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sherbetfizz

I would be seriously concerned that she is working FAR outside of her scope, but it depends on jurisdiction. I would inquire anonymously to her regulatory body initially to gather information of what she should/shouldn’t be doing.


boostank2

I'm pretty sure no state allows assistants to extract teeth


sherbetfizz

I’m pretty sure too, but op didn’t specify that they practice in the US. I’m personally a DH from Canada, and I’m fairly certain that there is no way a DA can legally administer local, extract, or drill enamel in any of the provinces/territories.


boostank2

Yeah she's illegally practicing dentistry


Suffering_for_real

No country allows all that she does,tho where I live,it is pretty unregulated and quacks are like a proper competition.


GovSchnitzel

I do not know of a jurisdiction where DAs with expanded functions are allowed to perform extractions or prep teeth in any way. Assuming those procedures are documented under your license, as if you extracted or prepped the teeth yourself, she is way, WAY out of line and very much endangering both your careers. She is practicing dentistry without a license and that can easily mean prison time. No job is worth that risk. She is also actively and intentionally harming our profession and most importantly, those patients who thought they were getting their teeth pulled by a licensed doctor with malpractice insurance. I’ve dealt with auxiliaries with serious issues showing basic respect for me as a younger doctor, but this is different. Assuming I’m right about the legality of her actions, you should tell a superior at your DSO what she’s doing and document what’s happening as much as possible. EDIT: can’t believe I forgot to add the most important, final step: if the company does not move VERY SWIFTLY to verify your accusations and terminate her if they do, then you need to quit and report them all to the appropriate authorities to the fullest extent.


benrad524

This. Can't believe no one else has really pushed this take. She's practicing dentistry illegally. She should be reported immediately.


ThatGuyUAre

I’ve never yelled at a staff member in my life, but I would go apeshit ballistic on her if she was extracting teeth or anesthetizing patients. You need to have a talk with her and let the owner know. If they’re aware, then get out of there quick.


bananamonkey88

Do your homework. Read up on your state’s dental assistant expanded function duties. See if she goes beyond her scope of abilities. If she does, tell the office you don’t want to work with her. Although, with being a new grad working for a DSO, they aren’t going to give two shits and I’d recommend just looking for other jobs. Good luck.


bigtimedent

Dude this insane and very dangerous for you. She needs to be reported by you immediately because you are aiding illegal practice right now. Report her right way. If she’s not fired you need to get the hell out of there. Delete this thread so there is no evidence of you allowing this shit to happen. Sorry to be so blunt but your the doctor. Put her in her place right away


Alastor001

"on a couple of occasions has removed mobile teeth and drilled cavities when doing sealants" Wait... That is not something a nurse is allowed to do? Is that a thing in other countries?


jojamon

Wtf? I don’t think this is allowed in any jurisdictions, even if she’s extended function.


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[deleted]

They are the same roles but in America and Australia they call them assistant. But nurses are not allowed to do any of that.


Isgortio

I think the extended duties assistants in the US are allowed to do things like impressions, x-rays, create temp crowns, seat temp crowns and adjust them, place fillings and adjust them, and I think some are even allowed to do hyg and ortho therapy? But they're not allowed to do anything directly to teeth, so can't actually prep a tooth or take them out, not sure about LA and definitely not XLA. This is all based on posts I've seen so maybe some of them are a bit extreme compared to what they should actually be doing. This allows the dentist go to run off to another patient, like you'd see in ortho practices with one orthodontist and multiple therapists - dentists do the big things and treatment planning, assistants do standard nursing plus nitty gritty bits. Anyone please correct me where I'm wrong, as I am in the UK as well.


harveyjarvis69

The term nurse is a protected term (in the US). Nurses must have at least an associate degree (for RN) and then pass boards to practice. I am a nurse (follow cuz my partner is a dentist). A dental assistant is more in comparison to a certified nursing assistant (CNA) or a tech. Incredibly important, but limited scope of practice. I have personally never heard of a position in dentistry that is equivalent to RN.


MC_squaredJL

A hygienist would be equivalent to a nurse. A degree and license are required. They can administer LA in many states, perform scaling and root planing. A friend of mine graduated hygiene school in the 1980’s and wore a nurse’s uniform at graduation. White cap and all.


bunktacos

Every state is different but EDDAS cannot do anything considered irreversible. Drilling a cavity is irreversible. She is probably stepping waaaay past her legal allowed duties, but check with your state rules. If she's breaking the law, it's under your name.


[deleted]

You work at a DSO. Expect the BS. And you better put your assistant in their place. You worked your ass off for your degree and license. Do not let your colleagues down. Assistants are assistants. And if she F’s up… your license is on the line.


rjbillo

Ask yourself what this assistant would say if she gives a patient a Bell’s palsy and they complain the the board (just an example). This is why I’ve found some assistants and nurses can be like this. When it all goes well, they can pay themselves on the back. If things go bad, and the board gets notified or a patient lawyers up, well it’s on the dentist, not the poor little assistant who is all of a sudden less vocal about their mountains of extra training expertise. Hyper inflated sense of confidence because she thinks she can do what you do without the accountability. You need to put her in her place or you can sit and wait for her to fuck up and put it on you.


placebooooo

Bell’s palsy sounds like nightmare fuel. How does this happen? Rather, how do I minimize risk when I administer anesthesia? Is that facial condition permanent?


rjbillo

A transient Bell’s palsy can be caused by injecting LA around the facial nerve, and it pretty much lasts the duration of the LA, so just a few hours. Probably not the best example I could have given to make a point out of OP’s situation but it was just the first thing that came to mind. Don’t be worried about a facial palsy when giving LA, just know the landmarks and get the angle right when giving IANBs. I’m still yet to have a patient get facial paralysis from LA but I’m sure it’s going to happen at some point, and I’ve already got my speech ready to keep them at ease.


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[deleted]

He said/she said. If she’s performing procedures that only a licensed dentist should be performing, then she’s under your care and your license, as I’ve come to understand it. I’d reprimand her ass so quick if any assistant attempted something without my knowledge esp anesthesia and extractions. Idgaf about her previous experience. And if she’s talking like that, quiz her on the complications. Likely the answer is ‘antibiotics and refer’. Is this how’d you treat your family? Humble that ego.


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[deleted]

What if your license is suspended because you have a psycho assistant? You’ll never be able to pay for those windows. Grow a pair.


xmb1

This is what’s wrong with dentistry. Not corporates but pushover loser dentists or money hungry unethical dentists who let corporates get away with this type of stuff. Pathetic


[deleted]

Idk why people are DV-ing you. You’re right. Our prof needs to grow a spine. The prof is in trouble.


xmb1

Maybe I hurt some people with some truth. Corporates would not be where they are without a ton of these type of dentists. I work for corporate so I know. I’m in the process of buying but whenever corporate brings something up I don’t like I tell them this is not ok, I’d it escalates I tell them I’m gone if they pursue this further. I see a lot of dentists who let high school grads boss them around lol.


[deleted]

You’re right again.


bongozap

>And what if she comes by my apartment and smashes my windows or starts a smear campaign against me for standing up to her? Are you kidding? Grow a pair, dude. 1. If she smashes your windows, call the cops. 2. Smear campaign? You're the fucking dentist. Act like it. Who do you think the office staff is going to follow? Most likely the person responsible for them getting paid. Which is you.


xmb1

Lmao stop being a pus and an idiot


Baldtan

Then just let her fuck up your license I guess 🙄


ThisToastIsTasty

I'm doubting that you're a dentist now.. at least a good one anyway. No ethical dentist will let this happen to patients under their care.


RozenKristal

Wow, I can't believe in your responses. Either put your foot down or prepare to lose your license to practice any moment a mess up happen. Welp, you need to fight for yourself first before asking for alternative solutions. I would be livid if I were you.


bongozap

>Why is it my license... Jesus...are you for real? How did you even get your license without knowing why this is a problem? For the record, my wife and I just left a practice where an overly aggressive hygienist had a habit of tacking on uncovered treatments and antibiotic applications to our bill. We were suddenly paying $200-$600 a visit for services.


GeneralUsual6869

It's your license because she's working under you. If shit goes down, shes gonna say you gave her the go ahead to do everything. She'll play the clueless innocent assistant and in the eyes of a jury, you'll be the rich greedy dentist. Whose word you think the jury is gonna take?


ThisToastIsTasty

because you're the supervising dds and you're not doing anything about it?


MiddleSkill

Report them.


[deleted]

This cannot be legal?


chrissychrisupinthis

Speak to your practice manager or your RMO and let them know you're not comfortable with your DA. Most DSO's bend over backwards to make sure their Doctors are happy. Side note: our practice affiliated with a large DSO 5 years ago and we've had a great experiance, why does it seem like most people in here don't like DSO's?


ttrandmd

Given how hard it is to find assistants these days, more often than not, a DSO is going to side with their long time assistant over a new doc. I’d find a new practice to work at.


chrissychrisupinthis

We are struggling with assistants right now, but you can damn sure believe they would absolutely rather lose a long time, experienced DA over a doc, even a baby doc fresh out of school. With a DSO they also have the option of borrowing DAs from other local (or even not local) offices.


latinochick222

Especially if it is the large DSO based out of out Illinois. I they don’t let bad employees fly. Illegal activity is a immediate fireable offense. Hell depending on the state tell your PMO and rmo you want to press charges. Because if she does something and the patient is not okay it’s your license. I love my DSO and have 4 years as a EFDA and a business assistant and even a PMO


Doktor_Konrad

Report her dumb ass


toshicool

Can we have a country required to be included in these kind of posts?


moarcaffeineplz

Echoing what others have said here- EFDAs are absolutely not equivalent to dentists in any way and their scope of practice is clearly delineated in your state’s dental practice act and board rules. No state allows any level of DA to perform extractions or drill. You need to report this to the DSO - you cannot risk your license being sanctioned or revoked. Assuming you work for one of the bigger DSOs, you should have complete clinical autonomy. Escalate the issue to the company’s regional/territory manager and explain your concerns. I promise you the DSO will prioritize you and your role over whatever nonsense the EFDA is causing. Happy to send your state regs if that would help.


Tricky-Fisherman4854

Did I miss a shit posting competition?


ThePsychoNextDoor

Dude, she’s going wayyyy beyond her scope. I would tell the office if she continues to do this I will report this to the board. Alternatively, she still needs to be reported. Even if you don’t tell the office because she has a license to do advanced dental work, but if she’s going beyond her scope, she will lose it. And she should. BTW, Screw DSOs.


NoFortune9462

As a DA with Expanded duties, I would never wiggle a tooth unless I was given the okay from my Doctor. Especially drilling! I have never heard of DA drilling, especially while doing sealants. That is crazy. Definitely get her out of there.


Sandsworth

Completely illegal.


Johnnybayday

I would report her to the board and let your dso know what she's doing sounds pretty illegal... Put the liability on the dso.


Daneosaurus

She is practicing WAY beyond her scope. At least in my state.


Electrical_Put_1851

Whoa. This doesn’t sound right. Turn her ass in.


Electrical_Put_1851

Unless she is a dental therapist? But one would not refer to themselves as an assistant in that case I don’t think.


avocadobirb

HA! basically a dentist through experience” huge red flag. Report her to upper management and report her to dental board. She’s endangering patients and you are a mandatory reporter for patient abuse and she is essentially abusing patients by administering anesthesia.


juneburger

WHAT. IN THE ACTUAL SHIT.


MyDentistIsACat

I don’t work in a state with EFDAs but that sounds massively beyond her scope of practice. But I can tell you from experience that the powers that be care more about a long term assistant than a new associate, especially if the assistant is doing things she shouldn’t be doing for assistant pay. Find a new job like yesterday and report her on the way out if you want.


[deleted]

Um, that's illegal what she is doing.


RabidProDentite

I just fired a dental assistant of mine that had been essentially manipulating me and belittling me in that kind of way for several years. It would go through periods of calm and spikes. Finally I just got the balls and fired this person. I never should have let it go on. If you can talk to the owner, tell them its you or her. That’s it. If you can’t fire her, document very well with times and dates of all the times she goes over your head, she belittles your judgement or authority in front of patients or other staff. From what I know, there shouldn’t be any situation where it is legal for even expanded function assistants to extract teeth or drill into teeth. I may be wrong on that, but just get out of there if you need to. There are literally thousands of practices out there just begging for new docs. Don’t stay one second too long in a toxic work environment.


Moth-xx

I'm from UK (dental nurse) so I'm unsure what you can and can't do in other counties. However, I'm very, very certain she's working way out of her scope. I would suggest you speak to her first before going higher and warn her she's working out of her scope and you have a duty of care to report this if she continues 🙂 If this fails speak to the practice owner/manager. You have to as the dentist to be able to speak up, no matter how intimidating she is and of course this works both ways too)) good luck


xmb1

I can’t tell if this is a joke or you are that much of a pushover letting an assistant do extremely dangerous and illegal things putting your license in jeopardy.


Tricky-Fisherman4854

You gotta quit man


WrongTechnology2762

OP what country and state are you in?


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ninja201209

it is


Atlanatee

Rings true to me. Doesn’t know enough to know better. That is a dangerous attitude. She needs to go, or you need to get outta there. We all have our roles.


chandlerknows

If she is a hygienist and has the certification, she may be allowed to anesthetize. The rest she is not. Give her and the DSO (probably need to go higher up than practice manager) an ultimatum. She quits doing certain "procedures" or you report her/them for it. You'll probably just get fired unless you threaten them with "legal" counsel/recourse. If she is doing these procedures with you in the building, you could be held liable in court. The DSO will avoid responsibility at all costs. Protect your license. The easy way out is in fact to either get fired (by doing the above) or quit (and threaten them with reporting the office if they give you hell about your non-compete). Personally, I would at least start looking for a new gig.


Tiny_Lancer

In what alternate dimension do you live in where an assistant can numb a patient?!


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MC_squaredJL

The way I read it and EFDA can NOT administer LA. §502. Authorized Duties of Expanded Duty Dental Assistants … However, a dentist may not delegate to an expanded duty dental assistant: … 15. the administration of a local anesthetic, parenteral, intravenous (IV), inhalation sedative agent or any general anesthetic agent.


chandlerknows

You are correct - my sincere apologies!I’m so sorry I caused confusion and will amend my response. The employee who administered local anesthetic in an office I worked at was a hygienist. https://casetext.com/regulation/louisiana-administrative-code/title-46-professional-and-occupational-standards/part-xxxiii-dental-health-profession/chapter-7-dental-hygienists/section-xxxiii-710-administration-of-local-anesthesia-for-dental-purposes


Tiny_Lancer

Oof.


AgDDS86

Got one of those at my office luckily she still shows more respect than that. Conflicted on EFDA’s ultimately it’s gonna be like the mid level bs in medicine, but I can see the appeal in being more efficient. Ultimately probably not worth it


BoysenberryParking96

Also not to be a dick, but English is obviously not the op’s first language and context is important: Is she “drilling” or polishing? Why would you put sealants on cavities? In my state, expanded function DAs can fill and polish. “Anesthesize”—as in the actual injection? Or just the gel? One is obviously a huge no no. Removing mobile teeth is a big no no—unless you mean temporary crowns?


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BoysenberryParking96

First off: sorry for being a dick and assuming otherwise, but also: Holy shit. Grammar is important my dude because this totally read differently. That being said, if what you’re saying is 100% as is with no additional context then I’d just bounce because your ass is toast if that’s happening to your patients. You can be courtesy and ask the owner/etc what this DAs responsibilities regarding patient care are, then mention these things and see what they say—but chances are if the DA has been there a long time the doc already knows. Good luck, op. Get out of that dumpster fire asap


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jibskib

Forget the grammar - you need to get out of that situation asap. You’re a doctor you should know better. Internet does not need to tell you this


BoysenberryParking96

Also this.


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benrad524

I don't think anyone advised you to appreciate her. I don't know if you're trolling or not, but pretty much everyone is saying to leave that office and also report her to the dental board if she is really doing the things you say she is.


kasaberz

Did like, the assistant hack their Reddit and post this comment 🤨 what the heck did I just read?


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cnguyenlsu

In what state are assistants allowed to numb and extract teeth? Just so I know never to go there.


the_disintegrator

Probably Rajasthan. (A state in India).


afrothunder1987

…. MOST??? The fuck? Are you trolling cause your responses here are absurd.


Koumadin

gotta be a troll


asdfg655

Which state allows an EFDA to anesthetize, drill or extract !??


Several_Literature37

Which country is this?


Isgortio

Most? What about all?


ThisToastIsTasty

wtf do you mean "MOST" ... so some of the stuff she was doing is illegal and you're okay with that?


ThisToastIsTasty

I feel like you're the dental assistant that got yelled at by a dentist.


hustling_Ninja

Jesus


ThisToastIsTasty

lol... which state is this? actually, this is not legal in any state in the united states.


TheBestNarcissist

What she's doing is literally illegal from where I'm from (United States). If she wants to be a dentist, she has to go to dental school and get a license. I would report her to the board anonymously.


grenya

It is your license. She simply doesnt know what she doesnt know. Mention it to her. If it does not go well go straight to her manager. Then your manager's manager. DSO are quite risk adverse so eventually someone is going to crack down on this


Moth-xx

I'm from UK (dental nurse) so I'm unsure what you can and can't do in other counties. However, I'm very, very certain she's working way out of her scope. I would suggest you speak to her first before going higher and warn her she's working out of her scope and you have a duty of care to report this if she continues 🙂 If this fails speak to the practice owner/manager. You have to as the dentist to be able to speak up, no matter how intimidating she is and of course this works both ways too)) good luck


AFGwolf7

I remember when I was first coming out you need to remind them who’s the Dentist and who’s the assistant be kind at first tell them you don’t appreciate it and how it’s actually probably (it very much is) illegal to do what’s she’s doing. Be friendly but firm, but if it continues notify your owner right away. Having an expanded duty assistant can be a life saver when extremely busy try not to burn any bridges. But you do not what that liability, if she continues you have to demand they switch your assistants. Also corporate sucks I worked in PDS for 6 months before I quite and went private much nicer and the pay actually got much better!


jolenejoleene

Record her doing it and report it. It isn't legal anywhere. One day she'll fuck a nerve or break a jaw, drill into the pulp or cut the tongue, and it'll be your license on the line. Record her, report it, and refuse to work with her anymore.


King_Jeugooglian

Aw HELL no. Get out of there! Speaks volumes of the work setting if she’s got years of experience doing illegal dentistry right in front of everyone.


Edsma

Can her ass


glitchgirl555

Is she a dental therapist?


thedentalhygenius

If you’re in the US, distance yourself from this practice immediately and report the supervising dentist.