Can Assistants Place Fillings In A Dentist’s Office?

The answer to this question depends on which state you are in. Each state has different regulations as to what dental assistants can do. Most states allow every dental assistant to do some basic things. These include…

• Assisting the dentist with suction and instruments
• Taking impressions of your teeth
• Making temporary crowns
• Taking x-rays (if they have the appropriate education)

Now in some other states they have dental assistants known as Expanded Function Dental Assistants (EFDA). Some states call them different names including Registered Restorative Assistant in Expanded Functions or Registered Dental Assistant Qualified In Or To Perform Expanded / Extended  Duties / Functions. Talk about a mouthful! These assistants have usually had significantly more training and are able to do some additional things. These include…

• Polishing teeth
• Filling cavities after the dentist has drilled them

Now here is the real question. Is it a good idea for assistants to place fillings? 

Personally, if I was having fillings done I wouldn’t let an assistant place them on me unless they had someone else assisting them. It isn’t because I think assistants are bad at placing fillings. Most experienced EFDAs are actually quite good at it. I worked with a couple early in my career that did a great job. The biggest challenge they faced wasn’t putting the filling material in well though. It was keeping the teeth isolated! The success and life of a dental filling is strongly related to how well your tooth was kept entirely isolated from any saliva or blood during the process. This is less important with silver fillings and extremely important for any type of white filling. I’ve found that one person alone will almost always struggle to keep a tooth isolated well. If they use a rubber dam or Isolite system they may be able to do better but otherwise another assistant is almost a necessity.