Factors Associated with Fissure Sealant Delegation: Dentist Characteristics and Office Staffing Patterns

Abstract

The purpose of this research was to identify dentist characteristics and dental office staffing patterns related to delegation of sealant applications. Results from a 1989 mailed survey were used to characterize Michigan general dentists (N = 300) who did or did not delegate sealant applications to auxiliaries and to identify factors associated with delegation. Nearly 50 percent of respondents were applying all sealants themselves. In offices that delegated the procedure, the mean proportion of sealants being applied by dentists was 39.9 percent. Registered dental hygienists were applying 51 percent, while registered dental assistants were applying 6.5 percent. Delegating dentists were more knowledgeable about sealant procedures, held more favorable attitudes, treated more young patients, placed more sealants, and were better informed about the legality of delegation according to the state practice act. Logistic regression analysis found that employing a registered dental hygienist was the most significant factor associated with sealant delegation, followed by employing a registered dental assistant. Findings suggest that dental auxiliaries, and particularly registered dental assistants, are underutilized for applying sealants. Approaches to increasing delegation of sealants may include changing dentists' traditional hiring patterns, highlighting the skills of auxiliaries such as the registered dental hygienist (RDH) and the registered dental assistant (RDA), and increasing awareness of legally allowable procedures that RDHs and RDAs can perform.

Dental therapists in general dental practice. A literature review and case‐study analysis to determine what works, why, how and in what circumstances

“…Alongside regulatory factors, intra and interpersonal factors influenced DTs role in practice. Lack of knowledge of DTs' role and their scope of practice were reported in the case studies and in international literature . We note that the influencing factors are not mutually‐exclusive and that interactions may occur.…”

“…Lack of knowledge of DTs' role and their scope of practice were reported in the case studies and in international literature. 51,66 We note that the influencing factors are not mutually-exclusive and that interactions may occur. For example, while a clear knowledge of DTs' scope of practice was an important factor in including a DT within the team, if the business case were clearer, dentists may be motivated to learn more about the potential contribution of DTs' roles in practice.…”