Shining the Light on Dental Assistants

Shining the Light on Dental Assistants seeks to identify factors creating and sustaining a stalled professional situation of dental assistants (DAs) in Québec where DAs are routinely delegated regulated tasks such as radiographic exposure while simultaneously being denied professional status under the Professional Code. Regulation of dental assisting has been repeatedly recommended yet never actualized; Québec’s Minister of Education found the majority of dentists “would like to see radiographic exposure by DAs become an officially delegated act as a way of legalizing what is common practice” (Étude, 1992).

DA’s professional work is “not part of the official and textual organization” of oral health care delivery in Québec, thus their work is “not officially noticed and (may even) be illegitimate” (Campbell and Gregor, 2008). Dentists continue to delegate restricted tasks to DAs and DAs continue to perform them so that DAs have been subjected to fines for illegal practice as a result of law suits by Québec’s Order of Hygienists. Why would DAs perform restricted tasks in such a climate and how has the situation so degenerated that DAs are daily placed in a situation of ethical quandary?

State-provided DA curriculum in Québec incorporates training in restricted tasks alongside professional ethics and inculcates in DAs a tolerance to contradictory imperatives; they are trained to ignore their own ethical guidelines in deference to their employers’. Jackson (1995) states curricular guidelines may “constitute the actual and stand in for workplace reality” and Smith refers to curriculum decisions which just happen as an experience of textually mediated social organization and suggests “the sequence of textually coordinated moves is foundational” (Smith, 2006). An Institutional Ethnography (IE) of the revision process of the current DA training program in Québec permits us to see how restricted tasks came to be simultaneously required of and disallowed by DAs.