{ from the editor }
The Expanded Function Dental Assistant: Past, Present, Future
I
n the late 1980s, dentists were facing manpower shortages that involved almost every aspect of their practices. Not only were there fewer dentists coming into practice, but the supporting staff numbers were on the decline as well. This all translated to having issues in being able to have the time available to perform the treatment that patient’s needed. MDA members, in conjunction with the MDA’s Council on Professional Affairs and Labo- ratory Relations, spent hundreds of hours working hard to develop what is now known as the Expanded Function Dental Assistant (EFDA) position in the dental team. Many hurdles had to be overcome with legalities and legislation, and then actually develop- ing a training program to educate those who would be pursuing this certification. With a tremendous amount of time (years) and hard work by the Council, MDA House of Delegates, Missouri Dental Board (MDB) and legislators, the first pilot program was given at UMKC School of Dentistry in 1998.
Today, there are five modules for assistants to pursue: Restorative I, Restorative II, Ortho- dontics, Fixed Prosthodontics and Remov- able Prosthodontics. There are more than 10 member offices across Missouri that offer courses with more than 25 dedicated trainers who consistently teach these.
The EFDA program has grown tremendously since its inception. These EFDAs have helped with some of the manpower issues that were occurring and the program has allowed professional growth for dental assistants wanting to further their education in their field. The assistants have gone from having a certificate for their position to a MDB permit to be able to serve as an EFDA. Whether or not a Missouri dentist utilizes EFDAs in their office is completely up to their comfort
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committee have been proactive in trying to work on what changes could occur.
level, knowing that an assistant has to be a permitted EFDA to do any of the delegated procedures.
Having employed EFDAs now and for the past several years, I can say that this program works. The MDA has consistently worked hard to ensure that these assistants are trained and competent to do the delegated tasks, including ongoing curriculum review and clinical course updates. I have been able to help with some training, and it is a great experience watching these assistants learn and better themselves in their careers. Their sense of accomplishment can’t be overlooked, and they truly are helping the patient flow in my office. I am able to serve more patients and address more complicated oral health issues, while delegated procedures are being taken care of. I know that these assistants are providing quality treatment—I see it every day as I work in the office with them.
The MDB has an established “task list” for its work projects, and a review of the EFDA rules has been on this list for quite some time. The MDA has presented some basic changes to the rule over the past several years and most of the areas the MDB has been in agreement.
More recently, the MDB meetings have al- lowed for open discussion, between the MDB and those in attendance, on possible EFDA rule changes. The MDA is present at each MDB meeting to listen and give input, and members of the MDA Board and MDA EFDA
In recent MDA meetings, there has been some discussion around the MDB mention- ing the possibility of some of the current EFDA procedures being replaced with on-the-job training instead. It seems many ideas are on the table. Members of the MDA EFDA Committee take seriously their role of being stewards of the program and continu- ally review various aspects of it. The major- ity of its members agree that the training (and competency evaluation) should remain unchanged because the program, as it stands, is far superior to any other available.
Time will tell on where all of this lands and whether any changes occur or not. It ulti- mately is up to the MDB on what happens. They have been good to listen to sugges- tions from the MDA and hopefully that will continue. I can tell you from my standpoint, I hope that the program as it is now remains unchanged. Quite simply, it works and has shown time and again that it produces well trained, competent assistants to provide the delegated duties. There will always be further on-the-job training that occurs as the assistant grows in confidence and skill to provide the expanded functions of their training. I feel the training that is occurring now is doing due diligence and another way of protecting the public that we see in our dental chairs. By the time you receive this, the MDB will have met again. If this topic is of interest to you, stay tuned with the MDA as it will have current information as to what may be happening with the EFDA rules. f
Your feedback is welcome. Contact Dr. Wyckoff at 816-632-2822 or editor@modental.org.
