Dental Therapy The New Zealand Scene

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Dental TherapyThe New Zealand Scene

• Dr Lyndie Foster Page
• BSc BDS MPH
• Dental Public Health Specialist
• Taranaki District Health Board
• New Zealand

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New Zealand

• 4 million people
• 1.5 million in Auckland
• Maori people are the tangata whenua (indigenous
  people)
• 15 percent of the NZ population

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History

• NZ government noted the appalling state of
  soldiers teeth in WWI
• Survey showed 90 of NZs children required
  dental care
• Introduced trained women into primary schools to
  educate children and families on healthy living
  and nutrition and provide treatment
• World first
• 1921 SDS began with dental nurses entering the
  workforce 2 years later

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School Dental Nurses
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Presently

• HPCA Act 2004 Therapists registered
• Workforce shortage nationally
• Employed in public sector
• Facilities not meet standards to practice
• modern day dentistry
• Increase in wages and professional status
• Review of child and adolescent oral health

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19902004 Prevalence of DecayPercentage Decay
Free
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1990-2004 Severity of DecayDecayed, Missing, and
Filled Teeth
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Access Outcomes

• 5-year-olds nationally 95-99 seen annually till
  year 8 of school
• Early enrolment
• Projects running to improve preschool access to
  Maori and low-SES families

• Data analysed at ethnicity/SES/fluoride exposure
  level
• 2003 Public Health Advisory Committee report
  showed that the SDS reduces oral health
  inequalities but they return in the early 20s
• Reduced acute sequelae from early enrolment,
  early detection, prevention and intervention when
  needed

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Dental Therapy Training

• Two training institutes in NZ
• AUT University
• Bachelor of Health Sciences in Oral Health 2002
• Bachelor of Health Sciences in Oral Health 2006
  (hygiene/therapy) intake numbers doubled
• Plan to introduce Adult Scope into degree in
  future
• University of Otago
• Diploma in Dental Therapy
• Bachelor of Health Sciences (Dental Therapy) 2002
• Bachelor of Oral Health 2007 (hygiene/therapy)

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Safety

• Therapists were not registered until 2004
• PDO (dentist) was responsible for standard of
  care prior to this date
• No cases against PDOs and only one case of a
  therapists standard of care has been
  investigated but not pursued
• Complaints occur with any health professionals
• DCNZ national competencies for therapist to
  ensure ongoing high standards of care
• Currently 500-600 therapists

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NZ Dental Therapy Scopes of practice DCNZ

• Subset of the practice of dentistry
• Commensurate with a dental therapists approved
  education, training and competence
• Provide oral health assessment, treatment,
  management and prevention services for children
  and adolescents up to age 18
• Disease prevention and oral health promotion and
  maintenance are core activities
• Dental therapists and dentists have a
  consultative working relationship which is
  documented in an agreement

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My Role

• Clinical governance and support
• Continuing professional development
• Clinic visits
• Health promotion/prevention
• Dental advisor for DHB
• Ministry of Health steering group for improving
  oral health for children
• Hospital Clinician

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Future in NZ

• Joint dental therapy and hygiene degree
• Adult scope of practice
• Working in private/public
• More Maori/Polynesian and male therapists
• Team working environment
• More involved in public health policy

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Thank you