What to do if you’re asked to perform prohibited duties
Have you ever been asked to help with something outside of your scope of practice? Maybe you’ve been asked to adjust a patient’s crown during a procedure or make a preliminary diagnosis to keep appointments moving. Or, maybe it’s a duty that’s allowed in your state, like coronal polishing or monitoring nitrous oxide, but you don’t meet the qualifications. This can be stressful and challenging for dental assistants who find themselves in this position. Because every member of a dental practice shares responsibility for maintaining a high standard of care, it’s crucial for dental assistants to understand their state’s allowable and prohibited duties to help prevent malpractice and protect patient safety.
Julie Goldberg, D.D.S., a senior dental risk specialist and former general dentist, says, “Understanding your legal scope protects your practice from exposure to risk.”
While dental assistants perform many duties, there are limits to what they can do. Here are steps dental assistants can take to ensure they do not exceed their permitted duties.
Think before you act
On a busy day, it may be easy to lend a helping hand without realizing strict boundaries govern your allowed duties. The pressure to keep the patient schedule on track coupled with a dentist’s requests may lead to instances of malpractice. Even a simple ask or “quick favor” can put patients and your career at risk.
“Risk management is proactive, not reactive,” says Dr. Goldberg.
When a dental assistant performs a duty that they haven’t been trained on, isn’t allowed to do without supervision, or falls outside their permitted responsibilities, it increases the chances of mistakes being made and puts patient safety at risk. Some states may impose employment, civil, or criminal penalties if a dental assistant is found working outside their scope of practice. States are constantly updating their dental assisting requirements and legislation, as shown in DANB’s recent State of the States report, so dentists and dental assistants should stay informed of regulatory changes affecting their role.
Politely decline
If this situation arises, your dentist may be unaware they are asking you to do something prohibited, so you should reply in an informative, nonconfrontational way. For instance, tell your dentist you are not authorized to help with the requested task and refer them to your state’s regulations. This shows that your response is based on professional standards rather than personal preference.
It’s also essential to be firm and consistent when declining illegal duties so there is no confusion about your role or willingness to comply. This approach supports a respectful work environment while preserving high standards of care even in fast-paced or high-pressure situations.
Offer alternative support
After politely declining a request, dental assistants can remain engaged with the situation in a safe and appropriate way. This may include tasks such as stocking an exam room for a procedure, sterilizing instruments, or breaking down a procedure for a patient. If there’s a task that is within a dental assistant’s scope but requires additional licensing or certification, they may consider discussing with their dentist how to become qualified to perform that function in the future.
Dr. Goldberg explains, “It takes every single person in the practice setting to see the potential risks and to improve patient and employee safety.”
Staying within your role can protect your professional reputation and help you avoid any legal or ethical complications. By consistently working within established boundaries, dental assistants also reduce the risk of errors that may arise from performing unfamiliar or unauthorized duties.
Report the incident
If you’re pressed to perform a prohibited duty after declining, you can report the incident to your state dental board. Each state’s requirements page includes a link to the state dental board website where you can learn how to file a complaint.
Additionally, if the request involves safety risks, you can report the incident to the Occupational Safety and Health Administration (OSHA). For instance, if you’re being asked to take x-rays but you don’t have the proper training to do so, there is a greater chance of unsafe exposure to radiation. This organization requires employers to maintain a workplace environment where employees are not afraid of facing consequences for voicing safety or legal concerns.
Consider your options
If you are still being asked to perform illegal duties after raising your concerns, you may consider seeking employment at a different practice. You should never feel pressured by your employer to do anything that could put your career in jeopardy. A workplace that repeatedly disregards legal and ethical boundaries can create an unhealthy environment for all staff members and may signal deeper organizational or management issues within the office.