FACTORS ASSOCIATED WITH FISSURE SEALANT DELEGATION - DENTIST CHARACTERISTICS AND OFFICE STAFFING PATTERNS

The purpose of this research was to identify dentist characteristics a nd dental office staffing patterns related fo delegation of sealant ap plications. Results from a 1989 mailed survey were used to characteriz e Michigan general dentists (N =300) who did or did not delegate seala nt applications to auxiliaries and to identify factors associated with delegation. Nearly 50 percent of respondents were applying all sealan ts themselves. In offices that delegated the procedure, the mean propo rtion of sealants being applied by dentists was 39.9 percent. Register ed dental hygienists were applying 51 percent, while registered dental assistants were applying 6.5 percent. Delegating dentists were more k nowledgeable about sealant procedures, held more favorable attitudes, treated more young patients, placed more sealants, and were better inf ormed about the legality of delegation according to the state practice act. Logistic regression analysis found that employing a registered d ental hygienist was the most significant factor associated with sealan t delegation, followed by employing a registered dental assistant. Fin dings suggest that dental auxiliaries, and particularly registered den tal assistants, are underutilized for applying sealants. Approaches to increasing delegation of sealants may include changing dentists' trad itional hiring patterns, highlighting the skills of auxiliaries such a s the registered dental hygienist (RDH) and the registered dental assi stant (RDA), and increasing awareness of legally allowable procedures that RDHs and RDAs can perform.