This paper focuses on the Expanded Function Dental Auxiliary (EFDA). Specifically, the paper covers benefits of EFDA, laws and regulations in Ohio for EFDA, and it presents a single case scenario in which EFDA was particularly useful.
An EFDA personnel are highly trained and competent dental hygienists or dental assistants who get further education to ensure that they can conduct reversible, intraoral dental care, and other related tasks referred to as expanded duties, and services, including direct dental patient care, which are usually delegated under the law and under direct supervision of a licensed dentist. It is generally acknowledged that the inclusion of EFDA specialists in a dental office as personnel to offer services will enhance access to dental care specifically for underserved patients, including younger patients, senior citizens, patients with special needs, and other marginalized categories of patients. Available evidence suggests that the inclusion of EFDA specialists can improve the capacity of dental office team (Beazoglou, Brown, Ray, Chen, & Lazar, 2009). Beazoglou et al. (2009), from economic perspectives, observed that EFDA could lead to improved “gross billing, value addition, patient visits, effectiveness in care delivery, and net income increase as more tasks were delegated” (p. 36). Enhanced quality of services eventually led to reduced cases of preventable dental infection and decay common in children and senior citizens.
EFDA also offers direct public health and safety benefits. Oral hygiene is related to optimal social, physical, emotional, and intellectual developments. However, most children, particularly from disadvantaged backgrounds, who suffer from dental conditions, cannot gain access to oral care. Failure to get treatment therefore affects the above-mentioned developmental factors. On this note, the inclusion of EFDA specialists will improve the number of patients who can get access to care in dental offices. EFDA, therefore, improves productivity of dental offices through enhanced screening, preventive care, and patient education.
Further, EFDA is seen as the best alternative to increase access to dental care, specifically among children. Dental diseases impair productivity of children in school, work, and home. Hence, it affects the quality of life. EFDA can creates a ‘dental home’ with all necessary oral care services to develop a sustained relationship between patients and dentists. As such, EFDA can offer thorough, available coordinated care. In fact, the care is usually patient-centered by accounting for patient characteristics, such as age, developmental factors, psychological status, and family needs. Hence, dental patients are more likely to get effective preventive care and management services.
Finally, EFDAs also ease shortage of dentists. It noted that the enhanced efficiency in dental offices leads to increased service provision to other patients under public insurance. According to Beazoglou et al. (2009), more personnel increase office hours and outputs. In fact, these are the major goals of the extended function dental auxiliaries. Further, EFDA, when used effectively, improves efficiency to enhance care delivery and service availability. EFDA personnel allow dentists to concentrate on other complicated dental procedures and to care for more patients. The realized increased productivity assist in reducing shortage of dentists, and dentists will also note improved productivity and pass low costs to patients.
There are stringent laws and regulations in Ohio for EFDA. These laws and regulations cover registration, application to register, expiration and renewal of registration, practice, records of all registered EFDA persons, and other general rules and penalties applicable (Ohio State Dental Board, 2015).
For registration, the law does not allow any individual to practice as EFDA without proper registration. However, licensed dentists, dentist students covering roles of EFDA, and EFDA student conducting practicum are exempted from registration.
The law also defines all application processes and requirements for EFDA. Every individual seeking to register must file the application with the Ohio State Dental Board as EFDA. The application must include applicable fees, proofs of successful completion of EFDA studies at recognized institutions, proofs of passing examinations, and the proof that an applicant has a certificate of basic life-support procedures. Once an applicant meets all these conditions, the Board shall then proceed to register them.
The registration expires on the thirty-first day of December of the following year in which the registration took place (Ohio State Dental Board, 2015). Thus, EFDA personnel may opt to renew their registration by providing a duly filled application form for renewal and applicable fees to the Ohio State Dental Board every time they wish to renew their registration.
EFDA can only conduct some specific roles under Ohio laws and regulations. EFDA personnel can perform dental procedures related to the placement of restorative materials, but restricted to amalgam restorative and nonmetallic materials. In addition, they can also apply pit and fissure sealants, topical fluoride, disclosing solutions and desensitizing agents, perform temporary crowns recementation and caries susceptibility testing. They can also provide patient education, including instructions on oral care and use of dental floss and toothbrushes. EFDA personnel may also perform additional procedures as defined by the Ohio State Dental Board. These procedures are however regulated and may only be performed under the supervision of a fully responsible licensed dentist. In addition, EFDA cannot work alone for 15 consecutive days when the dentist is not physical present at the office. However, EFDA may perform some procedures when they meet specific conditions, including at least two years of experience; required skills; completed approved courses; had examined the patients before but within the year; dentists have written protocols for EFDAs; patients informed about the absence of their dentists; and EFDA is employed by the dentist and meets all required conditions.
The Secretary of the State Dental Board keeps all records about EFDA registered persons. The records cover location and supervising dentists.
The general rules applicable to EFDA usually focus on education and qualifications, standards expected of examinations, and other specific procedures the Board deems fit for EFDA.
Finally, the Board imposes penalties on whoever violates EFDA laws and regulations. Misdemeanor on a first offense and misdemeanor of the fourth degree applies for various subsequent violations. The fifth offense automatically leads to a felony of the fifth degree.
While good oral health is important for the overall health of a person, many Americans in the State of Pennsylvania, particularly from underserved, disadvantaged backgrounds lack access to basic oral healthcare. Children and senior citizens, in this case, are the most affected. Their challenges are described as insistent, systemic barriers. As such, the growing dental health disparities in the State, which is driven by various factors, including structural, geographical, and socioeconomic factors, will continue to persist unless these variables are addressed.
One major challenge has been the reducing dental healthcare workforce. As such, many states seek various solutions to address this issue and find alternatives for low-income households, children, and adults. Fortunately, some states have found opportunities to address certain factors responsible for dental healthcare disparities using different approaches. Specifically, the State of Pennsylvania, which has identified critical dental professional shortages, has focused on enhanced training of EFDAs to alleviate the shortage. EFDA focuses on improving abilities of dental services, reaching marginalized areas, and acting as safety net healthcare providers for more dental patients (Beazoglou et al., 2009).
The State has identified that the number of its aging dentists has increased steadily and the retirement rate among dentists will increase. On this note, the State pursued an improved training program and approach for EFDA to revamp its dental workforce, specifically for inner city and rural locations. Consequently, EFDA graduates have been able to complement and support licensed dentists by conducting some defined dental procedures while allowing dentists to attend to more patients.
The State has worked closely with some academic institutions to attain this goal. EFDAs have found new opportunities in underserved locations and now play critical roles in improving dental practices in the State.
In conclusion, it is generally noted that oral dental healthcare continues to affect millions of Americans from underserved, marginalized backgrounds. On this note, the inclusion of EFDA personnel in the dental care team has proved useful in improving productivity, cost-saving, and improving access to some underserved, marginalized patients with oral health conditions. As such, many states should consider the inclusion of EFDAs in dental offices and increasing the number of procedures, which they can perform. The State of Pennsylvania, which experienced significant shortage of dentists, opted for EFDAs to alleviate the shortage.
References
Beazoglou, T., Brown, L., Ray, S., Chen, L., & Lazar, V. (2009). An Economic Study of Expanded Duties of Dental Auxiliaries in Colorado. Chicago: American Dental Association, Health Policy Resources Center.
Ohio State Dental Board. (2015). Dental Practice Act. Web.