Use of Assistant Practitioners in Maxillo-facial, oral and Periodontal Surgery

The purpose of this statement is to clarify the position with regard to the use of “assistant practitioners” during maxillofacial, oral and periodontal surgery. “Assistant practitioners” may be general medical or dental practitioners or other specialists.

In the interests of patient safety and quality of care, increased effectiveness of the surgeon, limiting the duration of theatre time, minimising complications and maintaining proper visualisation of the operatory field, The South African Dental Association (SADA) believes that the involvement and assistance of a qualified assistant in the operative care of every patient is necessary.

The use of a very skilled assistant with good understanding and anticipation of the procedure is of vital importance during the performance of virtually all procedures in maxillofacial, periodontal and oral surgery.

All surgical services and care shall be provided personally by the primary surgeon, with some services provided by the assistant as directed by the surgeon. Overall responsibility for the surgical, assistant’s and patients’ safety ultimately rests with the primary surgeon.

All members of the team have an obligation to accurately identify themselves and other team members to patients and families.

The guidelines of the Health Professions Council of South Africa (HPCSA) stipulate the use of a qualified professional for assistance. Nursing personnel do not have the required experience and training to assist in maxillofacial and oral surgery and therefore do not comply with the HPCSA regulations. Only a general practitioner dentist, medical GP or another surgeon qualifies to assist in maxillofacial, oral and periodontal surgery both under local and general anaesthesia.

The South African Dental Association (SADA) supports the use of a qualified general practitioner or specialist assistant in maxillofacial, periodontal and oral surgery.

The primary surgeon is responsible for informing every patient (or the patient’s guardian) admitted to theatre through a proper informed consent process that:

  • the surgeon shall be assisted by a general dentist/specialist during a procedure.
  • a fee shall be charged by the assistant and details of the assistant’s fees shall be supplied and agreed to with the patient.
  • Informed consent must be recorded.
  • the assistant’s name and HPCSA registration number shall appear on the invoice rendered to the patient.