At the present time in Australia (1992) there exists no undergraduate training for dental students in auxiliary utilisation. The result of this is that new dental graduates have no understanding of the concept of practicing sit-down four-handed dentistry in a comfortable and efficient manner. This compares with the United States of America (USA) where, since 1961, every dental student receives formal instruction in Dental Assistant Utilisation (DAU) and, since 1973, Training in Expanded Auxiliary Management. In this treatise the history and development of “four-handed dentistry” is presented along with a literature review of the fundamental principles of DAU. The intial pilot programmes and the subsequent federally funded national DAU programme in the USA are analysed. Four undergraduate DAU programmes from the USA and the current graduate continuing education DAU programme at Westmead Hospital Dental Clinical School are examined. Finally, guidelines for the establishment and operation of a DAU programme are outlined. The aim of this treatise therefore, is to provide the necessary information for a thorough understanding of the fundamentals and philosophy of Dental Assistant Utilisation. This information is presented in the hope that at some stage in the future training in assistant utilisation would become an integral and important part of the undergraduate dental curriculum in Australia. The purpose of this would be to fill a major void that currently exists in the undergraduate training of dental students in auxiliary utilisation.