Outside of periodontists, dentists don’t like to clean teeth as a rule. What most dentists want is for their hygiene department to run smoothly and be profitable. As conditions evolve, recall patients often need new treatment, and the hygienist is the first in position to notice and make recommendations to the patient. New patients are sometimes seated with the hygienist, which may require them making a rough clinical judgment on what radiographs will be most useful, and what treatment plan is most likely. Hygienists should have a basic understanding of treatment planning, and how the treating dentist rationalizes their findings to patients.
Dentists are responsible for training their assistants. This is an irrefutable dental law: if you don’t train your assistants, then they will run you ragged. Why? Because they aren’t able to see the entire picture the way doctors do. This mismanagement happens a lot, as dentists get too busy and have to trust staff to “get it done,” which often means problems get dumped– instead of solved. This includes operatory set-up & clean-up, sterilization, recording patient notes, lab scripts & cases, ordering supplies, equipment maintenance/repair, and so on.
Assistants are also the primary contact with the patient before, during, and after treatment; meaning they are very influential in the patient experience. It is really nice when assistants are actually helping the dentist. The primary responsibility for their failures in any of these departments always falls back on the dentist, who must care enough about his/her practice to pay attention and train themselves (and others) properly, otherwise nothing gets done correctly. Remember, no one cares more about the practice than the owner.