Ever wonder who is cycling in and out of the room while you’re in the dental chair? During a dental visit, you’ll likely spend less time with your dentist than with the rest of their colleagues — it’s a team effort.
There are a handful of professionals you may encounter at a routine dental visit, plus some who might be helping behind the scenes. Here’s a guide to the role each person plays to keep you smiling.
A dentist is a doctor who specializes in oral health. All dentists complete dental school — typically a four-year program — then must pass a series of state licensure exams.
About 80% of dentists are general practitioners, performing a wide range of preventive care, screenings, and treatments, according to the American Dental Association. The other 20% of dental school grads go on to a residency in one of 12 dental specialties, such as orthodontia or pediatric dentistry.
Some dentists have DDS after their name, while others have DMD. The difference? There is none: A Doctor of Dental Surgery (DDS) and Doctor of Medicine in Dentistry (DMD) are just different names for the same training.
You will likely communicate the most with your dentist’s support team. They will also take care of teeth cleaning and any other basic treatments. But the dentist is responsible for clinical supervision, diagnosis of dental disease or other issues, and creating treatment plans.
During an appointment, your dentist will likely stop by for a quick check-up and to discuss your oral health and habits. Generally, the healthier your teeth, the less you’ll see of them.
Dentists are often supported by dental assistants who perform a wide range of duties, depending on the needs of the office and the licensing requirements of the state. Dental assistants prep the chair area by cleaning and disinfecting between patients and laying out instruments before a visit.
During treatments, dental assistants may work directly with the dentist. “A chairside dental assistant becomes part of what’s called ‘four-handed dentistry’ – all four hands involved with treatment,” says Dr. Martin A. Wohl, a retired family practice dentist and adjunct clinical instructor of dentistry at Springfield Technical Community College in Massachusetts.
At a routine visit, the dental assistant may help you get settled into the chair, collect your medical history, set up instruments and cleaning materials, take X-ray images of your teeth and talk to you about proper dental hygiene.
Depending on the size of the office, the dental assistant may also handle administrative duties like scheduling and billing. They won’t be cleaning your teeth, however: Direct intra-oral treatment requires specialized training. Cleanings are typically performed by a dental hygienist.
The dental hygienist is usually the person you can thank for bravely venturing into your mouth and leaving your teeth sparkly clean.
Dental hygienists attend a dental hygiene program and must pass national and state exams to become board-certified registered dental hygienists. At a routine visit, the dental hygienist will clean your teeth to remove plaque and tartar build-up, screen for dental health issues such as dental decay and periodontal (gum) disease, and review your oral health history and dental routine.
Dental hygienist duties vary by state, so depending on where you live, they may also be responsible for applying sealants or fluoride varnish, developing X-ray images and taking impressions or digital scans of your teeth.
Dental hygienists don’t diagnose dental conditions, but if something looks amiss, they will consult with the dentist. Hygienists are thoroughly trained in oral healthcare, so they’re a great resource for questions about your teeth, gums and mouth.
Treatment coordinators help patients understand the doctor’s diagnosis and plan of care. “They talk about how much things are going to cost and how you can pay for it,” Wohl says.
If you see a treatment coordinator, it will usually be at the end of your visit, perhaps in a separate office. They will make sure you understand any at-home care instructions, verify your next appointment and answer follow-up questions. Think of the treatment coordinator as your liaison to the rest of your dental team.
Dental therapists are a relatively new specialty in the United States. While the profession has existed in other parts of the world since the 1920s, dental therapists first appeared here in the early 2000s as a solution to dentist shortages in under-resourced regions. Dental therapists function similarly to physician’s assistants in a medical office: they perform a wider range of duties than dental hygienists, but fewer than dentists.
In states where they are licensed to practice, dental therapists work under dentists but don’t need to be directly supervised, which makes them an important part of delivering oral healthcare in rural areas and communities with few local dentists. For that reason, dental therapists often work in community health clinics or on tribal lands.
Some dental industry groups — including the American Dental Association — have expressed doubt over dental therapists’ ability to provide the same level of care as dentists. So while some private practices are experimenting with hiring dental therapists, you may not encounter one in your office.
Dental lab technician
If you’re getting dental veneers, dentures, or another manufactured oral appliance, one of the most important members of your care team is one you probably won’t even meet. Dental lab technicians fabricate artificial dental appliances from materials like plastic polymer and stainless steel. They typically work in another part of the office away from patients or in an off-site lab.
When you need a dental appliance, the dental assistant or hygienist will take an impression or digital scans of the relevant area. The dentist will then write specific instructions for the dental lab technician and send them to the lab along with the molds or scans. Once the lab tech has finished the appliance, you’ll come back to the office for a fitting.
Depending on where you live and the size of your dental practice, the team members you’ll encounter during a routine visit will vary. A new dentist starting out may work with a single assistant, while a large practice may employ a host of administrators like billing specialists and receptionists.
“There isn’t a particular ratio,” Wohl says. “It’s really a matter of, what does it take to get the treatment done for our patients?”