Is that legal for me to do, Doctor?

Do you know what the scope of practice is in your state? Why should you care what it is? You might ask, “What’s the big deal if I just do what the doctor asks me to do? Why should I care what the scope of practice is?”

Having a scope of practice is, in a perfect world, designed to reflect which procedures can be done safely and effectively based on the education and training of the person doing it -- with the goal of protecting the patient. None of us wants someone working on us -- in any capacity -- who doesn’t know what they’re doing, whether it’s a dental assistant, doctor, or an esthetician. Did you now that in California, you have to have a license to be able to wash someone’s hair, but not to work in someone’s mouth? That is crazy, if you ask me.

Dentistry has changed tremendously in the past 30 years when many of the laws governing dental assistants were developed. Materials have changed, becoming more technique-sensitive; technology continues to be integrated into treatment; and access to care and economic issues have made it possible for dental assistants to do more direct patient care. But are they adequately prepared and trained for that?

So, a “scope of practice” is the state rules and laws that tell the dentist, hygienist, and sometimes the assistant what they can and cannot do legally (dental assistants aren’t even recognized in some of the laws!). Does it really matter if you follow the scope of practice? What’s the big deal, anyway? Well, do you want someone working in your mouth who isn’t legally supposed to and hasn’t been trained to do what they’re doing? Are you aware that you can be held legally responsible for performing procedures for which you are not educated, trained, and licensed by your state’s Board of Dental Examiners? In most states that constitutes “practicing dentistry without a license” -- and negates any malpractice insurance you have.

Not only that, but when we work outside the scope of practice, we are devaluing ourselves and other assistants. For instance, in California there are three levels of assistants: dental assistant (no license, $), RDA (licensed, bigger scope of practice than DA and earns more $$, and RDAEF (even bigger scope of practice and earns more $$$ than RDA). So, if a DA making $10/hour agrees to do a procedure that is an RDA duty, it is devaluing the RDA. After all, why would a dentist pay for an RDA when he can get a DA to do it for less money? That’s not good for us, is it? It is also unfair to the patient.

If you don’t know what the scope of practice is in your state, you can check it out on the ADAA website at www.dentalassistant.org. There you will find the scope of practice for each state as well as each state’s dental board information. Additionally, the ADAA supports its state associations in their efforts legislatively by providing funds for legislative activities. That information is also on the website.

Not only is the ADAA a wonderful resource for information like this to all dental assistants, we are working on your behalf to move dental assisting forward to a place where each state would require a dental assistant to have some form of education or license/credential. That is our goal and the desire of our members -- and we hope it’s yours, too. If you are not a member, I hope you’ll consider joining because the more members we have, the louder our voice (you can review the benefits and get the application on our website, too).

Claudia Pohl, CDA, RDA, FADAA, BVEd
President, American Dental Assistants Association
The people who make dental assisting a profession