The New Brunswick Dental Assistant's Association (NBDAA) website is provided at the link below:
New Brunswick Dental Assistant's Association

The New Brunswick Dental Society (NBDS) does not publish their By-Laws for viewing by the public.  However, the NBDAA publishes the NBDS By-Law which is applicable to Dental Assistants (i.e.NBDS By-Law No. 3-2 Dental Assistants).  By-Law 3-2 is a new By-Law replacing NBDS By-Law No. 17.

By-Law No. 3-2 removes the listing of permitted & prohibited dental assistant clinical activities which are detailed in the Previous By-Law No. 17 Dental Assistants.  However, current By-Law No. 3-2 retains the following inappropriate definition of "Direct Supervision and Control".

“Direct supervision and control” when used in this by-law shall mean that a dentist is present in the office or premises where the dental assistant is carrying out the duties, tasks and functions.

Does the NBDS By-Law No. 3-2 definition of “Direct Supervision and Control“ serve the best interests of the patient or the dentist?

In accordance with the Royal College of Dental Surgeons of Ontario (RCDSO), for the intra oral services permitted under the RCDSO Standards of Practice: The dentist assigning the duties is responsible for the performance of the assigned procedure. The assigning dentist must be present in the office suite while the service is being performed and ensure prior to the patient’s discharge that the procedure was performed safely and competently.

It is interesting to note that the American Dental Association differentiates direct and indirect supervision of the Dental Assistant.  Direct supervision means the dentist needs to be present whereas indirect supervision means the dentist must authorize procedure and be in the dental office while the procedure is performed.

Based on the NBDS By-Law No. 3-2 definition of “Direct Supervision and Control“, a patient could receive a complete set of new dentures (includes initial impressions, trial denture assessment, denture inserted and adjusted etc.) and never actually be examined by the dentist.

Clearly it is not in the best interests of a patient if the dentist never checks the work of the dental assistant. The NBDS By-Law No. 3-2 Dental Assistants definition of “Direct Supervision and Control” can/should be challenged in Court.

PROFESSIONAL LIABILITY FOR DENTISTS IN CANADA: MANAGING THE RISK
Eric A. Dolden & Colleen O’Neil - July 2015 – Page 13:  The courts will not allow a profession to maintain standards that endanger those who use the service. Accordingly, while the legal standard of care for a dentist may be described as that of the ‘average’ practitioner, average dental practice itself will also be scrutinized for its reasonableness whenever an individual dentist’s actions are called into question. This requires the profession as a whole to be self-conscious and self-policing – proactively advancing its professional standards to avoid stagnation of procedure or practice that could jeopardize the public.
14 Oliver v. Dr. B. Cervienka Inc. 2011 BCPC 371; Guerrero v. Trillium Dental Centre, 2014 ONSC 3871.
15 [1997] OJ No. 4384 (Gen. Div.).