Economic implications of adding two expanded-duty
dental assistants to a practice
Walter J. Pelton, DDS, MSPH
Olice H. Embry, PhD
George A. Overstreet, MA, MBA
James B. Dilworth, PhD, Birmingham, Ala
The addition of a second expanded-duty dental
assistant to a practice can substantially increase
a dentists productivity. However, the greatest in
cremental increase in revenue was found in the
addition of one expanded-duty assistant and one
chairside assistant to the practice of a dentist em
ploying two traditional assistants. The average
theoretical revenue per day in the surrogate prac
tice involving one dentist, two expanded-duty as
sistants, and four chairside assistants was almost
64% greater than that produced by the dentist with
two chairside assistants, and 19% greater than
that produced by one dentist, one expanded-duty
assistant, and three chairside assistants. The addi
tion of one expanded-duty assistant enabled the
dentist to treat 4.58 more patients a day, whereas
the addition of two assistants enabled him to treat
10.0 more patients a day.
In a previous pap er1 a tabulation o f tim e, pro
ductivity, revenue, cost, and incom e was re
p o rted fo r one dentist working with tw o chair
side assistants com pared with the figures for the
sam e dentist working with one expanded-duty
dental assistant (E D D A ) and three chairside as
sistants in an experim ental program that was de
signed to resem ble a private practice as closely
as possible. T h e substitute for a bona fide pri
v ate p ractice, called a surrogate practice here,
p rovided for econom ic incentives to be paid to
th e dentist and his auxiliaries according to their
productivity. In addition, the surrogate practice
w as concerned with the quality of services sup
plied and included a population group that, even
though w eighted with dentally indigent, m ay be
typical o f som e situations encountered today.
So th at acceptable m onetary com parisons could
be established, actual and assum ed costs were
u sed along w ith theoretical incom es based on
th e 1970 V eterans A dm inistration2 fee schedule.
T h e conclusion reached in the previous report
6 0 4 J A D A , V o l. 8 7 , S e p t e m b e r 1 9 7 3
indicates that a busy, independent dentist gross
ing m ore than $120,000 could increase his gross
incom e about 37% by adding one E D D A and
one chairside assistant to his initial team o f tw o
assistants.
T he basic data for team A (one dentist and
tw o chairside assistants working in a two-chair
operatory) and team B (one dentist, one E D D A ,
and three chairside assistants working in a three-
chair operatory), as cited in the previous report,
are repeated in this paper. In essence then, data
on another E D D A and her chairside assistant
are added here. T hus, team C , com posed of the
dentist, tw o E D D A s, an d four chairside assis
tants working in a four-chair operatory, p ro
vides a com parison for judgm ents relating to the
m ost satisfactory com bination of auxiliaries
th at might b e used in a given practice.
F in d in g s
Table 1 shows the average num ber o f daily p ro
cedures produced by each o f the three team s
during com parable periods o f patient dem and.
T eam A produced 53.70 total procedures p er
day, team B produced 67.60 procedures p er day,
and team C produced 86.00 procedures p er day.
E xcept for a slight difference in the num ber of
prosthetic sittings, the specific procedures show
similar escalations. T able 2 shows th at the per
centages o f the procedures perform ed each day
by each team w ere not significantly different;
this implies that the patient needs, except for
prosthetic services, w ere approxim ately the
sam e in each of the three periods. F o r exam ple,
operative procedures m ade up about 40% o f the
total procedures accountable to each team .
T he average theoretical revenue p er day (Ta
ble 3) was $824.09 with the use o f tw o E D D A s
(team C), an increase in income o f $320.93 per
day o r alm ost 64% over the average produced
w ithout an E D D A (team A) and 19% over the
revenue produced with one EDDA* (team B).
W hen the revenue was com pared with th at for
a solo dentist, how ever, the increm ental increase
was $187.02 for the first E D D A and only $133.91
for the second E D D A .
Table 1 Average number of procedures supplied by Table 3 Theoretical daily revenue produced by specified teams
team A (one dentist and two assistants), team B {one In surrogate practice.
dentist, one EDDA, and three assistants), and team C Fee A v t h e o r e t ic a l r e v e n u e p e r d a y ($ )
(one dentist, two EDDAs, and four assistants) in sur s c h e d u le *
($) T y p e o f p ro c e d u re Team A Team B Team C
rogate practice.
P r e v e n tiv e p r o c e d u r e s 9 2 .8 9 13 6 .8 0 1 6 5 .3 5
A v no. p ro c e d u re s p e r day 5 P r e v e n t iv e in s t r u c tio n 2 3 .7 8 3 3 .5 0 4 0 .2 9
10 P r o p h y la x is 3 9 .0 2 6 5 .5 0 7 6 .4 7
T y p e o f p ro c e d u re Team A Team B Team C
12 P e r io d o n t a l t r e a t m e n t 3 .8 0
P r e v e n t iv e p r o c e d u r e s 1 2 .7 4 1 8 .6 5 2 2 .6 5 7 F lu o r id e 2 6 .2 9 3 7 .8 0 4 8 .5 9
P r e v e n t iv e in s t r u c tio n 6 .7 0 8 .0 6 D ia g n o s t ic p r o c e d u r e s 8 3 .8 0 1 0 0 .1 8 1 5 1 .7 7
4 .7 6
P r o p h y la x is 3 .9 0 6 .5 5 7 .6 5 8 E x a m in a tio n s 3 7 .8 5 4 9 .8 0 6 8.7 1
P e rio d o n ta l tre a tm e n t .32 R a d io g r a p h s 4 5 .9 5 5 0 .3 8 8 3 .0 6
FI u o r id e 3 .7 6 5 .4 0 6 .9 4 16 F u ll m o u th 27.71 3 4 .0 0 5 3 .6 5
D ia g n o s t ic p r o c e d u r e s 1 1 .6 3 1 2 .2 4 1 8 .8 2 3 S in g le f ilm 3 .7 3 4 .2 8 4.41
E x a m in a t io n s 4 .7 3 6 .2 3 8 .5 9 5 B it e w in g 1 1.1 0 1 2 .0 0 24.41
R a d io g r a p h s 6 .9 0 6.01 1 0 .2 3 2 P o s t o p e r a t iv e b it e w in g 3.41 0 .1 0 0 .5 9
F u ll m o u th 1 .7 3 2 .1 3 3 .3 5 O p e r a t iv e p r o c e d u r e s 2 2 9 .0 7 2 8 9 .9 0 3 5 5 .3 0
S in g le f ilm 1 .2 4 1 .4 3 1.71 8 A m a lg a m 1 s u r f a c e 7 3 .1 7 7 4 .8 0 7 6 .2 4
B it e w in g 2 ,2 2 2 .4 0 4 .8 8 12 A m a lg a m 2 s u r fa c e 5 5 .0 2 6 0 .6 0 8 7 .5 3
P o s t o p e r a t iv e b it e w in g 1.71 0 .0 5 0 .2 9 18 A m a lg a m 3 s u r f a c e 3 1.61 4 5 .0 0 6 0 .3 5
O p e r a t iv e p r o c e d u r e s 2 1 .8 8 2 7 .2 9 3 2 .7 0 20 A m a lg a m 4 -5 s u r f a c e 1 1 .2 2 1 5 .5 0 1 7 .6 5
A m a lg a m 1 s u rfa c e 9 .1 5 9 .3 5 9 .5 3 10 S ilic a t e p la s t ic 5 8 .0 5 9 4 .0 0 1 1 3 .5 3
A m a lg a m 2 s u r fa c e 4 .5 9 7 .2 9 5 T r e a tm e n t f i l l i n g s
5 .0 5
A m a lg a m 3 s u r fa c e 1 .7 6 2 .5 0 3 .3 5 10 P u lp re m o v a l
A m a lg a m 4 -5 s u rfa c e 0 .8 8 S u r g ic a l p r o c e d u r e s 2 6 .5 4 3 0 .2 3 4 8 .2 9
0 .5 6 0 .7 8
S ilic a t e p la s t ic 5 .8 0 9 .4 0 1 1 .3 5 70 R o o t c a n a l tr e a t m e n t 1.71 1 .7 5 4 .1 2
8 R e m o v a l e r u p te d t o o t h 1 3 .8 5 1 8 .6 0 17.41
T r e a tm e n t f i l l i n g s 0 .0 2 0 .1 8 0 .1 2
10 D if f ic u lt e x tr a c t io n 3.41 5 .2 5 1 0 .5 9
P u lp re m o v a l 0 .0 3 0 .1 8
45 R e m o v a l im p a c t e d to o th 1 .1 0 1 .1 3 5 .2 9
S u r g ic a l p r o c e d u r e s 2 .6 7 3 .3 2 4 .5 4
R o o t c a n a l tre a tm e n t 0 .0 6 35 A lv e o le c t o m y 4 .2 7 1 .7 5 6 .1 8
0 .0 2 0 .0 3
R e m o v a l e ru p te d to o th 1 .7 3 2 .3 3 2 .1 8 5 P o s t o p e r a t iv e t r e a t m e n t 2 .2 0 1 .7 5 4 .7 0
D if f ic u lt e x tr a c t io n 0 .3 4 0 .5 3 1 .0 6 P r o s th e tic p r o c e d u r e s ( s itt in g s ) 5 3.01 1 1 7 .4 7 76.91
R e m o v a l im p a c te d to o th 0 .0 2 0 .0 3 0 .1 2 2 40 B r id g e s
A lv e o le c t o m y 0 .1 2 0 .0 5 0 .1 8 85 C r o w n s , f u ll 6 .5 6 9.21 2 .5 0
P o s t o p e r a t iv e tr e a t m e n t 0 .4 4 0 .3 5 0 .9 4 C ro w n s , %
P r o s th e tic p r o c e d u r e s ( s itt in g s ) 1 .8 0 3 .5 0 2 .8 8 100 V e n e e r c ro w n s
B r id g e s 115 P o rc e la in ja c k e t c r o w n s 5.61 1 7.2 5
C r o w n s , fu ll 0 .1 7 0 .2 5 0 .0 6 161 U p p e r d e n tu re 6 .2 8 2 0 .7 3
C r o w n s , Va 161 L o w e r d e n tu r e 1 .3 2 6.71
V e n e e r c ro w n s 140 P a r tia l d e n tu r e 2 8 .0 7 5 7 .1 6 6 6 .7 0
P o r c e la in ja c k e t c r o w n s 6 .1 0 0 .3 8 13 R e p a ir 1 .2 7 1 .9 5
0 .1 7 0 .5 3 2 A d ju s t m e n t s 0 .4 9 0 .9 5 1 .5 3
U p p e r d e n tu r e
0 .0 2 0 .1 5 35 D u p lic a t io n 3.41 2 .6 3 6 .1 8
L o w e r d e n tu r e
P a r tia l d e n tu r e 0 .9 0 1 .4 5 1 .8 8 35 R ebase 0 .8 8
R e p a ir 0 .1 0 0 .1 5 6 N o n s p e c if ic 1 7 .8 5 1 5 .6 0 2 6 4 7
0 .2 4 0 .4 8 0 .7 6 T o ta l 5 0 3 .1 6 t 6 9 0 .1 8 * 8 2 4 .0 9
A d ju s t m e n t s
D u p lic a t io n 0 .1 0 0 .0 8 0 .1 8
* 1 9 7 0 V A f e e s c h e d u le , b a s e d o n r e la t iv e v a lu e s c a le .
R ebase 0 .0 3
t S t a n d a r d d e v ia t io n e q u a ls $ 9 0 .2 9 .
N o n s p e c if ic 2 .9 0 2 .6 0 4 .41
t S t a n d a r d d e v ia t io n e q u a ls $ 1 2 9 .2 7 .
T o ta l 5 3 .7 0 * 6 7 .6 0 t 8 6 .0 0 $
S ta n d a rd d e v ia t io n e q u a ls $ 1 4 9 .9 4 .
S ta n d a r d d e v ia tio n e q u a ls 1 1 .2 9 .
t S t a n d a r d d e v ia t io n e q u a ls 1 3 .6 0 .
^ S ta n d a r d d e v ia t io n e q u a ls 1 5 .1 5 .
Table 4 Percentage of daily revenue by specified
teams in surrogate practice.
Table 2 Percentage of procedures supplied daily by % re v e n u e p e r day
specified teams in surrogate practice. T y p e o f p r o c e d u r e ______________________ T e a m A Team B Team C

% p ro c e d u re s p e r d ay P r e v e n t iv e p r o c e d u r e s 1 8.4 8 1 9 .8 2 2 0 .0 7
P r e v e n t iv e in s t r u c t io n 4 .7 3 4 .8 5 4 .8 9
T yp e o f p ro c e d u re Team A Team B Team C
P r o p h y la x is 7 .7 6 9 .4 9 9 .2 8
P r e v e n t iv e p r o c e d u r e s 23.71 2 7 .6 2 26.41 P e r io d o n t a l tr e a t m e n t 0 .7 6
9 .4 0 F lu o r id e 5 .2 3 5 .4 8 5 .9 0
P r e v e n tiv e in s t r u c t io n 8 .8 6 9 .9 2
D ia g n o s t ic p r o c e d u r e s 1 6 .6 6 1 4.5 2 1 8 .4 2
P r o p h y la x is 7 .2 7 9 .7 0 8 .9 2
P e r io d o n t a l tr e a t m e n t 0 .5 9 E x a m in a t io n s 7 .5 2 7.22 8 .3 4
8 .0 9 R a d io g r a p h s 9 .1 4 7 .3 0 1 0 .0 8
F lu o r id e 6 .9 9 8 .0 0
D ia g n o s t ic p r o c e d u r e s 2 1 .6 6 F u ll m o u th 5.51 4 .9 3 6.51
2 1 .6 6 1 8 .1 0
10.01 S in g le f ilm 0 .7 4 0 .6 2 0 .5 4
E x a m in a t io n s 8.81 9 .2 2
B it e w in g 2.21 1 .7 4 2 .9 6
R a d io g r a p h s 1 2.8 5 8 .8 8 1 1 .6 5
3.91 P o s t o p e r a t iv e b it e w in g 0 .6 8 0.01 0 .0 7
F u ll m o u th 3 .2 2 3 .1 5
2.11 1.71 O p e r a t iv e p r o c e d u r e s 4 5 .5 3 4 2.01 4 3.11
S in g le f ilm 2 .3 2
5 .6 9 A m a lg a m 1 s u r f a c e 1 4 .5 4 1 0 .8 4 9 .2 5
B it e w in g 4 .1 3 3 .5 5
0 .3 4 A m a lg a m 2 s u r f a c e 1 0 .9 4 8 .7 8 1 0 .6 2
P o s t o p e r a t iv e b it e w in g 3 .1 8 0 .0 7
3 8 .1 4 A m a lg a m 3 s u r f a c e 6 .2 8 6 .5 2 7 .3 2
O p e r a t iv e p r o c e d u r e s 4 0 .7 3 4 0 .4 0
1 1.11 A m a lg a m 4 -5 s u r f a c e 2 .2 3 2 .2 5 2 .1 4
A m a lg a m 1 s u r fa c e 1 7 .0 3 1 3 .8 5
8 .5 4 8 .5 0 S ilic a t e p la s t ic 1 1 .5 4 1 3 .6 2 1 3 .7 8
A m a lg a m 2 s u r fa c e 7 .4 8
3 .2 7 3 .7 0 3.91 T r e a tm e n t f i l l i n g s
A m a lg a m 3 s u r fa c e
A m a lg a m 4 -5 s u r fa c e 1 .0 4 1 .1 5 1 .0 3 P u lp re m o v a l
S u r g ic a l p r o c e d u r e s 5 .2 8 4 .3 7 5 .8 5
S ilic a t e p la s t ic 10.81 1 3.9 2 1 3 .2 4
0 .1 4 R o o t c a n a l tr e a t m e n t 0 .3 4 0 .2 5 0 .5 0
T r e a tm e n t f illi n g s 0 .0 4 0 .2 6
R e m o v a l e ru p te d to o th 2 .7 5 2 .7 0 2.11
P u lp re m o v a l 0 .0 4 0.21
5 .2 9 D if f ic u lt e x tr a c t io n 0 .6 8 0 .7 6 1 .2 8
S u r g ic a l p r o c e d u r e s 4 .9 9 4 .8 9
0 .0 7 R e m o v a l im p a c t e d t o o th 0 .2 2 0 .1 6 0 .6 4
R o o t c a n a l tr e a t m e n t 0 .0 4 0 .0 4
3 .4 4 2 .5 4 A lv e o le c t o m y 0 .8 5 0 .2 5 0 .7 5
R e m o v a l e ru p te d to o th 3 .2 2
1 .2 3 P o s t o p e r a t iv e t r e a tm e n t 0 .4 4 0 .2 5 0 .5 7
D if f ic u lt e x tr a c t io n 0 .6 4 0 .7 8
0 .0 4 0 .1 4 P r o s th e tic p r o c e d u r e s ( s itt in g s ) 1 0 .5 5 17.01 9 .3 3
R e m o v a l im p a c t e d t o o t h 0 .0 4
0 .2 3 0 .0 7 0.21 B r id g e s
A lv e o le c t o m y
1 .1 0 C r o w n s , f u ll 1 .3 0 1 .3 3 0 .3 0
P o s t o p e r a t iv e tr e a t m e n t 0 .8 2 0 .5 2
P r o s th e tic p r o c e d u r e s ( s itt in g s ) 3 .4 0 5 .1 5 3 .3 6 C ro w n s , %
V e n e e r c ro w n s
B r id g e s
C r o w n s , f u ll 0 .3 2 6.37 0 .0 7 P o r c e la in ja c k e t c ro w n s 1 .1 3 2 .5 0
3 .0 0
C ro w n s , % U p p e r d e n tu r e 1 .2 5
L o w e r d e n tu re 0 .2 6 0 .9 7
V e n e e r c ro w n s
P a r tia l d e n t u r e 5 .5 8 8 .2 8 8 .0 9
P o r c e la in ja c k e t c r o w n s 0 .1 8 0 .5 6
R e p a ir 0 .2 5 0 .2 8
U p p e r d e n tu r e 0 .3 2 0 .7 8
A d ju s t m e n t s 0 .1 0 0 .1 4 0 .1 9
L o w e r d e n tu r e 0 .0 4 0 .2 2
D u p lic a t io n 0 .6 8 0 .3 8 0 .7 5
P a r tia l d e n tu r e 1 .6 8 2 .1 5 2 .1 9
R ebase 0 .1 3
R e p a ir 0 .1 8 0 .2 2
N o n s p e c if ic 3 .5 5 2 .2 6 3.21
A d ju s t m e n t s 0 .5 0 0 .7 0 0 .8 9
T o ta l 1 0 0 .0 0 1 0 0 .0 0 1 0 0 .0 0
D u p lic a t io n 0 .1 8 0.11 0.21
R ebase 0 .0 4
N o n s p e c if ic 5 .5 4 3 .8 5 5 .1 4
T o ta l 1 0 0 .0 0 1 0 0 .0 0 1 0 0 .0 0
Table 5 Practice data for team A (one dentist, two as Table 4 gives the percentage o f the average
sistants, two operatories), team B (one dentist, one daily revenue by procedures, according to the
EDDA, three assistants, three operatories), and team C
sources o f revenue for each team . A s previously
(one dentist, two EDDAs, four assistants, four opera
tories) in surrogate practice. Standard deviations given noted, the higher num ber of prosthetic proce
in parentheses. dures produced by team B slightly distorts these
Team A Team B Team C data; yet the patient needs for services w ere suf
A v n o . p a t ie n t s s e e n p e r d a y 1 6 .0 2 2 0 .6 0 2 6 .0 0 ficiently similar to perm it meaningful com pari
(2 .8 3 ) (2 .8 1 ) (2 .5 4 )
A v n o . p a t ie n t s s c h e d u le d
sons.
p e r day 2 2 .2 2 2 7 .0 8 3 1 .2 9 Table 5 also substantiates the assum ption
(2 .7 1 ) (3 .0 9 ) (2 .8 6 )
A v n o . b r o k e n a p p o in t m e n ts that the periods studied w ere sufficiently similar
p e r day 6.41 6 .4 8 5 .2 9
(1 .9 8 ) (2 .5 7 ) (2 .2 9 )
for com parisons, although the average revenue
% b r o k e n a p p o in t m e n ts 2 7 .8 8 % 2 3 .9 1 % 2 0 .3 6 % p er patient for team B was slightly higher than
A v n o . p r o c e d u r e s p e r fo r m e d
p e r p a t ie n t v is it 3 .3 5 3 .2 8 3 .3 0 that produced by team s A and C. Again, the de
A v re v e n u e p e r p ro c e d u re $ 9 .3 7 $ 1 0 .2 2 $ 9.61
A v t h e o r e t i c a l re v e n u e viation in revenue for team B is a reflection of
p e r p a t ie n t v is it $ 3 1 .4 0 $ 3 3 .5 0 $ 3 1 .7 0
a greater num ber of prosthetic sittings. F u rth er,

Table 6 Mean number of minutes devoted to specific activities per day

by personnel of team A (one dentist and two assistants), team B (one den
tist, one EDDA, and three assistants), and team C (one dentist, two EDDAs,
and four assistants) in surrogate practice.
Team A* Team B t i T e a m C$

Mean SD Mean SD Mean SD

T e a m m ix (m in ) (m in ) ( m in ) (m in ) (m in ) (m in )

D e n tis t
C h a ir t im e 2 7 6 .5 5 5 6 .1 5 2 4 6 .5 6 4 8 .4 0 2 0 8 .3 4 3 2 .8 5
O f f ic e p r o c e d u r e s 1 2 6 .1 9 6 2 .0 8 1 5 2 .4 6 5 8 .9 0 1 2 7 .0 0 5 9 .7 6
R a d io g r a p h s 8 .6 2 4 .7 9
C le a n u p 9 .2 6 9 .9 9 1.85 0 .5 6
T o ta l a c c o u n t a b le t im e 4 0 7 .3 7 3 8 .8 4 4 0 3 .8 0 49.61 3 3 6 .3 9 5 3 .3 0
W a it in g tim e U 6 8 .5 2 3 6 .0 2 7 1 .8 7 4 6 .1 2 143.61 53.31
% u t i liz a t i o n 8 5 .7 2 % 8 5 .0 2 % 7 0 .1 3 %
ED D A no. 1
C h a ir t im e 2 3 7 .1 9 5 0 .1 6 2 0 8 .3 9 5 9 .1 8
O f f ic e p r o c e d u r e s 2 3 .5 2 2 6 .7 0 8 9 .9 7 3 6 .8 9
R a d io g r a p h s 5 .2 2 2 .6 2 3 9 .3 3 3 2 .1 2
C le a n u p 1 4 1 .5 0 4 6 .4 2 6 9 .7 8 3 2 .6 7
T o ta l a c c o u n t a b le t im e 3 8 5 .6 4 45.41 3 9 6 .3 3 5 4 .7 3
W a it in g tim e U 9 4 .3 6 45.41 8 3 .5 8 5 7 .4 9
% u t i liz a t i o n 8 0 .3 4 % 8 2 .6 3 %
E D D A no. 2
C h a ir t im e 2 3 2 .4 8 67.11
O f fic e p r o c e d u r e s 8 5 .5 8 5 3 .2 0
R a d io g r a p h s 3 3 .2 0 2 4 .9 9
C le a n u p 7 1 .0 8 4 0 .6 0
T o ta l a c c o u n t a b le t im e 4 0 5 .7 3 7 7 .4 7
W a it in g t i m e f 8 1 .8 7 6 7 .6 6
% u t i liz a t i o n 8 4 .5 9 %
A s s is t a n t n o . 1
C h a ir t im e 1 5 9 .1 2 4 3 .4 6 2 4 6 .6 6 6 0 .5 2 1 9 8 .0 3 6 2 .6 0
O f f ic e p r o c e d u r e s 1 3 8 .3 9 4 6 .0 2 2 1 .5 2 16.01 2 7 .7 2 2 3 .2 2
R a d io g r a p h s 1 5 .0 4 9 .9 0 2 8 .2 9 3 1 .0 2 5 1 .6 8 3 4 .3 6
C le a n u p 1 0 6 .0 9 4 3 .0 9 1 3 2 .0 8 3 7 .4 4 1 1 7 .9 0 4 5 .4 5
T o ta l a c c o u n t a b le tim e 4 1 2 .4 9 4 0 .6 5 3 8 5 .0 8 4 5 .5 5 3 8 2 .2 8 5 4 .0 6
W a it in g t i m e t 6 8 .7 6 3 8 .3 6 9 3.71 4 6 .7 8 9 8 .7 9 5 1 .9 5
% u t iliz a t io n 8 5 .6 7 % 8 0 .4 7 % 7 9 .7 0 %
A s s is t a n t n o . 2
C h a ir t im e 1 8 9 .1 7 5 7 .6 8 2 4 2 .1 3 5 1 .0 5 1 5 7 .0 8 3 6 .9 5
O f f ic e p r o c e d u r e s 3 9 .8 8 4 5 .8 2 1 1 .5 0 9 .4 3 5 6 .7 3 4 5 .5 0
R a d io g r a p h s 60.51 3 5 .8 9 3 5 .0 8 2 5 .3 3 4 6 .7 0 2 8 .4 0
C le a n u p 1 1 8 .8 5 3 4 .7 8 1 2 5 .9 5 3 9 .2 3 1 3 1 .4 4 4 5 .6 4
T o ta l a c c o u n t a b le t im e 3 9 9 .7 8 4 3 .4 4 3 8 0 .1 8 5 1 .2 3 3 7 8 .2 0 5 0 .5 0
W a it in g tim e U 8 1 .4 7 4 2 .9 7 9 3 .0 1 5 2 .0 8 1 0 2 .0 5 5 0 .5 2
% u t i liz a t i o n 8 3 .0 2 % 8 0 .6 2 % 7 8 .8 5 %
A s s is t a n t n o . 3
C h a ir t im e 1 8 4 .7 9 6 3 .7 6
O f f ic e p r o c e d u r e s 5 3 .0 8 5 4 .7 3
R a d io g r a p h s 5 4 .3 9 2 2 .7 5
C le a n u p 1 1 7 .6 2 4 2 .2 5
T o ta l a c c o u n t a b le tim e 3 8 2 .8 6 6 7 .7 3
W a it in g tim e U 9 9 .3 3 6 3 .8 2
% u t i liz a t i o n 7 9 .8 2 %
T o ta l a s s is t a n t u t i liz a t i o n 8 4 .3 5 % 8 0 .5 5 % 7 9 .4 6 %

F e b r u a r y a n d M a rc h 1 97 2.
t A p r il a n d M a y 1972.
t O n e a s s is t a n t s e r v e d a s r e c e p t io n is t- b o o k k e e p e r ; h e r f u n c t io n a l t im e a n a ly s is w a s n o t
re c o r d e d .
J u ly 1 9 7 2 .
W a i t i n g t im e is 4 8 0 m in u t e s p e r w o r k d a y le s s m e a n t o t a l t im e p e r w o r k d a y .

6 0 6 J A D A , V o l. 8 7 , S e p t e m b e r 1 9 7 3
the addition o f one E D D A enabled the dentist respectively for team s B and C. E ven though
to treat 4.58 m ore patients per day, and the ad the proportion of the E D D A s utilized tim e re
dition of tw o E D D A s enabled him to treat 10.00 m ained fairly constant am ong the team s, this
m ore patients p er day. T he increm ental increas finding suggests that the efficiency o f assistants
es w ere 4.58 and 5.40, respectively. T hus, by dropped som ewhat and reinforces the belief that
all m easures of productivity the larger team s scheduling problem s could have been the rea
w ere able to supply m ore care, although the in son. A n analysis for the fourth assistant in team
crem ental increases in productivity w ere not ex C is not included in Table 6 because the num
actly equal. ber of patients precluded her routine functioning
T he percent of utilization of the dentists time at the chair; instead she functioned as appoint
w as 85.72 w ithout an E D D A and 85.02 w hen he m ent clerk, receptionist, and bookkeeper. T hese
worked with one E D D A as in team B (Table 6). duties had been shared but later they had to be
T h e com parable figure for the dentist in team C centralized in one individual. N evertheless, it is
decreased to 70.13%; this suggests that the team likely that the productivity of team C is under
could have treated m ore patients had they been stated in this study because both the dentist and
scheduled. T otal assistant utilization decreased the assistants seem to be underutilized.
from 84.35% for team A to 80.55% and 79.46% A ctual and assum ed costs w ere consolidated

Table 7 Hypothetical cost per workday in surrogate practice.

C o s t p r o je c t io n s C o s t p r o je c t io n s C o s t p r o je c t io n s
te a m A te a m B te a m C

C ost per C ost per C ost per

w o rk d a y w o rk d a y w o rk d a y
C o s t c a te g o r ie s C ost p e r annum (2 4 0 w o r k d a y s ) C o st p e r annum (2 4 0 w o r k d a y s ) C ost p er annum (2 4 0 w o r k d a y s )

R e n t a n d u t i lit ie s $ 4 ,8 0 0 .0 0 1 $ 2 0 .0 0 $ 5 ,4 0 0 .0 0 1 $ 2 2 .5 0 $ 6 ,0 0 0 .0 0 1 $ 2 5 .0 0
S a la r ie s fo r
a u x ilia r y p e r s o n n e l 1 0 ,8 0 0 .0 0 2 4 5 .0 0 2 5 ,2 0 0 .0 0 3 1 0 5 .0 0 3 9 ,6 0 0 .0 0 4 1 6 5 .0 0
F r in g e b e n e f it s 5 4 0 .0 0 5 2 .2 5 1 ,2 6 0 .0 0 5 .2 5 1 ,9 8 0 .0 0 7 8 .2 5
In s u r a n c e 6 95 .04 1 2 .9 0 7 80 .00 1 3 .2 5 8 6 5 .0 0 1 3 .6 0
D e p r e c ia t io n o n
o f f ic e e q u ip m e n t 1 ,0 0 0 .0 0 4 .1 6 1 ,3 3 3 .0 0 9 5 .5 5 1 ,3 3 3 .0 0 9 5 .5 5
D e p r e c ia t io n on
d e n t a l e q u ip m e n t 2 ,1 5 4 .9 8 10 8 .9 8 2,8 5 4.9 81 1 1 1 .9 0 3 ,5 5 6 .8 0 1 2 1 4 .8 2
D e n ta l la b o r a t o r y c h a r g e s 3 ,8 1 6 .0 0 1 3 1 5 .9 0 8 ,4 5 7.6 01 4 3 5 .2 4 5 ,5 3 7 .5 2 1 5 2 3 .0 7
N o n e x p e n d a b le
d e n t a l s u p p lie s 3 ,0 9 9 .9 2 1 6 1 2 .9 2 4 ,1 8 9 . 8 2 i7 1 7 .4 6 5 ,2 7 9 .1 0 1 8 2 2 .0 0
E x p e n d a b le d e n ta l s u p p lie s 7 ,8 1 9.2 01 9 3 2 .5 8 1 0 ,9 03 .20 19 4 5 .4 3 1 2 ,9 3 1 .2 0 1 9 5 3 .8 8
T ra v e l t o d e n ta l m e e tin g s ,
s o c ie t y d u e s , jo u r n a ls ,
lic e n s e fe e s , a n d s o o n 1,0 2 4.0 02 0 4 .2 7 1,02 4.0 02 0 4 .2 7 1 ,0 2 4.0 02 0 4 .2 7
A ll o th e r o v e r h e a d 3 ,5 3 8 .7 0 2 0 1 4 .7 4 5,1 4 7.2 02 1 2 1 .4 4 5 ,6 2 9 .7 5 22 2 3 .4 6
B ad d e b t e xp e n se 3 ,6 2 1 .6 0 2 3 1 5 .0 9 4 ,9 7 0 .4 0 2 4 2 0.71 5 ,9 3 2 .8 0 2 5 2 4 .7 2
T o ta l $ 4 2 ,9 0 9 .4 4 $ 1 7 8 .7 9 $ 7 1 ,5 2 0 .2 0 $ 2 9 8 .0 0 $ 8 9 ,6 6 9 .1 7 $ 3 7 3 .6 2

1. A p p r o p r ia te B ir m in g h a m , A la , c o s t e s tim a te s .
2 . T w o a s s is t a n t s a t $ 4 5 0 p e r m o n th .
3 . T h r e e a s s is t a n t s a t $ 4 5 0 p e r m o n th a n d o n e E D D A a t $ 7 5 0 p e r m o n th .
4. F o u r a s s is t a n t s a t $ 4 5 0 p e r m o n th a n d t w o E D D A s a t $ 7 5 0 p e r m o n th .
5 . $ 1 0 ,8 0 0 (a n n u a l s a la r ie s a u x ilia r y p e r s o n n e l) m u lt ip lie d b y 5 % e q u a ls $ 5 4 0 .
6. $ 2 5 ,2 0 0 (a n n u a l s a la r ie s a u x il ia r y p e r s o n n e l) m u lt ip lie d b y 5 % e q u a ls $ 1 ,2 6 0 .
7. $ 3 9 ,6 0 0 (a n n u a l s a la r ie s a u x il ia r y p e r s o n n e l) m u lt ip lie d b y 5 % e q u a ls $ 1 ,9 8 0 .
8. $ 3 ,0 0 0 o f f ic e e q u ip m e n t ( th r e e - y e a r lif e , s t r a ig h t lin e d e p r e c ia tio n , z e r o s a lv a g e v a lu e ) .
9 . $ 4 ,0 0 0 o f f ic e e q u ip m e n t ( t h r e e - y e a r lif e , s t r a ig h t lin e d e p r e c ia t io n , z e r o s a lv a g e v a lu e ) .
1 0 . T w o o p e r a t o r ie s a t $ 7 ,0 0 0 e a c h p lu s a t o t a l o f $ 7 ,5 4 9 .8 3 f o r s u p p ly a re a , X - r a y ro o m a n d d a r k r o o m , a n d la b o r a t o r y , u s in g t e n - y e a r lif e ,
s t r a ig h t lin e d e p r e c ia tio n , a n d z e r o s a lv a g e v a lu e .
1 1. T h re e o p e r a t o r ie s a t $ 7 ,0 0 0 e a c h p lu s a t o t a l o f $ 7 ,5 4 9 .8 3 f o r s u p p ly a re a . X -ra y ro o m a n d d a r k r o o m , a n d la b o r a t o r y , u s in g t e n - y e a r lif e ,
s t r a ig h t lin e d e p r e c ia tio n , a n d z e r o s a lv a g e v a lu e .
12. F o u r o p e r a t o r ie s a t $ 7 ,0 0 0 e a c h p lu s a t o t a l o f $ 7 ,5 4 9 .8 3 f o r s u p p ly a re a , X -ra y r o o m a n d d a r k r o o m , a n d la b o r a t o r y , u s in g t e n - y e a r lif e ,
s t r a ig h t lin e d e p r e c ia t io n , a n d z e r o s a lv a g e v a lu e .
13. $53 .01 (a v e ra g e d a ily p r o s t h e t ic r e v e n u e f r o m T a b le 3 ) m u lt ip lie d b y 3 0 % ( a s s u m e d la b o r a to r y c h a r g e s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls
$ 3 ,8 1 6 .
14. $ 1 1 7 .4 7 (a v e ra g e d a il y p r o s t h e t i c r e v e n u e f r o m T a b le 3 ) m u lt ip lie d b y 3 0 % (a s s u m e d la b o r a t o r y c h a r g e s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls
$ 8 ,4 5 7 .6 0 .
15. $76 .91 (a v e ra g e d a ily p r o s t h e t ic r e v e n u e f r o m T a b le 3 ) m u lt ip lie d b y 3 0 % (a s s u m e d la b o r a t o r y c h a r g e s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls
$ 5 ,5 3 7 .5 2 .
16. B a s e d o n s t a r t- u p c o s t e s tim a te s f o r t w o o p e r a t o r ie s f r o m B ir m in g h a m , A la , d e n ta l s u p p ly fir m s .
1 7. B a s e d o n s t a r t- u p c o s t e s tim a te s f o r t h r e e o p e r a t o r ie s f r o m B ir m in g h a m , A la , d e n t a l s u p p ly firm s .
1 8. B a s e d o n s t a r t- u p c o s t e s tim a te s f o r f o u r o p e r a t o r ie s fr o m B ir m in g h a m , A la , d e n t a l s u p p ly fir m s .
19. E s tim a te d u s in g e x p e n d a b le s u p p ly c o s t s p e r p r o c e d u r e a s d e v e lo p e d o n a n a v e r a g e c o s t b a s is .
2 0 . F ro m B u r e a u o f E c o n o m ic R e s e a rc h a n d S ta t is t ic s . 1971 S u r v e y o f d e n ta l p r a c t ic e IV . P r o fe s s io n a l e x p e n s e s (J A D A 8 4 :8 6 8 A p r il 1 9 7 2 ),
T a b le 17, w it h a 1 0 % a d ju s t m e n t f o r in f la t io n .
2 1 . F ro m B u r e a u o f E c o n o m ic R e s e a rc h a n d S ta t is t ic s . 1971 S u r v e y o f d e n t a l p r a c t ic e IV . P r o fe s s io n a l e x p e n s e s ( J A D A 8 4 :8 6 8 A p r il
1 9 7 2 ), T a b le 17, w it h a 6 0 % a d ju s t m e n t t o in c lu d e 1 0 % in f la t io n a n d 5 0 % in c r e a s e in g r o s s in c o m e .
2 2. F ro m B u r e a u o f E c o n o m ic R e s e a rc h a n d S ta t is t ic s . 1971 S u r v e y o f d e n t a l p r a c t ic e IV . P r o fe s s io n a l e x p e n s e s ( J A D A 8 4 :8 6 8 A p r il 1 9 7 2 ),
T a b le 17, w it h a 7 5 % a d ju s t m e n t t o in c lu d e 1 0 % in f la t io n a n d 6 5 % in c r e a s e in g r o s s in c o m e .
2 3 . $ 5 0 3 .1 6 (a v e ra g e d a ily r e v e n u e fr o m T a b le 3 ) m u lt ip lie d b y 3 % ( u n c o lle c t a b le s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls $ 3 ,6 2 1 .6 0 .
24. $ 6 9 0 .1 8 ( a v e r a g e d a il y r e v e n u e f r o m T a b le 3 ) m u lt ip lie d b y 3 % ( u n c o lle c t a b le s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls $ 4 ,9 7 0 .4 0 .
2 5. $ 8 2 3 .2 5 (a v e ra g e d a ily r e v e n u e f r o m T a b le 3 ) m u lt ip lie d b y 3 % ( u n c o lle c t a b le s ) m u lt ip lie d b y 2 4 0 d a y s e q u a ls $ 5 ,9 3 2 .8 0 .

Peltonothers: ECONOMIC IMPLICATIONS OF ADDING TWO ASSISTANTS 607

 in an accounting of the hypothetical cost per be em phasized that the dentist and his ancillaries
w orkday for the three team s (Table 7). T he net practiced four-handed sit-down dentistry in prop
incom es before taxes (Tables 8 and 9) reflect erly equipped, m odem operatories. H ow ever ef
the difference betw een theoretical cost and the ficiency was im proved or w hatever advantages
theoretical revenue for each team com position. accrued from this type of practice, the effect
In T able 8, the dollar am ounts in each situation was constant in all team situations.
com puted to arrive at gross revenues and an N o defense is offered for the plan in which the
nual n et incom e before and after taxes are self- num ber o f operatories used in each team con
explanatory. Table 9 shows th at with the addi figuration was one m ore than could be occupied
tion o f one E D D A , one assistant, and one oper- w hen all operators w ere functioning. A spare
atory th e d entists increase in annual after-tax chair was alw ays available in which to seat a
net incom e was $8,462.68 (corporate tax rate) new patient.
or $8,047.26 (personal tax rate). W ith the addi T hree factors have been m entioned that in
tion o f yet another E D D A , assistant, and oper- fluence the data presented. It is acknowledged
ato ry , th e increm ent o f increase was $7,274.60 that the proportion of tim e devoted to specific
(corporate tax rate) or $6,561.00 (personal tax types o f service m ay have altered auxiliary p er
rate). O bviously, tax shelter plans used by some form ance and incom e. This observation stem s
dentists m ay have conserved m ore of the before from the inability to keep prosthetic sittings
tax net benefit o f $30,264.00. In any event, these constant throughout the study. T he second fac
d ata show th at the addition o f the first E D D A tor relates to the num ber of patients and the
(team B) produced a greater percentage increase sophistication needed to schedule patients for
in revenue than did the addition of a second E D the m ost efficient use of all operators involved.
D A (team C), that is, 37.16% versus 19.40%. T he final factor is the lack of docum entation
relating to specific duties perform ed by the fourth
assistant w ho w as utilized alm ost solely as re
D isc u ssio n ceptionist, appointm ent clerk, and bookkeeper.
Finally, w hatever voids existed, know n or
A lthough a description of the physical facilities unknow n, these data possibly underestim ate
has been om itted from this presentation, it should the productivity or incom e that is possible in a

Table 8 Annual income, before and after taxes, projected from daily average revenue and cost for specified teams in
surrogate practice.
Av E s tim a te d a n n u a l E s tim a te d a n n u a l
Av n e t in c o m e E s tim a te d a n n u a l n e t in c o m e n e t in c o m e
re v e n u e Less Av cost E q u a ls b e fo re ta x e s E s tim a te d a n n u a l n e t in c o m e a fte r ta x e s * a f t e r ta x e s
T e a m m ix p e r day p e r day p e r day g ro s s re v e n u e * b e fo re ta x e s t ( c o r p o r a t e t a x r a te ) ( p e r s o n a l t a x ra te )

Team A $ 5 0 3 ,1 6 1 $ 1 7 8 .7 9 * * $ 3 2 4 .3 7 $ 1 2 0 ,7 5 8 .4 0 $ 7 7 ,8 4 8 .8 0 $ 4 6 ,9 8 1 .3 8 $ 5 1 ,7 4 3 .6 3
Team B $690.1811 $ 2 9 8 .0 0 * * $ 3 9 2 .1 8 $ 1 6 5 ,6 4 3 .2 0 $ 9 4 ,1 2 3 .2 0 $ 5 5 ,4 4 4 .0 6 $ 5 9 ,7 9 0 .8 9
Team C $ 8 2 4 ,0 9 1 $ 3 7 3 .6 2 * * $ 4 5 0 .4 7 $ 1 9 7 ,7 8 1 .6 0 $ 1 0 8 ,1 1 2 .8 0 $ 6 2 ,7 1 8 .6 6 $ 6 6 ,3 5 1 .8 9

A v e r a g e re v e n u e p e r d a y m u lt ip lie d b y 2 4 0 w o r k d a y s .
t A v e r a g e n e t in c o m e b e f o r e t a x e s p e r d a y m u lt ip lie d b y 2 4 0 w o r k d a y s .
C o r p o r a t e t a x r a t e s ( 2 2 % o n t h e f i r s t $ 2 5 ,0 0 0 o f t a x a b le in c o m e a n d 4 8 % o n a ll t a x a b le in c o m e a b o v e $ 2 5 ,0 0 0 ) a r e u s e d in t h e c a lc u la t io n s
b e c a u s e t h e p o in t w h e r e t h e a v e r a g e c o r p o r a t e t a x ra te b e c o m e s lo w e r th a n t h e in d iv id u a l t a x ra te is a p p r o x im a t e ly 5 4 ,0 0 0 t a x a b le d o lla r s .
N o te , h o w e v e r , t h a t t h e d e n t is t w o u ld b e ta x e d o n a n y s a la r y p a id t o h im s e lf ; t h i s a m o u n ts t o s u b s t it u tio n o f p e r s o n a l t a x e s f o r t h e c o r p o r a t e
ta x e s .
A s s u m e s d e n t is t is m a r r ie d , h a s t w o c h ild r e n , f ile s a jo in t r e t u r n , a n d h a s o th e r d e d u c t io n s e q u a l t o 1 0 % o f n e t in c o m e b e fo r e t a x e s .
I T a b le 3 .
* 'T a b l e 7.

Table 9 Financial productivity comparison in surrogate practice.

Av E s tim a te d a n n u a l E s tim a te d a n n u a l
n e t in c o m e E s tim a te d a n n u a l n e t in c o m e n e t in c o m e
A v re v e n u e Av cost b e fo re ta x e s E s tim a te d a n n u a l n e t in c o m e a ft e r ta x e s a fte r ta x e s
p e r day p er day p e r day g r o s s re v e n u e b e f o r e ta x e s ( c o r p o r a t e t a x ra te ) ( p e r s o n a l t a x ra te )

D o lla r % D o lla r % D o lla r % D o lla r % D o lla r % D o lla r % D o lla r %

in c r e a s e in in c r e a s e in in c r e a s e in in c r e a s e in in c r e a s e in in c r e a s e in in c r e a s e in
($) c re a s e ($) c re a s e ($ ) c re a s e ($) c re a s e ($ ) c re a s e ($) c re a s e ($) c re a s e
In c re a s e b e tw e e n
te a m s A and B 1 8 7 .0 2 3 7 .1 6 119.21 6 6 .6 7 67.81 2 0 .9 0 4 4 ,8 8 4 .8 0 3 7 .1 6 1 6 ,2 7 4 .4 0 2 0 .9 0 8 ,4 6 2 .6 8 18.01 8 ,0 4 7 .2 6 1 5.5 5
In c r e a s e b e tw e e n
te a m s B and C 133.91 1 9.4 0 7 5 .6 2 2 5 .3 7 5 8 .2 9 1 4 .8 6 3 2 ,1 3 8 .4 0 1 9.4 0 1 3 ,9 8 9 .6 0 1 4 .8 6 7 ,2 7 4 .6 0 1 3 .1 2 6 ,5 6 1 .0 0 1 0 .9 7
In c re a s e b e tw e e n
te a m s A and C 3 2 0 .9 3 6 3 .7 8 1 9 4 .8 3 1 0 8 .9 7 1 2 6 .1 0 3 8 .8 7 7 7 ,0 2 3 .2 0 6 3 .7 8 3 0 ,2 6 4 .0 0 3 8 .8 7 1 5 ,7 3 7 .2 8 3 3 .4 9 1 4 ,6 0 8 .2 6 2 8 .2 3

608 JADA, Vol. 87, September 1973

well-managed private practice in which the kinds
of auxiliaries used in this study are em ployed.
Sum m ary
A n increase o f alm ost 64% in annual gross rev
enue, alm ost 40% in annual before-tax net in
com e, and m ore than 33% in annual after-tax
incom e (corporate rate) dem onstrates the eco
nomic feasibility of adding m ultiple expanded-
duty auxiliaries to the basic team of the solo
practitioner. A lthough the econom ic benefits
o f adding the second E D D A and her assistant
and operatory w ere not of the sam e m agnitude
as those w ith the addition of the first E D D A and
h er assistant and operatory, the benefits derived
from the addition of a second E D D A w ere sub
stantial. P atient needs for the three periods
studied w ere sufficiently similar for meaningful
com parisons. A ll assum ed data in the study
w ere intentionally conservative; the actual bene
fits derived by a solo practitioner m ay well be
m ore favorable w hen his own fee schedule,
costs, and individual tax sheltering program s
are substituted in the analysis. A s was deter
m ined in a previous p a p e r,1 the dentist working
under team B conditions could have produced
the sam e annual net incom e produced by team A
if he had w orked only 220.3 days rather than
240 days. Likew ise, the dentist with the even
greater productive capabilities of team C could
have netted th e sam e am ount as the solo practi
tioner in team A by working only 198 days. In
the com putations that w ere applied, constant
conditions for team s B and C as set forth in T a
bles 5, 6, and 7 w ere assum ed. H ad the dentist
been able to schedule patients for team C so that
he was fully utilized, he may have produced the
Peltonothers: ECONOMIC IMPLICATIONS OF ADDING TWO ASSISTANTS 609
sam e net income in less than 198 days. N one
theless, if these estim ates are reasonably pre
dictive of w hat may occur in a real practice, a
dentist using two E D D A s (team C) would have
the option of working 240 days (assum es a four-
w eek vacation) at a significantly increased in
com e, or working 198 days (38 w eeks and as
sum es about a 14-week vacation) and still m ain
tain the incom e level of the practitioner in team
A. T he ability of a dentist to schedule this much
free tim e is, of course, theoretical and m ay be
practical only in group practices.
T he question of w hether the additional rev
enue or the free time is w orth the increased m an
agerial responsibility and attendant problem s
can be answ ered only by the p ractitioner him
self.
This investigation was supported by Public Health Service
grant no. 43024, Division of Dental Health, National Institutes
of Health, and Public Health Service grant no. HS00785, Health
Services and Mental Health Administration.
Dr. Pelton is assistant dean for auxiliary training programs and
chairman of the department of community dentistry, School of
Dentistry, University of Alabama in Birmingham, University Sta
tion, Birmingham, 35294. Dr. Embry is assistant professor of
dentistry, department of community dentistry, and associate
professor of business administration, School of Business, Uni
versity of Alabama in Birmingham. Mr. Overstreet is an assis
tant professor of business administration and assistant profes
sor of dentistry, department of community dentistry, University
of Alabama in Birmingham. Dr. Diiworth is assistant professor
of dentistry, department of community dentistry, and associate
professor of business administration, University of Alabama in
Birmingham.
1. Pelton, W.J., and others. Economic implications of adding
one expanded duty dental assistant to a practice. JADA 86:1301
June 1973.
2. Veterans Administration. Department of Medicine and Sur
gery Manual. Basic dental fee schedule. Washington, Veterans
Administration, July 1, 1970.