions. Completion of the Radiation Health and Safety examination or the Certified Dental Assistant examination offered by Dental Assisting National Board (DANB) meets the standards in 30 States and the District of Columbia. Some States require completion of a State-approved course in radiology as well. Twelve States have no formal requirements to perform radiological procedures.

OTHER QUALIFICATION
Dental assistants must be a second pair of hands for a dentist; therefore, dentists look for people who are reliable, work well with others, and have good manual dexterity.

CERTIFICATION & ADVANCEMENT
Without further education, advancement opportunities are limited. Some dental assistants become office managers, dental-assisting instructors, dental product sales representatives, or insurance claims processors for dental insurance companies. Others go back to school to become dental hygienists. For many, this entry-level occupation provides basic training and experience and serves as a steppingstone to more highly skilled and higher paying jobs. Assistants wishing to take on expanded functions or perform radiological procedures may choose to complete coursework in those functions allowed under State regulation or, if required, obtain a State-issued license.

EMPLOYMENT
Dental assistants held about 295,300 jobs in 2008. About 93 percent of all jobs for dental assistants were in offices of dentists. A small number of jobs were in the Federal, State, and local governments or in offices of physicians.

JOB OUTLOOK
Employment is expected to increase much faster than average; job prospects are expected to be excellent.

Employment change. Employment is expected to grow 36 percent from 2008 to 2018, which is much faster than the average for all occupations. In fact, dental assistants are expected to be among the fastest growing occupations over the 2008–18 projection period. Population growth, greater retention of natural teeth by middle-aged and older people, and an increased focus on preventative dental care for younger generations will fuel demand for dental services. Older dentists, who have been less likely to employ assistants or have employed fewer, are leaving the occupation and will be replaced by recent graduates, who are more likely to use one or more assistants. In addition, as dentists' workloads increase, they are expected to hire more assistants to perform routine tasks, so that they may devote their own time to more complex procedures.

JOB PROSPECTS
Job prospects should be excellent, as dentists continue to need the aid of qualified dental assistants. There will be many opportunities for entry-level positions, but some dentists prefer to hire experienced assistants, those who have completed a dental-assisting program, or have met State requirements to take on expanded functions within the office.

In addition to job openings due to employment growth, some job openings will arise out of the need to replace assistants who transfer to other occupations, retire, or leave for other reasons.

EARNINGS
Median annual wages of dental assistants were $32,380 in May 2008. The middle 50 percent earned between $26,980 and $38,960. The lowest 10 percent earned less than $22,270, and the highest 10 percent earned more than $46,150.

Benefits vary substantially by practice setting and may be contingent upon full-time employment. According to a 2008 survey conducted by the Dental Assisting National Board (DANB), 86 percent of Certified Dental Assistants (CDA) reported receiving paid vacation from their employers, and more than half of CDAs received health benefits.

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